Critical Incident Stress Management

1. Critical Incident Stress Management Critical Incident Stress Management: Psychological First Aid for Trauma • Disasters, terrorist events and various everyday traumatic events produce stress that can cause emotional and physical debilitation and may result in more serious stress related conditions. Through timely intervention CISM provides support to lessen or eliminate the effects of the traumatic stress.

2. Critical Incident Stress Management • Disasters, terrorist events and various everyday traumatic events produce stress that can cause emotional and physical debilitation and may result in more serious stress related conditions. Through timely intervention CISM provides support to lessen or eliminate the effects of the traumatic stress.

3. Critical Incident Stress Management • The need for CISM • The value • The purpose • The components • Tennessee Emergency Services CISM Team

4. Critical Incident Stress Management • Introductory Story • Midland Texas October 14, i987 • Who remembers the date?

5. Critical Incident Stress Management • Introductory Story • Midland Texas October 14, i987 • Who remembers the date?

6. Critical Incident Stress Management • Introductory Story • Midland Texas October 14, i987 • Who remembers the date? • Jessica McClure • Maybe “Baby Jessica” • Successful rescue • The aftermath

7. Critical Incident Stress Management • CRITICAL INCIDENTS • Unusually challenging event • Potential to create significant human distress • Overwhelm one’s usual coping mechanisms

8. Critical Incident Stress Management • The Need ( a few statistics): • PTSD IN LAW ENFORCEMENT 10-15% • Fire suppression 10-30% • Estimated as many as 45% of those exposed to mass disaster PTSD or depression • U.S. Center for Mental Health: 1.5 million persons in NYC counseling following 9 11 • Critical Incident Stress Serious Matter

9. Critical Incident Stress Management • Value of early crisis intervention • May reduce need for more intense Psyc services • Mitigate acute distress • May reduce ETOH use • Reduce distress in medical surgical patients • First responders resistant to tradition Psyc • Intervention NOT Counseling

10. Critical Incident Stress Management • History of intervention • “Shell shock” WW I • “Battle Fatigue” WW II • Viet Nam began to study and work problem • British military: • Proximity • Immediacy • Expectancy

11. Critical Incident Stress Management • The Purpose of Crisis Intervention • Stabilization • Symptom reduction • Return to adaptive functioning and/or • Facilitate access to continued (higher level) care • Psychological First Aid

12. Critical Incident Stress Management • Critical Incident Stress Management • Comprehensive • Integrated • Systematic • Multi-tactic

13. Critical Incident Stress Management The various components combine to provide broad-based solution to traumatic stress

14. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning • Demobilization • Crisis management briefing • Defusing • Critical Incident Stress Debriefing

15. Critical Incident Stress Management • Significant other/Family support • Organizational/community consultations • Pastoral crisis intervention • Follow-up services and/or referals

16. Critical Incident Stress Management • Pre-incident education and preparation

17. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning Used for pre-planning and/or choosing and setting up proper interventions for major sized crises

18. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning • Demobilization Used in large on-going operations at the end of the first shift when workers have to return to operations next day

19. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning • Demobilization • Crisis management briefing Town meeting used to inform a population of the status

20. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning • Demobilization • Crisis management briefing • Defusing Small group crisis intervention normally on shift often follow-up later with CISD

21. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning • Demobilization • Crisis management briefing • Defusing • Critical Incident Stress Debriefing Team lead group intervention 24 – 72 hours

22. Critical Incident Stress Management • Significant other/Family support • Organizational/community consultations • Pastoral crisis intervention • Follow-up services and/or referrals

23. Critical Incident Stress Management • Significant other/Family support Obvious point—not just emergency service worker affected

24. Critical Incident Stress Management • Significant other/Family support • Organizational/community consultations Meetings like this, school systems disaster groups

25. Critical Incident Stress Management • Significant other/Family support • Organizational/community consultations • Pastoral crisis intervention Recently recognized the value of faith-based spiritual support (crisis of faith)

26. Critical Incident Stress Management • Significant other/Family support • Organizational/community consultations • Pastoral crisis intervention • Follow-up services and/or referrals We teach refer, refer, refer we provide first-level care

27. Critical Incident Stress Management • Pre-incident education and preparation • Assessment/strategic planning • Demobilization • Crisis management briefing • Defusing • Critical Incident Stress Debriefing

28. Critical Incident Stress Management • Significant other/Family support • Organizational/community consultations • Pastoral crisis intervention • Follow-up services and/or referrals

29. Critical Incident Stress Management Tennessee Federation of Fire Chaplains Affiliated Federation of Fire Chaplains Tennessee Emergency Services Chaplains Association Provides training using FFC standards and CISM Team and services