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Critical Incident Stress ManagementCritical Incident Stress Management
Critical Incident Stress Management: Critical Incident Stress Management: Psychological First Aid for TraumaPsychological First Aid for Trauma
Disasters, terrorist events and various Disasters, terrorist events and various everyday traumatic events produce stress everyday traumatic events produce stress that can cause emotional and physical that can cause emotional and physical debilitation and may result in more serious debilitation and may result in more serious stress related conditions. Through timely stress related conditions. Through timely intervention CISM provides support to lessen intervention CISM provides support to lessen or eliminate the effects of the traumatic or eliminate the effects of the traumatic stress. stress.
Critical Incident Stress ManagementCritical Incident Stress Management
Disasters, terrorist events and various Disasters, terrorist events and various everyday traumatic events produce everyday traumatic events produce stress that can cause emotional and stress that can cause emotional and physical debilitation and may result in physical debilitation and may result in more serious stress related conditions. more serious stress related conditions. Through timely intervention CISM Through timely intervention CISM provides support to lessen or eliminate provides support to lessen or eliminate the effects of the traumatic stress. the effects of the traumatic stress.
Critical Incident Stress ManagementCritical Incident Stress Management
The need for CISMThe need for CISM The value The value The purposeThe purpose The componentsThe components Tennessee Emergency Services CISM Tennessee Emergency Services CISM
TeamTeam
Critical Incident Stress ManagementCritical Incident Stress Management
Introductory StoryIntroductory Story Midland Texas October 14, i987Midland Texas October 14, i987 Who remembers the date?Who remembers the date?
Critical Incident Stress ManagementCritical Incident Stress Management
Introductory StoryIntroductory Story Midland Texas October 14, i987Midland Texas October 14, i987 Who remembers the date?Who remembers the date?
Critical Incident Stress ManagementCritical Incident Stress Management
Introductory StoryIntroductory Story Midland Texas October 14, i987Midland Texas October 14, i987 Who remembers the date?Who remembers the date? Jessica McClureJessica McClure Maybe “Baby Jessica”Maybe “Baby Jessica” Successful rescueSuccessful rescue The aftermathThe aftermath
Critical Incident Stress ManagementCritical Incident Stress Management
CRITICAL INCIDENTS CRITICAL INCIDENTS Unusually challenging eventUnusually challenging event Potential to create significant human Potential to create significant human
distressdistress Overwhelm one’s usual coping Overwhelm one’s usual coping
mechanismsmechanisms
Critical Incident Stress ManagementCritical Incident Stress Management
The Need ( a few statistics):The Need ( a few statistics): PTSD IN LAW ENFORCEMENT 10-15%PTSD IN LAW ENFORCEMENT 10-15% Fire suppression 10-30%Fire suppression 10-30% Estimated as many as 45% of those Estimated as many as 45% of those
exposed to mass disaster PTSD or exposed to mass disaster PTSD or depressiondepression
U.S. Center for Mental Health: 1.5 million U.S. Center for Mental Health: 1.5 million persons in NYC counseling following 9 11persons in NYC counseling following 9 11
Critical Incident Stress Serious MatterCritical Incident Stress Serious Matter
Critical Incident Stress ManagementCritical Incident Stress Management
Value of early crisis interventionValue of early crisis intervention May reduce need for more intense Psyc May reduce need for more intense Psyc
servicesservices Mitigate acute distressMitigate acute distress May reduce ETOH useMay reduce ETOH use Reduce distress in medical surgical Reduce distress in medical surgical
patients patients First responders resistant to tradition Psyc First responders resistant to tradition Psyc
Intervention NOT Counseling Intervention NOT Counseling
Critical Incident Stress ManagementCritical Incident Stress Management
History of interventionHistory of intervention ““Shell shock” WW IShell shock” WW I ““Battle Fatigue” WW IIBattle Fatigue” WW II Viet Nam began to study and work Viet Nam began to study and work
problemproblem British military: British military:
Proximity Proximity Immediacy Immediacy ExpectancyExpectancy
Critical Incident Stress ManagementCritical Incident Stress Management
The Purpose of Crisis InterventionThe Purpose of Crisis Intervention StabilizationStabilization Symptom reductionSymptom reduction Return to adaptive functioning and/orReturn to adaptive functioning and/or Facilitate access to continued (higher Facilitate access to continued (higher
level) carelevel) care Psychological First AidPsychological First Aid
Critical Incident Stress ManagementCritical Incident Stress Management
Critical Incident Stress ManagementCritical Incident Stress Management CComprehensiveomprehensive IIntegratedntegrated SSystematicystematic MMulti-tactic ulti-tactic
Critical Incident Stress ManagementCritical Incident Stress Management
The various components combine to The various components combine to provide broad-based solution to provide broad-based solution to traumatic stresstraumatic stress
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and Pre-incident education and preparationpreparation
Assessment/strategic planningAssessment/strategic planning DemobilizationDemobilization Crisis management briefingCrisis management briefing DefusingDefusing Critical Incident Stress DebriefingCritical Incident Stress Debriefing
Critical Incident Stress Critical Incident Stress ManagementManagement
Significant other/Family supportSignificant other/Family support Organizational/community Organizational/community
consultationsconsultations Pastoral crisis interventionPastoral crisis intervention Follow-up services and/or referalsFollow-up services and/or referals
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and Pre-incident education and preparationpreparation
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and Pre-incident education and preparationpreparation
Assessment/strategic planningAssessment/strategic planning
Used for pre-planning and/or Used for pre-planning and/or choosing and setting up proper choosing and setting up proper interventions for major sized crises interventions for major sized crises
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and Pre-incident education and preparationpreparation
Assessment/strategic planningAssessment/strategic planning DemobilizationDemobilization
Used in large on-going operations at Used in large on-going operations at the end of the first shift when workers the end of the first shift when workers have to return to operations next dayhave to return to operations next day
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and Pre-incident education and preparationpreparation
Assessment/strategic planningAssessment/strategic planning DemobilizationDemobilization Crisis management briefingCrisis management briefing
Town meeting used to inform a Town meeting used to inform a population of the status population of the status
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and preparationPre-incident education and preparation Assessment/strategic planningAssessment/strategic planning DemobilizationDemobilization Crisis management briefingCrisis management briefing DefusingDefusing
Small group crisis intervention normally Small group crisis intervention normally on shift often follow-up later with CISDon shift often follow-up later with CISD
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and preparationPre-incident education and preparation Assessment/strategic planningAssessment/strategic planning DemobilizationDemobilization Crisis management briefingCrisis management briefing DefusingDefusing Critical Incident Stress DebriefingCritical Incident Stress Debriefing
Team lead group intervention 24 – 72 Team lead group intervention 24 – 72 hourshours
Critical Incident Stress ManagementCritical Incident Stress Management
Significant other/Family supportSignificant other/Family support Organizational/community Organizational/community
consultationsconsultations Pastoral crisis interventionPastoral crisis intervention Follow-up services and/or referralsFollow-up services and/or referrals
Critical Incident Stress ManagementCritical Incident Stress Management
Significant other/Family supportSignificant other/Family support
Obvious point—not just emergency Obvious point—not just emergency service worker affectedservice worker affected
Critical Incident Stress ManagementCritical Incident Stress Management
Significant other/Family supportSignificant other/Family support Organizational/community Organizational/community
consultationsconsultations
Meetings like this, school systems Meetings like this, school systems disaster groupsdisaster groups
Critical Incident Stress ManagementCritical Incident Stress Management
Significant other/Family supportSignificant other/Family support Organizational/community Organizational/community
consultationsconsultations Pastoral crisis interventionPastoral crisis intervention
Recently recognized the value of Recently recognized the value of faith-based spiritual support (crisis of faith-based spiritual support (crisis of faith)faith)
Critical Incident Stress ManagementCritical Incident Stress Management
Significant other/Family supportSignificant other/Family support Organizational/community Organizational/community
consultationsconsultations Pastoral crisis interventionPastoral crisis intervention Follow-up services and/or referralsFollow-up services and/or referrals
We teach refer, refer, refer we We teach refer, refer, refer we provide first-level care provide first-level care
Critical Incident Stress ManagementCritical Incident Stress Management
Pre-incident education and Pre-incident education and preparationpreparation
Assessment/strategic planningAssessment/strategic planning DemobilizationDemobilization Crisis management briefingCrisis management briefing DefusingDefusing Critical Incident Stress DebriefingCritical Incident Stress Debriefing
Critical Incident Stress ManagementCritical Incident Stress Management
Significant other/Family supportSignificant other/Family support Organizational/community Organizational/community
consultationsconsultations Pastoral crisis interventionPastoral crisis intervention Follow-up services and/or referralsFollow-up services and/or referrals
Critical Incident Stress ManagementCritical Incident Stress Management
Tennessee Federation of Fire ChaplainsTennessee Federation of Fire Chaplains
Affiliated Federation of Fire ChaplainsAffiliated Federation of Fire Chaplains
Tennessee Emergency ServicesTennessee Emergency Services
Chaplains AssociationChaplains Association
Provides training using FFC standards Provides training using FFC standards and CISM Team and servicesand CISM Team and services
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