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Northeast Region Civil Air Patrol/USAF-Auxiliary. Critical Incident Stress Management (CISM). Objectives of this Presentation. To provide the participants with. An introduction to NER CISM.

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Presentation Transcript
objectives of this presentation
Objectives of this Presentation

To provide the participants with

  • An introduction to NER CISM
  • An overview of critical incident stress, crisis management and critical incident stress management (CISM)
  • An orientation to CAP’s CISM program
a crisis
A Crisis

A response to an event wherein

  • One’s normal psychological balance (homeostasis) has been disrupted,
  • One’s usual coping mechanisms have failed to reestablish the needed homeostasis, or
  • There is evidence of functional impairment.
critical incident stress

Critical Incident Stress

“Any event in which there is a stressful impact

sufficient enough to overwhelm

the usually effective coping skills

of either an individual or a group.”

(Everly & Mitchell, 1999)

examples of critical incidents
Examples of Critical Incidents
  • Line of duty death or death at workplace
  • Serious line of duty injury or workplace injury
  • Suicide of coworker, friend, family member
  • Multiple casualty incidents (MCI’s), disasters
  • Significant events involving children
  • Prolonged events especially with loss
  • Any powerful event which overwhelms a person’s normal coping mechanisms
crisis intervention
Crisis Intervention

The provision of timely “emotional first aid”

  • An exercise in psychological damage control…stopping the bleeding!
  • Not a cure
  • An opportunity for assessment and

for follow-up

  • Guided by a mental health professional (MHP)
crisis intervention8

Crisis Intervention

Is one aspect of

a continuum of care

It requires

specialized &uniquetraining

crisis intervention principles

B

I

S

E

P

Crisis InterventionPrinciples

Spell B -I -S -E -P

  • Brevity- few minutes up to 1 hour
  • Immediacy – Rapid Intervention
  • Simplicity – KIS – Keep it Simple
  • Expectancy – A reasonable positive outcome
  • Proximity – Close to operational zone is most effective
post traumatic stress

Post-Traumatic Stress

Post-Traumatic

Stress Disorder

A normal reaction

in a normal person

to an abnormal event

It is a

survival mechanism

(PTSD) is a pathogenic (unhealthy) variation

of that normal survival mechanism

stress response timelines
Stress Response Timelines
  • Immediate – up to 24 hours post event.
  • Delayed – 24 to 72 hours post event.
  • Cumulative – buildup of stress over time.
critical incident stress management cism is

Critical Incident Stress Management (CISM)is

One type of crisis intervention

It is a comprehensive,

systematic program

for the mitigation of

critical- incident related stress.

the goals of cism
The goals of CISM
  • Preventtraumatic stress
  • Mitigate traumatic stress
  • Intervene to assist recovery from traumatic stress
  • Accelerate recovery
  • Restore function
  • Maintain worker health and welfare
cism involves many facets
CISM involves many facets
  • Pre-crisis preparation and education
  • Demobilization (for large groups)
  • Crisis management briefings (large groups also)
  • Defusings
  • Critical incident stress debriefing (CISD)
cism also involves
CISM also involves
  • One-on-one, individual crisis intervention
  • Pastoral crisis intervention
  • Family CISM
  • Organizational crisis intervention/consultations
  • Follow-up and referral mechanisms
cism deals with the current circumstances the current event or crisis not personal histories
CISMdeals with the current circumstancesthe current event or crisis NOT personal histories

It is First Aid, not definitive care.

pre incident education pep talks
Pre-Incident Education“PEP Talks”
  • General information: stress, trauma, etc.
  • Set expectations for actual experiences
  • Teach stress management and coping skills
  • Appropriate for ALL members
demobilizations
Demobilizations
  • Provide decompression
  • Transition workers from disaster work (large-scale incident) to routine duties or home
  • Used with large numbers of people
  • A 10- to 30-minute session
  • An opportunity for assessment of group needs
  • Alert workers to possible stress effects
  • Always followed by a CISD (debriefing, usually within one week
defusing
Defusing
  • A small group intervention conducted within hours of the incident, usually within 12 hours
  • Shortened version (20-45 mins) of the CIS- Debriefing
  • May eliminate the need for, or increase effectiveness of, CISD – opportunity to assess the need for CISD
  • Seeks to reduce intense reactions to a trauma
  • Seeks to “normalize” the effects of the event
the defusing 3 step
The Defusing 3-Step

*Introduction

*Exploration

*Information

the critical incident stress debriefing cisd

C I S D

The Critical IncidentStress Debriefing (CISD)
  • A group discussion of a traumatic event
  • Peer driven
  • Clinician (MHP) guided
  • Lasts 1-3 hours
  • Closed circle format
  • Held 1-10 days post event
  • NOT psychotherapy!
objectives of the cisd
Objectives of the CISD
  • Education
  • Ventilation
  • Reassurance and forewarning
  • Positive contact with an MHP
  • Improvement of interagency cooperation
  • Increase group cohesiveness
  • Restore self-confidence
  • Facilitation of follow-up
referral
Referral
  • Is made for those requiring a more thorough process of assessment and evaluation
  • The mental health provider should understand the “culture” of the agency in which the person is employed, and
  • Should have specialized training/experience in post-traumatic stress.
family support
Family Support
  • An essential component of a comprehensive CISM program
  • Consists of

- Educational programs

- CISD for significant others

- Bereavement support/grief & crisis counseling

  • Provided by peers, MHP, clergy, trained spouses
  • Includes children and elderly as well
follow up
Follow-up
  • Essential element in all CISM interventions
  • Can be made by - Phone calls - Station/workplace visits - Home visits
slide28

CISMa comprehensive,systematic maintenance program for the overall well-beingof our most valuable assets

our members

a cap cist
A CAP CIST

The CIS Team consists of:

  • Mental Health Professionals (MHP)
  • Peer Representatives

CAPR 60-5 (3)a 2

cap s cism program

CAP’s CISM Program

“The use of qualified, local, non-CAP teams to respond to incident stress-affected CAP members is highly encouraged … The use of local non-CAP teams will somewhat limit the need to dispatch a trained CAP CIS [Team]”

--CAPR 60-5 (2)e

cap s cism program32
CAP’s CISM Program
  • Mandated by CAPR 60-5
  • Not optional
  • Specifically an operations program
  • Implementation is assigned to Region Commanders by CAPR 60-5
  • Wings are to “assess the need for a CIST”
  • All personnel are encouraged to receive CIS training.
funding cism
Funding CISM
  • CISM is not, presently, a specifically USAF funded mission (by itself).
  • CAP CISM may be funded through an existing mission’s funding.
funding cism34
Funding CISM
  • CAP National HQ has approved limited funding to support CISM missions.
    • Housing and feeding of a team will normally NOT be reimbursed.
    • The “use of host families” is encouraged to mitigate housing costs.
compare these

Compare these...

According to the Wing Aircraft Maintenance Officer, HQ-TX Wing expects to spend approximately $187,000.00

this year to maintain our fleet of airplanes.

But …

How much are we spending

to maintain our most valuable asset

OUR PEOPLE?

request deployment
Request & Deployment
  • After a SAR or DR mission “… a review of the need for CIS intervention should be made for all personnel ...”
  • The Incident Commander or Unit Commander will pass a request to Wing Commander.
  • In consultation with staff, the Wing CC will coordinate use of a local non-CAP team or request one of the Region Teams.
for more information
For More Information ...
  • Visit the website of the International Critical Incident Stress Foundation (ICISF) at http://www.icisf.org.
  • Join the ICISF.
  • Review CAPR 60-5.
for more information39
For More Information

Contact the NER CIS Staff

- Jack Arena, NER CIS

631-645-7912 (cell), mission [email protected]

- Paul Mondoux, NER Deputy CIS

603-424-3019 (home) or 603-759-0178 (cell), [email protected]

  • www.icisf.org
  • www.capcism.com
  • www.ner.cap.gov/cism/ops_cism.htm
  • http://cism.nhplm.org/index.php
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