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Critical Incident Stress Management. FBI NAA Summer Conference. July 2011. Chuck Russo, PhD American Military University Daytona Beach Police Department SPS Group, LLC. Chuck Russo, PhD. Team Leader RDBHAT (ESF-8) Team Member: Volusia County CISM Daytona Beach PD CISM. Professor

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slide1

Critical Incident Stress Management

FBI NAA

Summer Conference

July 2011

Chuck Russo, PhD

American Military University

Daytona Beach Police Department

SPS Group, LLC

chuck russo phd
Chuck Russo, PhD

Team Leader

RDBHAT (ESF-8)

Team Member:

Volusia County CISM

Daytona Beach PD CISM

  • Professor
    • AMU
  • Police Officer
    • Daytona Beach PD
why i m here
Why I’m Here…

NY Daily News

Newsday

goal of presentation
Goal of Presentation
  • Identify the importance of dealing with critical incident stressors
    • Psychological and physiological responses related to traumatic stress
  • Addressing how to break the code of silence
what is critical incident stress management
What is Critical Incident Stress Management?
  • Critical Incident Stress Management (CISM) is a brief intervention utilized to mitigate the stressors associated with exposure to a traumatic event
  • CISM is frequently confused with Critical Incident Stress Debriefing (CISD)
    • Debriefing just one component of the overall response
stress and law enforcement
Stress and Law Enforcement
  • Police officers address their sworn duties and responsibilities with dedication and valor
  • Sometimes the compounded stresses of daily tragedies can become overwhelming and can lead to personal and professional stressors
  • Other first responders tend to respond to critical incidents in a team structure; police officers frequently do not
sources of stress and law enforcement
Sources of Stress and Law Enforcement
  • Organizational/administrative stressors
  • Daily field/job related stressors
  • Interaction with the criminal justice system
  • Personal stressors including the co-existence of the officer’s personal life and their professional life
how has law enforcement become more stressful
How Has Law Enforcement Become More Stressful?
  • Unfortunately with current reductions in community resources, officers are faced with more complex emergencies
  • Community policing has intensified the level of responsibility placed on officers
  • Police officers have to react quickly to solve a multitude of problems
how does stress impact law enforcement officers
How Does Stress Impact Law Enforcement Officers?
  • Heightened divorce rates
  • Substance dependence/abuse
  • Depression
  • Financial difficulties
  • High rates of suicide
critical incident stress traumatic stress
Critical Incident Stress & Traumatic Stress
  • Critical Incident Stress = Traumatic Stress
  • These terms are frequently used interchangeably
  • A critical incident usually occurs suddenly, is disturbing, or is an unusually challenging event that generates a strong emotional and/or reaction
examples of critical incidents
Examples of Critical Incidents
  • Events that overwhelm an individuals normal coping mechanisms
    • Officer involved shootings
    • Line of duty injuries/deaths
    • Incidents when a child is a victim
    • Incidents involving death/serious injury to others
    • Disasters
    • Employee suicide
impact of traumatic stress
Impact of Traumatic Stress

Engaging in response efforts during a critical incident is often stressful for all those involved in emergency response efforts; regardless of the responder’s ability to acknowledge the impact of their involvement

impact of traumatic stress1
Impact of Traumatic Stress

While this type of work is personally rewarding and challenging, it also has the potential for affecting responders in negative psychological and physiological ways

commonly recognized definition of stress
Commonly Recognized Definition of Stress

The most commonly accepted definition:

  • Stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize
definition of traumatic stress
Definition of Traumatic Stress
  • In the line of duty, first responders are trained to utilize tactical strategies in crisis situations, and they are quick to respond to protect the lives and property of those they serve
  • Unfortunately, a hidden danger is often ignored:

TRAUMATIC STRESS!

what is traumatic stress
What is Traumatic Stress?

Precipitated by stressors that include sudden, disturbing, or unusually challenging events that generate a strong emotional and/or cognitive reaction

Stressors Include:

  • Gruesome crashes
  • Homicides
  • Vicious crimes against a child/children
  • A close personal brush with death/injury
  • Officer involved shooting

Return

psychological and physiological responses to traumatic stress
Psychological and Physiological Responses to Traumatic Stress

Exposure and side effects to traumatic stress are individualized and may include:

  • Physical symptoms
  • Psychological symptoms
  • Reoccurrence or re-victimization can occur if the first responder does not address the symptomology
physiological responses
Physiological Responses

Examples encountered may include:

  • Increased fatigue – poor sleep and/or nightmares
  • Headaches
  • Muscle twitches
  • Unexplainable body aches and pain
  • Gastrointestinal distress
physiological responses1
Physiological Responses

Additional examples encountered include:

  • Weight loss or gain
  • Grinding of teeth
  • Chest pain
  • Difficulty breathing
  • Elevated heart rate and blood pressure
psychological responses
Psychological Responses

Examples encountered may include:

  • Emotional detachment
  • Withdrawal from social situations
  • Mood swings, anger and aggression
  • Intrusive thoughts/obsessive compulsive behaviors
  • Anxiety, panic attacks, and nervous energy
additional psychological symptoms
Additional Psychological Symptoms

More examples encountered may include:

  • Attention difficulties
  • Feelings of helplessness/hopelessness
  • Burnout
  • Depression
  • Grief
  • Interpersonal difficulties
exposure to traumatic stress
Exposure to Traumatic Stress

Often challenges an individual's sense of:

  • Sense of self-worth or self-esteem
  • Personal safety or sense of control
  • Impairs an individual’s ability to control their emotions
  • Increases their feelings of vulnerability
frequent exposure to traumatic stress
Frequent Exposure to Traumatic Stress

Can lead to hypervigilance:

  • A heightened state of alert; whereby an individual is constantly awaiting additional real or perceived threats
  • An individual is constantly on guard and this is also referred to as increased arousal
how to alleviate symptoms associated with traumatic stress
How to Alleviate Symptoms Associated with Traumatic Stress?

Engage in:

  • Debriefing
  • Defusing
  • Seek peer or supervisory support
  • Speak with a chaplin
  • Access EAP
minimizing the effects of traumatic stress
Minimizing the Effects of Traumatic Stress

Goal:

  • To facilitate a normal recovery process
  • To restore an individual’s level of adaptive functioning to their normal state of functioning
slide26
CISM
  • Definition of a Critical Incident
  • The Role of CISM
  • What CISM Does Not Do
  • How CISM Helps the First Responder
  • The CISM Team
break time
Break Time

We will begin again in 5 minutes.

definition of a critical incident
Definition of a Critical Incident

A critical incident is defined as:

  • A sudden or disturbing event
  • That generates a strong emotional and cognitive reaction
critical incidents
Critical Incidents

Examples encountered in may include:

  • Officer involved shootings
  • Line of duty injuries/deaths
  • Incidents when a child is a victim
  • Incidents involving death/serious injury to others
  • Disasters
  • Employee suicide
what is cism
What is CISM

CISM is:

  • Early psychological support for First Responders
goals of cism
Goals of CISM
  • To mitigate the impact of the event
  • Facilitate normal recovery processes
  • Restoration to adaptive function
role of cism
Role of CISM

To provide:

  • Temporary
  • Active
  • Supportive
  • Confidential

Assistance to aid the individual in crisis

what cism does not do
What CISM Does Not Do

CISM is NOT a function of/to:

  • Professional standards/internal affairs
  • Determine fitness for duty
  • Determine if policy was followed
  • Determine if state law was followed
  • Pass judgment on someone’s actions
how cism helps first responders
How CISM Helps First Responders

CISM helps by providing:

  • One-on-one peer support
  • Demobilization of information
  • Crisis management briefings
  • Defusing
  • Critical incident stress debriefings
one on one peer support
One-on-One Peer Support

Peer support is provided to individuals:

  • Mitigate symptoms
  • Return to previous level of functioning
  • Provide referrals if needed
demobilization information
Demobilization Information

This occurs:

  • At shift disengagement
  • To inform and consult
  • Provide psychological decompression
  • Stress management
  • Typically occurs in large groups
crisis management briefings
Crisis Management Briefings

This occurs:

  • At anytime post crisis
  • To inform and consult
  • Provide psychological decompression
  • Stress management
  • Typically occurs in large groups
defusing
Defusing

This occurs:

  • Post crisis (within a 12 hour time period)
  • To address symptom mitigation
  • To assist with providing possible closure
  • Triage of services and presenting symptoms
  • Typically occurs in small groups
critical incident stress debriefing
Critical Incident Stress Debriefing

This occurs:

  • Post crisis (occurs within 1-10 days, 3-4 weeks following mass disasters)
  • Facilitates psychological closure
  • To address symptom mitigation
  • Triage of services and presenting symptoms
  • Typically occurs in small groups
advantages of a cism team
Advantages of a CISM Team
  • Temporary
  • Active
  • Supportive
  • Confidential
  • Assistance to aid individuals involved in crisis situations
cism team
CISM Team

The CISM Team consists of:

  • Team Coordinator
  • Team Leader
  • Team Members
  • Mental Health Professional
  • Police Chaplin Volunteers
member training
Member Training
  • Specialized crisis intervention training
  • Small or large group crisis tactics
  • Recommended 50 to 80 hours of crisis intervention training in specialized areas
cism team1
CISM Team

Team members:

  • Have a responsibility and duty to keep information confidential
  • Shall not accuse or blame others of wrong doing
  • Shall refrain from engaging in any discussion involving responsibility or blame
cism team activation
CISM Team Activation
  • Responsibility of On-Scene Commander
  • Notify the CISM Team Coordinator of:
    • Officer involved shootings
    • Employee suicide
    • Mass casualty incident
    • Death or life threatening injury to a child
    • Incidents producing a high level of immediate or delayed emotional reaction
when activated
When Activated

Team members should:

  • Avoid direct involvement in the incident
  • Make contact with the involved employees
  • Separate the employee from the scene if approved
  • Ensure involved employees are allowed to contact family members if desired
  • Assist the involved employee until stabilized
when activated1
When Activated

Team members should ensure employees:

  • Are allowed to stabilize/calm down in a private environment
  • Permitted to shower and change when approved for such action
  • Have clergy and other spiritual needs met
  • Have food and drink if desired
  • Encouraged to seek follow up counseling, if needed
consequences of failure to address critical incident stress
Consequences of Failure to Address Critical Incident Stress
  • Negatively impacts all involved
  • Can lead to faulty decision making
  • Increased disciplinary problems
consequences of failure to address critical incident stress1
Consequences of Failure to Address Critical Incident Stress
  • Excessive use of sick leave, tardiness, and on-the-job accidents
  • Increased citizen complaints
  • Re-occurring officer turnover
slide49
CISM
  • Is for the employee experiencing a normal reaction to an abnormal event
  • Is to help the employee recover quicker from such an event
  • Is temporary, active and supportive
  • Is confidential
slide50

Every year, hundreds of officers experience intense, traumatic events that can have serious long-term consequences for them, their families, and their departments.

slide51

It is incumbent upon police administrators

to ensure that their officers and their departments have the tools at

hand to cope with such.

conclusions
Conclusions
  • Discussed the importance of dealing with critical incident stressors immediately following the traumatic event
  • Identified the deleterious impact of psychological and physiological stressors on first responders who frequently encounter traumatic stress
conclusions1
Conclusions
  • Discussed the importance of seeking CISM services to break the code of silence among first responders
questions
Questions

Questions concerning CISM should be directed to:

Daytona Beach Police Department CISM Team

Chuck Russo, PhD

russoc@dbpd.us

CharlesRusso7@mycampus.apus.edu

ChuckRusso@SPSGrp.com