Transcript Critical Incident Stress Management

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
• Professor
– AMU
• Police Officer
– Daytona Beach PD
• Team Leader
– RDBHAT (ESF-8)
• Team Member:
– Volusia County CISM
– Daytona Beach PD CISM
Why I’m Here…
NY Daily News
Newsday
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?
• 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
• 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
• 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?
• 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?
• Heightened divorce rates
• Substance dependence/abuse
• Depression
• Financial difficulties
• High rates of suicide
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
• Events that overwhelm an individuals normal
coping mechanisms
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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
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 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
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
• 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?
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
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
Examples encountered may include:
• Increased fatigue – poor sleep and/or nightmares
• Headaches
• Muscle twitches
• Unexplainable body aches and pain
• Gastrointestinal distress
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
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
More examples encountered may include:
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Attention difficulties
Feelings of helplessness/hopelessness
Burnout
Depression
Grief
Interpersonal difficulties
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
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?
Engage in:
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Debriefing
Defusing
Seek peer or supervisory support
Speak with a chaplin
Access EAP
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
CISM
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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
We will begin again in 5 minutes.
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
Examples encountered in may include:
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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
CISM is:
• Early psychological support for First
Responders
Goals of CISM
• To mitigate the impact of the event
• Facilitate normal recovery processes
• Restoration to adaptive function
Role of CISM
To provide:
• Temporary
• Active
• Supportive
• Confidential
Assistance to aid the individual in crisis
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
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
Peer support is provided to individuals:
• Mitigate symptoms
• Return to previous level of functioning
• Provide referrals if needed
Demobilization Information
This occurs:
• At shift disengagement
• To inform and consult
• Provide psychological decompression
• Stress management
• Typically occurs in large groups
Crisis Management Briefings
This occurs:
• At anytime post crisis
• To inform and consult
• Provide psychological decompression
• Stress management
• Typically occurs in large groups
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
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
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Temporary
Active
Supportive
Confidential
Assistance to aid individuals involved in
crisis situations
CISM Team
The CISM Team consists of:
• Team Coordinator
• Team Leader
• Team Members
• Mental Health Professional
• Police Chaplin Volunteers
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 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
• Responsibility of On-Scene Commander
• Notify the CISM Team Coordinator of:
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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
Team members should:
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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 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
• Negatively impacts all involved
• Can lead to faulty decision making
• Increased disciplinary problems
Consequences of Failure to
Address Critical Incident Stress
• Excessive use of sick leave, tardiness, and onthe-job accidents
• Increased citizen complaints
• Re-occurring officer turnover
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
Every year, hundreds of officers experience
intense, traumatic events that can have
serious long-term consequences for them,
their families, and their departments.
It is incumbent upon police administrators
to ensure that their officers and their
departments have the tools at
hand to cope with such.
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
Conclusions
• Discussed the importance of seeking CISM
services to break the code of silence among
first responders
Questions
Questions concerning CISM should be directed to:
Daytona Beach Police Department CISM Team
Chuck Russo, PhD
[email protected]
[email protected]
[email protected]