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EMERGENCY RESPONSE TEAMS AND THE MILITARY ARE NOT THE ONLY ONES AFFECTED BY TRAUMATIC EVENTS…

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Presentation on theme: "EMERGENCY RESPONSE TEAMS AND THE MILITARY ARE NOT THE ONLY ONES AFFECTED BY TRAUMATIC EVENTS…"— Presentation transcript:

1 EMERGENCY RESPONSE TEAMS AND THE MILITARY ARE NOT THE ONLY ONES AFFECTED BY TRAUMATIC EVENTS…

2 Do you remember where you were on September 11 th 2001 at 8:45 AM (EDT)? American Airlines Flight 11 & United Airlines Flight 175…

3 9:40AM (EDT)? American Airlines Flight 77…

4 How about 10:07 AM (EDT)? United Airlines Flight 93…

5 What emotion does this image invoke in you?

6 Who did this one single event affect? You, me, everyone… THE WORLD!

7 Got your attention?

8 HOW DID YOU COPE? When you are involved, either directly or indirectly (even watching TV or radio news, and seeing the headlines in your newspaper may cause trauma too) with trauma it places stress on your mental health. How do you cope or deal with these feelings? How do you chase away the demons? Keeping it inside can be the cause of loss of attention, anxiety, thoughts of hurting yourself or others, chemical abuse, depression and many other clinically diagnosed psychosis similar to that of combat stress and even PTSD. Carrying your feelings inside ultimately festers and becomes a severe burden on you, your family and your friends. Do you know where to go to reach out for help? There are many programs which are available but in all cases help is best offered while the events are fresh in your mind. You can call your local Law Enforcement Center for contact information of your local area CISM team.

9 WHAT CAUSITIVE REACTIONS DO CRITICAL INCIDENTS PRODUCE? A Critical Incident is any event that generates such intense emotional energy that it overwhelms an individuals or groups ability to cope and causes impairment in work or personal activities A crisis is an acute emotional reaction to a critical incident Critical Incident Stress is the cognitive physical, and emotional state of arousal that is part of the crisis response Critical Incident Stress (CIS) is also known as Post Traumatic Stress. This is NOT the same as PTSD. CIS is a normal response of normal People to an abnormal event

10 There are many everyday events which may cause personal psychological stress, its not just war & violence that professionals deal with, we are all vulnerable… Crime Rape Riots and Terror Fire Domestic Violence Natural Disaster Weather Accidental Tragedy War

11 WHAT CONSTITUTES MENTAL TRAUMA? Line of duty deaths Suicide of a colleague Serious work related injury Multi-casualty / disaster / terrorism incidents Events with a high degree of threat to the personnel Significant events involving children Events in which the victim is known to the personnel Events with excessive media interest Events that are prolonged and end with a negative outcome Any significantly powerful, overwhelming distressing event How do you react normally to an abnormal event? Defusing Debriefing Follow-Up

12 HELP IS AVAILABLE! CISM Critical Incident Stress Management PFA Psychological First Aid CFT C ompassion F atigue T herapy Hope

13 WHAT KIND OF HELP IS AVAILABLE? Incidents come and go but their memories may linger forever… Military members are apt to see/experience atrocities, older Veterans just kept the memories to themselves. Perhaps they were too painful to talk about or it was just the manly thing to do because it was a sign of weakness. Left untreated these memories can manifest into more sever clinically diagnosed issues such as depression and Post Traumatic Stress Disorder (PTSD). These issues have been recognized in many more than just the military and counseling is routinely performed following traumatic incidents for Emergency Responders, Health Care Workers, Family, and Law Enforcement. These sessions are referred to as Critical Incident Stress Management (CISM) & Psychological First Aid (PFA). There is help for the caregiver too, Compassion Fatigue Therapy.

14 CISM: Definition Critical incident stress management (CISM) is an adaptive short term helping process that focuses solely on an immediate and identifiable problem. It spans pre-incident preparedness to acute crisis to post-crisis follow up. Its purpose is to enable people to return to their daily routine more quickly and with less likelihood of experiencing Post Traumatic Stress Disorder (PTSD).

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16 SYMPTOMS

17 RECOGNITION & TREATMENT Click Here to watch short take from Patton

18 Kyle Housmann-Stokes: Now, After The producer, Kyle Housmann-Stokes, was an OIF Veteran who was preceded in military service by his grandfather who is a Lieutenant Colonel serving two tours in Viet Nam and one in Iraq. This film depicts the plight of stress and trauma that many returning service men and women suffer. Its poignant and its direct… Please be aware that there are some parts which are graphic representations but allows you a better understanding, if you are not military or a Vet, of what is war means to those returning. Regardless of the era, conflict or war, the technologies may change but the carnage and after effects remain much the same, as does the camaraderie among Veterans, young and old. You can see from this film how Veterans are not strangers and regardless of era rally to his side. Lets watch the film…Lets watch the film… (or via Internet: Watch Film)Watch Film For Kyles latest filmography you can go to: For a background on Kyle and how this came about you can log on to the following:

19 Kyle Housmann-Stokes: Now, After Personal observations about the film: Pride in his military service and accomplishments He possesses hyper-vigilance Flashbacks (both good & bad, human carnage and the Iraqi people) Indications of Obsessive Compulsive Disorder (O.C.D.) (preparing for his school day as if it were for a patrol) Anxiety Sweating Apprehensive about leaving the safety of his home Inability to disconnect himself from the Military Hyper-vigilance and flashbacks while driving (speeding up and driving the middle of the road to avoid possible IEDs) Avoiding others, loner Uncontrolled outburst of anger, anger management issues Once at the VA: Reverence when at the VA parking garage Realization that hes not alone…

20 GUIDELINES FOR STRESS MANAGEMENT Diet Mind what you eat… – Focus on the following: High Protein, raw fruits, vegetables – Stay away from: Carbohydrates, low sugar, low fat and low salt – Why? Cortisone levels rise when you are stressed Immune system depletes Brain tells our body that its starving to death

21 GUIDELINES FOR STRESS MANAGEMENT Exercise Sweat out the chemicals! – 132 chemicals mix together when your body goes into the stress response – Sweat is the only way to remove these quickly – Recommend physical therapy massage to ease the pains in the body Chemistry of survival: – Catecholamine Excites the System Triggers increased nervous system Flight or Fight response – Cortico-Steroids Moderates and controls extremes of catecholamine Keeps Flight or Fight response in check – Endogenous Opioids Creates Heightened threshold of pain Causes dissociative reactions Causes blunting of emotions with catecholamines, causes amnesiac reactions Causes feelings o f euphoria

22 GUIDELINES FOR STRESS MANAGEMENT Let It Run Your unconscious has to find a fit – Your mind must find a fit for the event in your memory so your memory can accept it – It will run at your request or when it feels it is necessary – Let it run when YOU control it – If it is overwhelming now, set it up to run at another day or time

23 GUIDELINES FOR STRESS MANAGEMENT Breathing Deep Breathing – Generally you only use 1/3 of your lung capacity – Deep Breathing, using more than 2/3 of your lung capacity: Increases oxygen flow to your brain Dumps the Carbon Monoxide in our lungs – This allows us to breath better Allows us to think with more clarity – Deep Breathing also increases the serotonin levels in our body Practice deep breathing techniques

24 CISM: Timeline Defusing – Immediately – On-site – Group or One-on-One Debriefing – Within 72 hours of the incident – Formal setting for group – Formal/informal setting for one-on-one Follow-up – Within approximately 30 days – Comfortable setting – Preferably in person

25 CISM: Defusing WHO: Individuals who were directly involved in the incident HOW: These are generally informal and often performed at the scene – Steps used in this process are: Introduction; Exploration; Information WHEN: The day of the event before the person gets to sleep – Initial Defusing: Initial informal defusing sessions should be held within 8-12 hours after the incident. A defusing session is a brief, spontaneous, non-evaluative discussion coordinated and conducted by a minimum of two peer supporters and held immediately following a critical incident. The defusing may be considered an emotional triage, in which a person can begin to talk about and explore their thoughts concerning the incident - a chance to vent feelings - in an informal, positive and supportive atmosphere. – It is NOT to serve as a critique of the situation WHAT: Designed to assure those involved that their feelings are normal: – Its a process of talking it out – Explanation of what symptoms to watch for over the short term – Offering a lifeline (phone number where they can reach someone with whom they can talk)

26 CISM: Group Debriefing WHO: Those who were directly affected by the incident and often the first for those not directly involved HOW: Formal, in a group setting – Seven Step Process is generally used in this setting Introduction; Facts; Thoughts; Reactions; Symptoms; Teaching; Re-Entry – No notes taken or paper/pen allowed – Facilitator and intervenor are the only two in the room besides those participating WHEN: Within 72 hours of the incident – A chance to vent feelings - in an informal, positive and supportive atmosphere. – It is NOT to serve as a critique of the situation WHAT: Structured to allow participants to talk it out and reflect on the event(s) to help them identify with how one another reacts to an abnormal event, everyones normal reactions are different – Group debriefing provides the group the opportunity to talk about their experience, how it has affected them, brainstorm coping mechanisms, identify individuals at risk – It also serves to inform the group about services available to them in their community – Provides an explanation of what symptoms to watch for over the short term – The intervenor is always on watch for individuals who are not coping well and additional assistance is offered at the conclusion of the process

27 CISM: One-on-One Debriefing WHO: An individual who was directly, or possibly indirectly, affected by the incident HOW: In a quiet & comfortable setting – Seven Step Process is generally used in this setting Introduction; Facts; Thoughts; Reactions; Symptoms; Teaching; Re-Entry – No notes taken or paper/pen allowed – Facilitator and intervenor are the only two in the room besides the participant WHEN: Within 72 hours of the incident – A chance to vent feelings - in an informal, positive and supportive atmosphere. – It is NOT to serve as a critique of the situation WHAT: Structured to allow participants to talk it out and reflect on the event(s) to help them identify with how one another reacts to an abnormal event, everyones normal reactions are different – Group debriefing provides the group the opportunity to talk about their experience, how it has affected them, brainstorm coping mechanisms, identify individuals at risk – It also serves to inform the group about services available to them in their community – Provides an explanation of what symptoms to watch for over the short term – The intervenor is always on watch for individuals who are not coping well and additional assistance is offered at the conclusion of the process

28 CISM: Follow-up Follow-up is the most important final step to the process Follow-up is generally done within the week (or up to 30 days) following the debriefing Follow-up is for participants as well as CISM team members as a check-in to make sure they are OK too During a follow-up additional intervention or a referral may be provided to the original participant. It may also be provided for the caregiver(s) to ensure the Caregiver(s) does not demonstrate the symptoms of Compassion Fatigue.

29 CISM: Referral Referrals are recommended any time that it is obvious that one or more persons needs are beyond the scope of the CISM program. The referral action is considered an essential component of CISM that supports and enhances the care provided for these people. There are many links in the chain of concern that are dedicated to assist you…

30 Compassion Fatigue Compassion Fatigue is the cost of caring… – You must care for yourself and allow others to help you care for yourself – Use your Compassion Fatigue Therapist It is care for the caregiver… Compassion fatigue plagues caregivers worldwide. When providing care to others without incorporating authentic, sustainable self-care practices into our daily lives, destructive symptoms surface. Isolation, emotional outbursts, substance abuse and reoccurring nightmares are just a few of the symptoms that can distress the life of a caregiver. With awareness and knowledge, compassion fatigue can be recognized and managed. For more information about Compassion Fatigue please visit:

31 Psychological First Aid WHO: HOW: WHEN: WHAT:

32 Discovering youre OK… PRICELESS!

33 CISDs are like visiting Las Vegas… What is said, what is heard & what is seen during a CISD will remain at the CISD! Everything is CONFIDENTIAL. Dont monkey around with another persons life…

34 Critical Incident Stress Management (CISM): Group Crisis Intervention (4 th Edition) Jeffery T. Mitchell, Ph.D., C.T.S. International Critical Incident Stress Foundation, JEC Counseling, Dr. Dan Casey, Traumatologist Green Cross Academy of Traumatology, Charles R. Figley, Ph.D., Green Cross Academy of Traumatology, International Red Cross,

35 Thank You! SPREAD THE WORD… THE WORD IS FAC ! (FAC = Family Assistance Center) Your Presenter: Jeff Gay Minnesota Military Family Assistance Center 500 Timmerman Drive Marshall, MN Office or Cellular You make the call; Well make the difference! 8 Locations! To locate your nearest FAC go to:

36 IN REVIEW Question, Comments, Observations, Conversation, Constructive Criticism, Blasphemous Comments about the Presenter, Praise, Adoration, Accolades…


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