Presentation is loading. Please wait.

Presentation is loading. Please wait.

Critical Incident Stress Management (CISM) LTC Clarence Bowser State Family Programs Director National Guard Trained Crisis Responder Program.

Similar presentations


Presentation on theme: "Critical Incident Stress Management (CISM) LTC Clarence Bowser State Family Programs Director National Guard Trained Crisis Responder Program."— Presentation transcript:

1 Critical Incident Stress Management (CISM) LTC Clarence Bowser State Family Programs Director National Guard Trained Crisis Responder Program

2 TCR Briefing for Command Military References… Military References… Trained Crisis Responder (TCR)… Trained Crisis Responder (TCR)… Crisis Intervention… Crisis Intervention… Critical Incidents… Critical Incidents… Post-Traumatic Stress… Post-Traumatic Stress… TCR Services… TCR Services… Rationale… Rationale… Overview

3 TCR Briefing for Command DoD: DoD: – Combat Stress Control Program – Combat Stress Control Program Air Force: Air Force: AFI – Critical Incident Stress Management AFI – Critical Incident Stress Management AFI Survivor Assistance AFI Survivor Assistance Army: Army: Field Manual FM 16-1, Annex F-1 "Critical Event Debriefings" Field Manual FM 16-1, Annex F-1 "Critical Event Debriefings" References

4 TCR Briefing for Command The National Guard TCR Program was developed from Critical Incident Stress Management (CISM) principles… Trained Crisis Responder

5 TCR Briefing for Command Crisis Intervention CISM is a subset of the general field of Crisis Intervention (CI) and may be thought of as the application of Crisis Intervention knowledge and techniques to high risk groups, e.g., emergency services, military, etc.CISM is a subset of the general field of Crisis Intervention (CI) and may be thought of as the application of Crisis Intervention knowledge and techniques to high risk groups, e.g., emergency services, military, etc. (J.T. Mitchell, G.S. Everly, 1995)

6 TCR Briefing for Command CISM Services Trained Crisis Responders are the first line of defense in coping with Post-Traumatic Stress Reactions to Crisis events. Trained Crisis Responders are the first line of defense in coping with Post-Traumatic Stress Reactions to Crisis events. CISM Services extend beyond the training levels of Trained Crisis Responders, therefore it is important for the TCRs to work in concert with military and civilian CISM Teams… CISM Services extend beyond the training levels of Trained Crisis Responders, therefore it is important for the TCRs to work in concert with military and civilian CISM Teams…

7 TCR Briefing for Command CISM Core Components Pre-Crisis preparation Pre-Crisis preparation Demobilization Demobilization Crisis Management Briefing Crisis Management Briefing Defusing Defusing Critical Incident Stress Debriefing Critical Incident Stress Debriefing Individual crisis intervention 1:1 Family CISM Community consultation Pastoral Crisis Intervention Follow- up/Referral

8 TCR Briefing for Command Trained Crisis Responder Trained Crisis Responders provide psychological and emotional Self-Aid and Buddy-Care

9 TCR Briefing for Command Incident Crisis Intervention EAP TCRs Legal Chaplain CISM Mental Health Psychotherapy Hospitalization Refer where needed… Family Support Rehab Spectrum Of Care

10 TCR Briefing for Command Critical Incidents Major Accidents (Air Crashes, etc.)… Major Accidents (Air Crashes, etc.)… Line of Duty Death(s)… Line of Duty Death(s)… Serious Line of Duty Injury(s)… Serious Line of Duty Injury(s)… Suicide of a Co-Worker… Suicide of a Co-Worker… Disaster / Multi-Casualty Incident(s)… Disaster / Multi-Casualty Incident(s)… Shooting(s)… Shooting(s)…

11 TCR Briefing for Command Critical Incidents Significant Events Involving Children… Significant Events Involving Children… Prolonged Incident(s) - Especially with loss… Prolonged Incident(s) - Especially with loss… Excessive Community Media Interest… Excessive Community Media Interest… Any Significant Traumatic Event… Any Significant Traumatic Event…

12 TCR Briefing for Command Primary Goal CISM and the TCR Program are forms of crisis intervention designed to help reduce Post- Traumatic Stress Reactions to Critical Incidents…

13 TCR Briefing for Command Post-Traumatic Stress Post - traumatic stress is a normal reaction, in a normal person, to an abnormal event.

14 TCR Briefing for Command Hallmarks of Crisis Intervention Immediacy Immediacy Proximity Proximity Expectancy Expectancy Brevity Brevity Practical Practical Its learning how to toss a life raft, not a course in ship building

15 TCR Briefing for Command Post traumatic stress Is everyone who experiences traumatic distress suffering from the disorder know as Post Traumatic Stress Disorder? NO.. NO..NO

16 TCR Briefing for Command Post Traumatic Stress Disorder PTSD represents a contradiction to some critically important assumption or belief about self and/or the world. PTSD represents a contradiction to some critically important assumption or belief about self and/or the world. (G.S. Everly, 1995)

17 TCR Briefing for Command Post Traumatic Stress Disorder A pathological and disabling variant of a normal stress reaction A pathological and disabling variant of a normal stress reaction Very clear criteria …symptoms must be over 30 days and it is impairing function Very clear criteria …symptoms must be over 30 days and it is impairing function

18 TCR Briefing for Command Important TCR Concept The TCR Program is NOT a stand alone process. Rather it is meant to be one part of a comprehensive CISM intervention program.

19 TCR Briefing for Command TCR Services… TCRs can be in any section (personnel, security forces, fire, chaplain, medical, family support, etc.)… TCRs can be in any section (personnel, security forces, fire, chaplain, medical, family support, etc.)… TCRs are normally among your first responders to an incident… TCRs are normally among your first responders to an incident… TCRs can support official military and civilian CISM Teams… TCRs can support official military and civilian CISM Teams…

20 TCR Briefing for Command TCR Services… Pre-incident education, preparation… Pre-incident education, preparation… One-on-one crisis intervention… One-on-one crisis intervention… Demobilizations (large groups of public safety)… Demobilizations (large groups of public safety)… Crisis Management Briefings [large groups of primary, secondary (emergency personnel), and tertiary (family, co-workers, etc.) victims] Crisis Management Briefings [large groups of primary, secondary (emergency personnel), and tertiary (family, co-workers, etc.) victims]

21 TCR Briefing for Command TCR Services… Family Support… Family Support… Organizational / Community intervention, consultation… Organizational / Community intervention, consultation… Follow-up and referral for TCRs & CISM services and/or continued care… Follow-up and referral for TCRs & CISM services and/or continued care…

22 TCR Briefing for Command Why have TCRs and CISM programs? We can learn from past experience. Rationale

23 TCR Briefing for Command 141 ARW Suicide December Fairchild AFB WA December Fairchild AFB WA Just-retired Wing Commander Just-retired Wing Commander Prior incidents in unit Prior incidents in unit Impact on unit Impact on unit Chaplains from outside called in for first UTA following incident Chaplains from outside called in for first UTA following incident Ministered to entire wing Ministered to entire wing

24 TCR Briefing for Command 141 ARW CRASH Six weeks after suicide of commander Six weeks after suicide of commander Four members killed in Germany Four members killed in Germany Chaplains called from outside; some had just been there Chaplains called from outside; some had just been there Assigned to each family to assist local clergy and chaplains Assigned to each family to assist local clergy and chaplains Memorial Service and Funerals Memorial Service and Funerals

25 TCR Briefing for Command Red Horse Crash March 2001 March 2001 Army NG Sherpa crashed over Ga. Army NG Sherpa crashed over Ga. 18 ANG and 3 ARNG members killed 18 ANG and 3 ARNG members killed Chaplains called in for ministry Chaplains called in for ministry Memorial Service and Funerals Memorial Service and Funerals Continuing care for families Continuing care for families

26 TCR Briefing for Command Red Horse, contd Late July - Early August report Late July - Early August report Some possible questions Some possible questions Chaplains and Line Colonels formed teams for each family Chaplains and Line Colonels formed teams for each family Trained at Langley then deployed Trained at Langley then deployed There to walk families through report and to offer pastoral care There to walk families through report and to offer pastoral care

27

28

29

30 TCR Briefing for Command Comparison Total Killed12582 Plane Survivors 0 0 Homes Destroyed 1616 Killed On Ground 1515 Emergency Personnel Body Parts Found 10,00010,000 San Diego, CA Air Crash Cerritos, CA Air Crash

31 TCR Briefing for Command Comparison Cerritos, CA Air Crash On Scene One on One Demobilizations 12 Debriefings Hot Line Number One on One Follow Up Support Services Provided San Diego, CA Air Crash Sporadic One on One Sporadic One on One

32 TCR Briefing for Command Comparison Personnel Lost in 1 Year Police5- Fire7-1 Paramedics17- Increase in Mental Health Services increase of 31% increase of 1% San Diego, CA Air Crash Cerritos, CA Air Crash

33 TCR Briefing for Command Rationale Trauma and stress-related disorders are sometimes disabling and costly to treat… Trauma and stress-related disorders are sometimes disabling and costly to treat… Interventions are designed to assist in preventing burnout and PTSD… Interventions are designed to assist in preventing burnout and PTSD… Healthy employees are more productive and effective on the job… Healthy employees are more productive and effective on the job…

34 TCR Briefing for Command Example 1… 100 trauma victims 100 trauma victims Intervention began after 6 months Intervention began after 6 months Average cost = $46, ea. Average cost = $46, ea. 94% filed civil litigation 94% filed civil litigation Friedman, et al, EAP Digest, 1988

35 TCR Briefing for Command Example 2… 100 trauma victims 100 trauma victims Intervention began within 6 months Intervention began within 6 months Average cost = $8, ea. Average cost = $8, ea. 13% filed civil litigation 13% filed civil litigation Friedman, et al, EAP Digest, 1988

36 TCR Briefing for Command Rationale On any given trauma/disaster, 4%-97% of the individuals exposed will develop Symptoms similar to PTSD. On any given trauma/disaster, 4%-97% of the individuals exposed will develop Symptoms similar to PTSD % of emergency responders are at risk of developing PTSD symptoms % of emergency responders are at risk of developing PTSD symptoms.

37 TCR Briefing for Command Rationale Disaster / Trauma planning (including CISM protocols) is appropriate for not only emergency response personnel and institutions, but for all business and industrial (and military) settings as well. Yandrick, EAPA Exchange, 1990

38 TCR Briefing for Command Main Goal Trained Crisis Responders help keep your team on the job!

39 TCR Briefing for Command WHERE YOU CAN LEARN THIS STUFF! Ch, LtCol Charles E. Woods Chief, Crisis Intervention McGhee Tyson ANG Base, TN Academy for Innovative Ministry

40 TCR Briefing for Command AIM COURSES AIM course offerings available on-line: https.//tys.tnknox.ang.af.mil/AAIM/AAIM.HTM This web site is accessible from a ".mil" computer only!

41 TCR Briefing for Command CHAPLAIN SERVICE AND FAMILY SUPPORT WHY DO CHAPLAINS EXIST? WHY DO CHAPLAINS EXIST? - First Amendment - Provision without establishment Requirements Requirements Skills Skills neutral zone neutral zone 100 % Confidentiality 100 % Confidentiality

42 TCR Briefing for Command Chaplain Service and Family Support LETS TALK!


Download ppt "Critical Incident Stress Management (CISM) LTC Clarence Bowser State Family Programs Director National Guard Trained Crisis Responder Program."

Similar presentations


Ads by Google