1. BENCHMARKS OF EXCELLENCE Spiritual First Aid

2. Life Threat A traumatic injury Due to an experience of death provoking terror, horror, or helplessness LossLoss A grief injury Due to the loss of cherished people, things, or parts of oneself Wear & Tear A fatigue injury Due to the accumulation of stress from all sources over time without sufficient rest and recovery Intense or Prolonged Disaster or Operational Stress Intense or Prolonged Disaster or Operational Stress Inner Conflict A moral injury Due to behaviors or the witnessing of behaviors that violate moral values Four Causes of Stress Injury

3. Stress Continuum READY READY (Green) REACTING (Yellow) INJURED (Orange) ILL (Red) Distress or impairment Mild and transient Anxious, irritable, or sad Behavior change More severe or persistent distress or impairment Leaves lasting memories, reactions, and expectations Stress injuries that don’t heal without help Symptoms and impairment persist over many weeks or get worse over time Good to go Well trained Prepared Fit and focused Cohesive units & ready families Team Leader Responsibility Team Leader Responsibility Caregiver Responsibility Caregiver Responsibility Individual, and Family Responsibility Stressor

4. 7C’s Stress First-Aid Model

5. Spiritual Fitness Decision Matrix Are there signs of spiritual distress or moral confusion? Has spiritual distress or moral failure become severe or persistent? Has spiritual distress or extreme immoral behavior? Green Zone (Fit) Good to Go Encourage good health and spiritual practices Yellow Zone (Distressed) Explore forgiveness issues Encourage spiritual practices, (worship, prayer, fellowship, etc.) Team Leader encourages spiritual practices Discuss with Pastor/Chaplain Orange Zone (Drained) Refer to Pastor/Chaplain Deal with guilt Red Zone (Depleted) Spiritual Distress: Less hopeful Some family life difficulties Less sociable, struggling with friendship Less participation in previous faith practices Makes some poor moral decisions contrary to previous ethical standards Has difficulty forgiving self and others Exhibits negative emotions more often Severe Spiritual Distress: Losing hope Family life threatened Withdrawal from friends, social isolation Discontinues and/or avoids previous faith practices Loss of moral values, makes poor moral decisions Unable to forgive or feel forgiven Blames God Loss of sense of life’s meaning PERSISTENT Spiritual Distress: Lost hope Faith, family, social/emotional or moral crisis Family ties cease to matter, often with complete family breakdown Complete social isolation Complete rejection of prior faith commitments Uncharacteristic extreme immoral or unethical behavior No concept of life having meaning and purpose Yes No

6. Green Zone (Fit) Good to Go Encourage good health and spiritual practices Are there signs of spiritual distress or moral confusion ? Yes No SPIRITUAL FITNESS DECISION MATRIX

7. Has spiritual distress or moral failure become severe or persistent? Yellow Zone (Distressed) Explore forgiveness issues Encourage spiritual practices, (worship, prayer, fellowship, etc.) Team Leader encourages spiritual practices Discuss with Pastor/Chaplain Yes No Spiritual Distress: Less hopeful Some family life difficulties Less sociable, struggling with friendship Less participation in previous faith practices Makes some poor moral decisions contrary to previous ethical standards Has difficulty forgiving self and others Exhibits negative emotions more often SPIRITUAL FITNESS DECISION MATRIX

8. Has spiritual distress or extreme immoral behavior? Orange Zone (Drained) Refer to Pastor/Chaplain Deal with guilt No Yes SPIRITUAL FITNESS DECISION MATRIX Severe Spiritual Distress: Losing hope Family life threatened Withdrawal from friends, social isolation Discontinues and/or avoids previous faith practices Loss of moral values, make poor moral decisions Unable to forgive or feel forgiven Blames God Loss of sense of life’s meaning

9. Red Zone (Depleted ) Needs clinical assistance REFER, REFER, REFER Yes PERSISTENT Spiritual Distress: Lost hope Faith, family, social/emotional or moral crisis Family ties cease to matter, often with complete family breakdown Complete social isolation Complete rejection of prior faith commitments Uncharacteristic extreme immoral or unethical behavior No concept of life having meaning and purpose SPIRITUAL FITNESS DECISION MATRIX