Security Levels

Office of Work-Life Programs -
Critical Incident Stress Management

Who is Eligible for this Program?
The Critical Incident Stress Management program is applicable to the following members of Team Coast Guard:

Active Duty, Reservists and their dependents
Civil Service employees
Exchange System and MWR employees

Purpose of Program
The Critical Incident Stress Management (CISM) program is intended to help individuals exposed to critical incidents to identify and cope with their responses to these events. The focus of CISM is to provide “psychological first aid” and to minimize the harmful affects of job stress, particularly in crisis or emergency situations. Critical Incident Stress Management includes pre-incident training and post-incident services.

Program Confidentiality
The Employee Assistance Program Coordinator will ensure CISM confidentiality and effectiveness. No team member shall make any written notes during or about a CISM intervention. An after action report may be used by team members only to discuss at team meetings as to lessons learned about the intervention process. The after action report shall be very generic and shall not include names or any specifics about the intervention.

Definitions
The following definitions apply to Critical Incident Stress Management Program:

Critical Incident - Any event with sufficient impact to produce significant emotional reactions now or later. It is generally considered extremely unusual in the range of ordinary human experiences. Examples of critical incidents include the following:

Crew members death in line of duty

Children’s death or serious injury

Multiple fatalities or seriously injured survivors

Suicide, successful or attempted

Natural disasters

Class A or B mishaps involving death or permanent injury and otherwise high emotional impact

Use of deadly force

Grotesque injuries

Acts of terrorism

Acts of violence resulting in injury or death

Observing any traumatic event

Critical Incident Stress Debriefing (CISD) - A group meeting intended to:

Acknowledge both potential and realized traumatic reactions to the event or incident

Stabilize and mitigate the impact of acute symptoms/signs of distress following the exposure

Assist individuals to evaluate their own responses in terms of the impact on their current occupational functioning and the possible need for ongoing referral/treatment

Encourage the mitigating effects of peer group support and interaction in the workplace

Facilitate participants’ use of social, emotional, and psychological resources available to them

To maximize effectiveness, a debriefing should normally occur 24-72 hours after an event. CISD usually uses all team members. It is not therapy even though a mental health professional is part of the team.

Critical Incident Stress Defusing - Small group process, usually no more than 30 minutes, ideally done within 8 hours after a critical incident. Purpose is:

Rapid reduction in the intense reactions to a traumatic event

“Normalize” the experience so people can return to their routine duties as quickly as possible

Re-establish the group’s social network so people do not isolate themselves from each other. In recognizing similarities to others, people often are more willing to help each other in troubled times

Provide information on acute stress and a few reminders about how to reduce it

Assess group’s response to determine if a full debriefing should be scheduled

Critical Incident Stress Management (CISM) – A system of interventions designed to mitigate the adverse psychological reactions that may accompany critical incidents. The CISM process is not therapy; its focus to minimize the harmful affects through psychological first aid, education and follow-up. The CISM process uses trained peers, chaplains, and mental health professionals, and is managed by CISM Team Coordinators who are usually the Employee Assistance Program Coordinators (EAPC) located at Work-Life Centers.
Critical Incident Stress Management Team - The Critical Incident Stress Management team normally consists of:

Team Coordinator

Mental Health Professional

Chaplain, and

Peers, all of whom have been trained in Peer Support CISM.

The EAPC coordinates, manages, and deploys the CISM Team.

Demobilization - Demobilization’s are generally used during a disaster or in a large-scale catastrophic critical incident. A primary stress prevention and intervention technique, it is applied immediately after personnel are released from the scene and before they return to normal duties. Its two segments are, first, a 10- to 15- minute talk and, second, a 20 - minute rest and eating session. The purpose is to provide an opportunity to 'decompress' before moving to the next assignment, provide practical suggestions for stress management and offer an avenue to those experiencing critical incident stress effects to receive further assistance.
Follow-up Services - If CISM provides initial services post-incident follow-up is considered to be essential. The Employee Assistance Program Coordinator is responsible for ensuring follow-up services are provided or accessible.
On–Scene Support Services - Services provided under “on-scene” conditions are brief, practical crisis intervention functions designed to limit the level of distress members encounter. On-scene support does not interfere with operations. These service providers usually are peers, with chaplains or mental health professionals called only as needed.
Psychological First Aid - The basic human responses of comfort and consoling a distressed person; protecting a person from further threat or distress, as far as is possible; furnishing immediate care for physical necessities, including shelter; providing goal orientation and support for specific reality based tasks (“reinforcing the concrete world”); facilitating reunion with loved ones from whom the individual has been separated; facilitating some telling of the “trauma story” and ventilation of feelings as appropriate for the particular individual; linking the person to systems of support and sources of help that will be ongoing; facilitating the beginning of some sense of mastery; and identifying the need for further counseling or intervention. (Raphael et al., 1996, pp. 466–467)

Services and Resources Available
The following services and resources are available within the Critical Incident Stress Management program:

Command Consultation
Critical Incident Stress Debriefing
Critical Incident Stress Defusing
On-Scene Support Services
Demobilization
Pre-Incident Training
Family Crisis Intervention
Anniversary Meetings
Follow -up Services

Requesting Services or Resources
CRITICAL INCIDENT REPORTING
To request CISM services, commanding officers and officers in charge can notify either the area or district command center, which will in turn notify the Work-Life Staff. In general, CISM services or resources can be obtained by contacting the Employee Assistance Program Coordinator (EAPC) on your Regional Work-Life Staff. Work-Life Staffs are located at Integrated Support Commands CG-wide and at the Headquarters Support Command.

Program References
The following reference provide details of the Critical Incident Stress Management program:

Critical Incident Stress Management (CISM) - COMDTINST 1754.3
Traumatic Incident Management Program - DHS Management Directive 3062

Related Web Sites
The following web sites provide information related to the Critical Incident Stress Management Program:

American Red Cross. Provides disaster-related information and resources. Includes a Disaster Online Newsroom on current disasters.
Centers for Disease Control and Prevention (CDC) – Emergency Preparedness and Response. This site includes links on each type of natural disaster: earthquakes, extreme heat, floods, hurricanes, landslides and mudslides, tornadoes, tsunamis, volcanoes, wildfires, and winter weather. Very comprehensive with lots of useful just-in-time information.
Center for the Study of Traumatic Stress
Defense Centers of Excellence (DCoE) for Psychological Health and Brain Injury - DCoE’s mission: assesses, validates, oversees and facilitates prevention, resilience, identification, treatment, outreach, rehabilitation, and reintegration programs for psychological health and traumatic brain injury to ensure the Department of Defense meets the needs of the nation's military communities, warriors and families. This site has many helpful links related to assisting persons impacted by critical incidents.
Incident Management Handbook – Click on Library > Incident Command System > scroll to Job Aids.
International Critical Incident Stress Foundation
National Integration Center (NIC) Incident Management Systems Integration Division (FEMA)
Substance Abuse and Mental Health Services Administration (SAMSHA). This Department of Health and Human Services website offers plenty of Mental Health and CISM-related resources including separate pages on Disaster Readiness and Response, the National Center for Trauma-Informed Care, and Suicide Prevention.
U.S. Office of Personnel Management (OPM) – A Manager's Handbook: Handling Traumatic Events, February 2003

Point of Contact
If you are unable to contact the Employee Assistance Program Coordinator on your Regional Work-Life Staff, or need additional assistance beyond the information provided here, please contact the Headquarters Employee Assistance Program Manager, Mr. John Reibling, CG-1112, at (202) 475-5161, Fax: (202) 475-5907 or email at John.S.Reibling@uscg.mil.

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Last Modified 1/28/2010

Security Levels

Office of Work-Life Programs - Critical Incident Stress Management

Office of Work-Life Programs -
Critical Incident Stress Management