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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
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.
- Comprehensive Soldier Fitness - A structured, long term assessment and development program to build the resilience and enhance the performance of every Soldier, Family member and DA civilian. This website is still under construction but looks very promising and worthy of a bookmark. The program is described in the April 2011 edition of the Harvard Business Review.
- 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:
- Anniversary Meetings
- Command Consultation
- Critical Incident Stress Debriefing
- Critical Incident Stress Defusing
- Demobilization
- Family Crisis Intervention
- Follow-up Services
- On-Scene Support Services
- Pre-Incident Training
- Stress Continuum Trifold
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 Office. Work-Life Staffs are located at Integrated Support Commands CG-wide and at the Headquarters Support Command.
Program References
The following reference provides details of the Critical
Incident Stress Management Program:
- Critical Incident Stress Management (CISM) - COMDTINST 1754.3A
- Traumatic Incident Management Program - DHS Management Directive 3062 (through Coast Guard workstation only)
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.
- Army Study To Assess Risk and Resilience in Servicemembers (STARRS) - Army STARRS is the largest study of mental health risk and resilience ever conducted among military personnel. This site already has many resources and links worth exploring and promises to add more over the 5-year span of this important study.
- 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 - Provides a wealth of information helpful to both individuals and communities dealing with the effects of critical incidents. Includes an excellent collection of just-in-time fact sheets.
- Comprehensive Soldier Fitness - The mission of this Army site is to "develop and institute a holistic fitness program for Soldiers, families, and Army civilians in order to enhance performance and build resilience." Includes a ton of great resources for commands, trainers, military members, and families.
- 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.
- Federal Emergency Management Agency (FEMA) - The Federal government’s main website for current disaster-related information. Contains many pages of useful information and links.
- Incident Management Handbook - Click on Library > Incident Command System > scroll to Job Aids.
- Insure You Can Save a Life! - A commercial insurance locator service’s great collection of links. It provides excellent information regarding a number of health and safety issues such as CPR, extreme weather, swimming safety and first aid.
- International Critical Incident Stress Foundation - The premier organization dedicated to helping communities and agencies respond to critical incidents.
- National Institute for Occupational Safety and Health (NIOSH) - Phone: 1-800-35-NIOSH. Provides many resources on the subjects of Workplace Safety and Health including Emergency Preparedness and Response.
- National Integration Center (NIC) Incident Management Systems Integration Division (FEMA)
- Navy and Marine Corps Public Health Center Portal - a great resource for all things related to promoting healthy living and resilience. One of the best sites available for those looking to make changes for themselves as well as for those who are in the business of advising/training others. Literally covers related subjects from A to Y. A very well organized site.
- Navy Operational Stress Control (OSC) Official Blog Site - Has tips and ideas for controlling stress. Be sure to scroll to the cartoons. This is a new site that will be developed further. Note: the social media links do not work on CG computers.
- Psychological First Aid: Field Operations Guide - this site is sponsored by the Veterans Administration’s National Center for Post Traumatic Stress Disorder. It provides a wealth of just-in-time information including a great collection of related handouts.
- 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. National Response Team (NRT) - The National Response System is the government's mechanism for emergency response to discharges of oil and the release of chemicals into the navigable waters or environment of the United States and its territories. The CG’s National Strike Force is a key part of the NRT.
- 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, Ms. Lisa Teems,
CG-1112, at (202) 475-5157, Fax: (202) 475-5907 or email at
Lisa.A.Teems@uscg.mil.
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Last Modified 1/26/2012