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Trainer’s Corner: February 2008

Critical Incident Stress Management is a technique used to help trauma victims work through the period immediately following the event. While there are varying schools of CISM practice, all work toward helping victims return to a normal life as soon as possible while reducing the chances they will suffer long-term, post-traumatic stress disorder.

For our purposes, a critical incident is any situation that causes emergency personnel to experience unusually strong emotional reactions that limit their ability to adjust and negatively impacts their work and home environments. Tragedy, trauma, gruesome injuries, fatalities, serious incidents involving children and line-of-duty deaths are just some of the incidents that can cause critical-incident stress. How well people handle these situations depends on their mental and emotional states at the time of the incident. Whatever is happening, your personal life may impede your ability to cope with situations which, in your opinion, you always handled well in the past. Because each incident affects us in a unique way, do not measure your reactions to a critical incident against the reactions of your peers. Remember that CIS symptoms are a “normal reaction to an abnormal
situation.”

Tragedy, trauma, fatalities and incidents involving children can cause post-traumatic stress.

On-the-job stress is one of the most serious psychological hazards facing emergency service personnel. Among dispatchers, the causes of stress are everywhere. The work-a-day dispatching job is stressful and incidents involving deaths, injuries or other emotional events can create even more stress. Co-workers – not just supervisors and managers – must realize what might trigger a stress-related reaction, anticipate the effect and intervene. This will ensure that all dispatchers receive the attention and treatment they need.

It is believed that emergency services workers deal with a stress response similar to that seen in war.

There are many methods to deal with a stress response syndrome. One such method is known as Critical Incident Stress Debriefing or CISD. A CISD is an organized approach to the management of stress responses in emergency services. It entails either an individual or group meeting between the rescuer and a caring individual(s). The CISD model uses a team of 50 per cent mental health professionals and 50 per cent peer support de-briefers. The goal of the CISD is to protect and support emergency services personnel and to minimize the development of abnormal stress-response syndromes, which may cause lost time and effectiveness at work and problems within the family.

What is a critical incident? Any incident that causes an individual to experience unusually strong emotional involvement, and to have a  reaction that has the potential to interfere with that individual’s ability to function during or after the incident, may qualify for a CISD.

The sidebar on page 34 lists some of the symptoms a person may experience following a critical incident. These symptoms are temporary and may last from several days to a couple of weeks. If the symptoms last longer than several months it is important to seek professional help.

It is imperative that we understand that CIS can affect anyone on the job from the recruit to the 30-year veteran. Needing some type of assistance does not mean that you are not good at what you do.

Although most of us express a fear of taking the job home, chances are our families and friends will bear the brunt of our reaction to the incident. The symptoms of CIS may be more obvious to the people who care about you than they are to you. Although you may not think that you are experiencing stress or need to attend a defusing/debriefing, we encourage you to participate. Your presence may help someone else in the debriefing. Coming together and talking about the incident is the first step in dealing with it and may often be the only step required.

CIS can happen to anyone and the symptoms can be different from person to person. Remember, don’t compare yourself to others. These are normal reactions to an abnormal situation and these kinds of incidents affect us all differently, depending on our mental, physical and emotional states, as well as our personalities. Never feel afraid or embarrassed to seek help.

Please understand that the information provided here is general and is not intended to be used as a substitute for appropriate professional advice.

Until next time let’s protect our greatest resources, our members, training them like their lives depend on it, because it does.  

TIPS FOR COPING
WITH CRITICAL-INCIDENT STRESS

What you can do

• Get plenty of exercise.
• Structure your time; keep busy.
• Avoid alcohol and drugs as they can complicate the problem.
• Talk to people; don’t clam up.
• Spend time with others and reach out to people (family, friends, clergy, co-workers etc.).
• Try to keep a regular schedule.
• Give yourself permission to feel rotten but also do things that make you feel good.
• Don’t make any life-changing decisions but do make daily decisions to give you a feeling of control.
• Recurring thoughts, dreams or flashbacks are normal; try not to fight them. These episodes will decrease over time and become less painful.
• Eat a well-balanced diet and eat regular meals.

What family and friends can do

• Listen carefully
• Spend time with the affected person.
• Don’t take anger or moods personally.
• Offer care and concern, even if the affected person doesn’t ask you for help. Give the affected person private time and reassure them they are safe.
• Don’t tell the affected person he or she is lucky
• it wasn’t worse. Traumatized people are not consoled by these statements. Tell them you are sorry this incident occurred and you want to try to understand and help.

Ed Brouwer is the chief instructor for Canwest Fire in Osoyoos, B.C., and the training officer for West Boundary Highway Rescue. The 18-year veteran of the fire service is also a fire warden with the B.C. Ministry of Forests, a first responder, level III, instructor/evaluator and fire-service chaplan. E-mail: ed@thefire.ca