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Critical Incident Stress Management (CISM) Team

A Critical Incident Stress Management Team is a partnership between mental health professionals and emergency or other high-risk workers who are interested in preventing and mitigating the negative impact of acute stress on themselves or other workers. They are also interested in accelerating the recovery process once an emergency service person or a group has been seriously stressed or traumatized.

This valuable team has conducted and participated in numerous debriefings with their respective peers. Events in which required team activation included police-involved shootings, sudden deaths of coworkers, suicide investigations and other stress related incidents.

A CISM team meeting is comprised of both mental health professionals and peer support personnel. In a typical scenario, an incident, which is predominately police or corrections oriented, is worked by police or corrections peers with support of mental health professionals. Members of the Sheriff s CISM Team follow the International Conference of Critical Incident Stress Debriefing model.

Definitions:

Critical Incident Stress (CISM):

Responding to a scene and becoming overwhelmed by what one sees, hears, touches, feels, or smells;
Normal people suffering normal reactions at an abnormal event.

Post-Trauma Defusing:

The defusing process is implemented immediately (at least 1 - 2 hours) after the traumatic event, lasts approximately 20-45 minutes and is conducted at a neutral site, free of distractions. Team members typically respond to the scene of the traumatic incident and coordinate the defusing effort.

Goals of the Defusing Process include the mitigating the impact of the event, accelerate the recovery process, assessment of the need for debriefings and other services, and to reduce the cognitive, emotional and physiological symptoms.

Critical Incident Examples:

• Incidents involving deaths
• Mass casualty incidents
• High risk events and visible scenes
• Shooting incident
• Rescues
• Captive or hostage situation
• Serious traumatic event

Debriefing:

The CISM may be defined as group meetings or discussions about a traumatic event, or series of traumatic events. Persons involved in such incidents may experience short or long-term psychological consequences which, if ignored, may lead to long-term difficulties in an individual’s professional and personal life. Providing peer support immediately after the traumatic event can minimize the effects.

The Debriefing is NOT psychotherapy. It is a structured group meeting or discussion in which personnel are given an opportunity to discuss their thoughts and emotions about a distressing event in a controlled, structured and rational manner. They also get to see that they are not alone in their reactions and that others are experiencing the same reactions. The debriefing is usually scheduled 24 to 72 hours after the event and is peer driven and therapist guided for approximately 1.5 to 3 hours. The ideal is to have a defusing session followed by a debriefing, if necessary.

Confidentiality:
Confidentiality is vital. Notes are not taken and comprehensive reports are not kept. CISM members are restricted from revealing the content of what is discussed at defusing and debriefing sessions. Confidentiality may be broken only when:

• a participant demonstrates a clear and present danger to themselves or another;
• a participant discloses participation in a crime