Critical Incident Stress Management Chuck Russo, PhD American Military University Daytona Beach Police Department SPS Group, LLC July 2011 FBI NAA Summer Conference

Chuck Russo, PhD Professor –AMU Police Officer –Daytona Beach PD Team Leader –RDBHAT (ESF-8) Team Member: –Volusia County CISM –Daytona Beach PD CISM

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Identify the importance of dealing with critical incident stressors –Psychological and physiological responses related to traumatic stress Addressing how to break the code of silence Goal of Presentation

Critical Incident Stress Management (CISM) is a brief intervention utilized to mitigate the stressors associated with exposure to a traumatic event CISM is frequently confused with Critical Incident Stress Debriefing (CISD) –Debriefing just one component of the overall response What is Critical Incident Stress Management?

Stress and Law Enforcement Police officers address their sworn duties and responsibilities with dedication and valor Sometimes the compounded stresses of daily tragedies can become overwhelming and can lead to personal and professional stressors Other first responders tend to respond to critical incidents in a team structure; police officers frequently do not

Sources of Stress and Law Enforcement Organizational/administrative stressors Daily field/job related stressors Interaction with the criminal justice system Personal stressors including the co-existence of the officer’s personal life and their professional life

How Has Law Enforcement Become More Stressful? Unfortunately with current reductions in community resources, officers are faced with more complex emergencies Community policing has intensified the level of responsibility placed on officers Police officers have to react quickly to solve a multitude of problems

How Does Stress Impact Law Enforcement Officers? Heightened divorce rates Substance dependence/abuse Depression Financial difficulties High rates of suicide

Critical Incident Stress & Traumatic Stress Critical Incident Stress = Traumatic Stress These terms are frequently used interchangeably A critical incident usually occurs suddenly, is disturbing, or is an unusually challenging event that generates a strong emotional and/or reaction

Examples of Critical Incidents Events that overwhelm an individuals normal coping mechanisms –Officer involved shootings –Line of duty injuries/deaths –Incidents when a child is a victim –Incidents involving death/serious injury to others –Disasters –Employee suicide

Impact of Traumatic Stress Engaging in response efforts during a critical incident is often stressful for all those involved in emergency response efforts; regardless of the responder’s ability to acknowledge the impact of their involvement

Impact of Traumatic Stress While this type of work is personally rewarding and challenging, it also has the potential for affecting responders in negative psychological and physiological ways

Commonly Recognized Definition of Stress The most commonly accepted definition: Stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize

Definition of Traumatic Stress In the line of duty, first responders are trained to utilize tactical strategies in crisis situations, and they are quick to respond to protect the lives and property of those they serve Unfortunately, a hidden danger is often ignored: TRAUMATIC STRESS!

What is Traumatic Stress? Precipitated by stressors that include sudden, disturbing, or unusually challenging events that generate a strong emotional and/or cognitive reaction Stressors Include: –Gruesome crashes –Homicides –Vicious crimes against a child/children –A close personal brush with death/injury –Officer involved shooting Return

Psychological and Physiological Responses to Traumatic Stress Exposure and side effects to traumatic stress are individualized and may include: Physical symptoms Psychological symptoms Reoccurrence or re-victimization can occur if the first responder does not address the symptomology

Physiological Responses Examples encountered may include: Increased fatigue – poor sleep and/or nightmares Headaches Muscle twitches Unexplainable body aches and pain Gastrointestinal distress

Physiological Responses Additional examples encountered include: Weight loss or gain Grinding of teeth Chest pain Difficulty breathing Elevated heart rate and blood pressure

Psychological Responses Examples encountered may include: Emotional detachment Withdrawal from social situations Mood swings, anger and aggression Intrusive thoughts/obsessive compulsive behaviors Anxiety, panic attacks, and nervous energy

Additional Psychological Symptoms More examples encountered may include: Attention difficulties Feelings of helplessness/hopelessness Burnout Depression Grief Interpersonal difficulties

Exposure to Traumatic Stress Often challenges an individual's sense of: Sense of self-worth or self-esteem Personal safety or sense of control Impairs an individual’s ability to control their emotions Increases their feelings of vulnerability

Frequent Exposure to Traumatic Stress Can lead to hypervigilance: A heightened state of alert; whereby an individual is constantly awaiting additional real or perceived threats An individual is constantly on guard and this is also referred to as increased arousal

How to Alleviate Symptoms Associated with Traumatic Stress? Engage in: Debriefing Defusing Seek peer or supervisory support Speak with a chaplin Access EAP

Minimizing the Effects of Traumatic Stress Goal: To facilitate a normal recovery process To restore an individual’s level of adaptive functioning to their normal state of functioning

CISM Definition of a Critical Incident The Role of CISM What CISM Does Not Do How CISM Helps the First Responder The CISM Team

Break Time We will begin again in 5 minutes.

Definition of a Critical Incident A critical incident is defined as: A sudden or disturbing event That generates a strong emotional and cognitive reaction

Critical Incidents Examples encountered in may include: Officer involved shootings Line of duty injuries/deaths Incidents when a child is a victim Incidents involving death/serious injury to others Disasters Employee suicide

What is CISM CISM is: Early psychological support for First Responders

Goals of CISM To mitigate the impact of the event Facilitate normal recovery processes Restoration to adaptive function

Role of CISM To provide: Temporary Active Supportive Confidential Assistance to aid the individual in crisis

What CISM Does Not Do CISM is NOT a function of/to: Professional standards/internal affairs Determine fitness for duty Determine if policy was followed Determine if state law was followed Pass judgment on someone’s actions

How CISM Helps First Responders CISM helps by providing: One-on-one peer support Demobilization of information Crisis management briefings Defusing Critical incident stress debriefings

One-on-One Peer Support Peer support is provided to individuals: Mitigate symptoms Return to previous level of functioning Provide referrals if needed

Demobilization Information This occurs: At shift disengagement To inform and consult Provide psychological decompression Stress management Typically occurs in large groups

Crisis Management Briefings This occurs: At anytime post crisis To inform and consult Provide psychological decompression Stress management Typically occurs in large groups

Defusing This occurs: Post crisis (within a 12 hour time period) To address symptom mitigation To assist with providing possible closure Triage of services and presenting symptoms Typically occurs in small groups

Critical Incident Stress Debriefing This occurs: Post crisis (occurs within 1-10 days, 3-4 weeks following mass disasters) Facilitates psychological closure To address symptom mitigation Triage of services and presenting symptoms Typically occurs in small groups

Advantages of a CISM Team Temporary Active Supportive Confidential Assistance to aid individuals involved in crisis situations

CISM Team The CISM Team consists of: Team Coordinator Team Leader Team Members Mental Health Professional Police Chaplin Volunteers

Member Training Specialized crisis intervention training Small or large group crisis tactics Recommended 50 to 80 hours of crisis intervention training in specialized areas

CISM Team Team members: Have a responsibility and duty to keep information confidential Shall not accuse or blame others of wrong doing Shall refrain from engaging in any discussion involving responsibility or blame

CISM Team Activation Responsibility of On-Scene Commander Notify the CISM Team Coordinator of: –Officer involved shootings –Employee suicide –Mass casualty incident –Death or life threatening injury to a child –Incidents producing a high level of immediate or delayed emotional reaction

When Activated Team members should: Avoid direct involvement in the incident Make contact with the involved employees Separate the employee from the scene if approved Ensure involved employees are allowed to contact family members if desired Assist the involved employee until stabilized

When Activated Team members should ensure employees: Are allowed to stabilize/calm down in a private environment Permitted to shower and change when approved for such action Have clergy and other spiritual needs met Have food and drink if desired Encouraged to seek follow up counseling, if needed

Consequences of Failure to Address Critical Incident Stress Negatively impacts all involved Can lead to faulty decision making Increased disciplinary problems

Consequences of Failure to Address Critical Incident Stress Excessive use of sick leave, tardiness, and on- the-job accidents Increased citizen complaints Re-occurring officer turnover

CISM Is for the employee experiencing a normal reaction to an abnormal event Is to help the employee recover quicker from such an event Is temporary, active and supportive Is confidential

Every year, hundreds of officers experience intense, traumatic events that can have serious long-term consequences for them, their families, and their departments.

It is incumbent upon police administrators to ensure that their officers and their departments have the tools at hand to cope with such.

Conclusions Discussed the importance of dealing with critical incident stressors immediately following the traumatic event Identified the deleterious impact of psychological and physiological stressors on first responders who frequently encounter traumatic stress

Conclusions Discussed the importance of seeking CISM services to break the code of silence among first responders

Questions Questions concerning CISM should be directed to: Daytona Beach Police Department CISM Team Chuck Russo, PhD