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Published byBrice Patterson Modified over 9 years ago
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Critical Incident Stress Management
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Why Prepare? “The psychological states of emergency response personnel can have a direct effect on the mental and physical health of survivors of a trauma or disaster” (Glass, 1956)
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Crisis An acute response to a Critical Incident wherein: – Psychological homeostasis has been disrupted – Usual coping mechanisms have failed – Some evidence of impairment is present
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Seven Basic Truths Many experiences can be traumatic Some are traumatic to some, but not to all Various factors may make some more vulnerable than others Traumas create reactions now and later Experiencing these reactions means the situation was serious for you Reactions sometimes get worse before they get better Sometimes they reappear later
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Crisis Intervention Urgent and acute psychological “first aid” characterized by: – Immediacy – Proximity – Expectancy – Brevity
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Goals of Crisis Intervention Stabilization of symptoms Mitigation of symptoms Restoration of independent functioning Facilitation to higher level of care if necessary
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Relative Intensity of Interventions Demobilization Defusing 5 Phase CISD 7 Phase CISD Reaction IntroductionInformation Exploration Reaction Fact ThoughtSymptoms Reentry Teaching
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Common Problems Failure to understand ingredients of CISM Failure to understand group processes Inappropriate timing of interventions Group size Group is too heterogeneous Incomplete instructions/expectations Participants rush from FACT to REACTION
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Common Problems Failure to return to the Cognitive level Doing psychotherapy instead of Crisis Intervention – Watch the “F” word Dwelling on past rather than current events Failure to provide closure Failure to follow-up
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Children & Trauma 2 – 6 Years Sleep disturbances Short and frequent expressions of sadness Tantrums Death is temporary Reunion fantasies Anxious attachment Reenactments Mute and withdrawn Regression
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Children & Trauma 6 – 10 Years Withdrawal of trust from adults Somatic complaints Regression/slowed maturation Behavior problems Expression through play and art Concentration problems Radical changes in behavior Savior fantasies
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Children & Trauma 10 – 14 Years Suppress thoughts and feelings Sense of meaninglessness of existence Somatic complaints Childlike behaviors and attitudes Symbolic interpretations Sense of foreshortened future
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What to do – Ways to be helpful Offer hope that alternatives are available. Avoid glib reassurances. Take action. Remove means such as guns and other weapons. Get help from persons or agencies specializing in crisis intervention and suicide prevention.
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Intervention Gather information: known stressors, family background, academic history, observable behaviors, child’s statements. Approach child: establish trust, show concern, offer self as a resource.
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Intervention Listen. Use normal speaking pattern. Keep questions gentle and respectful. Show concern with body language: posture, eye contact, position Do not promise confidentiality. Let him or her know what you’re going to do.
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