1. Chapter 13 Providing Emotional Support 13-1

2. Introduction An organization is defined by the people who make it up Recent push for improving our health and wellness The Fire and Life Safety Initiatives have devoted an initiative to address responders’ physical health (Initiative 6) and a separate initiative to their emotional health (Initiative 13) Note the ties between the physical and psychological sides of human beings 13-2

3. Life Safety Initiative 13 Firefighters and their families must have access to counseling and psychological support 13-3

4. Life Safety Initiative 13 STRESS Overview Physical strains Emotional strains Adrenaline Long term effects Short term effects Cont. 13-4 Photo courtesy of Bob Gahr

5. Life Safety Initiative 13 STRESS Coping with stress Must be able to accept the facts Must be prepared Impossible to not be affected Alcohol abuse Drug abuse Cont. 13-5

6. Life Safety Initiative 13 STRESS Failure to cope with stress Likely to bring on severe depression Police officer study in 2008 Must expose causes, signs and symptoms of stress 13-6

7. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Overview Only officially labeled in last 30 years Early human stresses Webster’s 1913 dictionary Railway spine Cont. 13-7

8. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Overview Acute stress disorder (ASD) Precursor to PTSD Generally lasts less than a week Some proceed with no intervention Cont. 13-8

9. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Overview PTSD could include Avoidance Seclusion Flashbacks Change in eating and sleeping habits Cont. 13-9

10. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Signs and symptoms Categorization Re-experiencing Avoidance Hyperarousal Cont. 13-10

11. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Treatment Psychotherapy Counseling as an avenue for healing Traditional psychotherapy Group therapy Individual therapy Cont. 13-11

12. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Group therapy Overview Brief group therapy Bottling it up proven to be ineffective Discussion encourages healing Handbook of Psychotherapy and Behavior Change Cont. 13-12

13. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Group therapy Alcoholics Anonymous (AA) Meetings Similarities to fire departments Single share Cross-talk Closing Cont. 13-13

14. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Group therapy Critical incident stress management (CISM) Pre-incident CISM Incident response Post-incident response AA and CISM differences Cont. 13-14 Courtesy of Scott Beveridge, Observer-Reporter

15. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Group therapy Psychological first aid (PFA) Effectiveness of CISM Effectiveness of PFA Primary psychological victims Secondary psychological victims Cont. 13-15

16. Life Safety Initiative 13 POST TRAUMATIC STRESS DISORDER (PTSD) Individual therapy Mental health support Employee assistance programs (EAP) Chaplains Available Approachable Adaptable 13-16

17. Life Safety Initiative 13 THE FUTURE Overview Relative anonymity Texting Complete anonymity Web based program Support system Include family members 13-17 Courtesy of Erica Ziegler

18. Summary Psychological stress of emergency scenes can be as severe as the physical stresses CISM has evolved into a successful form of group therapy We need to research, obtain, and implement instruments such as CISM, EAP, and chaplaincy programs Improve the tools we have, and invent the ones that don’t yet exist 13-18