Bolling AFB

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Bolling AFB
CRITICAL INCIDENT STRESS MANAGEMENT
Chaplain, Lt Col Dave Wilshek 11
WG/HC 767-8558 This briefing is
classified UNCLASSIFIED
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CRITICAL INCIDENT STRESS MANAGEMENT
Ch Dave Wilshek
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What is Critical Incident Stress Management?

A comprehensive approach to traumatic stress
management containing many special programs and
strategies including pre-incident education,
significant other support programs, debriefings,
demobilizations, defusing, on-scene support
services, follow-up services, community outreach
programs.
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What is Critical Incident Stress Management?
continued...

• Individual consults, peer counseling informal
  discussions, crisis intervention training,
  disaster preparedness, and disaster assistance
  programs. (International Critical Incident
  Stress Foundation)

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What is the rationale for Chaplain Services
involvement in CISM?

• People Most important resource for military
  readiness.
• Demand CCs want chapel personnel to do
  something and the community wants answers to
  why and what now questions of lifes
  meaning, NOW!

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What is the rationale for Chaplain Services
involvement in CISM?

• Ministry of Presence Entwined with the
  community through work, play, and worship
  presence of the Holy in a myriad of unholy
  situations.
• Known Helping profession willing to participate
  in the praise and laments of people.
• Offering Spiritual healing that restores hope,
  trust and community.

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Goals of CISM

• Promote spiritual health/well-being of
  victim/survivor
• Mitigate critical incident stress impact on life
  function
• Empower through acceptance/use of available
  resources
• Implement Crisis Management Intervention
  strategies

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Goals of CISM continued...

• Assist in the return to effective coping skills
• Educate and Celebrate, Counsel and Console
• Avoid loss of hope, trust and community

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Which people are most affected by crisis and
trauma?

• Primary victims - Those directly traumatized by
  the event
• Secondary victims - Emergency services personnel,
  eyewitnesses
• Tertiary victims - Family and friends

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How do people react to crisis and trauma?

• Full range of human emotions
• No set standard
• Depends upon the individual

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What does PEP stand for?

• PEP stands for
• Pre-event
• Event
• Post event

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CRISIS STAGES

• Pre-event Time when the environment / persons
  are in a general state of normalcy.
• Event Stressful / Traumatic incident has
  occurred that overwhelms victims normal coping
  abilities.
• Post-event Persons coming out of crisis and
  moving to resume baseline level of functioning.

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CISM STAGES

• Pre-event Pre (inter) vention - Preparation and
  training time.
• Event Enter (inter) vention - Active but
  temporarily entry into the life situations of
  group, family or individual during critical
  incident.
• Post-event Post (inter) vention - Continue
  pastoral care and follow-up.

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CISM STRATEGY

• Pre-event Pre-Vention-Prepare the way.
• Train staff.
• Educate the community, analyze,
  assessments/intervention methods currently in
  place.
• Establish a CISM Interdisciplinary Team -
  Chaplains, Doctors, Nurses, Social Workers,
  Psychologists, Firefighters, Policemen and Family
  Support Personnel (as a minimum).

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CISM STRATEGY continued...

• Event Enter-Vention - Incarnational Ministry
• Crisis Assessment Continuous process
• On-scene support services Direct support,
  one-on-one while event is in process
• Group Processes
• CISD Critical Incident Stress Debriefing
• Defusing
• Demobilization
• Support Groups

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Post-Event Post-VentionWalk through the
Valleyof the Shadow of Crisis

• Unit and Commander contact
• Phone Calls
• Memorials / Rituals
• Support Groups continuing
• Debriefing debriefers
• Referrals
• One-on-Ones

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The Assessment

• Name Crisis Event What happened? Who is
  involved? What is the perceived threat / loss?
• Reactions to Event - Physical, Emotional,
  Cognitive, Behavioral
• Pastoral care resources
• Community resources

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The Assessment continued...

• Victim (s) Needs LEAP
• Listen Who/Where are victims?
• Expect Primary Victims Direct impact -
  casualties.
• Anticipate Secondary Victims - in contact with
  primary victims, emergency responses.
• Plan for Tertiary victims - impacted vicariously
  - family, friend, unit, chapel personnel.

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The Assessment continued..

• Intervention Steps (DEPEND)
• Define the problem
• Ensure victim safety
• Provide support
• Examine options / resources
• Negotiate course of action
• Dispatch plan
• Assessment review
• Special Concerns

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I. DEMOBILIZATION PROCESS

• Usually conducted at the scene or near the scene
  by trained peer support members who are known by
  the personnel.

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GOALS

• Give information about C.I.S.M. to personnel.
• Evaluate functional status of personnel prior to
  their return to duty.
• Provide references/contacts for personnel in the
  event they need assistance later.
• Act as informational support for the command
  element.

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GUIDELINES

• Time frame - 10-20 minutes.
• Personnel should be out of services break or
  shift over.
• Conducted by peer support members known by the
  personnel.
• DO NOT discuss feeling. Return to work with
  coping abilities in place.

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The EndAny Questions?