Office of Work-Life Programs -
Critical Incident Stress Management
Call the Employee Assistance Program Coordinator in your regional Health,
Safety, and Work-Life (HSWL) office to access CISM services.
List of EAPCs.
To access the CG SUPRT Program, call 1-855-CGSUPRT (247-8778)
Who is Eligible for this Program?
The Critical Incident Stress Management
program is applicable to the following members of Team Coast Guard:
- Active Duty, Reservists and their dependents
- Civil Service employees
- Exchange
System and MWR employees
Purpose of Program
The Critical Incident Stress Management (CISM) program is
intended to help individuals exposed to critical incidents to identify and
cope with their responses to these events. The focus of CISM is to provide
“psychological first aid” and to minimize the harmful affects of job stress,
particularly in crisis or emergency situations. Critical Incident Stress
Management includes pre-incident training and post-incident services.
Program Confidentiality
The Employee Assistance Program Coordinator will ensure
CISM confidentiality and effectiveness. No team member shall make any
written notes during or about a CISM intervention. An after action report
may be used by team members only to discuss at team meetings as to lessons
learned about the intervention process. The after action report shall be
very generic and shall not include names or any specifics about the
intervention.
Definitions
The following definitions apply to Critical Incident Stress Management
Program:
- Critical Incident - Any event with sufficient impact to produce significant
emotional reactions now or later. It is generally considered extremely
unusual in the range of ordinary human experiences. Examples of critical
incidents include the following:
- Crew members death in line of duty
- Children’s
death or serious injury
- Multiple fatalities or seriously injured
survivors
- Suicide, successful or attempted
- Natural disasters
- Class A or B
mishaps involving death or permanent injury and otherwise high emotional
impact
- Use of deadly force
- Grotesque injuries
- Acts of terrorism
- Acts of violence
resulting in injury or death
- Observing any traumatic event
- Critical Incident
Stress Debriefing (CISD) - A group meeting intended to:
- Acknowledge both
potential and realized traumatic reactions to the event or incident
- Stabilize
and mitigate the impact of acute symptoms/signs of distress following the
exposure
- Assist individuals to evaluate their own responses in terms of the
impact on their current occupational functioning and the possible need for
ongoing referral/treatment
- Encourage the mitigating effects of peer group
support and interaction in the workplace
- Facilitate participants’ use of
social, emotional, and psychological resources available to them
To maximize
effectiveness, a debriefing should normally occur 24-72 hours after an
event. CISD usually uses all team members. It is not therapy even though a
mental health professional is part of the team.
- Critical Incident Stress Defusing - Small group process, usually no more
than 30 minutes, ideally done within 8 hours after a critical incident.
Purpose is:
- Rapid reduction in the intense reactions to a
traumatic event
- “Normalize” the experience so people can return to their routine duties
as quickly as possible
- Re-establish the group’s social network so people do
not isolate themselves from each other. In recognizing similarities to
others, people often are more willing to help each other in troubled
times
- Provide information on acute stress and a few reminders about how to
reduce it
- Assess group’s response to determine if a full debriefing should be
scheduled
- Critical Incident Stress Management (CISM) - A
system of interventions designed to mitigate the adverse psychological
reactions that may accompany critical incidents. The CISM process is not
therapy; its focus to minimize the harmful affects through psychological
first aid, education and follow-up. The CISM process uses trained peers,
chaplains, and mental health professionals, and is managed by CISM Team
Coordinators who are usually the Employee Assistance Program
Coordinators (EAPC) located at Work-Life Centers
- Critical Incident Stress Management Team - The Critical
Incident Stress Management team normally consists of:
- Team Coordinator
- Mental
Health Professional
- Chaplain, and
- Peers, all of whom have been trained in Peer
Support CISM.
The EAPC coordinates, manages, and deploys the CISM Team.
-
Comprehensive Soldier Fitness - A structured, long term assessment and
development program to build the resilience and enhance the performance of
every Soldier, Family member and DA civilian. This website is still under
construction but looks very promising and worthy of a bookmark. The program
is described in the April 2011 edition of the
Harvard Business
Review.
- Demobilization - Demobilization’s are generally used during a
disaster or in a large-scale catastrophic critical incident. A primary
stress prevention and intervention technique, it is applied immediately
after personnel are released from the scene and before they return to normal
duties. Its two segments are, first, a 10- to 15- minute talk and, second, a
20 - minute rest and eating session. The purpose is to provide an
opportunity to 'decompress' before moving to the next assignment, provide
practical suggestions for stress management and offer an avenue to those
experiencing critical incident stress effects to receive further
assistance.
- Follow-up Services - If CISM provides initial services
post-incident follow-up is considered to be essential. The Employee
Assistance Program Coordinator is responsible for ensuring follow-up
services are provided or accessible.
- On–Scene Support Services - Services
provided under “on-scene” conditions are brief, practical crisis
intervention functions designed to limit the level of distress members
encounter. On-scene support does not interfere with operations. These
service providers usually are peers, with chaplains or mental health
professionals called only as needed.
- Psychological First Aid - The basic
human responses of comfort and consoling a distressed person; protecting a
person from further threat or distress, as far as is possible; furnishing
immediate care for physical necessities, including shelter; providing goal
orientation and support for specific reality based tasks (“reinforcing the
concrete world”); facilitating reunion with loved ones from whom the
individual has been separated; facilitating some telling of the “trauma
story” and ventilation of feelings as appropriate for the particular
individual; linking the person to systems of support and sources of help
that will be ongoing; facilitating the beginning of some sense of mastery;
and identifying the need for further counseling or intervention. (Raphael et
al., 1996, pp. 466–467)
Services and Resources Available
The following services and resources are available within the
Critical Incident Stress Management program:
- Anniversary Meetings
- Command Consultation
- Critical Incident Stress
Debriefing
- Critical Incident Stress Defusing
- Demobilization
- Family Crisis
Intervention
- Follow-up Services
- On-Scene Support Services
- Pre-Incident Training
- Stress
Continuum Trifold
Requesting Services or Resources
CRITICAL INCIDENT REPORTING
To request CISM services, commanding officers and officers in charge can
notify either the area or district command center, which will in turn notify
the Health, Safety, and Work-Life Office in your region. In general, CISM services or resources can be obtained
by contacting the Employee Assistance Program Coordinator (EAPC) on your
Regional Work-Life Office. Work-Life Staffs are located at Integrated Support
Commands CG-wide and at the Headquarters Support Command.
Program References
The following reference provides details of the Critical
Incident Stress Management Program:
Related Web Sites
The following web sites provide information related to the
Critical Incident Stress Management Program:
- American Red Cross - Provides disaster-related information and
resources. Includes a
Disaster Online Newsroom on current
disasters.
-
Army Study To Assess Risk and Resilience in Servicemembers
(STARRS) - Army STARRS is the largest study of mental health
risk and resilience ever conducted among military personnel.
This site already has many resources and links worth exploring
and promises to add more over the 5-year span of this important
study.
- Centers for Disease Control and Prevention (CDC) -
Emergency
Preparedness and Response. This site includes links on each type
of natural disaster: earthquakes, extreme heat, floods,
hurricanes, landslides and mudslides, tornadoes, tsunamis,
volcanoes, wildfires, and winter weather. Very comprehensive
with lots of useful just-in-time information.
-
Center for the Study of Traumatic Stress - Provides a wealth
of information helpful to both individuals and communities
dealing with the effects of critical incidents. Includes an
excellent collection of just-in-time
fact sheets.
-
Comprehensive Soldier Fitness - The mission of this
Army site is to "develop and institute a holistic fitness
program for Soldiers, families, and Army civilians in order to
enhance performance and build resilience." Includes a ton of
great resources for commands, trainers, military members, and
families.
-
Defense Centers of Excellence (DCoE) for Psychological
Health and Brain Injury - DCoE’s mission: assesses, validates,
oversees and facilitates prevention, resilience, identification,
treatment, outreach, rehabilitation, and reintegration programs
for psychological health and traumatic brain injury to ensure
the Department of Defense meets the needs of the nation's
military communities, warriors and families. This site has many
helpful links related to assisting persons impacted by critical
incidents.
-
Employee Assistance Program
Coordinator (EAPC) - The EAPC within HSWL is
responsible for coordinating responses, in collaboration with
appropriate commands.
-
Federal Emergency Management Agency (FEMA) - The Federal
government’s main website for current disaster-related
information. Contains many pages of useful information and
links.
-
Incident Management Handbook - Click on Library > Incident
Command System > scroll to Job Aids.
-
Insure You Can Save a Life! - A commercial insurance locator
service’s great collection of links. It provides excellent
information regarding a number of health and safety issues such
as CPR, extreme weather, swimming safety and first aid.
- International Critical Incident Stress Foundation - The
premier organization dedicated to helping communities and
agencies respond to critical incidents.
- National Institute for Occupational Safety and Health
(NIOSH) - Phone: 1-800-35-NIOSH. Provides many resources on the
subjects of Workplace Safety and Health including Emergency
Preparedness and Response.
-
National Integration Center (NIC) Incident Management
Systems Integration Division (FEMA)
-
Navy and Marine Corps Public
Health Center Portal - a great resource for all things related
to promoting healthy living and resilience. One of the best
sites available for those looking to make changes for themselves
as well as for those who are in the business of
advising/training others. Literally covers related subjects from
A to Y. A very well organized site.
-
Navy Operational Stress Control (OSC) Official Blog Site -
Has tips and ideas for controlling stress. Be sure to scroll to
the cartoons. This is a new site that will be developed further.
Note: the social media links do not work on CG computers.
-
Psychological First Aid: Field Operations Guide
- this site
is sponsored by the Veterans Administration’s National Center
for Post Traumatic Stress Disorder. It provides a wealth of
just-in-time information including a great collection of
related
handouts.
-
Substance Abuse and Mental Health Services Administration
(SAMSHA) - This Department of Health and Human Services website
offers plenty of Mental Health and CISM-related resources
including separate pages on Disaster Readiness and Response, the
National Center for Trauma-Informed Care, and Suicide
Prevention.
-
U.S. National Response Team (NRT) - The National Response
System is the government's mechanism for emergency response to
discharges of oil and the release of chemicals into the
navigable waters or environment of the United States and its
territories. The CG’s National Strike Force is a key part of the
NRT.
- U.S. Office of Personnel Management (OPM) -
A Manager's
Handbook: Handling Traumatic Events, February 2003
Point of Contact
The Employee Assistance Program Coordinator within HSWL is responsible for
coordinating responses, in collaboration with appropriate commands. Click
here to find the number to your EAPC. If you
need additional assistance, contact
the Headquarters Employee Assistance Program Manager, Ms. Lisa Teems,
CG-1112, at (202) 475-5157, Fax: (202) 475-5907 or email at
Lisa.A.Teems@uscg.mil.