CISM Application In An Activated Emergency Operations Center
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(Video)
Overview
Presentation Details:
This presentation will be prerecorded followed by a live breakout session with interactive activities and facilitated conversation. The content will include educational information on the particular types of stress that comes with disasters and impacts an activated Emergency Operations Center environment. Whether that EOC is a government agency, a private business or a school system, the work is impacted by the intensity of the task at hand. Emergency Managers of all kinds often see themselves as immune since they are not in the field dealing hands-on with victims or survivors.
The reality is they are at times more prone to disaster stress than their counterpart first responders. The appropriate use of CISM activities are designed to keep people productive, not take them off line. Just like trickle charging a battery, effective in the moment disaster stress management can help ensure good judgement and appropriate decisions are being made. This workshop will use case studies and facilitated conversation to explore this topic.
Learning Objectives:
- Participants will examine the unique stressors in an EOC environment
- Participants will be able to differential between Disaster Stress Management on Disaster Mental Health
- Participants will increase their knowledge of deploying to an activated Emergency Operations Center
Related products
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Overview
Health and safety legislation exists to protect the mental health of workers, including those at high risk of psychological injury, by separating the responsibilities between the worker (for self and others) and the manager (for the work environment). However, the traditional clinical viewpoint seems to ignore this in favour or seeing all psychological injuries as phenomena in need of medical, psychiatric or psychological expertise once symptoms have emerged and persisted. For example, symptoms of posttraumatic stress disorder (PTSD) have to await the passage of 28 days before diagnosis and treatment, while health and safety law demands immediate action. As crisis intervention is designed for immediate action and clinical guidance requires a delay, crisis intervention appears to be in keeping with legislation created to secure mental health. The tension that exists between the clinician’s advice to ‘watch and wait’ and the peer’s compulsion to ‘act now’ might be resolved by a psychological risk assessment undertaken in the immediate 28 day post-incident period.
Risk assessment for any health condition has three steps: 1. Identify the hazard, 2. Intervene to minimise or eliminate the hazard, and, 3. Monitor to ensure the intervention has worked. An online portal that measures depression, anxiety and PTSD and reports results to the completer themselves has several advantages. First, the assessments can be the same as those likely to used by the clinician should symptoms persist and recovery does not occur. Second, the completer is now aware of their likely condition and the level of risk exhibited by the scores. Third, the organisation can be informed of the overall levels of mental health by demographic variables including team, department and location. With information shown to the worker and statistical patterns shown to the manager both carry their own legal responsibility to act to ‘minimise or eliminate’ the hazard represented by high scores on clinical assessments.
Taking the discrepancy that exists between the clinical viewpoint and the crisis intervention viewpoint a secure online portal has been designed to meet the health and safety demand for risk assessment by informing the worker themeslves (with contact details for support and guidance), informing the organisation’s managers of ‘hot-spots’ of mental health hazards in the workplace and putting both ‘on notice’ that they should now act. The ‘I didn’t know’ claim to justify inaction would become invalid for both parties. This presentation will show how the backdrop of health and safety legislation justifies the use of crisis intervention following critical incidents. It also offers a means by which workers can self-assess and decide how they will tackle the risk they have been informed of, In addition this will allow managers to shape the workplaces structure and policies in light of the patterns emerging from the de-identified data generated by the workers collectively. The potential to use the data generated to underpin mental health policy, identify training needs and show the effectiveness of crisis intervention will be discussed.
Learning Objectives:
Upon completion, participants will be able to:- Recognise key indicators that return to duty is safe following a critical incident
- Assess risks to mental health in compliance with workplace safety and health legal demands
- Complete assessment, intervention and return-to-duty within 28 days of a critical incident
Presenter
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John Durkin, MSc. PhD
STAGE-28 International
John Durkin Ph.D sits on the Boards of the International Critical Incident Stress Foundation (ICISF), Crisis Intervention Management, Australasia (CIMA) and is co-director of STAGE-28 International offering training, research and consultancy in crisis intervention and psychological risk assessment. His interest in posttraumatic growth took hold in his early career as a firefighter and was later strengthened by his role in the post-9/11 support effort at New York’s fire and police departments. Convinced that critical incident stress management (CISM) delivered by peers had the potential to prevent a number of mental disorders he sought enhancements that might challenge clinical therapies for effectiveness. Further qualifications and training persuaded Dr Durkin that peers delivering crisis intervention in a person-centered fashion would prove superior to standard treatments for PTSD and facilitate posttraumatic growth. A number of pilot projects have supported this and led to training a team of firefighters in CISM, informed by person-centered theory. When Dr Durkin was called to lead the crisis response for the Metropolitan Police Service following London’s 2017 terrorist attacks and Grenfell Tower fire, the same team of firefighters came in support. Over 80 police officers were seen and no report of PTSD or depression had been received three years later. Growth in police officers and firefighters has been widely reported and awaits empirical confirmation in future projects. The legal demands of occupational safety and health were met during this period leading to the design of a psychological risk assessment for use in the emergency, medical and military services.
Handouts
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Overview
I’m a volunteer firefighter. It’s been twenty fives years but I can still see the young mans face as he lay there void of life at a motorcycle crash during my first year of service. I think that’s why it took me 25 years to figure things out. I compartmentalized everything to survive. It took years to let those barriers relax enough for my experiences to blend and realize I can help other first responders.
In the volunteer model there’s no-one there to follow up to see how providers are managing the stressors after a call. The responder goes back to empty firehouse and then home. There was nothing in place to mitigate or manage a “bad” call. The connection of seeing my dog at the door when I came home from a bad call was powerful. I didn’t understand the science, I just knew how it made me feel. Call after all and year after year I continued to receive healing comfort from the many dogs that lived with me and the ones that crossed my path.
The purpose of this presentation is to reach as many first responders and provide them with tools to mitigate or interrupt the process of PTS/PTSI.
There are four levels of intervention in this model. In level one and two the dog belongs to the handler responder and trained and certified at the therapy dog level and exposed to the components present in debriefing and various settings. Level 3 uses puppies. Most are obtained from breeders.
There are several different organizations that provide services dogs and they all have their own different ways of doing so. Some use rescue dogs, others use breeders. Each has pros and cons. The ideal breed for service is the breed with which the handler is most comfortable. Any breed is suitable for service, but the requirements for temperament are not. Temperament is critical and cannot be compromised. Again, keeping the mantra of “safety” in mind is key. If the responder/handler is afforded a safe environment (which becomes mobile with a service dog), this process becomes life changing and all possibilities are on the table.Level 1. K9 CISM
To provide peer debriefings for fire fighters, EMS personnel and police; essentially providing Critical Incident Stress Management support for first responders who have experienced trauma — in the line of duty, during active duty or after leaving service – in order to attempt to prevent the onset of PTSI using the Mitchell model of peer support.
To support various first responder agencies to create preventative support strategies to head off PTSI before it takes hold, by creating safe places to process traumaLevel 2. Therapy/”Mobile Service” (1:1 – K9 Team: Responder)
Handler uses their personal therapy dogs for those who require K9 intervention, but for some reason are not able/do not want their own dogLevel 3. PTS Service Dogs
To network with breeders and trainers in order to provide affordable service dogs to first responders, veterans and others who suffer with PTSI who are in need of PTSI Service Dogs. The canines are puppies obtained from established selected breeders and provided to handler at minimal cost.
The puppy is in handlers possession at 8 weeks, then to trainer for 1-2 week B/T for polishing and detailing4. Education
To speak to as many groups as possible to educate in PTSI prevention in high risk environments in order to be able to access what ever services are needed when the time comes.Learning Objectives:
Upon completion, participants will be able to- Know the two hormones stress reduction and production.
- Know the five levels of K9 Intervention.
- Know the difference between “PTSD” and “PTSI”.
Presenter
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Michelene L. McCloskey, EMT, FF, EMSI, K9 Handler
EMT, FF, EMSI, K9 Handler
K9 PTS Intervention
With over 20 years of service as a Fire Fighter/Emergency Medical Technician, 20 as a CISM provider and 14 as an Emergency Medical Services Instructor, Michelene became the Coordinator of the Animal Response Team in her home town of Chester County, PA after hurricane Katrina. In 2015 she became the event manager for a local Search dog team and has since founded K9 PTS Intervention, an organization providing interventions in many different models to responders traumatized in the line of duty or during active duty.
Handouts
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Overview
Crisis responders, peer supporters, and caregivers have entered into the world of COVID crisis and trauma. They experience the worst of situations many only read about or see through electronic media. They enter into COVID crisis day after day and hour after hour. Distress and the results of this high level of stress are a constant companion and the ramifications are life altering for most of these providers of care in crisis. Research, education, and training have taught them that stress mitigation is an essential part of their survival. Self-care is fundamental to being a crisis responder and building resiliency is not an option. Unfortunately, most crisis responders have only learned and practiced the physical and emotional aspects of building resiliency, and sometimes they have found it lacking. Rest and exercise, diet and hydration– these are the physical essentials for building resiliency. Building a strong system of social support, catharsis, and reinterpretation – these are some emotional essentials for building resiliency. What if there’s more? What if there are untapped resources for enhancing the resiliency we try to build? What if you could develop a few habits that could multiply your ability to be resilient even through the worst events and times of your life? What is you could do it without going to the gym, without spending a lot of money, or without having to go to a therapist? It can be done. Transformational resilience can happen!
Transformation is not a change brought about by simply doing good or improving our behavior. Imagine a person who is undernourished, sickly, and pale, but who puts on makeup to improve their appearance. They may look healthier, but the makeup is only cosmetic, something externally applied. What they really need is a genuine change that results from a life process within.
If that same undernourished, pale person were to eat healthy, nourishing food, a noticeable change would begin to occur. Their color would improve and their body would be strengthened. Eventually, their appearance would become healthy not because of something they did outwardly, but because of something that changed inwardly.Transformation occurs at the cellular level – the lump of coal, under a great deal of pressure, becomes a diamond. The coal does not become fluorescent nor does it change color – it becomes completely different matter with different characteristics, value, and purpose. Coal does not pretend to be a diamond; it completely becomes a diamond.
NEED THIS PRESENTATION ADDRESSES:
Today, responders face a myriad of COVID challenges on a regular basis. These challenges may be physical, emotional, operational, organizational, financial – in addition to relational, personal, spiritual, mental, behavioral, etc. Unfortunately, most crisis responders have only learned and practiced the physical and emotional aspects of building resiliency, and sometimes they have found it lacking.Each individual may experience COVID challenges differently. However, each responder has the ability to transform his or her present self into a healthier self by using the pressure of the COVID crisis to transform characteristics that will enhance resilience.
PURPOSE OF THIS PRESENTATION:
To teach crisis responders, peer supporters, and care providers to enhance resilience at the cellular level in a COVID world.PRESENTATION CONTENT:
1. Presentation includes a broad survey of factors that influence resiliency – internal, external, and personality characteristics.
2. Based on the principles of self regulation, actions to choose responses that will enhance resilience will be presented through data, anecdotes, and research.
3. A final action plan with responses, action required, and stress/resilience benefits will be presented.Learning Objectives:
Upon completion, participants will be able to- Understand pandemic’s unique stressors
- Describe traditional and transitional resilience
- Describe strategic application of transformational resilience tactics
Presenter
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Naomi Paget, BCC, DMin, FAAETS
Rev. Dr.
K-LOVE Crisis Response Care / FBI
Rev. Dr. Naomi Paget BCC is the Chair, National VOAD ESCC. Her work in disasters/crises has officially spanned 55 years with Red Cross, FBI, SBC Disaster Relief, ICISF, National VOAD and other crisis relief agencies. Instructor, curriculum writer, awarded Fellowship in American Assoc. of Experts in Traumatic Stress and Fellowship in the National Academy of Crisis Management, she is a published author and K-LOVE CRC and ICISF Approved Instructor for many crisis and trauma courses, consulting for several national and international organizations. She is an adjunct professor at Denver Seminary and Gateway Seminary. She has written several courses in peer support, crisis intervention, and chaplaincy which receive contact hours from Crown College. She received the Life Time Achievement Award from ICISF and from Southern Baptist Disaster Relief, and Distinguished Alumni Award from Golden Gate Baptist Theological Seminary.
Handouts
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Overview
The International Association of Campus Law Enforcement Administrators (IACLEA) featured the above named article in the 2021 Winter edition of their Campus Law Enforcement Journal. The action plan described in the article is consistent with recommendations from the National Consortium on Law Enforcement Suicide: Final Report, published October 1, 2020. ‘Unspoken Questions’ refers to the reluctance to and/or avoidance of asking direct and specific questions, due to concerns of stigma and negative occupational impact, that can occur when a law enforcement employee experiences a personal mental health issue. Despite being generally aware of available mental health services, skeptical perceptions exist regarding accessing mental health care. For the agency, this skepticism contributes to the suspicion of intent and general distrust among employees. Consequently, the specific and direct questions may never get asked and remain ‘Unspoken Questions’. The worst case outcome is death by suicide or ‘loss of a whole life’. Another tragic result is that an employee may continue to experience the pain and despair of unresolved mental health issues, ‘the loss of a partial life’. This bold action plan challenges agency leadership to demonstrate organizational commitment by endorsing two separate transparent trainings that call for the integration of command staff and designated human resources representatives in the actual training in order to provide a forum for employees and give a voice to those ‘Unspoken Questions’.
Learning Objectives:
Upon completion, participants will be able to- Be instrumental in leading an agency-wide culture committed to promoting physical and mental health and wellness.
- Play a critical role in the agency’s transparent integrated approach to ensure that suicide prevention is prioritized and that norms and practices that support mental health and wellness are integrated into every aspect of policing.
- Be more capable to support efforts to reduce law enforcement deaths by suicide and eliminate the stigma associated with law enforcement personnel who experience mental health issues.
Presenter
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Kevin W. Condon, LCSW, BCD
Owner
Law Enforcement Response to Mental Health, LLC
Kevin W. Condon, Licensed Clinical Social Worker (LCSW), Board Certified Diplomate (BCD). In June of 2002, Kevin retired from the Coral Gables (FL) Police Department (CGPD) as a lieutenant with over 25 years of service. He served as Commander of the Crisis Negotiation Team and SWAT Team. Kevin participated as a member of a CISM team for emergency responders serving Miami-Dade County. Kevin received the CGPD Life Saving Award for his interaction with a person with a mental illness.
Following his retirement, Kevin moved to Georgia and began a second career as a mental health professional. He held positions as a community Child and Adolescent therapist, Clinical Director of a State of GA residential program, and therapist at the University of Georgia. In March of 2018, after over six years with the Department of Veterans Affairs (VA), Kevin retired from the position of LCSW.
Kevin is certified by Georgia Peace Officer Standards and Training Council (P.O.S.T.) as a Lecturer on Law Enforcement and Mental Health. He is a certified instructor for Mental Health First Aid - Public Safety. Kevin has developed and presented training courses on issues of law enforcement and mental health.
Kevin has been recognized as a Subject Matter Expert (SME) on law enforcement and mental health by the Collaborative Reform Initiative-Technical Assistance Center. CRI-TAC is a partnership with the Department of Justice's (DOJ) Office of Community Oriented Policing which is implemented under the leadership of the International Association of Chiefs of Police (IACP).
In November of 2018, Kevin founded ‘Law Enforcement Response to Mental Health, LLC’. He provides training, consultation, and presentations related to law enforcement and mental health. During Kevin’s early years as a law enforcement officer, he experienced his own mental health issues. Kevin shares his personal journey in the interest of ‘paying it forward’.
