CISM as the Standard of Care in Response to COVID
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(Video)
Overview
Learning Objectives:
- Estimate surge of mental health distress
- Define CISM
- Explain why CISM is the standard of care for COVID
Presenter
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George S. Everly, Jr., PhD, ABPP, CCISM
Co-Founder
The ICISF, Inc.
George S. Everly, Jr., PhD, CCISM is an award-winning author and researcher. In 2016, he was ranked #1 published author in the world by PubMed PubReMiner in the field of crisis intervention. He holds appointments as Professor in the Department of International Health (affiliated) at the Johns Hopkins Bloomberg School of Public Health, Associate Professor (part time) in Psychiatry at the Johns Hopkins School of Medicine, and Professor of Psychology at Loyola University in Maryland (core faculty). He is considered one of the founding fathers of the field of disaster mental health. He was a co-founder of the Dept of Psychiatry at Union Memorial Hospital and served on the management committee 12 years. In addition, he has served on the adjunct faculty of the Federal Emergency Management Agency, the FBI’s National Academy at Quantico, Virginia, and ATF’s Peer Support Team. He is an advisor to the Hospital Authority of Hong Kong. Dr. Everly is co-founder of, and serves as a non-governmental representative to the United Nations for, the International Critical Incident Stress Foundation, a non-profit United Nations-affiliated public health and safety organization. He was Senior Advisor on Research in the Office of His Highness the Amir of Kuwait. Prior to these appointments, Dr. Everly was a Harvard Scholar, visiting in psychology, Harvard University; a Visiting Lecturer in Medicine, Harvard Medical School; and Chief Psychologist and Director of Behavioral Medicine for the Johns Hopkins Homewood Hospital Center.
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Overview
“When everyone walked away Charlie stayed by my side.
Not coping to healthy coping, he brought me from sinking further into that dark downward spiral back up into the light and life”After losing 6 friends on my FD to suicide, I went to Chaplain Mario Gonzalez, the director of my peer support program and he called for a meeting with the clinical director. It was decided there was an obvious need and I was instructed to do a 3 month pilot study with Charlie at my station. That’s how the MDFR Response K9 program got started. It looked different back then but has grown into what it is today.
When I started doing research into the benefit of therapy and service dogs I decided certification was the way to go for our teams and our organization as we already had CISM training for the humans. It was through the connections with I.C.I.S.F. and our CISM training program that I ended up meeting Cindy Ehlers, an expert in the field of civilian canine crisis response and a K9 handler at the WTC site after 9/11.
After seeing the direct benefits as backed up by current research indicating therapy and service dogs play a role in resiliency and post traumatic growth we set up the program with 3 separate tiers for this specific responder program.
The purpose of this presentation is to promote an awareness of how crisis response canines can help both civilian and responder organizations and explain the differences in training and certification currently available for both.
There are three parts to the program:
(1) CISM Response K9
In this tier, the responder with his or her own trained K9 is an active member of the CISM Peer Support team. In all CISM settings the benefit to the recipients is the oxytocin release and immediate physiological responses for calming. The dogs help create a safe space for responders where its ok not to be ok and process what they just experienced.
We’ve noticed the dog can also become a focal point for people who are struggling to share. when the guys have a hard time talking they automatically start staring at Charlie.
its easier to look at a dog than other people when they have something difficult to say. the dogs can be a focal point for people having a hard time sharing and some have used Charlie as a shield to lean on when they flat out broke down. In a diffusing setting we expect the dogs to alert to mood changes when humans change emotions and pheromones are produced. In this way the dogs aren’t just a prop for people to look at, they become active participants in the diffusing.(2) Station Dogs
Because of cumulative trauma, station dogs are justified as reasonable to have something in place before and after each call as responders are not able to process the events of the last call before running the next call.
The expected benefits from long term exposure to the same dog include less time off from work, more cohesive crews, less discipline issues, etc.(3) Service dogs
To be able to provide personnel with service dogs that can provide healing to the soul, reduce symptomology and build the foundation of the person, not just the first responder.Learning Objectives:
Upon completion, participants will be able to- List why the use of trained certified canines are beneficial for responders in CISM/ Stress management roles
- Define and describe the training and certification criteria such as ethical care of canines, what advocacy really means, why learning how to read your canine’s signs are paramount in the training process, etc.
- Learn the best practices for using canines in CISM and stress management roles in First Responder organizations
Presenters
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Shawn Campana, CK9RT, CDT, CISM
Response K9 Coordinator for Peer Support Team
Miami Dade Fire Rescue
Captain Shawn Campana has worked for Miami Dade Fire Rescue for 24 years. She has been on the department's CISM Peer Support team since 2015. Shawn started a Response K9 program 5 years ago in response to the PTSD and Suicide Ideation epidemic that has impacted her fire department. She started the program with her dog Charlie who was also her service dog, and has grown the program into what it is today. The team has grown to 10 Peer Support handler K9 teams. She is looking forward to expanding the program to provide station dogs, and service dogs for firefighters, and continues to help other organizations implement their own Peer Support canine programs.
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Cindy Ehlers, D.N.C.C.M., CT, CFE, FT
Cindy Ehlers
Green Cross
Cindy’s passion is helping responders and civilians through the human animal bond. After responding to a high school shooting in Oregon in 1998, she developed and implemented programs utilizing dogs to reach at risk populations and those in crisis. In 2001, at the request of the American Red Cross, Cindy and three other handler/dog teams provided comfort on the ferry boats and provided respite foot responders at the WTC site. She has achieved diplomate status through the National Center for Crisis Management for her experience & contribution in the field of Canine Crisis Response and Animal Assisted Crisis Interventions. Cindy provides expert advice in the field of canine crisis response to both civilian and responder organizations. She is a member of ICISF, Green Cross and National Center for Crisis Management.
Handout
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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
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’.
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Overview
Presentation Details:
The Crisis Management Briefing is one of the most versatile interventions we have in our toolkit. Over the years, I have developed and refined a structure for providing this intervention so our team is providing it in a similar fashion. This seminar describes the structure and offers a video sample of the model. It might be helpful to organizing your own approach for this often under utilized tool
Learning Objectives:
Upon completion, participants will be able to:- Identify 3 reasons to utilize a structured CMB
- Identify the 3 steps in completing a CMB
- Identify 5 keyk teaching points in a CMB
Presenter
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Dennis Potter, LMSW, FAAETS
CEO
Kantu Consultants
Dennis Potter is a licensed social worker who helped to form one of the first community based Crisis Response Teams in Michigan in 1986 and the Michigan Crisis Response Association. Dennis is the CEO of Kantu Consultants. He is an Approved Instructor for all of the ICISF Core Courses, and is a member of the ICISF Faculty since 2006.
Dennis has been a presenter at the last 14 International Critical Incident Stress Foundation World Congresses. Dennis was awarded the ICISF Excellence in Training and Education Award at the 2011 World Congress. Dennis was given the Grand Rapids Police Department Exceptional Civilian Service Award for his 22 years of working with their Peer-to-Peer program.
Handouts