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
The current spotlight on policing and law enforcement issues is focused mainly on urban departments rather than rural areas. Ironically, the majority of police agencies across the nation are not in large cities, but small or rural towns. In 2013, 71% of all police departments served jurisdictions of fewer than 10,000 residents, and 30% served communities of less than 2,500 residents. About half of law enforcement departments have fewer than ten officers (Weisner et al., 2020).
The U.S. Census Bureau (2016) defines rural areas as less dense and sparsely populated than urban areas. Ninety-seven percent of the United States’ landmass is rural. About one-fifth of the population, sixty million people, inhabit rural areas; many are employed in agriculture, forestry, mining, and manufacturing, sectors that are plagued by declining job opportunities. Rural areas tend to be impoverished and do not have the tax base to fund social programs, including police and public safety adequately. As a result, rural agencies are underfunded, understaffed, often undertrained, and lack the necessary equipment. (Ricciardelli, 2012). Rural agencies face challenges in training opportunities, access to resources, types of crimes, interaction with citizens, degree of scrutiny, inferior technology, and mutual aid access, and cooperating overlapping jurisdictions e.g. Native American, federal and local.
Rural areas are often characterized by conservative values, aversion to government interference and authority, a tendency to exert social control among their own, and higher gun ownership that urban areas. Crimes related to wildlife, agriculture, and hate groups are common. Of necessity, rural police departments tend to have a unique culture and way of doing things depending on local history, demographics, size, and budget. (Weisheit et al, 1994).In addition, because rural agencies are generally spread over large geographical areas and sparsely populated areas, response times are measured not in minutes, but hours. With few resources and more area to cover, they are spread thin. Consequently, big city solutions to policing issues are often not relevant to small town and rural police departments.
A sheriff’s deputy explains: “When our department goes to trainings in the big cities we just sit there. What they are teaching is not relevant to our daily operations. They have departments for every job. In rural policing we see and touch it all. Any of us could be first on scene at a traffic collision or a homicide. We’re search and rescue, the coroner, the victim advocate at the scene of domestic violence, the family therapist, the sex crimes investigator, and the ones who evacuate people from wildfires.”
Although the study of rural agencies has been largely neglected, it is essential as the profession faces upheaval. Rural policing is plagued by a lack of material resources, limited staffing, and vast response areas with limited back up. Rural officers also face mental health issues such as depression, anxiety, PTSD symptoms, and suicidal ideation similar to urban officers. These issues may be exacerbated by isolation, cultural barriers, and unique organizational expectations. Geographical location and long shifts often limit access to mental health services. Emerging advances and ongoing research in interventions such as telehealth and existing treatment modalities such as peer-support groups and critical incident stress management (CISM) may prove to be a bridge in closing the gap for this underserved population.
The purpose of this paper, while not comprehensive in addressing the myriad issues that are relevant to rural policing, will elucidate the stressors unique to rural law enforcement agencies and the peace officers who serve in them. Additionally, methods to increase resiliency and stress management will be proposed.References
– Ricciardelli, R. (2018). “Risk it out, risk it out”: Occupational and organizational stresses in rural policing. Police Quarterly, 21(4), 415-439. https://doi.org/10.1177/1098611118772268
– U.S. Census Bureau (2016). New census data shows differences between urban and rural populations. https://www.census.gov/newsroom/press-releases/2016/cb16-210.html
– Weisheit, R. A., Falcone, D. A., & Wells, L. E. (1994). Crime and Policing in rural and Small-Town America: an overview of the Issues. National Institute of Justice Rural Crime and Rural Policing, 2(2). https://www.ncjrs.gov/txtfiles/crimepol.txt
– Weisner, L., Otto, H. D., & Adams, S. (2020). Issues in Policing Rural Areas: A Review of the Literature. Criminal Justice Information Authority. https://doi.org/10.13140/RG.2.2.10290.76489Learning Objectives:
Upon completion, participants will be able to- To be able to identify five challenges faced by rural law enforcement .
- Describe five implications of the challenges.
- Identify three specific applications to help remedy the challenges.
Presenters
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Marilyn J. Wooley, Ph.D.
Psychologist
West Coast Posttrauma Retreat
Marilyn J. Wooley, Ph.D. is a clinical psychologist who has a private practice in semi-rural Redding, California. Her primary focus is treating first responders and their families, treatment of post traumatic stress injuries, pre-employment psychological evalutions, and crisis response. Marilyn teaches Mitchell Model CISM through the International Critical Incident Stress Foundation. She is actively involved with the First Responders Support Network and has regularly served as a volunteer lead clinician for the West Coast Posttrauma Retreat in California since 2001. Her published articles include the topics of crisis response, first responder resilience, critical incident stress, and surviving the 2018 Carr Fire. She is currently writing a manuscript about post-traumatic growth in first responders and a biography about her grandfather's experiences liberating Dachau Concentration Camp during WWII. Marilyn grows roses and enjoys adventures with her husband, daughter, and two brilliant grandchildren. She has survived skydiving, SCUBA diving with sharks, summitting Mt. Shasta, swimming a class IV rapid while attempting to whitewater kayak, and belly dancing at a biker bar.
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Shaneika Smith, MA
Psychological Assistant
West Coast Posttrauma Retreat
Shaneika Z. Smith currently resides in Redding, CA. She is a Clinical Psychology doctoral Student at Fielding Graduate University. Prior, she attended the University of Chico where she earned a B.S. and M.S. in psychology with an emphasis on Marriage Family Therapy. Shaneika became interested in working with first responders when she began a practicum with Dr. Marilyn Wooley in 2018. She quickly became affiliated with the West Coast Posttrauma Retreat where she provides treatment services for law enforcement, fire, communications dispatch, and medical personnel. She plans to continue her training in CISM and working with families of first responders while she pursues her doctorate in Psychology.
Handout
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Overview
By taking the ICISF Assisting Individuals in Crisis and Group Crisis Intervention courses, we, as mental health professionals, have learned how to provide assistance to First Responders after a Critical Incident. But what if they seek our help with none crisis issues, do we treat them the same as we would any civilian who comes to us for help? The answer is a resounding NO! As with any special group, we must take into consideration the “cultural issues” of the group and adjust our clinical interventions to acknowledge their difference. This seminar is a quick look at some of the specifics of first responders and the cultures of their profession and some ideas on adapting our clinical interventions to meet their needs.
Learning Objectives:
Upon completion, participants will be able to:- Identify 3 key aspects of a first responder culture
- Identify 2 unique stressors in each first responder culture
- Identify 2 adaptations they might make in their clinical approach to working with first responders in their practice setting
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
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Overview
Background for this Presentation:
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:- List 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 Distinquished Alumni Award from Golden Gate Baptist Theolocial Seminary.
Handouts
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Overview
Power point presentation to include the St Luke’s response to the COVID-19 Pandemic with specific attention to the mental health of our 22,000 network employees in our major University Healthcare network. How we identified needs, what we did to address needs, and what we continue to do to ensure the mental and physical health of our hospital employees. Attention to PTSD, Acute Trauma, Acute stress reactions. How we have supported our nextwork from the mental wellness aspect in order to mitigate long term critical incident stress disorders.
Learning Objectives:
Upon completion, participants will be able to- Verbalize 3 programatic elements they can add to their care of hospital, healthcare, first responder employee mental health.
- Plan live, large support group sessions for hospital and first responder personnell.
- Name evidenced based depression and trauma scales that can be used during and after pandemic or prolonged stress.
Presenter
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Amie Allanson-Dundon, LPC,CCTP,CAADC
Network Director, Clinical Therapy Services
St Luke's University Health Network
Amie Allanson-Dundon, MS, LPC, CFAS,CCTP, CCDPD, CAADC is Network Director, Clinical Therapy Services for Behavioral Health Services at St Luke’s University Health Network.. Focused on the treatment of substance use disorders, trauma, critical incident stress, and mood disorders, Amie assesses and supervises complex cases, consults with network physicians, and is a lead for the Crisis Response Team at St Luke's. Working with St Luke's University Health Netowrk since 1997, Amie oversees the clinical programming and teams for School Based Psychotherapy, Partial Hospitalization services, Outpatient therapy and Integrated mental and physical healh care. Amie is also Program and Facility Director for the DDAP certified and DOH approved level 4.0 Medical Detox at St Luke's Sacred Heart Campus in Allentown Pa. Amie completed her graduate work at Villanova University, has certifications in trauma, addiction, forensic addiction and is a licensed professional counselor in PA & NJ.