Understanding First Responder Cultures for Mental Health Professionals
$9.99
(Video)
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:
- 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.
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Overview
Learning Objectives:
Upon completion, participants will be able to:- 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.
Handouts
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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
This presentation outlines the findings of a small yet impactful study exploring the experiences of Peer Support Workers in an Irish Fire based EMS organisation. It was noted that there was a gap in the literature pertaining to the voices of those first responders who provide peer support to their colleagues and so a qualitative research approach utilising semi structured interviews was carried out. Interpretative Phenomenological Analysis was used to examine the results and findings revealed four master themes, namely Giving Back, Old versus New, Personal Transformations and Frustrations. These, along with their twelve superordinate themes, will be presented using direct quotes from participants transcripts. Much of the research on peer support in first responders reports the negative effects of critical incident stress but this study demonstrates that there are positives to be gleaned from this essential work. Reflexivity of the researcher will be described as it is of the utmost importance in this study and the quality of the work will also be addressed. Recommendations will be made on the implications for possible future research in this area.
Learning Objectives:
Upon completion, participants will be able to- Describe the ‘Shattered Vase’ metaphor.
- List some of the components of post traumatic growth.
- Outline the benefits and challenges of providing peer support in emergency services, from the peer supporter perspective.
Presenter
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Michelle L. O'Toole, BSc, GDip EMS, MA
Researcher (Former Firefighter/Advanced Paramedic)
Royal College of Surgeons in Ireland
Formerly a Firefighter, Advanced Paramedic and CISM Team member with Dublin Fire Brigade, Republic of Ireland, I was recently appointed to full time researcher role in the Simulation Dept of Royal College of Surgeons in Ireland. I'm an Accredited Paramedic Tutor and CISM Instructor with an interest in enhancing mental health and wellbeing in all first responders, particularly following traumatic events. I have completed a MAsters in Psychological Trauma at University of Nottingham (UK) which sparked my interest in Post Traumatic growth following adverse events. My presentation will be based on peer supporters perspectives of providing support in an Irish context.
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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.
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