EMS/Fire
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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
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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
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
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
The purpose of this presentation is to shed light and start the conversation of addressing PTSD in the 911 telecommunications profession. In 2015 I was working as a police dispatcher for Boston police, and successfully managed an officer involved shooting. While I received many awards for how I managed the situation, the fallout of PTSD and lack of support had me making the difficult decision to leave 911 altogether in order to address my mental health. During my journey of healing, I came to the realization that the 911 field was my passion, and that dispatchers everywhere are lacking the support needed in order to continue in the field. I’ve now been back in the filed for 4 years. In addition to sharing my story, I’ve applied my experience to working on NENA’s Wellness Committee, specifically the Peer Support sub-committee, and the Acute Stress working group. Locally, I attended the Group and Individual Counseling Training, and applied to be a part of the local CISM team, which recognizes the important of including 911 personnel for defusing and debriefings. I am currently the point of contact for my agency. Recently, myself and other 911 professionals on the team have been meeting to discuss the 10 top calls for dispatchers, as well as discuss how we can spread the word that CISM teams in our area is a resource available to all dispatchers. In addition to walking viewers through my story – the initial call, the PTSD fallout, and the steps I took to change my mindset and heal – I want to be able to present the dispatcher’s point of view in handling critical incidents, and how agencies can help stop burnout and high turnover by providing resources to their dispatchers.
Learning Objectives:
Upon completion, participants will be able to:- Identify problems 911 professionals face on the job
- Understand how they can contribute to changing the conversation about PTSD in first responders
- Identify obstacles 911 personnel face utilizing a CISM team
Presenter
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Nicole Janey
Emergency Communications Supervisor
Chelsea Emergency Management
Nicole has been working in the 911 field for 15 years. Highlights of her career include working the Boston Marathon Bombing and the ensuing week, as well as successfully managing an officer down call. Following that event, she took a break from 911 in order to address the PTSD. She returned to 911 with a passion for all things related to 911 mental health and wellness, and is particularly focused on spreading the word about the effects of PTSD in the 911 community, and the need for better support and services for our personnel. She is also involved in the Greater Boston Law Enforcement CISM team, and the National Emergency Number Association. She is active in several subcommittees within NENA's wellness continuum. As a side project, she is currently curating “You Are Not Alone: Portraits of the Gold Line Family” , a photography project that seeks to put a face to all members of the 911 profession, and showcase how everyone is effected by the job, regardless of role.
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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
