Military/Veterans

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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

    • 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

  • 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 trauma

    Level 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 dog

    Level 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 detailing

    4. 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

    • 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

  • 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

    • 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