Critical Incident Stress Management

Critical Incident Stress Management (CISM) is a program specially designed to help people cope up with harrowing events and experiences. It is focused on immediate and identifiable problems so as to help an individual to return to their daily routine faster experiencing little post traumatic stress or disorder.

It is a highly structured, formal and professionally recognized process to give the required help to those who strictly requires it after learning about their experiences, emotions, reactions and symptoms. This is an educative process and not a psychotherapy that involves confidential and voluntary, and is often known as ‘psychological first aid’. It involves allowing the victims to talk about the incident without passing any judgment or criticism.

Critical Incident Stress Management

The main purpose of CISM is to help people to overcome their stress and to return to their normal levels of functioning without any intervention from the past. Those who have suffered a critical incident may most likely suffer from strong emotional reactions. The people involved in the process come from all walks of life so as to extend a helping hand. But most of them are either first responders or who are already experienced in working in the field of mental health.

Here are some of the worst critical incidents scenarios that have been listed by Emergency services:

1) Line of duty deaths.
2) Suicide of a colleague.
3) Serious work related injury.
4) Multi-casualty/ disaster/ terrorism incidents.
5) Events with a high degree of threat to personnel.
6) Significant events involving children.
7) Events in which the victim is known to the personnel
8) Events with excessive media interest.
9) Events that are prolonged and end with a negative outcome.
10) Any significant powerful, overwhelming distressing event.

To deal with various types of situations there are various interventions and can be used for families, groups, individuals and in the workplace. First, is the Critical Incident Stress Debriefing. It is an intervention that involves group discussion, meetings, etc about a particular incident and focuses on helping people to accelerate their recovery process by lessening the impact of the distress. This intervention is conducted in between 24 – 72 hours of the crisis and the people involved are generally professionals and experts who are well-trained.

Secondly, Defusing, which is a less formal intervention and is shorter, which lasts from 30-60 minutes and is conducted within 4 hours of the occurrence of the crisis. At the most, this may extend up to 12 hours. It is similar to that of debriefing and is confidential and voluntary opportunity to learn about stress and share the reactions of the victims. Their primary effort is to alleviate the affected people, a formal debriefing may also be required.

Thirdly, is the ‘Grief and Loss Session’. Here the group of people or individual involved tries to create a healthy atmosphere of openness and dialogue and assist people in understanding their grief following a death.

Fourthly, Crisis Management Briefing, a large, homogeneous group intervention, which is used, to present facts, assist a brief, controlled discussion, Q & A and info on stress survival skills and other available support services, throughout and after the crisis.

Last but not the least is the Pre-Crisis Education, that provide a foundation for CISM services, which includes, crisis response strategies, incident awareness and develops stress management coping skills. It is a form of an employee handbook, e-book and/or workshops and training seminars, which can prevent major problems, should an incident occur.  

In critical incident stress management programs, other services such as pre-incident education, on-scene support, demobilization debriefings and specialty debriefings are also introduced. CISM was first developed for military combat veterans and civilian first responders such as police, fire, ambulance, emergency workers and disaster rescuers who faces immense psychological hazard. But it has now been used whenever the need to address traumatic impact on a person’s life arises.