|Tresa Martinez, MSSW CEAP
Municipal Bldg., Room 308/310
215 Martin Luther King Jr. Blvd.
|Patrick Nottingham, MA
Employee Assistance Specialist
What is a critical incident?
A critical incident is a situation experienced by a person that may cause them to experience unusually strong emotional reactions that have the potential to interfere with ability to function during the incident, immediately following the incident or later. A situation does not have to be a major disaster to be classified as a critical incident. The following are examples of some critical incidents:
- the serious injury of death of a member of the public while an employee is performing regular duties
- the serious injury or death of an employee on or off duty
- the suicide or homicide or unexpected death of an employee
- an event associated with prolonged and extraordinary input in rescue efforts
- any incident which can be considered a serious physical or psychological threat to an employee while on duty
- any incident in which there is unusual media coverage
- a series of incidents that may have cumulative effects
- any abnormal event in which circumstances are so unusual or so distressing as to produce immediate or delayed emotional reactions that surpass normal coping mechanisms
Goal of CISM
CISM services are not counseling or a therapy but rather, it is a system of services in which the normal recovery process to abnormal events are facilitated or supported through individual or group processes. The process in which individuals, who have been exposed to an abnormal event, share their experiences has generally been found to be helpful. Myths or attitudes that individuals should be able to "tough it out" have been found to be less helpful and are more likely to lead to abnormal responses or prolonged recovery to such events.
Importance of Response
It is important that all departments respond to a critical incident and that employees involved in the incident receive the referral or offer of these services in a timely manner. The number one factor in an employee's ability to recover from a critical incident is the amount of support they perceive from the organization. When an employee believes s/he experienced a critical incident for which no referral or offer of services has been made, s/he may request services through her/his supervisor or the Employee Assistance Program (both internal and external).
EAP/CISM staff are involved in planning and also provide orientation and training to employees, managers, supervisors and union representatives.
During the Incident
1. On-scene stress management services help with preventing or reducing acute stress reactions at the scene of major incidents.
- The effects of stress creep up on emergency personnel at the scene because everyone is involved in managing the situation and doing their jobs. The first signs of stress are usually internal and include loss of concentration, memory problems, thinking difficulties, nausea and minor tremors. These are usually suppressed by personnel as they get on with their jobs.
- Continued exposure may cause:
- intense nausea
- stomach cramps
- visual distortion
- tactical errors
- loss of emotional control
- difficulty in understanding and communicating with co-workers
- feeling overwhelmed with the challenges of the task
- inability to grasp scope of the disaster
- decrease in concentration
- When an individual acts differently than "usual," this is often an indication of a stress reaction.
2. Exiting Incident/Demobilization: includes help for relieving stress shortly after a critical incident.
- Demobilization is a process in which crews, as they are released from the scene, go to a Center for a few minutes of rest, food, drink and to sign off the scene. They will get updated information, announcements and appreciation for services provided.
- A very brief (10 minute) stress information presentation (defusing) is done, which includes what to look for and what to do over the next 24-72 hours to manage stress. A defusing is an opportunity to remind personnel of useful techniques to reduce the immediate effects of a critical incident.
- A handout sheet is given out covering the above and listing phone numbers of support personnel and mental health professionals. Finally, EAP/CISM staff will provide a debriefing schedule or indicate debriefing schedules will be coordinated and announced as soon as possible.
A debriefing is a way of reducing the impact of a critical incident. It can accelerate normal recovery in normal people experiencing normal reactions to abnormal events by giving them information, skills and support.
- All personnel at the scene or others indirectly involved attend a confidential 2-3 hour group or individual session typically held 24-72 hours after the incident.
- At the session personnel have an opportunity to talk about their role in the incident, identify stress reactions in order to develop specific skills in coping with reactions, and learn about resources for further assistance.
EAP/CISM staff are available to provide follow-up services to personnel and family members.
All individual referrals and the content of a defusing or debriefing session shall remain strictly confidential. The only exception is when, under extraordinary circumstances, an employee is believed to be an imminent threat to the safety of him/herself or others. Occurrence of a debriefing session, session content, or mention of any of the participants to anyone outside of the session is prohibited. No report will be made to management and no formal documentation will be maintained. Individuals are free to discuss the event and their own feelings with others, but there shall be no discussion of the defusing /debriefing with anyone no in attendance.
The referral procedures are as follows:
1. Any employee who has direct involvement in or knowledge of an incident and feels that a critical incident individual or group debriefing would be helpful may contact a:
- designated department contact person
- Employee Assistance Program (EAP) internal or external staff to request debriefing services.
2. Contact will then be made with the EAP/CISM staff to further determine the need for a debriefing.
- If a debriefing is appropriate, either an individual (one-one) debriefing would be scheduled with the individual or scheduling and referrals for group debriefings would be coordinated by EAP/CISM staff and the involved department(s).
3. Department supervisors, a designated department contact person or EAP/CISM staff may request a debriefing. If a debriefing (individual or group) is appropriate, the aforementioned procedure is followed.
Arrangements will be made by management to have employees attend the debriefing on paid time.
Follow-up or referral to other appropriate services will be provided by the debriefing team for debriefing participants who need additional services.
Recognizing that incidents which give cause for a debriefing session are frequently unique to and occur within different occupational work environments and that contact persons and procedural approaches to accessing services will vary, departments may, consistent with overall City policy, choose to develop departmental procedures to implement this policy.
For more information on CISM, see Administrative Procedure Memorandum #2-15 or contact Tresa Martinez at 266-6561.
- Video Library
- Understanding Deployment on Service Members and their Families (PDF)
- Journey Mental Health Crisis Line:
- EAP Coordinator:
Tresa Martinez (608) 266-6561
- Employee Assistance Specialist:
Patrick Nottingham (608) 266-6561
- Program Support:
Bill Wick (608) 266-4961