Is there anyone in here that is on a Critical Incident Stress Management (CISM) team? I have been on the NW Arkansas team for about 7 years. If so, how to you get people to talk about their 'feelings'? Also, does your department require a debriefing when something real bad happens?

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You are claiming that hurting someone's long-term mental health is worse than doing nothing??? That is flatly not the case. The entire basis of all medicine, including mental health care, is PRIMUM NON NOCERE...
"First, do no harm"

When you advocate that you "have to do something" even when that something has been shown to be useless at best and bad for the responders' long-term mental health at worst, then you are advocating for something that harms the recipients. We're supposed to be helping people, not hurting them. Your anecdotal "some people think it helps" does not rise to the level of scientific scrutiny of the studies that show that CISM doesn't work.

When you add the "false memory" problem that group debriefings add to responder stress, then it is easy to see how CISM is indeed harmful to a lot of already-stressed responders.

Stress relief can be like Hazmat. Sometimes, doing nothing is indeed the best response.

And... CISM has never been shown to have prevented a single fire or EMS suicide. We need to do the RIGHT thing to relieve responder stress - talk it out amongst ourselves if that relieves the stress and see a real mental health professional in a clinical setting if it doesn't.

When you ignore peer-reviewed research, you're essentially saying that you don't care what the science shows, you're going to keep on doing something just because of your personal opinion. That's a very dangerous tack to take with someone else's mental health.

Medicine - including mental health medicine - is based on science. Ignoring science is BAD medicine.

According to Dr. Bryan Bledsoe, a well-known EMS writer, researcher, and physican, CISM practicioners are like Vampire Hunters.
Claiming that CISM helps is like claiming that Vampire Hunters prevent Vampire infestations. The science shows otherwise, but that doesn't stop the claims.

Thus, Kali's request for you to show some peer-reviewed research that back your position. If you can't - or won't - find some science to back your position, then you're essentially arguing that Vampire Hunters are effective.

Hint: Dr. Bledsoe isn't from Kali's local area, or from mine.
He does read the nationally-available peer-reviewed research, though.

And, you have NOT "seen it work", because in the long term, it doesn't.
Aroma therapy "works" too! And people train long and hard (mustn't they?) to become Aroma Therapists.
It must work, 'Glade', 'Yankee Candle' et. al make a fortune by selling scented candles. But then, it's all anecdotal without any scientific and peer-reviewed data.

Wouldn't CISM be the chiropracty of Mental Health Science? Or would it be the Acupuncture of Medical Science, or perhaps the Feng Shui of Ergonomics, or the Trickle Down Theory of Economics, or is it just Voodoo? Who do that voodoo like you do that voodoo?

I am on a CISM team and there are a lot of good and valid points being thrown out in this forum. Its really too bad that we have to disagree and berate each other to get points across. While not being versed on the "studies or research" end of the process, I won't comment on that because I don't have the facts/references, I will say that there are good and bad elements out there in the CISM field. You have to watch how you go about things and do background on potential members. As for the money part, our team has been around just over 10 years now and we have not recieved a budget or any payment for service provided and we do not get paid by our respective fire, ems, pd, or mental health employers-and it works better that way. I do have to say that some people don't want to talk, and that's fine. Not everyone deals with pressure/stress the same way and that is what makes each of us unique. Let's remember that we are each different and that we need to respect each other. God Bless You All-Chaplain Mike.
And BTW you are NOT "one of my peers." Just the fact that you would presume that you are shows why the system you advocate is flawed.

How so? Are your peers only the people you work with or personally know? Wouldn't the majority of us on this site be considered peers, regardless if ever personally meeting? If on trial for a crime and facing a jury, is that not made up of your peers?
Well, thanks.
Now I'm going to have to go to Fire Barn and buy me some stylish self esteem.
My Ah-Hah moment just dipped to Uh-Oh.
Feel like a Partridge in a peer tree.
And I don't mean Shirley.
Most people use 'kid' gloves when trying to get their point across.
Kali uses the whole damn goat.
She's my personal hero role model peer leader assistant nightmare. She's ok.
Go to and check out the "HanderPants".
They're a glove; they're underwear for the hand.
Stick a pair in your bag.
When it comes to CISM teams, well I treat them the same way as news reporters. I politely turn them away at first. If they persist, I get real mean real fast. If I want to talk about something, it will be with one of my fellow officers or my wife, not someone who gets their rocks off hearing about someone elses pain.
Here we go again?? About what? I am just curious as to what you are considering as a peer. As I asked, wouldn't the majority be considered peers? I don't considered juniors a peer, but overall I would consider the majority a peer, regardless if ever meeting or not, even the ones I have vehemently disagreed with in the past on some issues, and even if they do have different training, etc.

In regards to this thread, the reason for asking is to ascertain what you are considering a peer, and the reason for putting the jury remark in there is the definition does vary. I have seen you generalize CISM teams off your own experience etc, and what you may have experienced can vary greatly and from what you state and what I experienced sound like night and day.

I do believe it has been the general consensus here that nobody likes to be pressured to talk and a CISD may not help everyone, but they have helped others and that is the point. Like I posted before I have been to a few CISD and never once had someone force you or even encourage you to talk, just that they were if you wanted to. As such some team members have been called at home and stuff because they wanted to talk, but not in the firehouse and found they couldn't talk to their spouse. Basically, you may not feel that a CISM is worthwhile, but others may, making generalized statements like CISM members do it for money or for their own ego is quite broad and insinuates most members have an ulterior motive and really is not the case.

Like I stated before, CISM or a debrief in itself is not the only answer, no one should be forced to talk or express their feelings and the should be more professional help also available such as EAP. However, those CISD I have experienced and the members I have interacted with made themselves available, not only to talk about the incident itself, but to make others aware of the phases of grief, to resist the urge to seek drugs or alcohol to "numb the pain", and even assist someone as to how to go about EAP. The reason you see such "peer" reviews is because it has shown that people open up to those who do understand, vs some psychologist acting as though they understand.

I don't think that there is consensus here - or anywhere else - that CISM is helpful.
WIth the scientific evidence pointing so strongly to the conclusion that CISM is not helpful at all and is actually harmful in a lot of cases.

There is no binary choice between CISM and alcohol/drugs.
The studies show that most people get over stress events just fine without any intervention.

The studies show no benefit to "opening up" to peers, especially when that opening up creates harmful false memories that can increase the stress, trigger the imagination to make the stress event seem worse than it is, and eventually make the stressed responder's mental health worse.

There hasn't been a single study that shows that CISM is actually helpful at all, ever.

It doesn't have anything to do with a psychologist "acting as though they understand".
That's not what mental health professionals do.

As for "it has been shown that people open up to those who do understand", please cite the source for that statement, and any evidence that shows that "opening up to those who do understand" actually helps a stressed responder's mental health. If it really "has been shown", then it should be easy to find the study that shows that evidence. I've looked on my own, and I can't find that evidence.

I have followed this discussion and understand your stance and Kali's on this well. If you want a source for my statement that a CISD has helped, it is me, I am telling you this as a person who was there for the CISD and had fellow members say they are glad they had this. After our LODD, we had a CISD, people didn't have to attend, didn't have to speak up, weren't even encouraged to speak up. I felt like speaking up and did and afterwards, more people opened up and it was found many people had some same issues and even different ways they found to cope. I spoke up because I was on the RIT team for that fire and I had a sense of guilt because I couldn't do the job I was assigned, I couldn't get him out and I felt I let Arnie down as well as the dept and I wanted to share that with my brother and sister FF's. For me it helped to know there wasn't that blame, and some others also stated they felt guilt as well, and "why him and not me". Afterwards, I did have some fellow FF say that they were glad that things were said. Is this scientific evidence? No, not by any means, but a personal experience that I am relaying.

I am not a member of our CISM and I have a twisted humor and my own way of coping. The majority of the bad calls I don't see a need for a CISD and the only times I have even seen one done was when requested by another FF, because he wanted to say something (so a CISD helped him) and when we had a LODD. I was on a fatality of a child run over by a vehicle and we worked her to the ER. We didn't have a CISD, but the call affected one member that he took the rest of the day sick because he was seeing his own kids at that point. He was back to work the next day, we were asked how we were doing by the chief and if we felt up to working and the rest of us did.

Our CISM members do work with us and we work in the firehouse together, but as CISM members, it is a resource that FF's can turn to and have turned to because they knew everything was confidential. They are there to answer questions and encourage EAP if someone is having issues, etc. They have gone out to other departments at the department request, just to be there.

Basically Ben, I'm not discounting the research out there and am not questioning that. I am stating that all CISM members are not doing this for money or some ego trip and am stating I have seen such debriefings help, not only me but fellow FF's. Yes, there are different ways to cope and there isn't always a reason to have a CISD, but despite studies or research against such debriefs or teams, I have seen such teams as nothing more than looking out for a fellow FF and to be another resource if one may be having issues.

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