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CISM
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?
Thanks,
Tana
Thanks,
Tana
Replies to This Discussion
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Permalink Reply by Paul Montpetit on
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Damn Ben...next thing you will tell us is that there is NO Santa Claus...or Easter Bunny........Paul
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Permalink Reply by Ben Waller on
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Don't feel bad, I've worked in a place that still has a state-funded CISM program that uses the Mitchell model (Tennessee) and a local EMS system that had their own similar team.
Both of those teams use a combination of a peer debriefer and a mental health counsellor.
The problem seems to be that different people handle stress issues differently, and that CISM's model is scientifically flawed.
I was surprised at the depth of the debate - the studies do indeed show that CISM generally has no value.
And...I've been involved in CISM debriefs twice. They seemed to help me, but they just seemed to make things worse for some of the others involved. That tends to validate Dr. Bledsoe's point.
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Personally I tend to use humor(yes sick jokes simply put) or I go to the gym and work-out till I about pass out.....BUT, everyone has to have their own coping mechanism....to both deal with it and to have the courage to come back tomorrow, climb on the same rig and do it all over again.....Just keep an eye open for your partner...no-one knows them as well as you (or than you should) and recognize when something isn't right.....Paul
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The Stop Hugging Us link is awesome. Anyone who is interested in CISM, who is on a CISM team, or who has experienced a really bad situation on a call should read it. It is quite enlightening.
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Really, I meant it when I said "Don't feel bad."
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Permalink Reply by Art "ChiefReason" Goodrich on
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I agree that a "cookie cutter" approach to addressing everyone's different mental states will not be effective, but I think the idea for CISD was to harness everyone involved in the incident as a group, identify the problems as a group and come out of it with the group still intact.
I can remember a bad incident that I missed, as I was out of town, CISD was brought in and they would NOT let me sit in, even though I was chief at the time.
Yeah; some of them take it very seriously.
But, I know this; if we are going to treat everyone differently, then the price for our medical insurance just went up with no guarantee that we will retain the aggrieved firefighter.
TCSS.
Art
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Art,
If a firefighter has a bad enough work-related experience that leads to post-traumatic stress, there's no guarantee that you will retain the firefighter, regardless of what intervention is offered.
Given that Wii Nintendo, PS/3, Facebook, and Twitter are so prevalent, there's no guarantee that you'll retain firefighters regardless of whether or not they ever run a call bad enough to induce PTSD.
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Permalink Reply by Capt./Chaplain Mike Petrosky on
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Tana-Yes, I am a member of our county wide CISM Team. I would say the same as "Oldman" - you can't MAKE them talk, you can provide them with the avenue and tools and let them make that choice. Remember, you have a debrief, you are systematically providing them with ?'s and thoughts and ways to talk if they really want to. I went to one debrief where we really expected it to be really tough. The crews came in and were trying to get out of it, but by the time we finished, everyone had contributed to the program and things went really well-sometimes you just don't know how people will react. On the "requirement of debriefing", I think that sometimes it should be mandatory dependant on the call and how people are reacting. Yes, we do sometimes have required ones. Most are handled on a one-to-one basis, in a more relaxed setting/enviroment.
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There's no CISM Claus, dunno about Santa.
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Permalink Reply by Tana Todd on
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For most of the discussions I have seen, you guys think we MAKE people talk during debriefings. We would like everyone to share in the discussion, but we never make someone talk if they don't want to. We always try to have PEERS present. Also present, which most of the time are peers, we have spotters who watch the group to see how they are acting. After the debriefing we go up to certain ones and chit chat with them. We ask them if they would like to talk anymore or we give them referrals for help. I was a volunteer firefighter for 15 years and I've seen a lot. In Arkansas, most FF's come from rural departments. Most have been taught to buck up and take it. What about those who want to buck up, but can't take it....who do they have help them or what do they do??? I have seen my share take up drinking 'too much' to handle things or even try to end their lives because they couldn't handle things. No, I don't believe everyone needs to be debriefed; but a lot of the ones that don't can help the ones that do. If everyone would just come out and tell their peers that it is ok to talk about things that bother them, there would be a lot of healthier people. But we know that that doesn't happen most of the time, so that is why there is help available. We put the info out there and if they choose to ask for a debriefing we go...if not, we don't go looking for debriefings.
The only thing I ask, is just make sure your peers know that it is ok "to talk about their FEELINGS". A man or a woman can still be strong and will be stronger if allowed to be mentally strong. Thanks!!!
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Tana,
With the mounting scientific evidence that CISM has no real mental health value and that in a lot of cases, it is actually harmful, why would ANY incident need a debriefing?
"...how firefighters act" is a generalization. Generalizations can be very, very dangerous when applied to individuals, particularly individuals who have experienced a critical incident.
It's not a matter of "macho" if if the person needs to talk that counts, it's WHO the person talks to, in what setting, and with what level of professional training, education, and licensure that counts.
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Tana,
With the mounting scientific evidence that CISM is actually harmful, why would you debrief anyone, at any time, for any reason?
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