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CRITICAL INCIDENT STRESS DEBRIEFING


The mission of the CISM Team is to provide a systematic approach to the mitigation of stress responses for fire department personnel having been exposed to, or showing signs of, critical incident stress experience in the line of duty.  A critical incident can be any situation which causes an officer to experience strong emotional reactions which have the potential to interfere with their ability to function at the scene or later.
 
The following are examples of incidents that might result in a CISM Team Response:

Major disaster/mass casualties

Serious injury, line of duty death or suicide of fire department personnel.

Serious injury or death of civilian resulting from fire department operations.

Death or serious injury of a child.

Multiple fatality incidents

Any incident which attracts large scale media attention.

Loss of life following unusual or extremely prolonged expenditure of emotional and physical energy from IFD personnel.

Any unusual incident in which the potential for an immediate or delayed emotional response is high.

Accumulating stress reactions over long periods of time, after involvement in many previous critical incidents.


THE FORMAL STRESS DEBRIEFING:

A qualified mental health professional will be present at the debriefing. The team coordinator or qualified team member may lead this process. CISD is held within one to ten days (3 -4 weeks for mass disasters)  after the incident.  The CISD is confidential and should follow this format:

There are 7 stages to a Critical Incident Stress Debriefing (CISD). 

Team members ensure that only qualified and necessary personnel are in attendance. No media or family members will be allowed.  There will be sufficient team members present at each formal debriefing to provide adequate support to the facilitator. 

Introductory Phase:  The team coordinator and peer support members of the team introduce themselves, describe the rules to be followed for the debriefing and emphasize the need for confidentiality.  Participants are to be assured that the open discussion of their feelings will be confidential. 

Fact Phase: involves the facilitator asking the participants to describe facts about themselves and their activities during the incident, as well as facts about the incident.

Thought Phase:  Designed to allow participants to describe cognitive (thoughts) reactions and transition to the emotional reactions.   Participation in this phase is not mandatory, but encouraged.

Reaction Phase:  Identification of the most traumatic aspect of the event for the participants and identify emotional reactions. 

Symptom Phase:  The facilitator encourages each participant to describe his/her own experience and the emotional and psychological effects of the incident. 

Teaching Phase:  The facilitator provides the participants with information about responses to critical incidents and coping techniques for dealing with symptoms.

Re-Entry Phase:  This phase wraps up the debriefing, answers questions, and establishes a plan of further action if needed. Summary comments are offered by the facilitator, coordinator or peer support personnel advising personnel on how to seek further help if this is needed.   Each participant is provided the information necessary to seek further help.

A follow up debriefing, performed several weeks or months after an incident may be held if necessary.  The main purpose of the follow up is to resolve any issues or problems that were not initially resolved or new issues or problems that have surfaced.  The follow up may include the entire group or a portion of the original group.

The initial debriefing may result in confidential referrals and/or one on one interventions as necessary.