CISM has been made unnecessarily complicated because of improper use the most fundamental terminology and lack of understanding of the process. CISM at its core is a program to foster human resilience. CISM is not just about crisis intervention.

- Dr. George Everly and Dr. Jeffrey Mitchell

Critical Incident Stress Management

Critical Incident Stress Management (CISM) is the selection and implementation of the most appropriate crisis intervention tactics to best respond to the needs of the situation at hand. However, CISM has multiple components other than responding after a critical incident. These components can be used before, during, and after a crisis. They include a wide range of various activities including pre-incident education (PIE) which includes resiliency, planning and preparedness, acute crisis management, and post-incident follow up.

The purpose of the crisis intervention portion of CISM is to mitigate the impact of an event, accelerate the recovery process, and assess the need for additional or alternative services. Crisis intervention, which is a component of an overall CISM program, is provided through trained and carefully selected peer supporters and licensed Mental Health Professionals (MHP) who specialize in trauma.

The wildland fire CISM program intends to provide pre-incident education, resiliency tools, and to support work-related incidents primarily for individuals and groups who work in the area of fire and aviation but may assist other disciplines as needed. The wildland fire CISM program delivers CISM services through Peer Support, which is the formal Standard of Care. Read More

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Critical Incidents and Trauma

The lesson to be learned about trauma of any form is that it never affects just one person, one family, one generation, or even one community. Like the rock thrown into the pond, the effects of trauma ripple out until its waves touch all shores.

Psychological trauma is a person’s emotional response to an extremely negative experience, such as suffering life-threatening danger, injury, or abuse, witnessing the death of others, or losing a colleague in the line of duty. Experiencing a traumatic incident does not mean someone is damaged or doomed to develop post-traumatic stress disorder (PTSD). Such experience means that the event occurred, is now part of a person’s sensory memory, and needs to be processed and integrated. The slight differences in how a person experiences a particular event, such as how close they were to the victims, or how long they were at the scene, can influence the intensity of their responses.

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Even with identical exposure to a traumatic event, responses will differ based on factors like how different individuals cope with stress, availability of social support, prior traumatic experiences, and the overall stress in their lives.

Peer Support

Peer Support is a great philosophy. That is, the idea of peers supporting peers is strong. Who better than a firefighter to know the struggles and concerns of another firefighter? Who better than a firefighter to know how to cope with the challenges of the job?

Members of the wildland fire culture tend to be very protective of outsiders. Talking about a critical incident in a group of Peers works because it gives individuals a chance to reprocess what they saw and how they reacted through both their eyes and the eyes of other group members. But it only works if they talk with people they trust and feel safe around.

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Pre-Incident Education

Educating employees about the Critical Incident Stress Management/Peer Support program, its services and the benefits it can provide before a critical incident occurs is the cornerstone of an effective CISM program. Plans and protocols must be developed and understood. Attempting to learn about crisis intervention after the fact is predictive of confusion, delays, and the possibility of improper or inadequate support or intervention strategies and tactics being applied.

Further, effective pre-incident education also instills resistance and resilience mechanisms so individuals and organizations are better prepared when faced with adversity.

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Critical Incidents

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Critcal incidents are important, often stressful, events which have the potential to overwhelm one's usual coping mechanisms. A Critical Incident is not defined by the incident itself; it is defined by individuals and/or an organization’s reaction to what occurred.

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Critical Incidents are likely to become part of the history of an agency and can influence the culture of the wildland fire community.

What is a Crisis

We all experience a variety of stressful events in our lifetime. Each of us has unique ways of dealing with these events in order to maintain a comfortable emotional balance, and when the usual coping mechanisms fail, we seek new ways of coping. A crisis state comes into being when these new attempts fail to return us to the precrisis level of emotional balance.

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Crisis is both a time of opportunity and danger. Crisis is useful when it causes one to go beyond familiar coping skills (both internal and external) and to develop new skills, therefore becoming more competent and autonomous. A crisis is dangerous when the person becomes overwhelmed with anxiety and pain and adapts in negative ways. Good mental health has been described as the result of a life history of successful crisis resolutions. Read More

CISM and EAP

While Employee Assistance Programs (EAP) services include response to crisis and trauma, EAP cannot provide peer support which is the foundation of the ICISF intervention models we utilize in wildland fire.

The Peer Support Program can be seen as the connecting link between employees and EAP services. The Peer Support Program and Employee Assistance Programs often complement each other to help employees, especially for follow-up care after crisis interventions services.

 

Additional Information

International Critical Incident Stress Foundation

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National Alliance on Mental Illness

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American Telemedicine Association

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We R Native

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Other Resources

National Suicide Prevention Lifeline

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1-800-273-TALK (8255)

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Treatment Referral Service

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Free, confidential, 24/7, 365-day-a-year treatment referral and information service.

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Veterans Crisis Line

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Bureau of Indian Affairs
Branch of Wildland Fire Management

3833 South Development Avenue t malesuada Boise, ID 83705

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