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Critical Incident Stress Management

WHAT IS A CRITICAL INCIDENT?

Critical Incidents (CIs) are highly stressful situations. Simply put, a critical incident is a traumatic event (or perceived life-threatening event) that has sufficient power to overwhelm an individual's ability to cope. Normal physical and psychological responses occur which place considerable pressure upon that person.

When the stressor becomes extremely threatening, overwhelming or severe, it often produces a heightened state of cognitive, emotional and behavioral arousal called Traumatic Stress. (Traumatic Stress [TS] and Critical Incident Stress [CIS] are terms that are often used interchangeably.) After having been exposed to traumatic stress, employees may experience a range of reactions including deterioration of job performance, personality change, anxiety states, relationship discord, grief reactions, depression and suicidal ideations. These effects can be immediate, appear later or both.

FOH describes a continuum of trauma (special, critical and catastrophic) each of which requires a different level of response. This is detailed in the CISD policy.

EXAMPLES OF CRITICAL INCIDENTS IN THE WORKPLACE

  • An employee who shoots a supervisor in the workplace
  • Workers at a site witness an industrial accidental death of one of their co-workers
  • An attorney in a large law firm commits suicide over the weekend
  • Bank tellers are held up at gunpoint by masked robbers
  • A city vehicle accidentally runs over a pedestrian who dies in front of other city employees
  • Air-traffic controllers are unable to avert major airline disaster and witness the plane crash
  • A group of school children are held hostage and injured
  • An earthquake occurs at a company branch location
  • Any incident where sights, sounds or odors are so distressing as to produce an intensive emotional response, i.e. flashbacks to other traumatic events

WHAT APPROACHES ARE USED TO TREAT TRAUMATIC STRESS?

Early intervention by both professional and peer-support personnel who are specially trained and follow an established standard of stress intervention techniques affect recovery from traumatic stress positively. Experts believe debriefing can help individuals improve their coping abilities and dramatically decrease the occurrence of Post Traumatic Stress Disorder (PSTD). The debriefing is a process in which traumatized individuals are led through a series of steps to: discuss their experiences, to be supported and to learn coping strategies.

When efforts to support traumatized employees are limited, delayed or non-existent, a Traumatic Stress Reaction may develop into Post-Traumatic Stress Disorder (PTSD), the pathological result of neglected Traumatic Stress. The EAP is called upon to provide Critical Incident Stress Debriefings (CISDs) to employees of client organizations who have been exposed to work-place Critical Incidents.

CISD ROLES and RESPONSIBILITIES

A Critical Incident is a traumatic event or perceived event that has sufficient power to overwhelm an individual's ability to cope. When the stressor becomes extreme or severe, it often produces a heightened state of cognitive, physical, emotional and/or behavioral reactions. Critical Incident Stress Debriefings were developed as a tool to help individuals cope with their exposure to traumatic events.

The concept of a Critical Incident Stress Debriefing (CISD) embraces the tenets of a crisis theory which believe that after exposure to a traumatic event: 1) people may need additional coping skills to deal with the event and 2) people are usually open to acquiring new skills after being exposed to critical incidents.

  • Special Incidents - Special Incidents usually do not involve the workplace. The appropriate intervention is at the Staff Counselor level. Examples of Special Incidents include:
    1. Employee involved in an auto accident
    2. Employee death due to natural causes
    3. Other requests identified by the agency

  • Critical Incidents - Incidents that involve or directly impact the workplace. The level of trauma can range from low to moderate level of workplace trauma. Production may be effected in some way. The appropriate intervention is at the Staff Counselor level with assistance from the Regional Supervisor if necessary. Examples of Critical Incidents include:
    1. Clerk is robbed
    2. On-site death
    3. Employee threatens violence or takes violent action against a co-worker
    4. Work site accident
    5. Employee killed in auto accident
    6. Employee suicide

  • Catastrophic Incident - Catastrophic Incidents are those situations which have an extreme impact on the workplace. These incidents significantly impact the work site, may draw media attention or significantly impact work site production. The level of trauma to the work site and employees is extreme. Examples of Catastrophic Incidents include:
    1. On-site shooting or hostages involved
    2. Bomb explosion
    3. Natural disaster, such as earthquake, tornado, hurricane, etc.
    4. A severe level of trauma to a large number of employees or the workplace
    5. Production is severely effected or stopped

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