CISM for Business

Has your organization ever found itself in unexpected circumstances, such as an employee death, a suicide, a robbery, an industrial accident, or terminations, layoffs, downsizings, natural disasters, and stress in the workplace?

If it has, then you know the impact these kinds of situations can have not only on the workplace, but the individual employee as well. Ask yourself, how did we make it through? What did we put in place to mitigate the stress on the organization and employees? Did you implement your Critical Incident Stress Management (CISM) Plan, of which a Critical Incident Stress Debriefing/Defusing (CISD) was an integral part? If you did, congratulations! It was one more resource, one more thing that you did to assist your employees in the recovery from stress. You probably saw that your employees were showing signs of being overwhelmed and their usual ways of coping was not working. You knew that this could lead to impairment on the job, compromised safety or working while in distress. Through a CISD intervention you allowed your people to vent their emotions, share their experiences and helped normalize their reactions and physical symptoms. It showed you cared for your staff.

More and more organizations are coming to the awareness that a CISM plan can be an important component of handling a critical situation. Since a lot of situations take us by surprise we often react by not being sure what to do. Some organizations “tough it out” and later wonder why employee production suffers or their behaviour changes. While not all behaviour changes can be attributed to the critical incident, it can be an additional stressor in the life of an employee. CISD can assist in the immediate situation by reducing stress and providing some normalcy in an abnormal situation.


What is a CISM plan?
A plan which includes advanced preparation for a crisis situation, procedures to be followed during a crisis event, and establishing ways for dealing with future issues arising from the crisis

What is a CISD intervention?
It is an intervention strategy developed by Dr. Jeffrey Mitchell to limit or decrease the acute stress responses of emergency workers. It is an intervention usually consisting of a small groups in which a defusing or debriefing takes place.

What does a CISD intervention do?
First, it lessens the impact of the event. Second, it helps people recover while at the same time assisting them in adapting their coping abilities to the situation. Third, it can be helpful in finding those who might benefit from professional care, additional resources or supports.

What kinds of CISD interventions are there?

Immediate Support
When people experience a crisis they may need immediate support in terms of physical safety, the necessity to eat, reducing stimulants such as coffee or other caffeine drinks, avoiding alcohol, talking with others and initiating self-care.

Defusing
A Defusing is usually initiated within 12 hours of a critical incident, designed to reassure people that their reactions are normal, inform them of what possible symptoms to look out for, provide resources and address if needed any immediate physical needs.


Debriefing
A debriefing – this is usually done within 24 to 72 hours following the incident, however it can be longer depending on the nature of the incident. It is designed to assist in mitigating the long-term effects of the incident and returning people to their normal routine as soon as possible. There are usually seven stages to a debriefing (using the Mitchell Model). We would be pleased to go over this model with, simply give us a call.

Are the groups voluntary?
Yes and no. In most situations the staff member or employee is made aware that the group session is voluntary however there may be organizations such as police officers and fire responders that are required to attend by their organizations.

What about privacy concerns?
One of the first things discussed is the confidentiality in the group and what is said in the group stays there. Individuals may express how they felt to others outside the group however they are requested not to express the feelings or opinions of other group members. Of course we cannot be held responsible if someone breaks the rules of group participation.

What are the normal group sizes?
The ideal group size is 8 to 12 people. Definitely not more than 20 per group, otherwise it becomes difficult for people to engage in the process, as our experience has shown.

What are the expectations of group members?

The group norms or rules include the following:

  • That confidentiality is respected by all.
  • All cell phones, pagers, BlackBerrys, two way radios be turned off.
  • One person speaks at a time.


Is there follow up?
In a session, natural and normal reactions will be identified; but, also areas of concerns are identified. If we are concerned with how an individual is coping then we will connect with them (with their permission) and connect them with other resources as needed.

What happens after an intervention?
For the most part, people are resilient and resume their normal routines and move on with their lives. But, when a critical incident happens, it may trigger other issues in an individual’s life such as overwhelming situations at home, in their relationships, or at work. That’s where we can step in and be an ongoing support until the individual has been able to deal with the situation and effectively cope once again.

What could happen if I don’t use or have a CISM plan?
Each person is different; however the effect of not going through a CISD intervention could be experienced on four levels: the cognitive, the physical, the emotional and the behavioural or a combination of any of the above or all of the above.

The Cognitive
When individuals have experienced a crisis their thought process may not be what it should be. There may be a literally hundreds of thoughts floating round in the person’s mind which means their ability to concentrate, their ability to focus and the ability to take in information may be impaired. Often this can express itself in apparent memory loss, in the inability do tasks, in a reduction of productivity, an increase in sick days or in increase safety accidents..

The Physical
A person may experience headaches, backaches, stomach problems, nausea, anxiety, depression, phantom pains or any number of other manifestations of bodily reaction to stress experienced after a critical incident.

The Emotional
Stress often shows itself in a person’s emotional state by emotional highs and lows, unexplained weeping, difficulty in maintaining control of emotions, unwarranted anger at colleagues or family, laughing off serious issues or blaming their emotional state on others.

The Behavioural
When people start to change their behaviour in a significant way from their normal behaviour it may be a signal that all is not well. You may observe a slow withdrawal from social interacting, less involvement at work, decrease in productivity, and taking more time off work. On the other hand you could observe more irritation with co-workers, less cooperation than usual, becoming more demanding, emotional outbursts, putting customers off, or an increase in caffeine intake, more alcohol use or more smoking. These are all signs that there may be cumulative stress, something directly related to the crisis that occurred or the crisis in conjunction with some other state of affairs be that with family, friends or other relationships.

None of the above should be ignored, and need to be addressed with the employee in an inquisitive and helping manner. Sometimes people just need an opportunity to talk and know that some else is listening and they can vent. Remember even if they assign blame to other employees or to you directly, do not take it personally. Rather explore with the employee what resources they need to address their immediate situation.

If they do not want to address it with you, then call us and we will work together for a solution that meets the employee’s needs as well as your needs.

Is there any research to back up your claims?
As with any psychological model or theory there are supporters and detractors. We have read both those who support and those who do not support CISD interventions. We stay current about what is happening and what appears to be beneficial for people and what is not. But what is relevant is our years of experience in dealing with people on a daily basis who have or had experienced a crisis situation. We understand where and when we need to be flexible during an intervention to provide a healthy and positive experience for those involved. Experience has taught us that “one size” may not always be appropriate and that is why when you choose us as your provider of crisis services you know you are getting reliable, competent and innovative professionals.

Additional Resources
Below are some resources and articles on CISM. For additional information please contact us directly.

CISM Slide Presetnation
http://www.slideshare.net/Nostrad/cism-presentation

CRISIS INTERVENTION & CISM: A Research Summary
By Jeffrey T. Mitchell, Ph.D., CTS
http://www.cism.cap.gov/files/articles/CISM%20Research%20Summary.pdf

CISM: A Rational Perspective
by Bryan E, Bledsoe, DO, DACEP, EMT-P
http://www.tema.ca/Cont3.pdf



What makes ACT Associates different?
We are more than trauma specialists. We have the added bonus of having been in the counselling field for 20+ years and with our doctoral degrees in counselling,  we understand the complexities of human nature which makes us ideal for helping you detect issues that could have short and long term consequences for you and your employees.

What is your approach?
Our approach is to ensure that crisis situations have the minimum impact on your organization. With your permission and the employee’s permission we can provide follow up interventions and/or counselling to ensure that crisis issues do not impair the employee’s ability to function in a healthy, constructive and productive way.

How do your services work?
You can contract only for services that you need without having to sign up for any of our other services.

What is your model of working with people?
At ACT we believe in a resiliency model. One that believes people can “bounce back” from a crisis situation without long term impairment. Sometimes people need support to get back to functioning normally and we provide the practical skills and education so people can once again cope with life on an even keel.

Do all people in a crisis situation require interventions?
The answer to that question is yes and no, it all depends on their natural coping abilities, their attitude towards life and what issues are currently impacting on their life. It also depends on how gruesome the situation is that your employee has witnessed. Some people are set back by a few hours to days and then settle to their normal routines. Others have a more difficult time, again depending on what has happened and is happening in their lives. However, we have found that when there is a group intervention, people come to the realization they are not alone, that there is support of their peers, and everyone copes in different ways and that is alright. In a group situation they are made aware of coping strategies which will strengthen their normal coping styles and help them move forward. During interventions people are made aware of potential physical, emotional or psychological issues that may arise and are given strategies which they can use to deal with these issues.

What is our focus for interventions?
We focus on people’s strengths and resiliency. Many interveners focus on deficits, dangers and negative consequences of the situation. WE DO NOT. We believe and focus in on the people’s desire to be healthy, productive and living well.

Should I have a plan or not?
In the end the decision is yours, on which side do you want to be? Assume everything will be alright, or take action and know that you have implemented best practices for your organization. CISM can be extremely cost effective in terms of reducing the time it takes for employees to return to acceptable levels of productivity; in fact they actually may be more productive. CISM reduces your risk to cognitive, physical, emotional and behavioural factors affecting your employees. It reduces the costs of machinery down time. It indicates that you are prepared to take action before a disaster or crisis occurs. Which would you like? Increased risk or decreased risk? The choice is yours. Act now and call us. We have the solutions to meet your needs.