Critical Incident Stress Management

What is a critical incident?

A critical incident is a situation experienced by a person that may cause them to experience unusually strong emotional reactions that have the potential to interfere with ability to function during the incident, immediately following the incident or later. A situation does not have to be a major disaster to be classified as a critical incident. The following are examples of some critical incidents:

• the serious injury of death of a member of the public while an employee is performing regular duties
• the serious injury or death of an employee on or off duty
• the suicide or homicide or unexpected death of an employee
• an event associated with prolonged and extraordinary input in rescue efforts
• any incident which can be considered a serious physical or psychological threat to an employee while on duty
• any incident in which there is unusual media coverage
• a series of incidents that may have cumulative effects
• any abnormal event in which circumstances are so unusual or so distressing as to produce immediate or delayed emotional reactions that surpass normal coping mechanisms

Goal of CISM

CISM services are not counseling or a therapy but rather, it is a system of services in which the normal recovery process to abnormal events are facilitated or supported through individual or group processes. The process in which individuals, who have been exposed to an abnormal event, share their experiences has generally been found to be helpful. Myths or attitudes that individuals should be able to "tough it out" have been found to be less helpful and are more likely to lead to abnormal responses or prolonged recovery to such events.

Importance of Response

It is important that all departments respond to a critical incident and that employees involved in the incident receive the referral or offer of these services in a timely manner. The number one factor in an employee's ability to recover from a critical incident is the amount of support they perceive from the organization. When an employee believes they experienced a critical incident for which no referral or offer of services has been made, they may request services through their supervisor or the Employee Assistance Program (both internal and external). 

CISM Components

Pre-Incident Planning & Education

EAP/CISM staff are involved in planning and also provide orientation and training to employees, managers, supervisors and union representatives.

Post-Incident/Debriefing

A debriefing is a way of reducing the impact of a critical incident. It can accelerate normal recovery in normal people experiencing normal reactions to abnormal events by giving them information, skills and support.

• All personnel at the scene or others indirectly involved attend a confidential 2-3 hour group or individual session typically held 24-72 hours after the incident.
• At the session personnel have an opportunity to talk about their role in the incident, identify stress reactions in order to develop specific skills in coping with reactions, and learn about resources for further assistance.
• EAP/CISM staff are available to provide follow-up services to personnel and family members. 

Referral Procedures

The referral procedures are as follows:

1. Any employee who has direct involvement in or knowledge of an incident and feels that a critical incident individual or group debriefing would be helpful may contact a:
   • supervisor
   • designated department contact person
   • Employee Assistance Program (EAP) internal or external staff to request debriefing services.
2. Contact will then be made with the EAP/CISM staff to further determine the need for a debriefing.
   • If a debriefing is appropriate, either an individual (one-one) debriefing would be scheduled with the individual or scheduling and referrals for group debriefings would be coordinated by EAP/CISM staff and the involved department(s).
3. Department supervisors, a designated department contact person or EAP/CISM staff may request a debriefing. If a debriefing (individual or group) is appropriate, the aforementioned procedure is followed. Arrangements will be made by management to have employees attend the debriefing on paid time. Follow-up or referral to other appropriate services will be provided by the debriefing team for debriefing participants who need additional services.

Recognizing that incidents which give cause for a debriefing session are frequently unique to and occur within different occupational work environments and that contact persons and procedural approaches to accessing services will vary, departments may, consistent with overall City policy, choose to develop departmental procedures to implement this policy.

See APM 2-15 or speak to an EAP representative for more details.

Critical Incident Response for Managers, Supervisors and Leads