Critical Incident Stress Management, or CISM, is an intervention protocol developed specifically for dealing with traumatic events.  It is a formal, highly structured and professionally recognized process for helping those involved in a critical incident to share their experiences, vent emotions, learn about stress reactions and symptoms and given referral for further help if required.  It is not psychotherapy.  It is a confidential, voluntary and educative process, sometimes called 'psychological first aid'.

First developed for use with military combat veterans and then civilian first responders (police, fire, ambulance, emergency workers and disaster rescuers), it has now been adapted and used virtually everywhere there is a need to address traumatic impact in peoples lives.

There are several types of CISM interventions that can be used, depending on the situation.  Variations of these interventions can be used for groups, individuals, families and in the workplace.

Debriefing  is a proactive intervention involving a group meeting or discussion about a particularly distressing critical incident. Based on core principles of crisis intervention, the CISD is designed to mitigate the impact of a critical incident and to assist the persons in recovery from the stress associated with the event. The CISD is facilitated by a specially trained team which includes professional and peer support personnel. Also called Critical Incident Stress Debriefing (CISD). Ideally it is conducted between 24 and 72 hours after the incident, but may be held later under exceptional circumstances.

Defusing  is an intervention that is a shorter, less formal version of a debriefing . It generally lasts from 30 to 60 minutes, but may go longer and is best conducted within one to four hours after a critical incident. It is not usually conducted more than 12 hours after the incident. Like a debriefing, it is a confidential and voluntary opportunity to learn about stress, share reactions to an incident and vent emotions. The main purpose is to stabilize people affected by the incident so that they can return to their normal routines without unusual stress. Where appropriate, a formal debriefing also be required.

Grief and Loss Session  is a structured group or individual session following a death and assists people in understanding their own grief reactions as well as creating a healthy atmosphere of openness and dialogue around the circumstances of the death.

Crisis Management Briefing  is a large, homogeneous group intervention used before, during and after crisis to present facts, facilitate a brief, controlled discussion, Q & A and info on stress survival skills and/or other available support services.  May be repeated as situation changes.

Critical Incident Adjustment Support provides multi-faceted humanitarian assistance to individual, families or groups for coping with the aftermath of an incident and overcoming the ongoing impact of a death or injury.

Pre-Crisis Education provides a foundation for CISM services.  It includes incident awareness, crisis response strategies and develops stress management coping skills that can prevent major problems should an incident occur.  It takes the form of an employee handbook, e-book and/or workshops and training seminars.

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