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www.military.ie the defence forces magazine | 25 Managing Responses to Critical incidents gRO 03/14 CRitiCAL iNCiDENt stREss MANAgEMENt. how the Defence Forces support staff members after a critical incident is very important. Early and appropriate intervention can help reduce the effects of stress and minimise the possibil- ity of further problems developing later. Interventions at the initial stage should be simple, pragmatic, local and informal. our primary focus should be on providing care and minimising further stress. Several types of interventions may be conducted depending upon the circumstances of a particular incident. In- tervention may be on an individual one-on-one basis or, ideally, in small groups. the following types of interventions, singularly or in combination, are the most common. however in the event of a critical incident or potentially traumatic event, commanders at all levels should ensure that one of the following interven- tions is provided: a. Pre-incident Education or Pre-Crisis Preparation Pre-Incident education regarding stress, stress recognition and stress reduction strategies is an essential part of the crisis support process. Educational programmes for line and com- mand staff also include information on critical incident stress debriefings, how to contact a team, and on-scene considerations. Programmes should be provided for recruits, refresher training, and overseas personnel. Programmes for spouses and significant others may alsoinclude stress recognition and management. b. On-scene support services Types of service for staff consultations, prolonged or large-scale incidents: (1) One-on-one sessions with personnel exhibiting signs of obvi- ous distress. (2) Consultation with the Officer in Charge or the scene commander. c. Demobilisation or De-escalation Used during or following a large-scale incident as units are re- leased from the scene to determine if all personnel are accounted for, to make announcements, etc. A Defence Forces CISM Team member or an experienced peer takes 1 O to 15 minutes to provide information about the signs and symptoms of stress reactions that may occur. The unit may be released from duty or return to the barracks or camp. The incident commander may require that all personnel go through a demobilization session before they are released from the scene. d. Crisis Management Briefing (CMB) Crisis Management Briefing (CMB) is a practical four (4) phase group crisis intervention. CMB may be used in a wide variety of situations. The four (4) phases include the following: (1) Assemble the group in an appropriate venue such as a meeting room or auditorium depending on the size of the group. (2) A credible source or authority explains the facts of the crisis event. (3) A credible crisis support resource discusses the most common reactions relevant to the particular crisis event. (4) Personal coping and self care strategies are addressed that may be of value and provide access to community and organisa- tional resources. e. Defusing A small group session conducted shortly after the incident, usually within 3-4 hours. It provides informa- tion about the incident and general information and advice on stress reactions. In some circumstances, a defusing may involve a more in-depth discussion of participant's feelings and reactions. It requires two (2) CISM support team members. A defusing may eliminate the need for a formal debriefing. f. Critical incident stress Debriefing (CisD) Ideally it is conducted within one (1) to ten days of the incident. It is a confidential, non-evaluative discussion of the involvement, thoughts, reactions and feelings resulting from the incident. It also includes education regarding possible stress related symp- toms and coping strategies. g. individual Crisis intervention One-on-one intervention for concerns related to the incident. It may be conducted by a mental health professional or a CISM peer team member. Providing on-going counselling is not a function of the Defence Forces CISM crisis support team. However, team clinicians may be used for referrals. h. significant Other support/ family CisM Includes the following services: educational programmes for significant others, debriefings for significant others, bereavement support, grief and crisis counselling, and family support. i. follow-up Referral Follow-up Referral is conducted following individual consults, defusings, debriefings, demobilisations, and significant other support in the weeks or months after an incident. It may include phone calls or personal follow-up. It is concerned with the detec- tion of delayed or prolonged stress syndrome. It may also be used to evaluate debriefing services offered. Visit the DF IKON site for the full version of GRO 03/14 Critical Incident Stress Management.

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