Critical incident stress management

The stress processing after stressful events ( SBE ) ( in Austria coping after stressful events or SVE) is a series of individual and group discussion techniques, which is aimed at emergency services, among other things, emergency services, fire brigades, civil protection and police, but also on other homogeneous groups can be transmitted that were occupationally exposed to a potentially traumatic situation caused jointly.

In addition to the SbE exists the very similar method of the Critical Incident Stress Management ( CISM ), according to Jeffrey T. Mitchell. Here, both methods are presented.

There are also other similar terms such as Organized personnel support in extreme missions, and aftercare (OPEN ) (see Notfallseelsorge ), and the psychosocial support for emergency responders (PSU ).

• 2.1 interventions
• 2.2 Debriefing, Defusing, Demobilization, One-on -One
• 2.3 CISM in aviation

Stress processing after stressful events

The SBE is to give participants the opportunity to process the experience and prevent the development of post-traumatic stress disorder ( PTSD). SbE is making for emergency responders about the same as the crisis intervention in the emergency service for relatives.

Therefore, the two terms are often used interchangeably, although this is not true: forces remain in contrast to members as a rule for the duration of the assignment fully operational and working her long program from trained. Experience the trauma through an insert until the first rest period after the use of events.

Therefore, the post-processing of the insert takes place in several phases: Still at or in the vicinity of the location, an insert statements ( Demobilization ) are performed, which focuses primarily on the use of information and events about possible stress reactions in the foreground. This event, which has mainly psychoeducational character, aimed at larger groups of forces ( maximum of 50 ) that are triggered after their use of the service. Alternatively, there is a short discussion, which may be performed a few hours after the end of the insert, for example, at the end of a service layer having a smaller number of subscribers and is more room for individual interaction. After a few days a debriefing ( debriefing ) in an orderly setting ( environment ) should be done if indicated, in which the subjective impressions and experiences of the participants can be addressed. These meetings are conducted by teams of mental health professionals and from specially trained emergency services (peers).

Jeffrey Mitchell, who has developed this aftercare techniques, it is recommended that this person none of the involved organizations consulted in order to maintain greater confidentiality and also hide self-interests of organizations in the debriefing.

The performance SbE is partially provided by own organization units, but partly also offered as part of an emergency counseling. Some dioceses ( Catholic administrative units ) have their own employees, who are solely responsible for pastoral care in Fire and Rescue Service. At the police station, this task is often taken over by the police psychological services.

The Munich fire department, for example, has established its own peer consultant service that performs similar tasks on a smaller scale.

In the early days SbE was considered particularly critical of emergency personnel are concerned about the image of the "tough guy and Saviour ." Meanwhile SBE is here to stay, even though the market operate some dubious suppliers.

SBE in aviation

In the meantime, crisis intervention teams were even with several airlines, such as Lufthansa, educated and employed. The last time these teams supervised by the tsunami disaster in Asia retrieved tourists, as well as their own colleagues, which were used on these flights as a crew. Also in the Concorde crash of Air France Lufthansa relief teams supported the French colleagues in the care of mainly German nationals.

The key figures in the German aviation Mayday Foundation, which in distress pilots and their families is further helps bureaucracy. The Foundation organizes inter alia also CISM courses. Together with psychologists and stakeholders, keeps the Mayday Foundation, a support network, the flight crew is to the side for critical and highly stressful forward or accidents.

Critical Incident Stress Management

CISM is in English for Critical Incident Stress Management. In German, the term is used SbE (stress processing after stressful events ) mainly.

Definition of a critical incident or a stressful event: Any situation that causes unusually strong emotional reactions so that the functionality of the person confronted with it is impaired. Such situations are characterized by feelings of powerlessness, helplessness or guilt, an identification with the victims, massive personal impact, high intensity event or a threat of their own body and life.

What this means is that this person might not be able return without another " back to business as usual ", as it has suffered psychological trauma. This trauma is a response to a massive stress situation which has clearly overwhelmed the individual coping strategies of the affected person. If the trauma over time persists, one speaks of the Posttraumatic Stress Disorder ( abbreviated to PTSD or in English Post Traumatic Stress Disorder, abbreviated to PTSD), it sounds like up to four weeks, the diagnosis is acute stress disorder.

As CISM doing all preventive and accompanying measures are referred to support people in the processing of stress symptoms after such a particularly stressful events. It includes specialized training and to ensure the implementation of various tailored to the stress response measures, eg CIS debriefing ( Critical Incident Stress debriefing ) and ensures follow-up. A scientific review of the effectiveness by Harvard University found that CISD is not only not work, but can even be harmful.

In case of faulty workmanship but persistent discomfort may occur, resulting in a strong limitation of the quality of life, cancel social contacts, in extreme individual cases, even in the form of difficult to heal and leading in the disability disease " Post Traumatic Stress Disorder (PTSD )" ( Posttraumatic stress disorder, PTSD) express.

All CISM measures do not constitute therapy, they serve only to maintaining the health of normal healthy people reacting to abnormal events ( " critical incidents ").

CISM is to psychotherapy in a similar relation as "first aid" to a surgical procedure.

Interventions

One sees a crisis (ie, PTSD / PTSD) as a poison, a CISM intervention is a possible antidote. An essential part is a system developed by the American psychologist Prof. Dr. Jeffrey Mitchell and Dr. George Everly, highly structured conversation model for the processing of critical events ( colloquially CIS debriefing ) set up by specially trained persons (peers) and psychosocial professionals, so-called MHP ( Mental Health Professionals ) is performed. The MHP occurs in this case as a leader, usually there is also a co-leader, which the MHP supports and assists. There are in addition to the debriefing also called Defusings, Demobilizations and one- on-ones. A CIS debriefing is not a ( psycho) therapy, individual counseling or psychological treatment.

Key elements of crisis intervention:

• Quick help
• Usually on site
• Nomalisierend
• Real support
• Pronunciation personally experienced before
• Discuss and recognition of emotions
• Feelings are repressed processed cognitively instead of / denied
• Reactions within the group are exchanged and communicated
• Reactions are considered normal discussed and experienced
• Stress management techniques are explained

Debriefing, defusing, demobilization, One-on -One

A debriefing is usually a seven- week model data (after Mitchell and Everly ). It is the most intensive, and the form of the longest CISM intervention (up to four hours). A debriefing is carried out until a few days after the potentially traumatisierendem event when cognitive coping mechanisms are identified. A debriefing may be conducted only by a physician or psychologist with appropriate additional training.

A Defusing is a much shorter (not longer than 45 minutes) and only three-stage "small" debriefing. It is often ( but not later than the same day) performed immediately after the stressful event and to allow the participants to talk about the event before they have an opportunity to reflect and to make very wrong interpretations.

A Demobilization usually lasts no longer than ten minutes and inform participants of any possible physical, cognitive, emotional and behavioral specific symptoms, as well as stress management.

A One-on -One is a conversation between a MHP / peer and an interested party. This is the most direct form of intervention and follow the CIS debriefing model.

Each intervention is confidential and anonymous. The supervisor will not get anything with the contents of the talks. The MHP / peers have a duty of which, however, has no legal relevance. After any form of intervention, there is the possibility for a direct, no-obligation consultation between the MHP / peers and stakeholders with a small snack and drinks.

CISM in aviation

With several airlines, such as Lufthansa, crisis intervention teams were formed. This Care or Special Assistance team supervised, among others of the Indian Ocean tsunami in 2004 affected passengers. Crew members, which had been used on these evacuation flights were supervised by CISM team.

Responsible for the training and provision of CISM team is in German aviation the Mayday Foundation. This helps in distress pilots and their families bureaucratic further, namely professional and private pilots in all fields of aviation.

Flight crews are then selected and prepared through training on how to deal with stressful and stressful situations. Nevertheless, pilots, flight attendants and other crew members occasionally get into situations that they perceive as critical or even life- threatening. Together with psychologists and stakeholders, keeps the Mayday Foundation, a support network, the flight crew is to the side after a heavy strain forward or accidents.

To prevent post-traumatic stress disorder and it may arise Fluguntauglichkeit, be the CISM team - matched to the incident - carried out various interventions. In this case, make the very time-consuming debriefings with complete crews of about 10% of the inserts. Demobilizations and individual meetings (so-called one- on-ones ) with crew members are the most common form of intervention, even within the Airlines. CISM teams are always among peers is ( = equals ), which have the same horizons as the stakeholders themselves

The frequency of use of the CISM teams of the Mayday Foundation is an average of three times a week.

The charitable foundation Mayday trains and intervenes according to the rules of the International Critical Incident Stress Foundation, Inc. ( ICISF ), is integrated into their quality monitoring and represents the ICISF as CISM hotline for aviation in Europe with focus on the German -speaking world.

In Austria, since 2010 Mayday Austria in particular for companies in the General Aviation Contact for CISM.