Q. What is the critical incident stress management program?
A. The CISM program provides an organized approach to cope with both general work stressors and crisis situations. CISM include educations on preparing for stress, one-on-one peer counseling, routine peer support/team building meetings, crisis intervention group meetings (defusings), and critical incident stress debriefings. These tools can equip Corps employees to have an organized approach to cope with the normal and abnormal stress they encounter. CISM work is done by specially trained Corps employees called Peer Supporters.
Q. What is the purpose of CISM and where did it come from?
A. CISM is a peer-driven stress management program that combines pre-crisis preparation, stress education and post-event response to help people recover more quickly from abnormally stressful job-related incidents and trauma, collectively known as "critical incidents." CISM does not replace professional counseling and other services available to employees through Employee Assistance Programs (EAP), but rather compliments that program.
CISM concepts were first developed during the 1970s and then widely applied in the 1980s for police, firefighters, Emergency Medical responsers and other emergency personnel. The success of the program grew across the nation as other agencies sought help for their employees that were dealing with life changing stressful events. Today, CISM is accepted and used worldwide.
Q. What is a critical incident?
A. A critical incident is any incident that adversely affects you or your family or any event during which the sights, smells, or sounds are so vivid as to cause an increase of stress or stress reactions either immediately following the incident or on a delayed basis. Some samples of these types of incidents are:
- Being the victim of an attack involving deadly force.
- Serious on-duty injury to yourself or another.
- A particularly unusual or gruesome injury or the death of a child or elderly person under unusually tragic circumstances.
- A serious injury to yourself or a family member.
- Divorce, separation, or a child custody dispute.
- Lawsuits or internal investigations.
- Any incident outside of our normal range of experience.
Remember - the effects of an incident will vary from one person to another. That which is traumatic for one may not be for another. Stress from a critical incident cannot be prevented. It is the result of your exposure to the trauma of the incident. It can, however, be recognized and managed to the point of healthy recovery and eventual healing after the incident. It is vital that each person who has experienced a critical incident realize that their recovery and healing are linked to first recognizing the effects of the trauma upon them.
Q. What are some signs or symptoms of critical incident stresses?
A. Individuals react differently to critical incidents and they may or may not experience some or all of the following symptoms. If you do recognize any of the symptoms listed below, don't worry. Your own reactions are normal and very appropriate in response to your critical incident experience.
- Re-experiencing the event
- Difficulty sleeping
- Exhaustion or hyperactivity
- Depression or anxiety
- Anger or irritability
- Marital or family problems
- Numbing, withdrawal, or isolation
- Decline in job performance
- Memory loss or confusion
- Loss of appetite and/or nausea
- Uncontrollable emotions
Q. What is stress?
A. Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment. Stress has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and . These can lead to health problems including headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we readjust our lives. In adjusting to different circumstances, stress will help or hinder us depending on how we react to it.
Q. Can CISM eliminate stress from my life?
A. No. The goal of the CISM program is not to eliminate stress, but to learn how to manage it and how to use it to help us. Insufficient stress acts as a depressant and may leave us feeling bored or dejected; on the other hand, excessive stress may leave us feeling "tied up in knots." What we need to do is find the optimal level of stress that will individually motivate but not overwhelm each of us.
Q. How can I request a CISM intervention?
A. A CISM intervention request is made by completing the Team Request Form and emailing the completed form to your supervisor, Division Program Manager, Division/District Commander, and Directorate/Division Chief. The person making the request for an intervention completes the request form. The Team Request Form is located on the Gateway CISM website under the Policy and Procedures link. The Division Program Manager will review the completed form and put together a team of Peer Supporters to conduct the intervention. The Division Program Manager may also contact the Division Employee Assistance Program provider if it is determined that EAP assistance is needed during the intervention. The Division Program Manager may need to contact the requester with questions for scheduling and logistics.
Corps employees can also call any Peer Supporter directly, if they just need to talk to someone over the phone. A list of current Peer Supporters can be found in the NRM Smartbook. On the internet, go to https://corpslakes.erdc.dren.mil/employees/people.cfm . Click on the NRM SmartBook, search for Critical Incident Stress Management in the Topic listing.
Q. Can CISM help me manage stress better?
A. Yes. But, identifying unrelieved stress and being aware of its effect on our lives is not sufficient for reducing its harmful effects. Just as there are many sources of stress, there are many possibilities for its management. However, all require work toward change: changing the source of stress and/or changing your reaction to it. Here are some important tips:
- Become aware of your stressors and your emotional and physical reactions - don't ignore problems!
- Recognize what you can change - you know what you can and cannot change.
- Reduce the intensity of your emotional reactions to stress - relax and think.
- Learn to moderate your physical reactions to stress.
- Build your physical reserves - exercise, walk, eat right, maintain a good weight.
- Maintain your emotional reserves - maintain support relationships like friendships.
Q. What is the cost for a CISM intervention, who pays?
A. Labor costs are paid by the Peer Supporters home project and travel costs are paid by the National CISM funds provided by Headquarters.
Q. Who can request an intervention?
A. Anyone can request an intervention. Supervisor approval is not required. If anyone feels that they have experienced a critical incident and is experiencing stress symptoms, they have the right to request a CISM intervention.
Q. What is the timing for requesting an intervention?
A. Its best to request the intervention as soon after the incident occurs as possible in order to allow time for the team to be formed and deployed. However, a CISM intervention may be requested at anytime. It usually takes a few days after an incident has occurred for stress symptoms to begin to show and a person may not realize they need CISM until theyve begun to experience stress symptoms
Q. Who are the Peer Supporters?
A. Peer Supporters are Corps of Engineers employees who have volunteered to participate in the CISM program. They have received specialized training for certification as Peer Supporters. All COE Peer Supporters are trained to International Critical Incident Stress Foundation (ICISF) standards and utilize internationally recognized methods. A contracted Mental Health Professional oversees the training and reviews all CISM responses for compliance with ICISF Standards of Care.
Q. What do Peer Supporters do?
A. Peer Supporters understand the stress of the work environment. They want to listen and be of help to peers who need or want the opportunity to talk. Peer Supporters value trust, and they respect the need for anonymity and confidentiality. Communication between a Peer Supporter and a peer is considered confidential, except for those matters that involve a life threat or a violation of the law.
Q. Counseling vs. a Peer Supporter - whats the difference?
A. Counseling is therapy and can only be conducted by a licensed mental health professional such as a psychologist or social worker. Peer Supporters are trained to practice emotional first aid where those involved in a critical incident are given the opportunity to talk about what happened from their perspective and how the incident is affecting them personally.
Q. What types of problems do Peer Supporters address?
A. Peer supporters are trained to do initial crisis intervention for many types of problems. Some of the more common issues are work-related, such as dealing with the death of a drowning victim, or victims of natural disasters. Other issues may be more personal, such as divorce, illness, disability, career concerns, family relationships, or financial difficulties. When peer supporters identify that additional or professional counseling is needed, appropriate referrals are made through the Corps Employee Assistance Program (EAP). If and when several employees are adversely affected by the same event, the CISM program offers group interventions.
Q. How is the CISM program connected with EAP?
A. Employees have the option of visiting the Employee Assistance Program (EAP) at any time they choose. The CISM program can be seen as a connecting bridge or a band-aid between the employees and the EAP services. The CISM program and EAP work together closely to help you.
Q. What are some specific examples of how the CISM Peer Support process and the Employee Assistance Program are different?
- Peer support is an immediate, short term intervention that is designed to last no more than 2-3 visits at a maximum. The EAP often is more of a long term action that may often consist of 12 or more visits.
- The emphasis of CISM and peer support is placed upon prevention and education whereas the employee assistance program is based upon treatment. CISM is an extensive multi-tactic program with the flexibility to support employees as they carry out the Corps many challenging global missions.
- CISM is able to provide an almost immediate tactical intervention at the field level. These interventions can be provided often in less than 24 hours following notification. EAP services are typically provided in a clinical setting and often take days to access.
- The CISM program offers peer credibility and empathy. For example, who understands better what another Corps employee might be experiencing than a peer?
Q. Who can become a peer supporter?
A. Certification courses are offered when enough new peer supporters are approved to make the training cost effective. Applications to become a peer supporter, including approval from a supervisor are reviewed by the Program Managers to insure all Peer Supporters meet the desired qualifications. Peer Supporters may be at a variety of grades and professional disciplines in order to ensure a broad-based application to employees in varying job series, functions, and locations. Application forms may be obtained from the Division Program Managers.
Peer Supporters are expected to remain active in the CISM program. While not everyone is always available for an on-scene response, Peer Supporters can also participate in developing new educational materials, marketing the program with the Corps, strategic planning and other avenues.
Q. How can the program benefit management?
A. CISM represents a powerful, yet cost-effective approach to crisis response. It is adapted and used effectively in a variety of business and industrial settings. As critical incidents cover the spectrum of distressing human experiences, swift and early preventive mitigation of traumatic impact can serve management by improving an employee's general sense of well-being, productivity, attendance, and long-term costs associated with Workman's Compensation benefits.
Q. How can the program help me, the employee?
A. Individuals can become 'stressed out' through pressures of work or problems at home. So, instead of reaching for the tranquillizers or sick leave, we can now reach for the assistance of a co-worker - to make contact with a peer supporter.
Q. What kind of feedback has been received for CISM?
A. CISM teams have responded to incidents included a catastrophic highway bridge collapse with multiple fatalities, coworker suicide, sudden employee workplace deaths and public fatalities involving drowning, suicide and vehicle accidents. In addition, CISM teams were deployed during Hurricanes Katrina, Ike and Sandy recovery operations. Many positive comments have been received from employees concerning the CISM program. Not one negative or unsupportive comment has been received.
Q. What other agencies are using CISM?
- American/International Red Cross
- National Park Service (NPS)
- Bureau of Land Management (BLM)
- Federal Aviation Administration (FAA)
- Environmental Protection Agency (EPA)
- Federal Emergency Management Agency (FEMA)
- Motorola Communications
- United Auto Workers
- Federal Bureau of Investigation (FBI)
- U.S. Department of Defense (Army, Navy, Air Force, Coast Guard)
- Department of Agriculture
- Department of Homeland Security (DHS)
- Martin Marietta Corporation
- Various police and emergency management response agencies
- Private airline companies
Q. Is CISM mandatory or can it be made mandatory?
A. Unlike EAP counseling, CISM can not be forced on any employee. In addition, any employee participating in a CISM group debriefing is not required to talk if they dont want to. All parts of the CISM program are voluntary.
Q. Is this work related, or can it be requested for personal matters?
A. Any stress that is affecting an employees functioning at work can be an indicator of the need for an intervention of some kind. Whether through EAP or through CISM, a one-on-one session can be utilized to help the employee recognize and cope with the stress that is affecting them.