A critical incident can be defined as any event that provokes a strong emotional reaction which has the potential to interfere with normal life. Firefighters, by the nature of their work, are exposed to critical incidents on a regular basis. In the past young firefighters were advised by their elders, “It’s part of the job, toughen up, get used to it.” We now recognize that these events take a toll on firefighters and that effect is cumulative over time. Naturally, some events have a greater effect than others. The death or serious injury of a child, the death or serious injury of another firefighter and any event causing a large number of deaths are examples of critical incidents that will have a lasting effect on firefighters.
Critical Incident Stress Management (CISM) is a system that provides help in dealing with these effects. The goal is to limit the effects of critical incidents. The system takes key concepts from lessons learned by the military from traumatic events and has been developed in the emergency response community over the years. CISM cannot take away the pain, but it helps firefighters to understand, anticipate and cope with the effects of traumatic situations. There are several aspects of the CISM system.
Fire chaplains will commonly encounter the following interventions:
- Defusing – takes place very soon after a traumatic event and provides a brief exploration of the event with information about how it may affect those who experienced it.
- Debriefing – a more detailed examination of the traumatic event, with examination of how the participants are being affected, along with suggested coping techniques. This typically takes place a few days after the event.
- Individual Crisis Intervention – a one on one meeting to discuss difficulties being experienced related to traumatic events.
- Pre-incident Education – Helping our firefighters understand critical incident response as part of an on-going educational effort.
- Crisis Management Briefing – a meeting with group of people to explain what is happening in a particular situation, how it may be affecting people and giving ideas on how to handle these effects.
The chaplain must remember that these interventions, with the exception of the individual crisis intervention, are conducted by a team. The team should include a chaplain, but also includes peers, who are trained emergency responders and trained mental health professionals.
One of the key concepts of CISM is that the reactions people experience to a critical incident may seem troubling, even abnormal. There may be flashbacks and nightmares, to name a few of many possible reactions. We assure our people that these are “normal reactions to an abnormal event.”
Confidentiality is a vital part of any CISM intervention. Nothing said in an intervention should be repeated. No reports are given to department command staff, except to say that an intervention was held. In fact, confidentiality is vital to all of the work done by a fire chaplain. However, if there is a threat of harm to others or self, then the chaplain is required to seek help for that individual, even if it means breaking confidence.
*This section is used by permission of the author and the Chief Chaplain of the Mass. Corps of Fire Chaplains, Jim Tilbe