The application of CISM within Indigenous Communities in Canada | Jason Walker PsyD, PhD

LifeNet

A PU BL ICATION OF I NTERNATI ON AL CRI TI CAL I N CI D E N T STRE SS F O U N DAT I O N

INSIDE THIS EDITION

A Police, Survivor, Victim, Family and Community Response to the Capital Gazette Shooting.............................................1 Paradise "Camp Fire".....................................1 ICISF Recognized with Gold Seal of Transparency on GuideStar..........................2 From the Approved Instructor Dept.........2 Find your Balance in Baltimore at the 15th World Congress.....................................3 Developing an Effective Behavioral Health Training Program for a Tough Crowd–Fire Fighters .....................................4

A Police, Survivor, Victim, Family and Community Response to the Capital Gazette Shooting

By: Steven Thomas, Anne Arundel County Police Dept., ICISF Member & Instructor Preparation for Anne Arundel County’s response to an active assailant began in 1999 with the creation of the Anne Arundel County Crisis Response System (CRS) and the partnership with Anne Arundel County Police. At that time the purpose was not to respond to an active assailant incident, but to help police patrol officers interact with individuals with mental illness. Although it began as a pilot project, made available through a grant from the Maryland Mental Hygiene Administration, it laid the foundation for uniting mental health services and law enforcement.

Beginning in 1999, Crisis Response Mental Health Clinicians responded to police calls for service when a mental health intervention rather than an arrest seemed to be the most appropriate action. The Mobile Crisis Teams or MCT (comprised of two licensed mental health professionals) carried police radios and had police call signs.

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Healthy Dispatchers Make Healthy Communities....................................................5 Building Resilience from Survivors’ Guilt After a Traumatic Event................................6 The Application of CISM within Indigenous Communities in Canada: Model Considerations in the Indigenous Context............................................................10 Pre Incident Training and Collaboration as Evidenced in the Aftermath of the Las Vegas Shooting........................................12 The Development of Resilience-Building Resources for Pastoral Careers.................14 From the Hotline Team Desk....................15

LifeNet

is a publication of the International Critical Incident Stress Foundation, Inc. ICISF is a non-profit, non-governmental organization in special consultative status with the economic and social council of the United Nations.

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Volume 30 | Number 1

Paradise "Camp Fire"

By: Georgina Verzal, Billy Graham Rapid Response Team Chaplain, ICISF Member

On the early morning of November 8, 2018, a devastating fire rapidly raged through a small town called Paradise located in Butte County in Northern California. The fire nicknamed “Camp Fire", is to date the deadliest and most destructive wildfire in California's State history with approximately 153,336 acres burned, including more than 14,000 structures and 85 confirmed deaths. Hundreds of families were left without a home and worse yet have lost friends and loved ones. Many remain missing as it is extremely challenging to recover remains amidst the ashes. The town of Paradise is leveled and covered in ashes and metal scrapings. With that, there are serious environmental hazards which pose grave concerns for everyone involved.

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2019 REGIONAL

TRAINING SCHEDULE August 1 – 4 | Houston, TX

Hosted by Emergency Chaplain Group

September 4 – 8 | Indianapolis, IN Hosted by Indiana CISM Team

September 19 – 22 | San Francisco, CA Hosted by San Mateo CISM Team

November 13 – 17 | Baltimore, MD Hosted by ICISF

STAY TUNED FOR: Atlanta, GA Las Vegas, NV San Diego, CA

2019

ONLINE COURSE SCHEDULE

CISM Practical Review & Update June 17 – July 5 October 28 – November 15

Law Enforcement Perspectives for CISM Enhancement

June 3 – 21 • August 26 – July 13 November 11 – 29

Managing School Crises: From Theory to Application April 1 – 12 • July 15 – 26 October 21 – November 1

Suicide Awareness: An Introduction for Crisis Responders April 8 – 19 • July 8 – 19 October 7 – 18

ICISF Recognized with Gold Seal of Transparency on GuideStar The International Critical Incident Stress Foundation, Inc. (ICISF) was recently recognized for our transparency with a 2018 Gold Seal on our GuideStar (By Candid) Nonprofit Profile!

GuideStar (By Candid) is the world’s largest source of information for nonprofit organizations. More than 8 million visitors per year and a network of 200+ partners use GuideStar data to grow support for nonprofit organizations.

In order to get the 2018 Gold Seal, ICISF shared important information with the public using our profile on www.guidestar. org. Now our community members and potential donors can find in-depth information about our goals, strategies, capabilities, and progress. We’re shining a spotlight on the difference we help make in the world.

Check out our GuideStar Nonprofit Profile today: www.guidestar.org/Profile/7786152

From the Approved Instructor Department Interested in becoming an ICISF Instructor?

Please see below for upcoming opportunities.

For an application or more information please contact aisupport@icisf.org.

Techniques for Delivering Bad News for Crisis Response Personnel

Advanced Group Crisis Intervention

April 29 – May 10 • July 15 – 26 Sept 30 – Oct. 4

Approved Instructor Candidate Program August 1-2, 2019 | Houston, TX

COMING ONLINE IN 2019!

STAY TUNED!

Advanced Assisting Individuals in Crisis

Workplace Violence

Approved Instructor Candidate Program August 3-4, 2019 | Houston, TX

Psychology of Terrorism and Psychological Counter-Terrorism

Group Crisis Intervention

F O R M O R E I N F O R M AT I O N ABOUT UPCOMING REGIONAL TRAININGS AND ONLINE COURSES, VISIT ICISF.ORG.

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Approved Instructor Candidate Program September 19-21, 2019 | San Francisco, CA We anticipate offering several more Approved Instructor Candidate Programs starting this summer. Our online calendar will publish updates as they become available!

Find your Balance in Baltimore at the 15th World Congress

By Terri Pazornick, World Congress Manager

These breakout sessions offer tools you can use, examinations of successful programs, reports on recent research, and lessons learned in an interactive setting, during which participants are able to explore topics in greater depth.

Networking Opportunities

Registration for the Crisis, Stress and Human Resilience: ICISF’s 15th World Congress opened in January! Seven hundred providers of crisis intervention and disaster mental health services are expected to convene in Baltimore to gain insight from over 100 presenters in 150 educational sessions. EXPLORE the presentations, special events and activities that have been planned to make time spent at the World Congress both professionally and personally fulfilling.

With just a couple more months until the World Congress opens in Baltimore, have you made your plans to attend?

Visit www.ICISFWorldCongress.org for complete details and registration information.

Educational Sessions EXPAND your knowledge through Pre-Congress workshops that include the opportunity to attend a course needed to complete an ICISF Certificate of Specialized Training. These include Assisting Individuals in Crisis and Group Crisis Intervention and seven other core or specialty courses.

Other sessions will be presented that are unique to the World Congress, on topics such as Domestic Violence, PTSD, Resilience, Group Think, the Bulletproof Mind and Death Notification. Additionally, Aviation Day includes over six different presenters and presentations and is titled “Looking Ahead to another 25 Years of Aviation CISM”. Look for a complete list online and in the Preliminary Planning Program.

The Main Congress educational program will feature seven two-hour General Session blocks with 30 scheduled presentations, including several that will review lessons learned from recent major disasters and incidents, such as the Las Vegas shooting, California Fires, Parkland, FL School shooting and Pittsburg, PA Synagogue terrorism attack .

International topics include the Syrian Crisis, Humboldt Bus Crash, Virgin Islands Recovery, Grenfell Tower Fire, Resilience in China and the Dublin Fire Brigade. Special interest topics discussed in interactive breakout sessions include the opioid epidemic, CISM in media, specialty populations and employee well-being.

EMBRACE the breaks throughout the six days of the World Congress as well as evening hours offer multiple opportunities to make valuable connections with other participants and help you find an important balance to the serious subject matter covered during the days’ presentations.

Ask past World Congress attendees why they keep coming back, and there would probably be a couple of common themes among their answers. Most would probably say that they come for the variety of presentations on disasters, lessons learned, research, etc. But they would also be just as likely to say they return for the incredible sense of community they feel when they’re amongst hundreds of others who do the same type of work and speak the same “language”. The opportunity to make personal connections, learn from one another and be among friends often renews their commitment to the selfless work they do, and they return to their communities, agencies and jobs with fresh ideas, reinvigorated. If you haven’t yet experienced a World Congress, we hope you’ll give it a try.

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Developing an Effective Behavioral Health Training Program for a Tough Crowd–Fire Fighters

By: Stacey Daniel, ICISF Member, Montgomery County CISM Team Coordinator In the past, fire fighters and behavioral health training have gone together like oil and water. Mental health issues were taboo in the fire station. If you dared to show any emotion, other than bravado, after a major incident, you were ostracized, considered weak or handed a job application for a fast food restaurant, much less supported. Today’s world has brought about hundreds of studies on fire fighter PTSD, sleep disorders, substance abuse and even suicide. The tide is turning, but articles in trade periodicals are not enough to protect our fire fighters from mental health issues. Tackling a taboo topic such as mental health for fire fighters can seem short of impossible. We must arm them with knowledge, tools, awareness and skills to manage stress, recognize depression and mitigate the effects of a traumatic insult. A comprehensive multi-dimensional training program, normalizing the conversation and touching on all aspects of self-care and awareness has proven successful for Montgomery County Fire Rescue.

In 2001, our Department embraced the IAFF Health and Wellness Initiative, recognizing mental health is just as important as physical health. Our CISM team was revamped and we began working under our newly hired staff psychologist. We recognized our firefighters were struggling but had few resources and little understanding of how to manage behavioral health issues. The stigma that surrounded depression, anxiety and PTSD created fear of being removed from the job, resulting in silent suffering. This was fast becoming a crisis in itself. Many of our fire fighters were retiring mentally broken, functioning in a chronic depressive state or worse, committing suicide.

We needed to develop and deliver a program that would be accepted, would have a tangible impact and produce positive results. In 2001 there were no models to reference. We started by asking a few key questions: What are the main issues we face as a department as it related to behavioral health? How can we make behavioral health an acceptable topic? How will we present this to our fire fighters to obtain buy in?

From these questions four guidelines came to light. Any program we designed needed to be comprehensive, credible, expandable and accessible.

A comprehensive program must cover all types of behavioral health. It is important to educate your fire fighters on critical incident stress as well as depression, traumatic stress, PTSD, substance abuse and suicide.

Signs and symptoms, causes and definitions of mental health issues gives your fire fighters a basic understanding of what these common issues look and feel like. This all-encompassing discussion helps to recognize a possible issue in themselves or a coworker, something that they could never define before. Once there is an understanding of the behavioral health problems that might affect a fire fighter, tools must be offered to deal with the issues at hand.

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YOUR TEAM’S MILESTONES WITH LIFENET READERS ICISF would like to acknowledge CISM Teams that have reached significant milestones in organizational longevity (i.e. 5, 10, 15 year anniversaries, etc.) in future issues of LifeNet. If your team reached such a significant anniversary this year, please contact George Grimm, ICISF CISM Team Coordinator (via email at hotline@icisf.org) and provide the appropriate information so we may proudly list your Team in a future LifeNet and provide a Certificate of Appreciation.

Healthy Dispatchers Make Healthy Communities By: Pam Opoka, ICISF Member On an icy winter morning in a small town in rural Missouri, a mother woke up to discover her baby was not breathing. She immediately called 9-1-1 and started frantically screaming at the dispatcher to help her. “Tell me what to do! Tell me how to give CPR, my baby is blue and cold!” The dispatcher immediately dispatched Police, Fire and EMS to the scene and due to departmental policy not allowing Emergency Medical Dispatch (EMD), give CPR instructions to the caller. The dispatcher had to sit there helplessly listening to the frenzied mother pleading for help, while attempting to calm her. The ambulance slid off the icy road en route, which caused further delay getting to the scene. This resulted in several radio transmissions from the dispatcher asking for an ETA while the mother was still screaming on the open phone line. A few minutes later, crews arrived to a SIDS baby and a distraught mother.

The dispatcher in this case was mentally and physically exhausted. She made all the proper chain-of- command notifications and completed the Computer Aided Dispatch (CAD) incident narrative but kept running the scenario through her head. Were the department’s policies and procedures followed? Had she done everything she could? She had her own infant at home. Would she ever be the screaming mother on the other end of a 9-1-1 call?

The dispatcher was the only one on duty, so she suppressed her emotions and moved on to the next emergency call. In the following weeks, she had nightmares of the screaming mother, isolated herself from social events and became hypervigilant about the safety of her kids; not letting them out of her sight.

As a dispatcher, she did a great job of supporting her first responders on the radio and in CAD but had nowhere to turn for support for herself. Her small department did not have access to a formal support program. She didn’t want anyone on her shift to know she was wrestling with these issues, and she wouldn’t even consider seeking help from a therapist in the community – in the public safety culture, that is often seen as a sign of weakness.

New Option for Support Luckily, there is now another solution for this dispatcher and others like her: a new roving peer support program specifically tailored for 911 telecommunicators.

As the nonprofit association of city and county governments for the Kansas City region, the Mid-America Regional Council (MARC) has managed the region’s 911 system since the early 1980s and manages 43 Public Safety Answering Points (PSAPs), with two more joining soon, that employ more than

700 dispatchers. The long history and strong network mean the necessary relationships, collaborative spirit and sense of trust the program needs to succeed are already in place.

“Dispatching is and always has been a stressful job,” said Hassan Al-Rubaie, Public Safety Technical Services Manager at MARC, “But as we implement Next Generation 911, dispatchers won’t just be hearing traumatic events take place through their headsets. They’ll also be seeing these events unfold through multi-media photos and video. We expect that may have a much greater impact on their mental well-being.”

The idea for this program began back in 2017, when MARC regional telecommunicators participated in a grant-funded research project through a collaboration between Dr. Michelle Lilly, an associate professor at Northern Illinois University and Dr. Hendrika Meischke, a professor at University of Washington. The MARC region was chosen due to the nine -county footprint of PSAPs made up of urban, suburban and rural settings. A seven-week online stress reduction training resulted in the participants reporting significant decrease in stress related problems.

That experience and success sparked an idea. Adding a wellness piece to the regional training concept would benefit hundreds.

With help from Dr. Holly Goerdel, associate professor at the University of Kansas, MARC staff was able to construct a regional roving 9-1-1 telecommunicator peer support program policy. The policy is established guidelines for the regional peer support program that offers assistance and appropriate support resources, --including referrals to professional or alternative resources, to members of the MARC region when personal or professional problems negatively affect them, their friends and family or their work performance. It serves as a CONTINUED ON PAGE 19

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Building Resilience from Survivors’ Guilt After a Traumatic Event By: Veronica Powell, PhD, CCTP, ICISF Member, Measures4Success, LLC, Washington, DC Not a year goes by without media coverage of causalities involving mass violence or natural disasters. Those affected directly or indirectly are left to pick up the pieces and establish a “new norm” for navigating the life that was lost pre-tragedy.

Trauma survivors who physically survived the trauma of mass casualties are challenged to reconcile various emotional reactions such as guilt from the tragedy. The emotions of guilt take on a trans-formative quality moving from healthy guilt to unhealthy guilt, as that in survivor guilt. With guilt itself being a powerful emotion, those plagued by the grips of survivor guilt may be limited in their ability to recognize the role of resiliency to assist in their recovery and healing from the trauma.

What is survivor Guilt and why should we know about this?

Survivor guilt is described as a psychological condition whereby a trauma survivor experiences deep remorse and feels responsible for others who did not survive the tragic event. Survivor guilt as an unintended consequence of a traumatic experience has been recognized as a shared phenomenon by trauma survivors (i.e., Holocaust survivors, airplane crash survivors, war veterans, school shootings, etc.).

Media interviews of a trauma survivors from high profile tragic events such as the 2017 Las Vegas massacre described the guilt of surviving the massacre with questions such “Did I do enough?” “Did I help enough people?” Why did I live and not them?” I too can attest to the experience of survivor guilt. When I was 14 years old (1984 Easter weekend), a tornado in my rural Mississippi community killed a family who lived approximately one mile from home. I reflect on my own experience of survivor guilt after surviving the storm. I was left with many questions such as “How come my family didn’t die from the storm?” How did the tornado side swipe my house (without destroying it) and then miraculously went back in the air only to touch down and destroy the house and the family down the road from us?” Why them and not us?”

How did we escape and not them?” “What could we have done to warn the family down the road?” “What was my purpose for living?”

As a CISM responder for several Employee Assistance Programs, I have unfortunately had the experience of assisting many survivors of trauma to navigate through various traumatic circumstances. For those employees who were survivors of mass causalities, I was able to quickly identify their own struggles with survivor guilt and help them to put their experience of guilt into a context of understanding and meaning. Through these experiences I realized a need to increase awareness, educate and inform the public of the consequences of survivor guilt and to mitigate the longterm negative consequences of psychological trauma. Most

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often trauma survivors are unable to immediately recognize or acknowledge their resilient ability along with protective factors as a source of strength in reconciling their response to guilt.

Unbeknownst to most trauma survivors is their resilient ability to navigate through traumatic experiences. The ability to be resilient in a time of crisis may seem like a foreign concept to a person amid a traumatic event. However, by definition, resiliency is the ability to adapt and bounce back from adversity. In building resiliency from survivor guilt through therapeutic intervention, trauma survivors can experience post-traumatic growth, which involves positive changes that individuals experience after challenges encountered with a major life crisis or traumatic event (Lucario, 2018). Protective factors, which refer to characteristics that prevent or reduce vulnerability for the development of maladaptive behavior or disorders, may contribute to post-traumatic growth as well.

Survivor guilt is a complex phenomenon that is rooted in trauma related experiences. Intervention strategies for managing survivor guilt allows trauma survivors the opportunity to leverage resources designed to promote and foster healing post tragedy. Individuals working with trauma survivors can facilitate movement toward accepting that their best was done and through the strength of resilience are able to navigate the adversity.

Resiliency strategies to curtail the impact of survivor guilt is teaching trauma survivors self-care and recognizing behaviors that contribute to self-neglect, which is an unhealthy way for trauma survivors to regain control over themselves.

Some examples of self-care include regular exercise, healthy nutritional and sleep hygiene, engagement in physical care and grooming, rest and relaxation (GoodTherapy, 2018).

A solid support system is another critical aspect of building resiliency from survivor guilt. Support networks that foster trusting and supportive relationships are beneficial for trauma survivors. Through these relationships, trauma survivors are able to (1) vocalize their experiences of living with the guilt and connect with those who shared the experience; (2) participate in support groups; (3) build a community that represents their new norm post-trauma; and (4) experience a sense of validation in being heard and understood by a support system that cares.

Trauma survivors who have been plagued with survivor guilt no longer have to be silent to its debilitating effects. Since healing from a trauma related injury is a lifelong process, strategies for promoting positive, healthy self-care is imperative for trauma survivors.

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Paradise "Camp Fire" (continued from page 1) FEMA (Federal Emergency Management Agency) is on the ground in Butte County in order to assist state and local governments, as now, individual households. Since President Trump signed the Major Disaster Declaration for the State of California, survivors of the Camp Fire can apply for aid for temporary housing and eventually to start the rebuilding process. State and government resources alone, however, are simply not sufficient in bringing aid to the victims. The Camp Fire is a good example of how non-profit organizations can unite with people for a common cause that works to fill in the gaps that government cannot fulfill. The Red Cross, Salvation Army and United Way are just a few of the larger organizations that have showed up to help the fire victims and hundreds of Airbnb hosts have offered their homes in surrounding areas at no cost to evacuees. Tragedies such as these tend to unite and bring people together despite their diverse religious, social or political views.

As a volunteer Chaplain for the Billy Graham Evangelistic Association’s Rapid Response Team, I deployed to Paradise this past December and spent the week before Christmas providing spiritual and emotional care to the victims.

Although as a Minister I’ve traveled extensively around the world and have experienced many unthinkable living conditions and devastating situations…this was my first official deployment as a Rapid Response Chaplain. Billy Graham RRT Chaplains typically work in conjunction with Samaritans Purse which is another Christian organization that mobilizes staff and equipment and enlists thousands of

volunteers to provide emergency aid to victims of tornadoes, hurricanes, wildfires, floods and other natural disasters in the United States. Oftentimes, both organizations stay behind their initial response to rebuild or restore houses for needy families.

We were stationed in a nearby town approximately 15 miles away from Paradise named Chico, CA. I will never forget the somber mood that took over our van as we made our way through Paradise to our first assigned property. When I exited the van, I slowly turned 360° scanning my entire surroundings in disbelief as to what I was seeing. The scene resembled that of a nuclear bomb explosion that would take place in a movie. Lot after lot after lot was eerily reduced to an apocalyptic scene of ashes, metal, brick and rubble. The only significant structures still standing were brick fireplaces surrounded by ashes and very few metal scrapings. One could find a few broken pieces of what used to be china, but there was not much more that was salvaged. The ashen scenes were surrounded by mere skeletons of the many vehicles that had been left behind as families rushed to flee from the flames. It was beyond depressing…it looked desolate and felt hopeless.

As a Chaplain I was there to provide emotional and spiritual support so as to bring hope to those who were feeling hopeless. Needless to say, I had to pull myself together rather quickly as I approached the homeowners who were returning to what used to be their home for the first time after the fire. This particular husband and wife were both in CONTINUED ON PAGE 18

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A Police, Survivor, Victim, Family and Community Response to the Capital Gazette Shooting (continued from page 1) The clinicians were available to respond and assist patrolman with varying police calls for service including: juvenile issues, traumatic events, homelessness, substance use, family violence, and elderly issues. MCTs can assess the individual’s need for services, such as a mental health crisis bed, case management or urgent outpatient services. The partnership developed as Police Officers and Mental Health Clinicians worked together on non-traditional crime issues. Routinely the Mobile Crisis Teams attend police line-up and integrate with officers strengthening the relationship. But that is just the basic structure. In 2014, the system had evolved and needed to be expanded to meet the local needs of the jurisdiction.

Therefore, the relationship became fully integrated with the creation of the Anne Arundel County Crisis Intervention Team (CIT) Unit.

This concept started in Memphis, Tennessee in 1988, with collaboration among the police, the Memphis chapter of the National Alliance of Mental Illness (NAMI), the University of Tennessee Medical School, and University of Memphis following the tragic shooting by a police officer of a man with a serious mental illness. The goals of CITs are to improve officer and consumer safety and to redirect individuals with mental illness from the judicial system to the health care system.

The Memphis Model has several key components which allow for its success. One of the primary components is community collaboration among mental health providers, law enforcement, and family and consumer advocates. The CIT Unit is based on the Memphis Model but modified for local use in Anne Arundel County Maryland.

The Crisis Response System includes both Crisis Intervention Teams and Mobile Crisis Teams. If a client is a high utilizer of services or seen on a regular basis by police or the hospitals, then the MCT refers the case to a CIT for more consistent follow-up for the initial few weeks from assessment.

The CIT Unit started with one Police supervisor and one officer and has grown to one Police supervisor and four officers. Each officer is partnered with a Crisis Response Clinician. This unit is an expansion of the Crisis Response System as there are still Mobile Crisis Units responding to police patrol calls for service. The key to both components of the system is the people and the training.

The officers in the CIT unit need to apply to be in the unit, and only after a highly selective process, are they chosen. At a minimum each officer completes a 40-hour Memphis Model CIT training, Mental Health First Aid and Critical Incident Stress Management (CISM) training through the International

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Critical Incident Stress Foundation or ICISF. CIT Officers have a passion to help people and are trained with the tools necessary to help in a time of crisis. The combination of the officer’s passion and training prepares these officers to respond appropriately to stressful and critical situations.

Additionally, the Anne Arundel County Police Department has another 117 personnel trained in CIT, of which 35 are trained in CISM. This creates a culture of helping within the police department. All officers voluntarily attend the training which gives them the tools they need when they are called to a scene where they observe that arrest is not the best alternative.

When combining an officers’ desire to help with the tools provided through CIT and CISM training, the officers can do extraordinary things. In times of high demand, additional CIT teams can be created by pairing Mobile Crisis Clinicians with CIT and CISM trained officers not assigned to the CIT Unit.

Numerous additional CIT teams were created throughout the response to the Annapolis Capital Gazette incident.

In our jurisdiction, we are creating a culture of helping and understanding. Whenever tragedy strikes, Crisis Response is there to assist the public. Officers also expect that our Peer Support Team will be there for them. A comprehensive CISM response to traumatic events has become routine and an expectation of the police force. Patrol officers request Mobile Crisis Clinicians to assist the public. Police peer support is there for officers. Additionally, after a homicide the CIT unit assists detectives with providing interventions for the victim’s family and the community. The CIT unit also assists the victim’s families after fatal accidents. CISM is the instrumental tool for the CIT unit’s community policing.

Our response to the Annapolis Capital shooting was comprehensive. CIT teams assisted all the officers who responded to the incident. CISM interventions were done for the shifts and officers from the Anne Arundel County Police, Annapolis Police and the Anne Arundel County Sheriff ’s Office. Due to the amount of interventions being conducted, regional peer support partners responded and assisted. This network had been established prior to any actual event, so that deployment could be immediate in the unfortunate event that one occurred. The interventions included one-on-one, interactive and informational groups. Critical Incident Stress Debriefings were done for all the units that responded.

The units included patrol officers, special operations, evidence collection and communications. Individual one-on-one interventions were done when appropriate.

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A Police, Survivor, Victim, Family and Community Response to the Capital Gazette Shooting (continued from page 8) Mobile Crisis Clinicians assisted the survivors, the victim’s fellow employees who were not in the newsroom at the time of the attack, those evacuated from the office building where the attack took place, and the community.

Initially, CIT teams were in the warm zone assisting those being evacuated. As special operations units were evacuating everyone from the office building where the attack took place, the CIT teams were assisting individuals. While homicide detectives were triaging the evacuees determining if they were suspects, victims or witnesses, the CIT teams were triaging the evacuees’ emotional and psychological well-being. There was an additional team at police Criminal Investigation Division (CID) assisting with witnesses after they were interviewed by detectives. All the survivors, who were in the newsroom at the time of the attack, were assisted after their interviews at CID. Crisis Intervention Teams assisted in several ways. They were in the unification center further assisting those evacuated, their families and coworkers who weren’t in the newsroom at the time of the attack, they made the death notifications to the families of the deceased and advocated for the release of the identification of the deceased knowing the stress on the deceased loved ones awaiting notification. A CIT team, with an additional two CIT/CISM trained officers, were at the incident building the next morning escorting the evacuated employees to their vehicles when the parking lot was no longer a secured crime scene. When all the evacuated employees

returned to work the next week, a CIT team, with additional clinicians, was there. It was extremely distressful time for all the employees who were evacuated. Additional information on trauma and stress from ICISF was distributed to every office along with the Crisis Response Warmline phone number in case the individuals affected needed more support.

Critical Incident Stress Debriefings were conducted for the survivors and the Annapolis Capital employees who were not in the newsroom at the time of the attack. Mobile Crisis Clinicians conducted follow-up interventions with anyone identified as being immediately involved. A Crisis Management Briefing was recorded and broadcast on the county’s television station and on social media. Members of the Crisis Response System and CIT trained officers were available throughout the crisis and for the many weeks following. Senior administrators throughout the county were simultaneously impressed and grateful for their intervention as they had no idea that the trauma would have such a ripple effect on the community at large.

You can see my presentation at the 15th World Congress on May 23rd at 8am.

Building Resilience from Survivors’ Guilt After a Traumatic Event (continued from page 6) The International Critical Incident Stress Foundation (ICISF) upcoming 2019 conference is one of many resources that is giving visibility to the concept of survivor guilt and a pathway to healing for trauma survivors. Reflecting on my own experience of survivor guilty, I now know my purpose for surviving the storm – I am a voice for the family that perished in our storm.

Dr. Powell will presenting on this subject at the 15th World Congress on May 22 from 4:00-6:00pm.

References GoodTherapy.org. (2018). Survivor guilt. Retrieved from www. goodtherapy.org/blog/psychpedia/survivor-guilt.

Lucario, L. H. (2018). Healing from complex trauma and PTSD. Retrieved from www.healingfromcomplextrauma andptsd.com/building-resilience.

You can support the International Critical Incident Stress Foundation, Inc. when you shop or sell on eBay through the eBay for Charity program!

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The Application of CISM within Indigenous Communities in Canada: Model Considerations in the Indigenous Context By: Jason Walker PsyD, PhD, Clinical Director, Inter Tribal Health Authority Hereditary Chief James Wilson, Associate Director, Inter Tribal Health Authority, We Wai Kai First Nation, BC Brittany Chartrand, (BScN. Student), UVIC Student, Fisher River Cree First Nation, Manitoba It is no secret that colonization has significantly impacted Canada’s Indigenous People resulting in a loss of traditional beliefs, knowledge and healing practices. Multiple, serious events of acute and historical violence and suicide across Canada exemplify the impact of life for Indigenous community members on and off reserve. There is a documented disparity that exists when it comes to accessing equitable health and mental health services and complex care needs amongst Indigenous when compared to non- Indigenous Canadians1234. Despite progress in many areas of care over the past 20 years, there remains considerable disparity especially amongst Indigenous children and youth with a burden of physical and mental health illness that is grounded in systemic discrimination in terms of law and policy, which is well documented in the literature567. Too often, Indigenous People have been left to suffer concerning basic medical needs that severely impact their ability to live a full and complimentary life. This is particularly true when faced with mental health crisis, violence, historical trauma and the complete lack of strategy across Canada to respond to critical incidents on reserve.8 The use of traditional Critical Incident Stress Management (CISM) protocols within mental health crisis models of care and critical response on reserve is fairly recent. Research shows that in generalized populations, the pre-crisis training, individual crisis counselling, group debriefing and post incident referral to specialized support for primary and secondary victims of trauma, results in better outcomes in a range of life functions9. Sadly, violent acts are unfortunately common place within Indigenous communities including

person on person violence, such as homicide or assault, and also high rates of suicide10. Although the CISM method is embraced particularly amongst first responders (police, fire, EMS), the structured method and inflexibly of true CISM is often a challenge in Indigenous communities since they also rely heavily on traditional values, healing and medicine. As well, the delivery of these services during periods of crisis, which vary widely in terms of the who, what, where, when, and how of providing service. More often than not, when a crisis occurs, mental health providers are ‘dispatched’ into Indigenous communities often with limited knowledge of the traditions, beliefs and healing practices of the community.

Research shows that critical incidents cause a great deal of disruption in people’s lives by strong emotional reactions and that CISM practice in general population can support a safe, expedited and successful impact on mitigating the results of long-term mental health reactions11 12 13. Further, one must question, if by normalizing the effects of a violent incident, the physiology and mental responses to an event, does in fact result in positive outcome, is this approach effective in working with a population that has been exposed to significant intergenerational trauma, even post critical event14 15?

Indigenous People in Canada have experienced systemic, collective and intergenerational group trauma with contributing oppression and racism, causing the perfect storm, especially when further, violent trauma is perpetrated in community16 17. The emotional responses to collective trauma and losses amongst Indigenous People must inform CISM practice, which is designed to alleviate or reduce CONTINUED ON PAGE 11

Naomi Adelson, The embodiment of inequity: health disparities in aboriginal Canada., 96 Suppl 2 CAN. J. PUBLIC HEALTH S45-61 (2005), http://www.ncbi.nlm.nih.gov/pubmed/16078555 (last visited Mar 19, 2018); H L MacMillan et al., Aboriginal health., 155 CMAJ 1569–78 (1996), http://www.ncbi.nlm.nih.gov/pubmed/8956834 (last visited Apr 13, 2018); V F Tookenay, Improving the health status of aboriginal people in Canada: new directions, new responsibilities., 155 CMAJ 1581–3 (1996), http://www.ncbi.nlm.nih.gov/pubmed/8956835 (last visited Apr 13, 2018); T K. Young, Review of research on aboriginal populations in Canada: relevance to their health needs, 327 BMJ 419–422 (2003), http://www.bmj.com/cgi/doi/10.1136/bmj.327.7412.419 (last visited Feb 13, 2018).

2 MacMillan et al., supra note 1.

3 Tookenay, supra note 1.

4 Young, supra note 1.

5 Cindy Blackstock, Jordan’s principle: Editorial update, 13 PAEDIATR. CHILD HEALTH 589–590 (2008), https://academic.oup.com/pch/article-lookup/doi/10.1093/pch/13.7.589 (last visited Dec 29, 2017); Cindy Blackstock, Jordan’s Principle: Canada’s broken promise to First Nations children?, 17 PAEDIATR. CHILD HEALTH 368–70 (2012), http://www.ncbi.nlm.nih.gov/pubmed/23904779 (last visited Dec 29, 2017); Cindy Blackstock, The Complainant: The Canadian Human Rights Case on First Nations Child Welfare, 62 MCGILL LAW J. 285 (2016), http://id.erudit.org/iderudit/1040049ar (last visited Apr 17, 2018).

6,7 Blackstock, supra note 5.

8 ELIZABETH FAST & DELPHINE COLLIN-­VÉZINA, FIRST PEOPLES CHILD & FAMILY REVIEW HISTORICAL TRAUMA, RACE-­BASED TRAUMA AND RESILIENCE OF INDIGENOUS PEOPLES: A LITERATURE REVIEW, https://fncaringsociety.com/sites/default/files/online-journal/vol5num1/Fast-Collin-Vezina_pp126.pdf (last visited Jan 30, 2019).

9 Jeffery A. Winer & Charles C. Lee, The distributed auditory cortex, 229 HEAR. RES. 3–13 (2007).

10 Id.; Sarah E. Nelson & Kathi Wilson, The mental health of Indigenous peoples in Canada: A critical review of research, 176 SOC. SCI. MED. 93–112 (2017).

11 Jeffrey T Mitchell & D Ph, Critical Incident Stress Debriefing ( CISD ), TRAUMA (1996); Winer and Lee, supra note 9; Nelson and Wilson, supra note 10.

12 Winer and Lee, supra note 9.

13 Nelson and Wilson, supra note 10.

14 Fariba Kolahdooz et al., Understanding the social determinants of health among Indigenous Canadians: priorities for health promotion policies and actions, 8 GLOB. HEALTH ACTION 27968 (2015), https://www.tandfonline.com/doi/full/10.3402/gha.v8.27968 (last visited Apr 14, 2018).

15 Blythe Shepard, Linda O’Neill & Francis Guenette, Counselling with first nations women: Considerations of oppression and renewal, 28 INT. J. ADV. COUNS. 227–240 (2006).

16 Robyn Jane McQuaid et al., Suicide Ideation and Attempts among First Nations Peoples Living On-Reserve in Canada: The Intergenerational and Cumulative Effects of Indian Residential Schools, 62 CAN. J. PSYCHIATRY 422–430 (2017), http://journals.sagepub.com/doi/10.1177/0706743717702075 (last visited Jan 19, 2019).

17 Corinne A. Isaak et al., Community-based Suicide Prevention Research in Remote On-Reserve First Nations Communities, 8 INT. J. MENT. HEALTH ADDICT. 258–270 (2010).

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F O R M O R E I N F O R M AT I O N , V I S I T C R I S I S J O U R N A L . O R G

The Application of CISM within Indigenous Communities in Canada (continued from page 10) psychological suffering and unresolved grief when faced with a new trauma. Regional differences and tribal culture do exist, which impacts the ability for CISM debriefing to most effectively be applied during critical events throughout these diverse communities. We provide a contextual framework of critical incident management to better respond to serious events in Indigenous communities.

Taking an innovative approach, the Inter-Tribal Health Authority (ITHA) located in British Columbia, which delivers a range of services to 52 First Nation communities, created an innovative community driven CISM model that also incorporates traditional practice and healing into application.

The ITHA Crisis Team embraces a trauma informed practice model18 that approaches service through a community focused lens. The team is comprised of professionals (psych nurses, clinical counsellors) and non-designated professionals (first responders, elders, healers), many of whom are community members or those who have multiple years of service working within the Indigenous communities served. This approach allows for a degree of familiarity and comfort for those impacted by a critical event, in terms of the service providers involved.

During crisis, the ITHA team works closely with community Leadership (elected and hereditary) to ensure that the needs of family are being met by the debriefers and the transfer of ‘care’ continues through hereditary mechanisms, such as clan leadership. Although the CISM method is followed as prescribed, some modifications have been made, comprising the inclusion of elders, prayer, traditional healers being

involved in the debriefing. A mix of highly trained community members and non-Indigenous professionals that complement the historical importance of culture, community and values with the methodology of CISM practice.

Anecdotal evidence from post critical event analysis indicates that on a qualitative level, there is a positive response to the modified CISM method used by the ITHA team. Clients, elders and clinical practitioners report increased cohesion amongst those debriefed, lowered rates of PTSD and associated mental health issues and also a strong sense that traditional values, approaches and healing has occurred. As there is no standard approach to Indigenous community crisis response, multi model approaches, often through trial and error, tend to guide practice. To mitigate these issues, in direct communication with the grassroots communities, ITHA has developed programs and services to address the most affected trauma inflicted Indigenous people in the Indian Residential School (IRS) survivors. In the initial IRS Gatherings, the feedback was that in many ways the services of the Gathering were as regimented as the residential schools themselves. The ITHA Board of Directors include IRS survivors and it was decided through dialogue and consensus, amongst the Board and Administration, to allow the survivors to develop their own approaches, agenda, methodology and services. The ITHA Administration provided the resources and Mental Health Professionals and support services for IRS Gathering. The response and results were astounding.

CONTINUED ON PAGE 13

18 EMILY ARTHUR ET AL., TRAUMA-INFORMED PRACTICE GUIDE BC PROVINCIAL MENTAL HEALTH AND SUBSTANCE USE PLANNING COUNCIL (2013); Elizabeth A Bowen & Nadine Shaanta Murshid, Trauma-Informed Social Policy: A Conceptual Framework for Policy Analysis and Advocacy., 106 AM. J. PUBLIC HEALTH 223–9 (2016), http://ajph.aphapublications. org/doi/10.2105/AJPH.2015.302970 (last visited Apr 15, 2018).

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Pre Incident Training and Collaboration as Evidenced in the Aftermath of the Las Vegas Shooting By: Johanna O’Flaherty, PhD, LADAC

Backdrop: On October 1, 2017 the close of the 3-day Route 91 Harvest Festival in Las Vegas, a shooter from a room on the 32nd floor of the Mandalay Bay hotel, that overlooked the venue, broke two windows and rapidly shot into the concert crowd with semiautomatic weapons creating horror and chaos. The shooter sprayed the crowd with bullets wounding about 500-people and fatally injuring 58 [58-victims and 1-perpatrator]. This was the worst single shooter event in the US history.

Mass shootings draw mass media attention and the event in Las Vegas was no exception. Media is usually grappling for accurate news of the event in addition to cover the emotionality of the event. Survivors, who are still in shock, are interviewed about how they feel! TV commentators review the gun legislation in the USA, and how this disastrous event may have been prevented if we had more stringent background checks prior to individual’s purchasing a firearm. However, this paper is not to discuss the political situation of gun-control but rather to discuss the role of Critical Incident Stress Management (ICISF) in the aftermath of the Las Vegas shooting.

This author has been involved with ICISF for over 30-years and have responded to several major disasters including 9/11/2001.

Nevertheless, in recent years, I had pulled back from response work (this was my intention) to dedicate my time to inpatient treatment centers. To this end, I had moved to Las Vegas, Nevada in the fall of 2013, to run a chemical dependency treatment center. Within a few months of my arrival in Vegas, I received a call from Henderson Fire Department expressing an interest in CISM training and consultation in setting up a Critical Incident Stress Management [CISM] program for their department.

This was my introduction to the Las Vegas First Responder community. I conducted several training classes on CISM for Henderson and subsequently for the other respective Fire Departments in the Vegas area: Henderson, North Las Vegas, Las Vegas, and Clark County, also members of the Henderson and Metropolitan police department attended these trainings.

Therefore, prior to the Las Vegas shooting on October 1, 2017, Las Vegas had over 160 trained peer support members, fire, and police, trained in the ICISF model, by this author.

My initial introduction to responding to the aftermath of disasters was in 1988, when a Pan American 747 exploded over the small town of Lockerbie, Scotland killing all 230 passengers on the plane and eleven residents of the small village of Lockerbie.

At that time, I was the corporate manager of Pan American’s Employee Assistance Program, based in the corporate medical department at John F. Kennedy Airport (JFK). My boss, Dr.

John McCann, suggested that I go to London and Lockerbie to assist the Pan Am employees and grieving family members. I asked my boss what I was supposed to do, as I had no training in crisis management, he stated ‘I don’t know but knowing you you’ll figure it out’. This was my introduction into chaos and trying to sort things out. As a result of this experience, I became a passionate pioneer in getting airline employees trained in the “psychological aspects of responding to a disaster’. I was a member of the ATA- Air Transport Association’s initial task force in establishing guidelines and procedures that eventually became the prototype for responding to aviation disasters. In 1997 Congress passed a bill that determined the NTSB would be the governing agency to oversee the care of grieving family members and survivors. The NTSB’s governance streamlined the process and established needed organizational systems to alleviate the chaos that accompanies such disasters. The reason to illustrate my background is to help the reader establish a schema to conceptualize my passion for organization and assisting CISM teams to be as prepared as possible in responding to the aftermath of a disaster where there are multiple fatalities.

Ironically, When the shooting took place this author was scheduled to fly out on American Airline’s early morning flight to Dallas to participate in American’s well-established Critical Incident Response Program. While the shooting was taking place, I was awakened by a colleague who informed me that there were multiple shooters on the Las Vegas strip and that numerous people were killed and injured. Personally, I was conflicted as to whether to proceed with my plans and go to Dallas or cancel and help the first responders here in Vegas. My training in CISM kicked in and my rational mind made the decision to continue with my plans and go to Dallas and keep my commitment to American Airlines.

While I was in Dallas, I was in contact with the coordinators for all jurisdictional fire departments; Henderson, North Las Vegas, Las Vegas, and Clark County. Additionally, I was in contact with the Police Employee Assistance Program (PEAP) and let them know that I was in Dallas and would be available to assist when I got back to Vegas.

Application of CISM and Lessons Learned: In situations like the Las Vegas shooting and other mass fatalities volunteers come from all over the country and this event wasn’t any different.

Support from Florida, Los Angeles, New York, and several other teams volunteered to assist Las Vegas and its first responders.

CONTINUED ON PAGE 22

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The Application of CISM within Indigenous Communities in Canada (continued from page 11) The survivors want to include their children and grandchildren to experience and discuss the residential school impacts on them and their off-spring. This is an example of prevention, intervention and postvention services directly related to trauma and the continuation of the CISM model.

Funding models for crisis teams are typically not found within prescribed agreements within Canada nor health authorities.

ITHA in response to community driven requests for a crisis response team created the team through unconventional funding models which is concerning when considering long term support. What is clear, is that community feedback indicates not only a need for such a team but a process to allow for community champions to engage in preventative actions that help to pave the way for a smooth transition of service when a critical incident does occur. It is apparent that a more in-depth research based assessment of the ITHA CISM method to better explain clinical and research implications.

References Adelson, N. (2005). The embodiment of inequity: health disparities in aboriginal Canada. Canadian Journal of Public Health = Revue Canadienne de Sante Publique, 96 Suppl 2, S45-61. Retrieved from http://www.ncbi.nlm.nih.gov/ pubmed/16078555

Isaak, C. A., Campeau, M., Katz, L. Y., Enns, M. W., Elias, B., & Sareen, J. (2010). Community-based Suicide Prevention Research in Remote On-Reserve First Nations Communities.

International Journal of Mental Health and Addiction, 8(2), 258–270. https://doi.org/10.1007/s11469-009-9250-0 Kolahdooz, F., Nader, F., Yi, K. J., & Sharma, S. (2015).

Understanding the social determinants of health among Indigenous Canadians: priorities for health promotion policies and actions. Global Health Action, 8(1), 27968. https://doi.org/10.3402/gha.v8.27968 MacMillan, H. L., MacMillan, A. B., Offord, D. R., & Dingle, J. L. (1996). Aboriginal health. CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 155(11), 1569–78. Retrieved from http://www. ncbi.nlm.nih.gov/pubmed/8956834 McQuaid, R. J., Bombay, A., McInnis, O. A., Humeny, C., Matheson, K., & Anisman, H. (2017). Suicide Ideation and Attempts among First Nations Peoples Living OnReserve in Canada: The Intergenerational and Cumulative Effects of Indian Residential Schools. The Canadian Journal of Psychiatry, 62(6), 422–430. https://doi. org/10.1177/0706743717702075 Mitchell, J. T., & Ph, D. (1996). Critical Incident Stress Debriefing ( CISD ). Trauma. https://doi.org/10.1016/03778401(94)00694-5

Arthur, E., Seymour, A., Dartnall, M., Beltgens, P., Poole, N., Smylie, D., … Schmidt, R. (2013). Trauma-Informed Practice Guide. BC Provincial Mental Health and Substance Use Planning Council. https://doi.org/682901795

Nelson, S. E., & Wilson, K. (2017). The mental health of Indigenous peoples in Canada: A critical review of research.

Social Science & Medicine, 176, 93–112. https://doi. org/10.1016/j.socscimed.2017.01.021

Blackstock, C. (2008). Jordan’s principle: Editorial update.

Paediatrics & Child Health, 13(7), 589–590. https://doi. org/10.1093/pch/13.7.589

Shepard, B., O’Neill, L., & Guenette, F. (2006). Counselling with first nations women: Considerations of oppression and renewal. International Journal for the Advancement of Counselling, 28(3), 227–240. https://doi.org/10.1007/s10447005-9008-8

Blackstock, C. (2012). Jordan’s Principle: Canada’s broken promise to First Nations children? Paediatrics & Child Health, 17(7), 368–70. Retrieved from http://www.ncbi.nlm.nih.gov/ pubmed/23904779 Blackstock, C. (2016). The Complainant: The Canadian Human Rights Case on First Nations Child Welfare. McGill Law Journal, 62(2), 285. https://doi.org/10.7202/1040049ar Bowen, E. A., & Murshid, N. S. (2016). Trauma-Informed Social Policy: A Conceptual Framework for Policy Analysis and Advocacy. American Journal of Public Health, 106(2), 223–9. https://doi.org/10.2105/AJPH.2015.302970 Fast, E., & Collin-­vézina, D. (n.d.). First Peoples Child & Family Review Historical Trauma, Race-­based Trauma and Resilience of Indigenous Peoples: A literature review.

Retrieved from https://fncaringsociety.com/sites/default/files/ online-journal/vol5num1/Fast-Collin-Vezina_pp126.pdf

Tookenay, V. F. (1996). Improving the health status of aboriginal people in Canada: new directions, new responsibilities. CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 155(11), 1581–3. Retrieved from http://www.ncbi.nlm.nih. gov/pubmed/8956835 Winer, J. A., & Lee, C. C. (2007). The distributed auditory cortex. Hearing Research, 229(1–2), 3–13. https://doi. org/10.1016/j.heares.2007.01.017 Young, T. K. (2003). Review of research on aboriginal populations in Canada: relevance to their health needs.

BMJ, 327(7412), 419–422. https://doi.org/10.1136/ bmj.327.7412.419

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The Development of Resilience-Building Resources for Pastoral Careers by the NSW Disaster Recovery Chaplaincy Network By: Rev. Stephen Robinson DMin, BTh and Rev. Susan Phalen M.Sc., CCISM Effective disaster recovery will be holistic; accounting for the physical, emotional, psychological and spiritual aspects of a person and community’s well-being. Disasters and traumatic events not only shake people’s physical environment, but their worldviews and their experience of life, justice and faith. In recognizing this, building resilience within a community should involve equipping and supporting its faith communities to better understand and participate in the disaster recovery.

In Australia, each state and territory has responsibility for Emergency Management and Disaster Welfare, under guidelines set by the Federal Government. In New South Wales (NSW) the Emergency Management Plan (EMPLAN) is a complex series of disaster response and recovery plans encompassing a wide range of arrangements involving scores of agencies both government and nongovernment. The Welfare Services Functional Area Supporting Plan covers all arrangements developed for people’s welfare following disasters within the state.

Key agencies are allocated roles of support The Uniting Church in Australia (Synod of NSW and ACT) through the Disaster Recovery Chaplaincy Network (DRCN) is tasked with organizing the provision of multi-faith and interdenominational chaplaincy in evacuation centers and other affected areas and supporting faith communities

(churches etc) as they contribute to the recovery of their wider community.

The Disaster Recovery Chaplaincy Network (DRCN) The DRCN was formed after substantial discussion in the State Welfare Services Committee which recognized that people’s faith is an important factor in their recovery from crisis, and faith communities are important support mechanisms in the process of recovery. The DRCN gathers faith leaders and pastoral carers from a wide range of denominations and faith groups, representative of the wider Australian population. Chaplains are faith community leaders such as ministers, priests and rabbis who are recommended by their faith overseers (bishops etc) for the work. They are given an intensive two-day training course and assessed on their attendance, attitude and aptitude. When a disaster occurs or is likely, Disaster Welfare Services contacts the Duty Officer and the chaplains are deployed to the event.

One of the key historic problems with chaplaincy in Australia is that well-intentioned volunteers have entered disaster zones and taken over, disempowering the locals in the context of their communities’ recovery.

CONTINUED ON PAGE 16

“

Especially in disaster settings, chaplains are called to be a nonanxious presence in the midst of chaos, yet it is very difficult to be an agent of care when one is anxious, stressed or burned out. The only way chaplains will be a healthy presence among the people they care for is to keep themselves healthy.

”

- The Development of Resilience-Building Resources for Pastoral Careers by the NSW Disaster Recovery Chaplaincy Network

14 14

From the Hotline Team Coordinator’s Desk Did You Know: CISM teams that are interested in being made available to the ICISF for referrals can be listed in a database to which the HOTLINE dispatchers have available 24/7 and the ICISF office. Both will be able to be refer a team when they receive requests for assistance. The basic requirement for teams desiring to be listed in this database is to file a “Team Information Form”, including basic contact numbers and other required information, with the ICISF by submitting the form to hotline@icisf.org.

The teams are indicated in the database as follows: • A team which simply submits the Team Information Form with the contact and activity information as requested on the form will be considered an ICISF Hotline Team.

• By submitting a Verification Packet which requires additional information such as the team mission statement, team policies and procedures, training practices, member qualifications required by the team and other information, and is signed by the team officers, the team may become designated as an ICISF Verified Hotline Team. After review and approval by ICISF, this verified information is used to more closely match the appropriate team to fit the criteria for a specific request.

• A team may, in addition to the above designations, become an active member of the Foundation to receive discounts for ICISF training, quick access to the latest information, consultations and other benefits by completing a Membership Application along with the required fee.

NOTE: The old designation “Registered Team” has been replaced by the “Verified Team” designation, and current “Registered” teams will be changed to the “verified” designation.

ALL TEAMS must submit an annual form with updated contact and activity information. It is imperative that ICISF have current information when responding to requests for assistance. Teams that do not submit an annual updated form will be indicated as “Not updated”. If no report is submitted by a team for 4 years, the team may no longer be considered for referral purposes.

As of this issue of Lifenet out of the 880+ teams in our database only 269 have current information on file. All of the other team information is over 18 months old. ICISF values all teams’ participation in the HOTLINE database; however, we cannot, in good faith to those accessing the HOTLINE, provide information to callers that may be inaccurate. To assist in this updating a reminder is emailed to teams as their update is nearing. Please help us to bring our files up to date. If you do not have access to the Team Information Form contact me at hotline@icisf.org or if you have further questions.

ALSO - ICISF often receives requests from persons looking to contact teams for various reasons. It is ICISF practice not to give out team contact information except for requests pertaining to a current or ongoing incident. Other requests, such as to locate or join a team, will be forwarded to the appropriate team contacts listed in our database. Please respond to these forwarded requests! Even if you or your team cannot assist with a particular request, you may be able to offer helpful information.

Thank you in advance for your help!

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The Development of Resilience-Building Resources for Pastoral Careers by the NSW Disaster Recovery Chaplaincy Network (continued from page 14) To overcome this, an important element of the DRCN’s charter is to build and carry resources to enable and equip local congregations and leaders of faith groups.

When DRCN chaplains enter a community, a key leader will connect with the faith leaders (usually through the ministers’ association or similar body) and explain the work they are doing. Beyond this, they will run training workshops teaching what happens to communities in disasters, issues of loss, clergy stress and self-care and the phases of recovery. This input is very valuable for these leaders early in the recovery phase. The DRCN has excellent links with other agencies entering a district following disasters and helps to connect local faith leaders to their response.

Resources Developed Pre-disaster information and training is vitally important.

The DRCN has created resources for churches and other faith groups to be educated, and plan towards disaster response well ahead of time.

Good Ideas booklet and Resource The “Good Ideas” booklet and training resource was developed from interviews and meetings with ministers who had been involved in three different disaster events in regional areas in NSW seeking to discern what churches and other faith groups needed to know before and after disaster strikes. The result is a kit which guides a congregational planning team through the education, planning and role-allocation process. This works as an audio-visual resource with an accompanying booklet and checklist. One evening is sufficient to build a plan for their congregation’s preparation and response ahead of, or in response to, a disaster event.

Bread for the Journey Especially in disaster settings, chaplains are called to be a non-anxious presence in the midst of chaos, yet it is very difficult to be an agent of care when one is anxious, stressed or burned out. The only way chaplains will be a healthy presence among the people they care for is to keep themselves healthy. Most of the chaplains in the DRCN are working full-time in pastoral or institutional ministry roles. Clergy are especially prone to anxiety, stress, compassion fatigue or burnout due, in part, to the increasing expectations of their role. In country NSW, as congregational membership is decreasing and fewer ordained or commissioned ministry agents are

in placement, the clergy who remain find themselves stretched to the limit. Even in larger urban congregations, ministry agents can become overwhelmed with responsibilities and expectations. “Bread for the Journey” is a one-day workshop that focuses on self-care strategies to help those who minister in disaster and crisis settings lead healthy, balanced, and resilient lives.

Caring for Ministers in Crisis The DRCN has been keenly aware of the toll of leading a faith community and ministering following critical incidents and emergencies. Burnout and compassion fatigue are very real risk factors for people in these situations. The “Caring for Ministers in Crisis” workshop runs alongside the “Bread for the Journey”. An adaptation of a peer support training for clergy used in the Uniting Church, it focuses on highlighting issues for a disasteraffected community, the stresses and risk of compassion fatigue on faith leaders, and strategies to assist these leaders through a process of listening, education, planning and integration. This is a particularly useful tool in a context where very few religious bodies understand the nature of vicarious traumatization and compassion fatigue for clergy in the recovery phases following a disaster event.

Case study: The Tathra Bushfire Emergency The Tathra bushfire burned between the 18th and 19th of March 2018 on the South Coast region of NSW. Starting in the locality of Reedy Swamp on March 18th, by the evening the fire had reached the town of Tathra, destroying homes and blocking one of only two roads out of the town. Two official evacuation centers were established. Although the total burn area was relatively small in comparison to many Australian bushfires (1,000 hectares or 2,500 acres), 69 homes and 30 caravans and cabins were destroyed and 39 others were damaged. The evacuation centers were closed on the evening of March 21st and an official Recovery Centre was opened on March 22nd at the Bega Civic Centre. A spontaneous information center and volunteer hub opened the same day at the Tathra Surf Life Saving Club. It is estimated that well over 1000 persons sought refuge and advice during this time.

Chaplaincy Response For the immediate response on March 18th, the DRCN was limited in numbers of chaplains available to the area.

CONTINUED ON PAGE 17

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The Development of Resilience-Building Resources for Pastoral Careers by the NSW Disaster Recovery Chaplaincy Network (continued from page 16) Three local chaplains responded within a few hours of the request and four additional chaplains the next day.

DRCN chaplains worked long hours dealing with the high intensity of need and emotion. Two of the first responders were ministers in placement, and they had additional responsibilities associated with parish ministry and upcoming Holy Week and Easter services.

As soon as it was safe, buses drove residents through the fire-damaged neighborhoods with two chaplains aboard each bus to give emotional support to the residents as they witnessed the destruction to their homes and the homes of their neighbors.

Mid-week, nine additional chaplains were able to relieve the first seven responders. From Friday, March 23rd through Monday, March 26th chaplains were paired with State Welfare and Red Cross volunteers to door-knock in the affected Tathra neighborhoods where chaplains connected with members of the community who had suffered devastating loss and with others who wanted to support their friends and neighbors. In the week that followed, additional chaplains were brought in to support the community and make connections with the local churches and ministry agents. The total operation involved 20 DRCN chaplains responding for a total of 516 face-toface hours.

Working with the Community and Churches The local ministers responded as well as they could to this situation but were unaware of what emergency procedures

were in place and how they could connect to the official disaster response. Within three days of the fire, Rev. Dr. Stephen Robinson, Coordinator of the DRCN met with the Ministers’ Association explaining the role of chaplains, seeking to make referrals to churches and helping to connect the churches to the local recovery subcommittee. During this time, he ran two education nights in local church buildings and, a month later, was able to involve all the local clergy in a two-day intensive disaster recovery chaplaincy course which helped them both understand, and work through the key issues in assisting local recovery.

Following the training, one of the local ministers came to represent the churches on the local subcommittee.

His work was so effective that, the coordinator of the DRCN was able to facilitate a joint Uniting and Anglican churches’ funding for him in the work part-time for a nine-month period as a recovery chaplain in the area.

This role continues to be very effective.

An indication of the value of this integrative support from the DRCN is that, leading up to the anniversary of the fires, the combined churches have invited Rev. Dr. Stephen Robinson to return to the community and preach at a community church service at the town’s Surf Life Saving Club - the focal point of community response during the early days of recovery.

Susan Phalen and Stephen Robinson and will be presenting at the World Congress on this topic May 22.

ANNOUNCING

CISM CERTIFICATION!

TO FIND OUT MORE, PLEASE VISIT:

CISM.UMBCTraining.com 17

Paradise "Camp Fire" (continued from page 7) their 80’s. It wasn’t until over one month after the incident that they had finally been granted permission to return back to their property. Not because the fire was still burning but because of all the safety issues resulting from the fire. For instance, many of the trees that were still standing needed to be cut down due to the fact they were unstable. Powerlines were down on the ground throughout, gas tanks needed to be inspected and there were many other hazards associated to the ashes and soot alone that can affect one’s health and safety that needed to be handled cautiously. First responders and inspectors had to go through each property searching for survivors and for active hazards, marking cars, gas tanks and trees with a large spray-painted “X” indicating it had been inspected. The search for human remains has also been a long challenging process that involved collecting DNA from relatives.

The wife of the elderly couple we met at the property had no desire to return to their lot as she had heard that their home had been burned to the ground and did not want to see that. She just wanted to move out of the area and start again somewhere else. However, once Samaritans Purse offered to sift through the ashes of their burned home in an attempt to recover any valuable items or specific remains that held a special meaning to them…there was one thing that made her want to return; the Purple Heart her husband had been awarded for his service in the military.

YOU CAN SUPPORT ICISF WHEN YOU SHOP ON AMAZON! GO TO SMILE.AMAZON.COM AND SELECT INTERNATIONAL CRITICAL INCIDENT STRESS FOUNDATION!

we presented them with a special edition of a Billy Graham Bible. They were so incredibly grateful and shared how they felt a renewed sense of hope! Like most of the victims I met, their Bibles had been burned in the fire.

When we arrived at the property, a Samaritans Purse team was already in the process of carefully sifting through the ashes in search for the Purple Heart while my Chaplain partner and I stood with the homeowners listening to their stories and their experience escaping the fire. As we attentively listened, we exchanged a lot of much-needed hugs.

One of the many things that I learned during my time with the victims of Paradise is how incredibly different victims’ reactions are. Many homeowners didn’t care to even go back, yet many couldn’t wait to go assess the damage. Most of them seemed similarly scatterbrained…with a lot of understandable confusion. This traumatic fire has disrupted their safety, trust, control, relationships, comfort, faith, family, health, finances, dreams and many people’s hope for the future. Many have not only lost all their material possessions but also loved ones. Their schools, hospitals, local shops…their community as they know it is gone. Many do not plan on ever returning to Paradise, and others look forward to rebuilding.

As the couple shared many stories about their history in that home, you could visually see how talking about the incident helped their state of mind and aided their healing process.

The deep anguish that dominated their posture and attitudes drastically improved as they safely shared their emotions and experiences with us. Asking key open-ended questions and merely listening to victims of trauma is one of the best things we can do as Chaplains. We call this the “ministry of presence” and it is very effective. As it turns out Samaritans purse found her husband’s Purple Heart amidst all the ashes!

You can only imagine the joy that brought everyone who was present and the numerous additional stories that they shared about his experiences in the military. But what really stood out to me the most was how deeply moved this couple was by the fact that a group of individuals whom they did not know showed up to serve them and care for them. Before we left,

What a challenging week it was hearing, seeing and experiencing so much loss and devastation. As difficult as it was to feel their grief with them, I wouldn’t change being a Chaplain for anything. Every evening when we got back to our headquarters, we all spent time debriefing and sharing stories, praying for one another and making sure that we were all coping properly with what we had experienced.

I will never be the same after that trip…and Paradise, CA will never be the same as it was before either. It will take years to rebuild Paradise…however not all hope is lost and as members of society I believe we need to get out of our comfort zone when we have the opportunity to do so and go help care for those whose lives have been gravely impacted by trauma. I am honored to be a member of ICISF and will continue to educate myself in order to better assist those in crisis.

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Healthy Dispatchers Make Healthy Communities (continued from page 5) primary support program for agencies without and existing program or as a supplement to agencies with an existing program. It outlines procedures for deployment to Critical Stress Incident Debriefings (CISDs) inside and outside of the MARC region. It also describes the roles and responsibilities of the Peer Support Advisory Committee, which oversees the program. It is comprised of individuals representing various PSAPs and mental health professionals with a first responder background and incorporates confidentiality and International Association Chiefs of Police (IACP) guidelines.

With guidance and support from MARC’s Public Safety User’s Committee and Board of Directors, the work to strengthen the capacity to help those affected by traumatic incidents and cumulative stress, resulted in a toolbox of several in-person stress reduction and resiliency training classes that include mindfulness, meditation, equine therapy and yoga for first responders. Post-trauma healing retreat programs are also available.

The regional roving 911 telecommunicator peer support program — believed to be the first of its kind in the nation----is a 28-person group that worked with a team of first responder-specific psychologists to customize a 40-hour training that addresses the unique challenges and stressors faced by 9-1-1 dispatchers.

Training modules in the program cover tools for dealing with 9-1-1 related stress, PTSD in first responders, suicide risk and assessment, resilience among first responders, practical applications of knowledge and critical-incident stress debriefing scenarios. International Association of Chiefs of Police (IACP) guidelines and state-level peer support legislation are also incorporated.

After completing the application process and their training, the program’s 28 participants formed the 9-1-1 Telecommunicator Peer Support Team, a roving team that stands ready to respond, to formally scheduled CISDs and to provide individual assistance to dispatchers in times of crisis. Since the group’s inception in January 2018, members have been asked to deploy 32 times to incidents involving suicide, officer-involved shootings and death, within their own agencies as well as others inside and outside the nine-county MARC region.

During the next year, The Peer Support Advisory Committee, will launch several new subcommittees that will focus on fundraising, creating additional educational resources, establishing a family liaison and offering therapy dog support services.

With the success of the 911 Peer Support Team model, a pilot program for command-level staff is currently underway. The Command Level Peer Support Team is made up of commanders from all first responder disciplines-Police, Fire and EMS. Since its formation in July 2018, the Command Level Peer Support Team has been asked to deploy 13 times to support fellow Commanders by attending CISDs. They were featured in EMS World and MEMSA Connection magazines in December 2018.

The 9-1-1 Peer Support Team and the Command Level Peer Support Team are both involved in a national-level research study to measure the efficacy of peer support programs and the data they provide will be used to help shape national-level programs in the future.

The Peer Support Teams serve as a niche that cannot be filled by typical employee assistance programs (EAPs), department psychologists or chaplains.

CONTINUED ON PAGE 20

F O R M O R E I N F O R M AT I O N , V I S I T I C I S F . O R G / S P E A K E R S - B U R E A U 19

Healthy Dispatchers Make Healthy Communities (continued from page 19) Peer support can be immediate, right after a call or even while still on the scene of an incident. Peers do the same job, and often understand each other’s stress in ways someone on the outside cannot. Peer support training augments other parts of an overall mental wellness program within an agency, but is not intended to replace professional help.

The Peer Support program is proactive and preventive in nature, helping identify problems immediately after an incident, before serious trouble develops. Peer Support Team members are trained to provide accessible, practical and de-stigmatized support to personnel during times of workrelated and personal crisis.

“Our goal is that 911 dispatchers will not feel like the one in

ROVING 911 TELECOMMUNICATOR PEER SUPPORT TEAM MEMBERS MISSOURI:

Brian Alexander & Christina Laing, Blue Springs Police Department Paula Pritchett, Grandview Police Department Mary Osterberg, Harrisonville Police Department Dawn Deterding & Andrea Khan, Kansas City Police Department Jamie Taylor, Lee’s Summit Police Department Kim Harris & Jamila Crawford, Lee’s Summit Fire Department Starlith McAdams & Richard Hedrick, Raymore Police Department Krystal Thompson, Sugar Creek Police Department Melanie Pumphery, Clay County Sheriff Eric Spradley, Jackson County Sheriff Victoria Geer, KCI Airport Police Department

KANSAS:

Karen Wilk, Leavenworth Police Department Naomi Kent, Leawood Police Department Kristin Boyes, Lenexa Police Department Shelley Stenshol & Amber Merritt, Shawnee Police Department Nicki Lantz & Marlynda Dixon, Gale Wash, Johnson County ECC Randy Rystrom, KU Medical Center Police Wendy Dedeke, Amanda Danser & Tanya Hawkins, Leavenworth Sheriff David Gibbs, Miami County Sheriff

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the beginning of this story,” said Eric Winebrenner, MARC’s public safety communications program director. “We want them to know they have a team of their own to reach out to in times of need, across jurisdictions and across first responder disciplines. Healthy dispatchers make healthy communities.” _______________________________________________ About MARC: The Mid-America Regional Council, commonly referred to as MARC, is the nonprofit association of city and county governments and the metropolitan planning organization for the bi-state Kansas City region. Governed by a Board of Directors made up of local elected officials, MARC serves nine counties and 119 cities in Missouri and Kansas, with a population of approximately 2 million. MARC provides a forum for the region to work together to advance social, economic and environmental progress, promoting regional cooperation and developing innovative solutions through leadership, planning and action.

MARC coordinates the Regional 911 System, which handles almost two million emergency calls each year. The regional system is coordinated through a number of committees and task forces comprised of representatives of local governments. They system is served by PSAPs operated by government agencies.

An Interlocal Cooperation Agreement, signed by counties in the region, formalized the cooperation among governments for the 911 emergency telephone number system. The coordination of 911 services assures that no matter where you live in the region, you’ll have access to the same responsive, high quality 911 service in an emergency. Standardization of equipment allows local communities to share a common support system.

Cooperation allows communities to stay abreast of new ideas and technology and build a cohesive 911 system for the future.

The MARC region implemented Text to 911 in February 2016.

About the Author: Pam Opoka graduated from Kansas University in 2018 with a master’s degree in public administration. She completed her Emergency Number Professional (ENP) certification through National Emergency Number Association (NENA) in 2015 and has over 23 years of experience in 911.

MARC 911 Peer Support Program webpage: www.marc.org/Emergency-Services-9-1-1/Regional-911System/Training/911-Peer-Support-Program Link to free online mindfulness training for 911 Telecommunicators and free toolkit for PSAP Managers: www.nwcphp.org/training/opportunities/online-courses/ stress-reduction-training-for-9-1-1-telecommunicators *approved by Hendrika Meischke at U of W.

Developing an Effective Behavioral Health Training Program for a Tough Crowd–Fire Fighters (continued from page 4) Arming you firefighters with stress management tools, tools for better sleep, concentration and anxiety, provide them with a starting point for self-care.

A credible program must be science based. No program solely based on “feeling bad” and things to do about it will pass muster with fire fighters. We like to know how things work. Just like when we are doing our jobs, it is important to understand the why and how of a fire ground operation, explaining the why and how of behavioral health issues is vital for buy in. Designing a science based program, relating stress with the fight or flight response or PTSD with hippocampus damage, makes stress and PTSD real. The physical damage produced by the release of cortisol is a reality and helps drive home the need to engage in stress relief. From the first day in recruit school, fire fighters are educated on the science of physical fitness and nutritional health, why would we not also train them on the science of stress health. All of our programs are delivered by a peer and our staff psychologist. This pairing provides the plain talk of the fire fighter (peer) and the scientific talk of the Doctor. Having this team approach brings an element of credibility that our firefighters can relate to.

An expandable program, as mentioned before, must be multidimensional. Our program has successfully grown into a series of presentations covering the basics of depression and stress, traumatic stress, PTSD and suicide, resiliency and finally tools for stress management and resilient living. We have designed this program to be able to modify the presentation for any audience and time frame. Any program must to be a living thing and adapt to your audience and their needs. We regularly look at our population and explore new topics to build upon that will resonate with our fire fighters. We are currently exploring a new program on managing transitions which will incorporate and tie into a topic from each past presentation. In addition to the stress management programs we have also incorporated much of this information into awareness programs for officers and management.

An accessible program has two meanings. First, the delivery of the program has to be accessible. You have to be willing to travel to any group, present in any time frame and be available in any capacity. Our team does just this. We look for any opportunity to present a class session. We take our training program to the recruits during their very first week in recruit school and provide three additional two hour sessions during their 28 weeks. We work with the academy staff to try and get some form of behavioral health lecture into any class offered to our fire fighters. Presentations during company training nights for our volunteer fire fighters has become a regular invite. Our instation training program brings a new behavioral health training program to the field every two years. This program is presented

in small intimate groups in the fire stations. This delivery model was deliberate and well thought out. With the presentation of such a sensitive topic, it was important for the sessions to be small. Groups of fire fighters who work side by side on a daily basis gather in the comfort of their own fire station, in the day room or around the kitchen table. We bring the program to them and offer it in a non-threatening environment, allowing it to be very accessible.

The second definition of accessibility is resources. It is imperative if you design and provide a program about behavioral health issues, you have to have available resources. As I mentioned we deliver most of our training programs by a CISM peer and our staff psychologist. As the department psychologist, he is a fantastic resource available to our firefighters. Not every department is fortunate enough to employ their own psychologist, so I recommend forging relationships with mental health professionals in your community. Ensure you determine their specialty and area of study. It is important to know what these mental health professionals can handle, they are not all created equal. Ensuring you have resources trained in trauma care, cognitive therapy, EMDR, substance abuse would benefit your workforce. It is critical you have resources to provide to your firefighters before a program is delivered. A phenomenon we experience during our in-station training program is self-referrals to our psychologist, averaging two per week. Firefighters were saying “I knew there was something wrong, I just didn’t know what it was. I am pretty sure you were talking about me.” This past spring we had multiple serious cases of PTSD diagnosed and treated from self-referrals after the program was presented.

Accessibility to resources is just as important as the program itself. Providing a list of local resources, EAP, CISM team access and even insurance coverage information will close the gap for any firefighter needing help and recognizing it immediately after the program or down the road.

A good behavioral health training program has to cover all of the bases. It cannot just be a lecture, it has to be personal, provide tools and resources as well. It takes time to develop a program that fits the needs of all of your fire fighters. Start simple. Provide signs and symptoms and a science based definition of the common behavioral health issues we see in the fire service. Provide some stress management tools. Don’t just tell them what to do, tell them how. Give them skills, tools for the tool box. Give them permission to be human.

Please join me and Dr. Michael Beasley during World Congress as we present “Developing an Effective Behavioral Health training Program for a Tough Crowd – Fire Fighters”, Friday May 24, 11:30 – 12:30 to learn more about how we have developed, implemented and deliver a successful behavioral health program for a tough crowd.

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Pre Incident Training and Collaboration as Evidenced in the Aftermath of the Las Vegas Shooting (continued from page 12) These volunteers were very well received and appreciated. When I returned from Dallas, about a week after the incident, most volunteers had returned to their respective home bases. Some of the challenges were communication from a CISM perspective.

Which first responders received interventions and what mode of intervention was applied? The respective coordinators did an outstanding job and worked extremely long hours along with other helpers, such as Mental Health Professionals. Some of the challenges experienced was that some out-of-town teams showed up and began applying their specific methodology of ‘Psychological First Aid; while indeed their methods were welcome, it leant towards confusion, especially for the recently established Las Vegas CISM teams. Experienced interventionists, (CISM) irrespective of their philosophy will be gracious enough to inquire what training and methodology the local teams are using and collaborate accordingly.

Coroners: Last Responders: While assisting the Las Vegas first responders, with debriefings, I had asked who is helping the Coroners? I was assured that they had teams in place. Ironically, two weeks into the aftermath, I was invited to a multi-agency meeting that was held at the coroner’s office. It was very evident that indeed the coroner’s office needed help with defusing and debriefings. As a result of this meeting, I had the honor (along with my colleague, Stephanie Glover) of assisting the coroner, John Fudenberg, and his staff in processing the horror of the aftermath. In my experience, the coroners are usually the forgotten group. The opportunity to work with with the coroner’s staff was indeed a ‘lesson learned’. Hopefully, going forward coroners will be included in the overall collaborative CISM response.

Collaborative Approach: Perhaps, the best example of a collaborative approach, in responding to the aftermath of a disaster, that I’ve experienced was in 1996, when Trans World Airlines (TWA) flight 800 exploded over Long Island Sound, killing all 230 passengers and crew onboard. At the time, I was the corporate director of TWA’s Employee Assistance Program and my department also oversaw the (Trauma Team) this team was comprised of a group of flight attendants, pilots, ground crews, and management, that volunteered their time to assist in the aftermath of a disaster.

The training was quite comprehensive and included CISM, as well as comprehensive training in the psychological aspects of responding to an aviation disaster. Emphasis was given to logistical challenges that are presented in the aftermath of an aviation disaster. The team engaged the Department of Casualty and Memorials Affairs from the United States Army to facilitate some of our training.

Some of the readers may remember the Chaos that was portrayed

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in the Media; we were very challenged and needed all the support that we could get in an organized fashion. To this end, we had volunteers show up from the following airlines: Alaska, Aloha, American, Canadian, US Airways, and several other regional carriers. These teams were highly sophisticated and trained in the CISM methodology, by ICISF. Additionally, we had volunteers from the police department and NYFD. Personally, I reached out to Dr. Jeff Mitchell for support and he gladly came to JFK to assist. So, you can imagine the opportunity that was presented for organization of these teams. We immediately established a CISM ‘command center’ and assigned a team leader to coordinate these teams as we had specific goals and objectives that needed to be met. Fortunately, airline pilots are gifted at ‘checklists’ and they developed and implemented a checklist for our out-of-town teams. We had goals and objectives that needed to be met as well as avoiding some of the potential obstacles that can manifest when the visiting teams are not supported and guided in a collaborative manner. The coordinator’s primary duties were to support the team by: A: assigning each visiting team a TWA [inhouse] team member to assist navigate the territory.

B: allow systematic handoff to the TWA team for continuity of care C: avoid confusion as to who did what to whom, e.g. what departments were assisted D: what departments and employee population still needed assistance E: duplication of efforts F: the visiting team became part of the TWA family G: the NYFD CISM team were also amazing and integrated seamlessly into the TWA system H: without a systematic approach there is a potential to alienate visiting teams, they may self-assign [as they came to help], this can add to the confusion rather than working together in a collaborative, seamless, manner.

The main principles guiding our response programs are: preincident training and organization, appropriate and targeted interventions, and continuity of care. My experiences, over the past 30-years, having responded to several aviation disasters as well as 9/11, and assisting in the aftermath of the Las Vegas Shooting is that we’ve come a long way with CISM. And, hopefully by sharing our collective “lessons Learned’ we can continue to improve. Some self disclosure, I’ve made many blunders in the aftermath of disasters and properly will continue to learn lessons. Hopefully, by sharing our collective lessons learned we can prevent other team members from falling into the same trap.

Frankly, I believe it’s my responsibility to assist new teams by sharing my experience and especially ‘Lessons Learned’ Dr. O’Flahetry will be presenting this topic at the World Congress on May 22 at 1:30.

I C ISF B OARD OF DIREC TORS

(From left to right): Chuck Hecker, Anne Balboni, Dave Evans - Chairman, Deputy Chief John Scholz, John Durkin, Frank Sullivan, Diane Taylor, Col. William B. Forbes, Rick Barton - CEO, Richard Bloch - Legal Counsel

I CI SF STAFF DIREC TORY Kelly Hall

Rick Barton

khall@icisf.org Development Coordinator Certificate of Specialized Training Program

rbarton@icisf.org Chief Executive Officer

Victor Welzant, Psy.D.

Welzant@icisf.org Director of Education & Training LifeNet Editorial Board

Kate Looram

Lisa Joubert

Thordis Boron

kate@icisf.org Approved Instructor Support Dept. Manager

lisa@icisf.org Chief Financial Officer

Thordis@icisf.org Approved Instructor Support Dept. Assistant

George Grimm

Terri Pazornick

Millie Morehouse

mmorehouse@icisf.org Education & Training Coordinator Speakers Bureau Trade Shows

Beth Kohr

bethk@icisf.org Education & Training Coordinator

Michelle Warshauer, MS, NCC

michellew@icisf.org Education & Training Curriculum Specialist

gagrimm@icisf.org CISM Teams Hotline Team Coordinator

terrip@icisf.org Education & Training Manager World Congress Manager

Diane Taylor, Ed.D, PMHCNS-BC

Michelle Parks

Michal Lesniak

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mparks@icisf.org Membership • LifeNet Editor CE Program Coordinator Online Training Course Program Manager

mlesniak@icisf.org Education & Marketing Coordinator

LifeNet Editorial Board

LifeNet@ICISF.org

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