Interventions for Trauma in Emergency Personnel
Abstract
In times of crisis, organizations must attend to and manage two populations: civilians and emergency personnel, or first responders. While much emphasis has been placed on addressing the emotional needs of the affected civilians, emergency personnel have been left to their own devices. CISM, on the other hand, was designed to meet the emotional needs of emergency personnel in terms of traumatic stress and to assist them in dealing with various work-related traumas. While CISM has been used to treat emergency personnel, it has been met with criticism from a variety of stakeholders who claim it is ineffective in addressing the issue. So, different alternatives to the CISM model have been made in an effort to help emergency workers deal with the most traumatic and stressful parts of their jobs.
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Introduction
Stress-related disorders are expected to be the second leading cause of disability by 2020.
Thus, stress-related disorders have become the primary strategic goal of the World Health Organization’s Global Burden of Disease and Stress-related Disorders Program (Fagel, 2011). Work-related stress is estimated to cost $171 billion in the United States each year, the same as cancer and cardiovascular disease, and more than Alzheimer’s, HIV, or AIDS. The annual cost of lost hours from absenteeism decreased work productivity, and health-care costs are estimated to be $300 billion. Personnel involved in emergency situations are one source of work-related stress. According to research, people who have never had any kind of disaster training or experience are more likely to develop posttraumatic stress disorder. In a study of PTSD after the World Trade Center, the rate for construction, engineering, sanitation, and unaffiliated workers was 21.1 percent, compared to 12.4 percent for rescue personnel. As a result, it is critical to consider not only the primary survivors’ but also the secondary survivors’ and response personnel’s mental health needs. This paper examines CISM as an intervention approach for emergency personnel, determining whether it is the best solution for long-term and short-term mental health issues. In addition, the paper will talk about some of the other things that can be done to help emergency workers.
Interventions for Emergency Personnel Using CISM
CISM was one of the first interventions used by the personnel involved in emergency services. It was first implemented as a choice intervention in the early 1980s. CISM is a multifaceted, work-based approach designed to help emergency personnel deal effectively with the traumatic and highly stressful aspects of their jobs. The approach’s comprehensiveness (preventative and remedial) and focus on traumatic stress as opposed to general work stress or organizational stress are key elements. It has parts like learning about and dealing with trauma, one-on-one counseling, group meetings, follow-up, and support from a partner.
Whether CISM is the best solution for both long-term and short-term mental health issues is debatable.
The application of CISM has generated a wide range of criticism. However, it remains a popular approach for many agencies and is supported by research findings. This is because it has been shown to be effective in many settings in helping people cope with trauma. The goals of CISM are its greatest asset. It aims to reduce the occurrence, duration, severity, and impairment of emergency personnel as a result of trauma caused by crisis environments. Furthermore, through group interventions facilitated by mental health professionals and counselors, CISM has been credited with successfully facilitating an individual’s psychological closure from a traumatic situation (Regel & Joseph, 2010). CISM also includes leadership training and support, as well as pre and post-incident teaching and education, all of which are critical to the success of any intervention. CISM is a good way to help people with long-term mental health problems because it includes optional informal group discussions and social support after an incident, as well as referrals to mental health professionals for people who need more help.
While CISM criticism is limited, it foreshadows its use as a successful intervention. Criticism has been leveled at the CISM’s effectiveness in assisting emergency personnel in dealing with trauma, as well as its ability to be applied to different people with similar positive results. Studies on post-incident and disaster mental health have called into question the effectiveness of CISM. According to some, CISM can be ineffective and even harmful to individuals. According to studies, the majority of personnel do not require structured group interventions such as CISM. Personnel in need of clinical care have been advised to avoid using this model because it would be too traumatic so soon after an event. According to studies, affected individuals can resolve their stress on their own, given enough time and with little outside assistance. That is, CISM has been blamed for interfering with any individual’s natural recovery process. The intervention’s generalized approach is another source of criticism for CISM. According to research, CISM is not recommended. This is because emergency workers who have been severely traumatized and are now suffering from PTSD have to go back to the scene of the incident, even though person-to-person help might be better in these situations.
As a trauma intervention, CISM is hailed as having numerous benefits that make it an intervention of choice for both long-term and short-term mental health issues. However, because of the unpredictability of CISM’s success, its application is a trial-and-error intervention. This is because it can make a person who has been traumatized feel worse, so it is only a solution for those who can use it well.
Other mental health professionals can help emergency responders.
The effectiveness of the CISM in dealing with the mental health of emergency personnel has been a source of contention among stakeholders such as medical professionals, emergency service workers, and allied professionals. While CISM has been the intervention of choice for the majority of emergency service personnel since the early 1980s, there has been an increase in dissent regarding its effectiveness since the 1990s. As a result, as an alternative to CISM, various intervention programs and mental health professionals have been identified. Programs such as Crisis Counselling Program (CCP), Psychological First Aid (PFA), and Resiliency Development are examples of these. Professional therapists, psychiatrists, occupational therapists in mental health, mental health nurses, social workers in mental health, and general practitioners are all examples of mental health professionals (Levers, 2012).
Psychological First Aid (PFA) is a technique used by disaster relief and first responders. PFA is recommended for emergency personnel by the National Center for Posttraumatic Stress Disorder (NCTSD) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The approach is recognized as a preferred emerging crisis intervention program. It was particularly effective as an intervention by law enforcement personnel deployed on 9/11. It fosters a supportive environment and encourages individual resiliency. It has been approved as a viable alternative to CISM.
Another option for CISM is the Crisis Counselling Program (CCP). It was created by the Federal Emergency Management Agency and is based on the belief that crisis counseling fosters natural resiliency. The strategy was designed to assist regions and personnel affected by terrorism-related disasters. Since the plan is being carried out on a large scale, a mental health corps is needed to help.
Resiliency development is primarily concerned with the resilience of emergency responders. It has been suggested as a substitute for CISM. This is because it prevents first responders from reliving graphic details of an emergency situation. It is based on a person’s inner strength so that the person’s natural resilience can be used to its fullest.
The use of licensed and competent mental health professionals who have previous experience working with and treating people suffering from trauma-related stress is one of the mental health professionals who can assist emergency personnel. In some cases, professional therapists have proven to be more effective than CISM. Their sessions primarily consist of the emergency personnel speaking, with the therapist simply listening and allowing the individual to speak. Psychiatrists have also been mentioned as effective mental health professionals who can assist emergency personnel with stress management. Psychiatrists use psychological treatments such as interpersonal therapy, medication, or behavior therapy, and in cases where stress levels are severe enough to necessitate hospitalization, a psychiatrist will supervise the individual’s treatment. In addition to general practitioners, there are also occupational therapists in mental health, mental health nurses, and mental health social workers who work in alternative mental health.
Conclusion
The last thing any organization wants is to expose their employees to services that harm them rather than help them recover from a stressful situation. While CISM has been shown to be effective in addressing the challenge of traumatic stress, research has shown that it is not completely effective and can be harmful to individuals in some cases. In the face of new, modern, and more effective interventions to address the problem of traumatic stress, it is critical that these modern interventions be used, and that CISM is used in some situations where it is appropriate.
References
M. J. Fagel (2011). Emergency Management Principles and Emergency Operations Centers (EOC). CRC Press, Taylor & Francis Group, Boca Raton, Florida.
L. L. Levers (2012). Theories and Interventions in Trauma Counseling (illustrated ed.). Springer Publishing Company, New York, NY.
Regel, S., and Joseph, S. (2010) Post-traumatic Stress Disorder (PTSD). Oxford University Press, New York.
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