Critical Incident Stress Management

Purpose of the Program

The CISM program assists persons who have been impacted by critical/traumatic incidents. The program's main purpose is to mitigate the impact of a traumatic event, facilitate the normal recovery process for those having normal reactions to abnormal events, and minimize harmful psychological effects resulting from reactions to these events.

Definition of a Critical Event

The definition of a critical event varies but, basically, it is any event that is usually outside the range of ordinary human experience and overwhelms the usual coping skills of an individual. These events include line of duty or exposure to deaths, serious line of duty injuries, multi-casualty incidents, failed missions, and difficult rescues. Critical incidents are typically sudden and unexpected, disrupt someone's sense of control, often involve loss, and can result in a great feeling of vulnerability. Although stress is an expected part of CG duties, it is routinely managed on a day to day basis. However, critical incidents can cause stress reactions that interfere with normal, routine coping skills.

Services Offered by the CISM Program

CISM is a form of psychological or emotional “first aid” which incorporates various interventions and strategies in response to a critical incident or crisis. The tactics are selected based on the nature of the event, the specific population affected, and the timing of the intervention. While mental health professionals may be involved in these interventions, none of the interventions are to be considered psychotherapy or a substitute for psychotherapy. Interventions may include:

• Pre-incident training/preparation 
• Informational, crisis-focused briefings 
• Leadership consultations 
• Defusings/Debriefings (group interventions) 
• On-scene support including 1:1 sessions 
• Family crisis management 
• Follow-up/referrals 

Requesting Services

CISM services are managed by Employee Assistance Program Coordinators or Specialists (EAPCs/EAPSs) located in Health, Safety, and Work-Life (HSWL) centers. Typically, commanding officers or officers-in-charge reach out to the local EAPC/EAPS to request CISM services. The EAPC/EAPS works with a CISM team to determine and carry out the best possible intervention(s). The EAPC/EAPS recruits, coordinates, manages, and deploys the CISM team when it is activated. The team normally consists of the EAPC/EAPS, a mental health professional, a chaplain, and CISM Peers who have been trained by the EAPC/EAPS.

To request CISM services, commanding officers and/or officers-in-charge can notify either the area or district command center, which will in turn notify the HSWL office in your region. The EAPC/EAPS within HSWL office is responsible for coordinating responses, in collaboration with appropriate commands.