While it is true that the original models for providing a Critical Incident Response (Mitchell‘s CISM or Dyregrov’s Psychological Debriefing) had principles of a resiliency approach to interventions, it was not clearly defined or emphasized. This was largely due to a lack of understanding in the behavioral health field of the nature of resiliency, and the focus then, on the potential pathology of trauma. Both models emphasized that we were working with people having “normal reactions to an abnormal event”. For those of us in the mental health world they reminded us that people we were talking to after a traumatic event were not “broken”, but rather their normal coping skills were disrupted and we needed to help them “ventilate” (tell their story), “validate” (their reactions) and “educate” (remind/teach coping skills).
So what do we know now?
- PTSD is not an automatic condition following a traumatic event. The latest research seems to indicate that about 4 to 6% of people exposed to a horrific event might develop PTSD, and they may have had earlier life experiences that made them vulnerable to the disease.
- When we are called out to a company to do an intervention, rarely do we respond to a “crisis” or “traumatic” event. We most often respond situations that are potentially disruptive to the workforce and/or the organization. Our most frequent cases are responses to an unexpected death of an employee off site. These are certainly potentially traumatic for the families, but not necessarily for the employees. They are often disruptive. Not all robberies are traumatic, but all robberies are frequently disruptive.
- 94% (at least) of people exposed to any disruptive event are likely to return to pre-incident functioning fairly quickly, especially with help.
What kind of help is most beneficial? The most recent research demonstrates that social support is a major protective factor following disruptive life events. There are various types of social support, informational, practical, and emotional.
So we want to provide for social, occupational and organizational support through group interventions when possible. We want to help the employee understand their experience of the event and facilitate emotional and cognitive processing. We want to appropriately address perceptions of guilt and self-blame, anger and grief. We want to remind, facilitate new ways, and encourage the use of appropriate coping strategies. Lastly we want to facilitate early help-seeking, thus hopefully minimizing psychological complications in the longer term in those rare cases where people might struggle.
This focus helps us to work with the individuals natural coping skills to be able to return to work and stay at work following a disruptive event. Isn’t that the most significant definition of resiliency?
About the Author: Dennis Potter is a licensed social worker, certified addiction counselor and a Fellow, by the American Academy of Experts in Traumatic Stress. Dennis helped to form one of the first community based Crisis Response Teams in the country, and was a founding member of the Mid-West Michigan CISM Team and the Michigan Crisis Response Association. Since 1989, Dennis has helped to train many of the CISM teams in Michigan and in 24 other states.
Dennis has conducted or consulted on all manner of traumatic events for communities, businesses, schools, police, fire and emergency services personnel, the U S Post Office, and community mental health agencies. He is frequently called upon for consultation after particularly difficult events. In addition to his trauma response experience he has received training and supervision in Cognitive Therapy from the Beck Institute in Philadelphia, PA and participated in train the trainer courses in Motivational Interviewing. He is a national and international presenter and trainer. He has presented at the last 10 International Critical Incident Stress Foundation (ICISF) World Congresses and was awarded the ICISF Excellence in Training and Educations Award at the ICISF 2011 World Congress. He has provided motivational training to a variety of mental health, substance abuse agencies and businesses. In addition, he has provided training in both Latvia and Denmark.
