Application and Integration of Psychological First Aid in First Responder Organizations

Author(s):  
Emily F. Brucia ◽  
Matthew J. Cordova ◽  
Angelique Finestone ◽  
Josef I. Ruzek

First responders are exposed to many potentially traumatic events throughout their careers. Given the risk of adverse mental and physical health outcomes secondary to frequent trauma exposure, access to culturally-sensitive, evidence-informed early intervention is paramount. Critical Incident Stress Management (CISM) and components therein (e.g., Critical Incident Stress Debriefing, peer support) represent the most commonly utilized early interventions within first responder organizations. Limited research has evaluated these models, and evaluation of early interventions presents many challenges due to characteristics of first responder cultures and organizational demands and constraints. Psychological First Aid (PFA) is a widely endorsed and promising evidence-informed early intervention model grounded in research on trauma recovery and resilience. This chapter examines the theoretical underpinnings and core actions of PFA and describes the potentially diverse applications of PFA within first responder organizations and concludes by discussing recommendations and future directions.

Author(s):  
Emily F. Brucia ◽  
Matthew J. Cordova ◽  
Angelique Finestone ◽  
Josef I. Ruzek

First responders are exposed to many potentially traumatic events throughout their careers. Given the risk of adverse mental and physical health outcomes secondary to frequent trauma exposure, access to culturally-sensitive, evidence-informed early intervention is paramount. Critical Incident Stress Management (CISM) and components therein (e.g., Critical Incident Stress Debriefing, peer support) represent the most commonly utilized early interventions within first responder organizations. Limited research has evaluated these models, and evaluation of early interventions presents many challenges due to characteristics of first responder cultures and organizational demands and constraints. Psychological First Aid (PFA) is a widely endorsed and promising evidence-informed early intervention model grounded in research on trauma recovery and resilience. This chapter examines the theoretical underpinnings and core actions of PFA and describes the potentially diverse applications of PFA within first responder organizations and concludes by discussing recommendations and future directions.


2017 ◽  
pp. 732-754
Author(s):  
Carole Adamson

This chapter addresses best practice for organisational support after critical incidents and traumatic events within social work. Critical incidents are situations and incidents within workplace settings or roles, which, whilst able to be anticipated and planned for, have the potential to create a sense of emergency, crisis, and extreme stress, or have a traumatic impact on those directly or indirectly affected. Alongside the notion of critical incidents are concepts of debriefing, psychological debriefing, critical incident stress debriefing (CISD), and critical incident stress management (CISM). Debate about debriefing models has concerned their effectiveness and safety; the terms being loaded with meaning and tensions between scientific and holistic paradigms and between academic and practitioner perspectives. The chapter suggests areas of research and exploration for agency managers and senior practitioners wishing to make sense of the debates and enables the reader to consider best practice for critical incident response within organisational settings.


2021 ◽  
Author(s):  
◽  
Julie Mary Maher

<p>This study originates from my practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where I piloted a Critical Incident Stress Peer Support programme in the No.4 Region. My interest in the area began after attending a seminar on Critical Incident Stress Debriefing based on Mitchell's model of debriefing (1983). I had begun to recognise in my practice what I believed to be work-related stress but was a little uncertain about where this stress originated. After attending the seminar I began to understand that some of this stress was related to Critical Incident Stress (CIS) from firefighters exposure to critical incidents.  This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM.  The aim of the study was to gain a greater indepth understanding of firefighters experience specifically in relation to their participation in a Critical Incident Stress Debriefing (CISD) following their exposure to a critical incident. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. I chose to use narratives as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD.  An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience.  As a Nurse Researcher with dual practice interests in the area of nursing education and Critical Incident Stress Management (CISM), I am in a position to inform practice and service development. It is my belief that the knowledge gained from this study has the potential to be transferred to others working in the field of CISM. The study results are timely, practical and informative at a time of major change in the New Zealand Fire Service.</p>


Author(s):  
Emily Brucia ◽  
Matthew J. Cordova ◽  
Josef I. Ruzek

Police officers are exposed to many critical incidents throughout their careers. This chapter discusses critical incident exposure and psychological sequelae in police officers, police culture, obstacles to mental health care, currently utilized early interventions, existing research for these approaches, alternative evidence-based early interventions, emerging models, and directions for future research. Given the frequency and potential impact of critical incidents, early intervention for exposed police officers is of central importance. One of the most commonly utilized group early interventions, Critical Incident Stress Debriefing (CISD), has limited empirical support, such that some departments are being advised against its use. That said, there are important challenges in identifying better, evidence-based alternatives.


2019 ◽  
pp. 159-182
Author(s):  
Emily Brucia ◽  
Matthew J. Cordova ◽  
Josef I. Ruzek

Police officers are exposed to many critical incidents throughout their careers. This chapter discusses critical incident exposure and psychological sequelae in police officers, police culture, obstacles to mental health care, currently utilized early interventions, existing research for these approaches, alternative evidence-based early interventions, emerging models, and directions for future research. Given the frequency and potential impact of critical incidents, early intervention for exposed police officers is of central importance. One of the most commonly utilized group early interventions, Critical Incident Stress Debriefing (CISD), has limited empirical support, such that some departments are being advised against its use. That said, there are important challenges in identifying better, evidence-based alternatives.


Author(s):  
Carole Adamson

This chapter addresses best practice for organisational support after critical incidents and traumatic events within social work. Critical incidents are situations and incidents within workplace settings or roles, which, whilst able to be anticipated and planned for, have the potential to create a sense of emergency, crisis, and extreme stress, or have a traumatic impact on those directly or indirectly affected. Alongside the notion of critical incidents are concepts of debriefing, psychological debriefing, Critical Incident Stress Debriefing (CISD), and Critical Incident Stress Management (CISM). Debate about debriefing models has concerned their effectiveness and safety; the terms being loaded with meaning and tensions between scientific and holistic paradigms and between academic and practitioner perspectives. The chapter suggests areas of research and exploration for agency managers and senior practitioners wishing to make sense of the debates and enables the reader to consider best practice for critical incident response within organisational settings.


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