Critical Incident Response Team helps reduce symptoms of post-traumatic stress

By Jodi S.W. Campbell

If you are in any way connected to or working with individuals diagnosed with mental illness and/or behavioral disorders you know that it’s not an easy job. If you are a parent, a counselor, a teacher, a therapist; if you are working in a home, classroom, hospital, residential facility, group home, clinic or any other setting with individuals who can be violent toward themselves and others, then you know the job is not only difficult but can also be dangerous. You may witness people harm themselves or even try to kill themselves. You may see people throw large objects or scream or threaten or assault others. You may be the one assaulted. You may be the therapist listening to hundreds of harrowing stories of abuse day after day.

And these things just represent your everyday job. What if on top of those normal risks associated with the work you do, you witness or are involved in a tragic event such as a patient death, a serious staff injury, a fire, an accident, act of community violence or natural disaster? The probability that you, a parent or a professional working with individuals who have serious mental illnesses or disabilities could be exposed to a potentially traumatic event (PTE) is very high. And yet, you go back to that job or to that individual again and again, helping, teaching, caring…and you go back to the same environment where the traumatic event took place.

Parents and professionals are just as human as those for whom they care. They are just as susceptible to the effects of trauma and vicarious trauma as anyone else. They probably just have more sophisticated coping skills that help them keep moving forward. But even so, that doesn’t mean that they aren’t affected. In fact, post-traumatic stress can cause many symptoms for the caregiver such as sleep disturbance, eating problems, lack of concentration, anxiety, nervousness and depression. The difference is the parents and professionals are expected to pick themselves up and move on, almost like nothing happened.

KidsPeace has become aware of this dynamic over the past 10 to 15 years and has begun to address post-traumatic stress in our workplace as well as in our community. Following a significant crisis, it is important that an organization is attentive to the potential mental health needs of both clients and staff. Given the caretaker role that program staff play in the lives of the clients they serve, it is important to not only recognize, but also actively attend to the potential negative effects a crisis may have on their health. Responding to the immediate needs of staff may reduce the chances of premature burnout, transference/counter-transference responses and the breakdown of staff objectivity. Caring for the caretakers of our clients is an increasing expectation of referral sources, governing bodies and parents/guardians, and it is consistent with the overall mission of KidsPeace. Following a crisis, staff members expect a formalized response from the corporation. Providing that response in a rapid and coordinated manner helps alleviate the burden of operating a program while attending to immediate self-care needs.

Empirical studies support the following benefits for organizations that provide a formalized system of support to staff members who are exposed to potentially traumatic events (PTEs). Some of these benefits include:

1. Declines in assault (40 to 63 percent declines in different facilities)
2. Decreased staff turnover
3. Fewer injuries
4. Decreased sick leave utilization
5. Decreased medical expenses
6. Decreased legal expenses
7. Sustained productivity
8. Improved morale

The KidsPeace Critical Incident Response Team (CIRT) was originally created to provide KidsPeace and the surrounding community a formally trained team of professionals available to provide post-crisis debriefing and support following significant and potentially traumatizing events. In its early stages, the CIRT received annual full-day trainings from “Extreme Crisis Management LLC” under the direction of Steve Crimando in a modified version of the “Mitchell Model” of Critical Incident Debriefing (CID). Critical Incident Stress Debriefing (CISD), originally developed by Jeffrey T. Mitchell, is an intervention that started in the 1970s to expedite the recovery process for people who need to get back to work quickly (like emergency personnel and firefighters) and to reduce the symptoms of post-traumatic stress after traumatic events (Everly & Mitchell, 1995). There has been some debate in the field about the effectiveness of the intervention, but recent research is showing positive results, especially in samples where the intervention was conducted in a group setting after the first 72 hours following a PTE. CISD is a brief, highly structured group debriefing designed to assist an individual in effectively processing thoughts about what occurred, provide psychoeducation about the nature of post-traumatic stress and connect individuals to other services when necessary. It is not therapy. Rather, it is a technique that helps an individual unpack a recent distressing memory related to a PTE and reorganize the event in his/her mind appropriately, potentially assisting ongoing recovery.

Members of the KidsPeace Critical Incident Response Team respond to internal PTEs such as staff assaults, violent incidents and situations in which clients harm themselves. But the KidsPeace CIRT is available for external response as well. By dispatching professional teams to community crises, KidsPeace can help begin the healing process for people who have been exposed to traumatic events. Our organization does this on a volunteer basis because we believe in sharing our expertise for the greater good. This improves community relations through gestures of public assistance and good will. In recent years, the KidsPeace CIRT has worked side by side with professionals in our communities following school shootings, student deaths, acts of terror and other tragedies. KidsPeace believes that providing the CIRT as one of several resources to staff will help reduce risk for individuals and corporations as a whole.

KidsPeace is absolutely committed to the well-being of our staff, our children and our community. It is time to recognize the effects of this work on caregivers and professionals. In a social environment where patients and students are receiving fewer services for increasingly complex disorders, we must expect the risks of violence and potentially traumatic events to rise. In light of that, the KidsPeace Critical Incident Response Team will be here for our staff and also for the professionals in our community. |

Everly, G. r., & Mitchell, J. T. (1995). Prevention of work-related posttraumatic stress: The critical incident stress debriefing process. In L. R. Murphy, J. r. Hurrell, S. L. Sauter, G. Keita (Eds.), Job stress interventions (pp. 173-183). Washington, DC US: American Psychological Association. doi:10.1037/10183-012

Jodi Campbell, Clinical Consultative Development Specialist, graduated from Cedar Crest College in Allentown, Pa., and has 17 years experience working in children’s mental and behavioral health. She has a broad range of direct-care experience with children ages 4 to 21 with various diagnoses in short-term and long-term hospital, therapeutic residential, independent living and drug and alcohol rehabilitative settings. She is currently pursuing a doctorate in psychology with Capella University. She has published articles on the topics of bullying, trauma and crisis intervention and been interviewed by major media outlets on the topics of parenting, child safety and relational aggression. For the past 14 years she has been teaching and developing curriculum for direct care and clinical staff in more than 25 areas of instruction related to children’s developmental and behavioral health, including Trauma, Resilience, Suicide Prevention, Bullying and Aggression, Child and Adolescent Development, Preventing Boundary Breaking and Abusive Relationships and LifeSpace Crisis Intervention. Campbell has been invited to speak at local, regional and national conferences on these and other topics relating to the mental health profession. Her community volunteer involvement includes holding board positions within Pennsylvania’s local, council and district PTA organizations, and she holds advanced regional licensure under the National Soccer Coaches Association of America. Jodi lives in Allentown with her twin sons Nickolas and Gaelan.