Critical Incident Stress Management

Mitchell and Everly wrote a primer on CISM. In their own words,

“As crises and disasters become epidemic, the need for effective crisis response capabilities becomes obvious. Crisis intervention programs are recommended and even mandated in a wide variety of community and occupational settings (Everly and Mitchell, 1997). Critical Incident Stress Management (CISM) represents a powerful, yet cost- effective approach to crisis response (Everly, Flannery, & Mitchell, in press; Flannery, 1998; Everly & Mitchell, 1997) which unfortunately is often misrepresented and misunderstood.
What is CISM? CISM is a comprehensive, integrative, multi-component crisis intervention system. CISM is considered comprehensive because it consists of multiple crisis intervention components, which functionally span the entire temporal spectrum of a crisis. CISM interventions range from the pre-crisis phase through the acute crisis phase, and into the post-crisis phase. CISM is also considered comprehensive in that it consists of interventions which may be applied to individuals, small functional groups, large groups, families, organizations, and even communities. The 7 core components of CISM are defined below . . .”

  • Pre-crisis preparation. This includes stress management education, stress resistance, and crisis mitigation training for both individuals and organizations.
  • Disaster or large-scale incident, as well as, school and community support programs including demobilizations, informational briefings, “town meetings” and staff advisement.
  • Defusing. This is a 3-phase, structured small group discussion provided within hours of a crisis for purposes of assessment, triaging, and acute symptom mitigation.
  • Critical Incident Stress Debriefing (CISD) refers to the “Mitchell model” (Mitchell and Everly, 1996) 7-phase, structured group discussion, usually provided 1 to 10 days post crisis, and designed to mitigate acute symptoms, assess the need for follow-up, and if possible provide a sense of post-crisis psychological closure.
  • One-on-one crisis intervention/counseling or psychological support throughout the full range of the crisis spectrum.
  • Family crisis intervention, as well as, organizational consultation.
  • Follow-up and referral mechanisms for assessment and treatment, if necessary.”

With regard to CISM, I have completed the following ICISF course work:

  • CISM: The Basic Course
  • CISM: Advanced Group Crisis Intervention
  • CISM: Individual Crisis Intervention and Peer Support
  • CISM with Children
  • Psychotraumatology for Clinicians
  • Domestic Terrorism and Weapons of Mass Destruction
  • The Assaulted Staff Action Program
  • Suicide

As a result of this course work, in October, 2003, I was awarded a Certificate of Completion by the ICISF in the study of Mass Disasters and Terrorism and later, a Certificate of Completion in CISM and Emergency Services. Since 1996, I have had extensive experience with on-scene trauma and participated in well over 100 CISM defusings and debriefings.

Much of this experience was at Ground Zero of the World Trade Center in New York City from 9/11/01 until 11/02, as a psychologist-consultant to an NYPD PBA-affiliated organization. For my clinical work at the World Trade Center, I received the Distinguished Service Award from the National Fraternal Order of Police, Critical Incident Response Service.  I am also a recipient of the Distinguished Service Award from the Detectives Endowment Association of the New York City Police Department.  Later, in 2001, I was at the scene of the crash of American Airlines Flight 587 in Belle Harbor, NY.  When called, I continue to be a responder to various crises in New York State and New York City, such as the United Nations, law enforcement agencies, schools, and businesses in the private sector.