CISM
Civil War
Nostalgia
Illness observed most often among the youngest
soldiers who frequently had no combat
experience
Symptoms
Signs
Causes
Treatment
Taken from War Syndromes and Their Evaluation
by Kenneth C Hyams, MD MPH
Civil War

Irritable Heart/Da Costa Syndrome
Postulated cardiac condition evaluated among
300 patients in a specialized referral center
Symptoms
Signs
Causes
Treatment
Taken from War Syndromes and Their Evaluation
by Kenneth C Hyams, MD MPH
World War I

Shell Shock
Considered psychological Illness after initial
evaluation of victims.
Symptoms
Signs
Cause
Treatment
Taken from War Syndromes and Their Evaluation
by Kenneth C Hyams, MD MPH
World War II
Battle Fatigue (acute combat stress reaction)
Symptoms
Signs
Cause
Treatment
Taken from War Syndromes and Their Evaluation
by Kenneth C Hyams, MD MPH
COCOANUT GROVE HOTEL
November 28th 1942
492 killed
Event involved 187 firefighters, 26 engine
companies, 5 ladder companies and 1
water tower
13 days before 6 firemen had been killed and
43 injured in a building collaspe
Pictures of Cocoanut Grove Fire
The following pictures were from the
Boston Globe Online Archives
Eric Lindeman 1944
Symptomatology and Management of
Acute Grief American Journal of Psychiatry 101,
pp141-148.
Conducted interviews with 101 people.
His work along with that of Caplan from Harvard University
formed the basis of the development of the theory and
practice of Crisis Intervention.
According to Lindemann persons experiencing
acute grief may show one or more of:
Somatic Distress
Preocupation with the image of the deceased
Guilt
Hostile Reactions
Loss of Patterns of condust
Crisis Intervention
Crisis Intervention is emergency psychological care aimed at
assisting individuals in a crisis situation to restore equilibrium
to their biopsychosocial functioning and to minimise the
potential for psychological trauma. Crisis can be defined as
one’s perception or experiencing of an event or situation as
an intolerable difficulty that exceeds the person’s current
resources and coping mechanisms.
The priority of crisis intervention and counseling is to increase
stabilization. Crisis interventions occur at the spur of the
moment and in a variety of settings, as trauma can arise
instantaneously. Crises are temporary, usually with short
span, no longer than a month, although the effects may
become long-lasting.
Taken from Wikipedia
A PRIMER ON CRITICAL INCIDENT
STRESS MANAGEMENT (CISM)
George S. Everly, Jr., Ph.D., C.T.S. and Jeffrey T.
Mitchell, Ph.D., C.T.S.
The International Critical Incident Stress
Foundation
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
Critical Incident Stress Management by Jeffrey T. Mitchell
taken from www.info-trauma.org
What is CISM?
Critical Incident Stress Management (CISM) iscomprehensive,
integrated, systematic and multicomponent
crisis intervention program. It was developed to help manage
traumatic experiences within organizations and communities
organizations and communities.
CISM is a “package” of crisis intervention tactics that are
strategically woven together to:
1)
Mitigate the impact of a traumatic event;
Facilitate normal recovery processes in normal people, who
are having normal reactions to traumatic events;
3)
Restore individuals, groups and organizations to adaptive
function;
4) Identify people within an organization or a community who
would benefit from additional support services or a referral for
further evaluation and, possibly, psychological treatment.
2)
Critical Incident Stress Management by Jeffrey T. Mitchell
taken from www.info-trauma.org (continued)
CISM is neither a form of psychotherapy, nor is it a substitute
for psychotherapy. Instead, CISM is a broad collection of
support services that can be selected and applied to
assist people who are experiencing a strong reaction to a
traumatic event.
In other words, it is “psychological first aid” or “emotional first
aid”.
Similar to a toolbox with many tools for different purposes,
CISM contains many crisis intervention “tools”.
Some of those tools are useful before a traumatic event
occurs. Others are useful while an event is ongoing. Still
others are available for when the event is over.
Critical Incident Stress Management by Jeffrey T. Mitchell
taken from www.info-trauma.org (continued)
Main Components of a CISM Program (include by are not limited to)
• Pre-incident planning, policy development, education, training
• Crisis assessment
• Strategic planning
• Individual crisis intervention
• Large group interventions (Demobilization, Crisis Management Briefing)
• Small group crisis interventions (Defusing, Critical Incident Stress
Debriefing {CISD})
• Pastoral crisis intervention
• Family support services
• Significant other support services
• Follow-up services
• Referral services
• Follow-up meetings
• Post-incident education
• Links to pre-incident planning and preparation for the next crisis
Critical Incident Stress Debriefing
developed by Jeffrey
T. Mitchell Ph.D.