1 CRITICAL INCIDENT STRESS DEBRIEFING FOR SCHOOL EMPLOYEES by NANCY BLACKWELDER May1995 Major Professor: Donald Orlosky, Ed. D. Nancy L. Blackwelder All Rights Reserved 1995 2 TABLE OF CONTENTS (Page numbers in the Table of Contents reflect original document) LIST OF TABLES vii LIST OF ABBREVIATIONS AND ACRONYMS x ABSTRACT xi CHAPTER 1. INTRODUCTION Problem and Its Significance The Problem Significance of the Problem Purpose of the Study Study Questions Definition of Terms Assumptions Study Format 1 1 2 3 4 4 6 6 CHAPTER 2. REVIEW OF THE LITERATURE School Violence Changes in Crime Rate Possible Causal Factors School Responses Summary Crisis Intervention Historical Perspective to Crisis Responses Definitions of Crisis Stages of Grief Response Psychological Responses to Critical Incident Stress Physiological Responses to Critical Incident Stress Somatic Responses to Critical Incident Stress Susceptibility to Critical Incident Stress Posttraumatic Stress Disorder Coping Strategies i Historical Perspective of Short -Term Crisis Intervention Short -Term Intervention Strategies Components of Crisis Intervention Strategies Establishing School Crisis Intervention Teams 9 9 12 13 19 21 21 23 25 28 29 30 32 35 37 38 42 44 49 3 Training for Crisis Intervention Teams Limitations of Crisis Intervention Teams Summary 51 54 57 CHAPTER 3. METHODOLOGY Introduction Assumptions Population Study Design Instrumentation Procedures Data Analysis Limitations 59 61 62 62 64 69 70 70 CHAPTER 4. RESULTS Introduction Data Sources Surveys Mailed and Received Survey Response Rates Interviews Conducted Documents Examined Staff Respondent Demographic Data Crisis Team Respondent Demographic Data Incidents and Interventions 84 District 1 Critique of the Incident District 1 Interventions and Crisis plan District 1 Staff Survey Results District 1 Crisis Team Survey Results District 1 Interview Summary District 2 Interventions and Crisis Plan District 2 Staff Survey Results District 2 Crisis Team Survey Results District 2 Interview Summary District 3 Critique of the Incident District 3 Interventions and Crisis Plan District 3 Staff Survey Results District 3 Crisis Team Survey Results District 3 Interview Summary Comparison Across Districts of Intervention Delivered Interventions Delivered and Received in Each District Comparison Across Districts of Crisis Team 72 72 72 74 75 75 76 77 84 84 88 92 97 99 101 104 107 110 111 114 116 118 120 122 4 and Staff Perceptions of Services Received and Delivered 128 Crisis Team 128 Staff 129 Who Staff Chose to Consult About Reactions to the Incident 131 District 1, 2, and 3 Staff Symptoms Summary 132 Proximity to the Incident 145 Comparison with EMS Agency Procedures 148 Perceived Effectiveness 151 Summary of the Strengths, Weaknesses, and Perceptions of CI Effectiveness From Staff Respondents Across Districts 151 Summary of Strengths, Weaknesses, and Perceptions of Crisis Intervention Effectiveness from Crisis Team Members Across Districts 155 CHAPTER 5. CONCLUSIONS AND RECOMMENDATIONS Summary The Problem The Significance of the Problem The Purpose of the Study Study Questions Assumptions Results Conclusion Implications Policy Recommendations Pre-Incident Education CISD Team for Employees On-Scene Support Services CISD Defusings CISD Debriefings Follow-up Services Spouse Debriefings Crisis Intervention Training for School Employees Community Outreach Programs Other Considerations Recommendations for Further Study BIBLIOGRAPHY APPENDICES APPENDIX A. CISD OF FLORIDA STATE PROTOCOLS AND PROCEDURES MANUAL 159 159 160 161 161 162 162 163 167 168 169 170 171 172 173 177 179 179 181 183 184 186 195 196 5 APPENDIX B. CIS INFORMATION SHEET 214 APPENDIX C. INTERVIEW QUESTIONNAIRE 217 APPENDIX D. QUESTIONNAIRE FOR CRISIS TEAM MEMBERS 218 APPENDIX E. QUESTIONNAIRE FOR SCHOOL STAFF MEMBERS 222 APPENDIX F. LETTERS OF TRANSMITTAL 227 APPENDIX G. CRITIQUE OF DISTRICT 1 INCIDENT DISTRICT 1 RECOVERY ACTIVITIES 231 237 APPENDIX H. CRITIQUE OF DISTRICT 3 INCIDENT 239 APPENDIX I. WRITTEN COMMENTS FROM STAFF SURVEYS 243 APPENDIX J. WRITTEN COMMENTS FROM CRISIS TEAM SURVEYS APPENDIX K. PERSONAL INTERVIEWS 265 280 APPENDIX L. DISTRICT 1 CRISIS PLAN 310 HANDLING CAMPUS EMERGENCIES 338 STRESS AND TRAUMA 347 VICTIM'S RIGHTS WITH THE MEDIA 352 SUGGESTED GUIDELINES FOR FIREARMS ON CAMPUS 353 GUIDELINES FOR BUS DRIVERS--STUDENT FIGHTS AND WEAPONS 355 APPENDIX M. DISTRICT 2 CRISIS PLAN 359 APPENDIX N. DISTRICT 3 CRISIS PLAN 397 LIST OF TABLES (Some graphs available in original document) Table 1. Factors Possibly Associated With School Violence 12 Table 2. Attempted Solutions to School Violence and Vandalism 17 6 Table 3. Stages of Grief 26 Table 4. Short-Term Effects of Crisis 30 Table 5. Diagnostic Criteria for Posttraumatic Stress Disorder 36 Table 6. Determining Expected Degree of Trauma 48 Table 7. Essential Concepts in the Training of Crisis Workers 53 Table 8. Staff Surveys Sent and Returned 73 Table 9. Crisis Team Surveys Sent and Returned 73 Table 10. Percentage of Staff and Crisis Team Responses to the Surveys for Districts 1, 2, 3, and the Pilot Study 74 Table 11. Percentage of Male and Female Staff Respondents 75 Table 12. Percentage of Staff Respondents' Occupations 76 Table 13. Percentage of Staff Respondents' Educational Level 77 Table 14. Percentage of Crisis Team Respondents' Occupations 78 Table 15. Percentage of Crisis Team Respondents' Educational Level 78 Table 16. Percentage of Crisis Team Respondents' Crisis Intervention Training 79 Table 17. Percentage of Crisis Team Respondents' Continuing Education in Critical Incident Intervention Training 81 7 Table 18. Table 19. Table 20. Table 21. Table 22. Table 23. Table 24. Table 25. Percentage of Crisis Team Respondents' On-the-Job Experiences Performing Critical Incident Intervention 82 Percentage of Crisis Team Respondents' Experience Conducting a Formal Critical Incident Debriefing Session 83 Percentage of Crisis Team Respondents who Delivered One-on-One Counseling at Various Time Intervals 123 Percentage of Staff Respondents who Received One-on-One Counseling at Various Time Intervals 123 Percentage of Crisis Team Respondents who Delivered Small Group Counseling at Various Time Intervals 124 Percentage of Staff Respondents who Received Small Group Counseling at Various Time Intervals 125 Percentage of Crisis Team Respondents who Delivered Large Group Counseling at Various Time Intervals 125 Percentage of Staff Respondents who Received Large Group Counseling at Various Time Intervals 126 Table 26. Percentage of Crisis Team Respondents who Distributed CIS Information, Mental Health Agency, or Other Handouts 129 Table 27. Percentage of Staff Respondents who Received CIS Information, Mental Health Agency, or Other Handouts 130 Percentage of Staff Respondents who Consulted with Various Individuals About Reactions to the Incident 131 Percentage of District 1 Staff Respondents Experiencing Delayed Symptoms in Descending Order of Frequency 133 Percentage of District 2 Staff Respondents Experiencing Delayed Symptoms in Descending Order of Frequency 135 Percentage of District 3 Staff Respondents Experiencing Delayed Symptoms in Descending Order of Frequency 137 Percentage of Staff Respondents Experiencing Zero, 1-3, or 4 or more Symptoms in the During Phase 140 Table 28. Table 29. Table 30. Table 31. Table 32. 8 Table 33. Analysis of Variance on the Average Number of Symptoms Experienced During Each Phase Ho: M1=M2=M3 141 Table 34. Percentage of Staff Respondents Experiencing Zero, 1-3, or 4 or more Symptoms in the After Phase 143 Percentage of Staff Respondents Experiencing Zero, 1-3, or 4 or more Symptoms in the Delayed Phase 144 Analysis of Variance Between Phases and Proximity to the Incident Ho: M1=M2=M3=M4 147 Table 35. Table 36. Table 37. Comparison Between CISM model and District Interventions 148 Table 38. Percentage of Staff Respondents Answering "Yes" to Questions 7-10 151 Percentage of Staff Respondents Answering "Yes" to Questions 12-14 and 16 153 Percentage of Staff Respondents Answering "Yes" to Questions 15 and 17 154 Percentage of Staff Respondents Answering "Yes" to Question 18 155 Percentage of Crisis Team Respondents Answering "Yes" to Questions 8-12 and 17 155 Percentage of Crisis Team Respondents Answering "Yes" to Questions 13-16 157 Table 39. Table 40. Table 41. Table 42. Table 43. Table 44. Comparison Between Staff and Crisis Team Respondents of Perceived Effectiveness LIST OF ABBREVIATIONS AND ACRONYMS CI Crisis Intervention CIS Critical Incident Stress 163 9 CISD Critical Incident Stress Debriefing CISM Critical Incident Stress Management CIT Crisis Intervention Team CT Crisis Team EMS Emergency Medical Services ERIC Education Resource Information Center FDLE Florida Department of Law Enforcement HMO Health Management Organization PE Physical Education PsycLit Psychology Literature PTA Parent Teacher Association PTSD Posttraumatic Stress Disorder SAC School Advisory Committee SRO School Resource Officer 10 Abstract School employees can incur debilitating emotional damage from trauma associated with school violence. "The trauma to the victims of violent crime often invokes an emotional response in excess of grief and closely resembling Posttraumatic Stress Disorder (Bixler, 1985, p. 3)." The stress is exacerbated by the necessity of the victims to return to the scene of the crime each day and the tendency to deny themselves the natural human responses to stress in an effort to care for the children. Emergency service professionals have incorporated Critical Incident Stress Management (CISM) programs and indicate worker burnout and workman's compensation claims decreased as a direct result. The purpose of this investigation was to describe, compare, contrast, and evaluate crisis intervention procedures provided for employees of three school districts where a critical incident occurred. A case study design included participant interviews, questionnaires and an analysis of public documents. Each district's crisis intervention plan is described, compared to emergency service CISM programs, and evaluated in terms of perceptions of the effectiveness of care provided. This study addressed the following questions: 1. What was the nature of the crisis intervention for staff? 2. How did the provisions for employee crisis intervention compare and contrast with those provided by emergency service agencies? 3. What was the perceived effectiveness in caring for the emotional and psychological needs of the staff involved in the crisis and what component (s) of the plan contributed to that perception? 11 Results indicated that employees were greatly affected, exhibiting symptoms of critical incident stress and posttraumatic stress months and years post-incident. There was a significant difference in the average number of symptoms respondents experienced according to their proximity to the incident and there was a significant difference in the average number of symptoms experienced according to the nature of the incident. There were services provided to staff members that were perceived as effective and largely an absence of services that contributed to a perception of ineffectiveness. It was recommended that school districts develop a Critical Incident Stress Management program for employees. Abstract Approved:_________________________________________________ Major Professor: Donald Orlosky, Ed.D. Department of Educational Leadership Date Approved:________________________ 12 CHAPTER 1. INTRODUCTION Problem and Its Significance The Problem Various types of crises have an impact on the function of the school; such as, social events and issues, economic changes, environmental crises, medical crises and deaths. natural disasters, Some crises or critical incidents are so traumatic they alter the consciousness of a school and community for many years. The issue of school violence is not new, but the more recent phenomenon of firearms at school has increased confiscations, subsequent expulsions, serious injuries, and deaths. Relatively few homicides have occurred on campus in past history; however, statistics may change with the increased occurrence of violent crime in the community and subsequent increases in the schools. When a major crisis occurs at school the staff is expected to take action immediately and to regain control of the situation. Children's needs are the primary concern as schools stand "en loco parentis". No matter how traumatic the situation, the children come first, a natural reaction for most due to the protective, nurturing nature of their profession. No matter how rattled, emotionally distraught, or frightened, educators are placed in the position to suppress and defer their natural responses in an effort to care for the children first. For days after a tragedy, they may be expected to console grieving, frightened children as they themselves grieve and inspect their own mortality. It is intense and exhausting. So who helps the helper? 13 Significance of the Problem The premise of this study is that school employees can incur debilitating emotional damage from trauma associated with school violence. "Research on bereavement suggests that homicide bereavement is more severe than bereavement for suicide, natural death, or accidental death. The trauma to the victims of violent crime often invokes an emotional response in excess of grief and closely resembling Posttraumatic Stress Disorder (Bixler, 1985, p. 3)." The stress is exacerbated by the necessity of the victims to return to the scene of the crime every day and the tendency to deny or to steel themselves against the natural human responses to stress in an effort to care for the children. Since the teachers must be the primary care-giver for the children, it seems reasonable the school district should take responsibility for looking after the needs of its employees, in as proactive a fashion as it cares for the children. Emergency service professionals have recognized the need for employee assistance and have incorporated effectively short-term crisis intervention strategies as a routinized protocol. The literature indicates that worker burnout and workman's compensation claims decrease as a direct result of this proactive initiative. The crisis team members require extensive training and practical experience in defusing and debriefing strategies, as well as periodical continuing education sessions. It is the contention of this researcher that schools can benefit from the research conducted in the emergency service field and can institute more aggressive employee assistance programs to deal with the ever increasing 14 possibility of traumatic incidents in the schools. A comprehensive crisis plan would need to address guidelines for handling weapons in school, plans to handle the inevitable media blitz, and victim assistance or crisis intervention plans for children, staff, and family during the incident, immediately after, and months post-incident, to facilitate the recovery of the school and community. Purpose of the Study The purpose of this study was to describe, compare, contrast, and evaluate crisis intervention procedures provided for school-based employees of three school districts in Florida, in which a critical incident occurred. For the purpose of this study, a critical incident was defined as a line of duty death or serious injury, mass casualty or multiple serious injury, homicide or suicide. Crisis intervention refers to the methodology or procedural protocol implemented to restore normal job and personal functioning to individuals who have experienced a critical incident. The researcher described each district's crisis intervention policy and procedural protocol, compared those policies and protocols to the crisis intervention of emergency service agencies and evaluated the perceived effectiveness of intervention provided. Study Questions This study addressed the following questions: 1. What was the nature of the crisis intervention procedures for staff members in the three school districts? 15 2. How did the provisions for employee crisis intervention compare and contrast with those provided by emergency service agencies which routinely face critical incidents? 3. What was the perceived effectiveness in caring for the emotional and psychological needs of the adults involved in the crisis and what component (s) of the policy or protocol contributed to that perception? Definition of Terms The following definitions are stipulative in nature and represent operational meanings for the purpose of this study. 1. Anxiety. a safety valve that helps us recognize and avoid danger. It increases our reflexive responses and sharpens our awareness of events around us. Excessive anxiety is a state of distress, trepidation, worry, apprehension or dread. Intense fear or dread lacking an unambiguous cause or a specific threat. (APA, 1988a, p. 1) 2. Critical incident. a line of duty death or serious injury, mass casualty or multiple serious injury, homicide or suicide. More generally it is any incident that causes personnel to experience unusually strong emotional reactions which have the potential to interfere with their ability to function. (Mitchell, 1988b, p. 47) 3. Critical Incident Stress Debriefing (CISD). an organized approach to the management of stress responses in or as a result of an emergency situation. 4. Critical Incident Stress Syndrome. a characteristic set of psychological and physiological symptoms related to experiencing a major disaster that causes people to experience unusually strong emotional reactions which have the potential to interfere with their ability to function either at the scene or later. (Mitchell, 1988a, p. 43) 5. Crisis Intervention. a methodology or procedural protocol implemented to restore normal job and personal functioning to individuals who have experienced a critical incident. (Mitchell, 1988b, p. 48) Denial. a refusal to grant the truth of a situation. Difficulty accepting a suddenly changed reality that is too overwhelming to manage at the time. 6. 16 (Morris, 1970, p. 352) 7. Depression. a transient normal emotion of sadness or mood swings. Serious depression. is an emotional problem characterized by persistent or severe feelings of worthlessness, hopelessness, sleeplessness, loss of self-esteem, loss of joy, social withdrawal, apathy, sudden outbursts of anger, loss of sexual desire and fatigue. Excessive sleep is commonly used as an escape mechanism as well as thoughts of suicide. (APA, 1988b, p. 1) 8. Hyperalertness. an exaggerated state of an alertness to one's environment or surroundings; excessive alertness and highly sharpened startle reaction. (Morris, 1970, p.31 & 647) 9. Hypervigilant. an exaggerated state of watchfulness which can result in sleeplessness. Ever watchful and alert. (Morris, 1970, p. 647 & 1429) 10. Intrusive Images. images and/or thoughts that plague ones consciousness. 11. Panic Attack. a category of anxiety that is unpredictable and creates a sudden, intense apprehension, fear or terror, and can cause heart palpitation, chest pain, choking or smothering sensations, dizziness, hot and cold flashes, trembling and faintness. (Upjohn, 1992,p. 2) 12. Posttraumatic Stress Disorder (PTSD). is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity, or witnessing an event that involves death, injury, or a threat to the physical integrity of another person: or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate. (APA, 1994, p. 424) 13. Psychic numbing or emotional anesthesia. a diminished responsiveness to the external world. (APA, 1988f, p. 1) 14. Somatic responses. a physical reaction to a physical or psychological stimulus affecting the body. Symptoms that show up as changes in bodily functions. (Everly, 1989, p. 153) 15. Stress. a physiological reaction, or response regardless of the source of the reaction. (Everly, 1989, p. 6) 17 16. Stressor. stimuli that alters the normal anatomical or physiological integrity of the individual to engender the stress response. (Everly, 1989, p. 7) 17. Stress response. the activation of psycholendocriological mechanisms. (Everly, 1989, p. 7) 18. Stress reactions. physical, cognitive, emotional or behavioral responses to stress. (see Appendix B for lists of reactions) Assumptions There are several assumptions the researcher has made in the design of this study: 1. Although people have been traumatized and a period of time has passed since the incident occurred, they will remember enough information about the incident to make the results valid. 2. The instruments developed will gather dependable data. 3. The Emergency Service Protocol and Procedures manual is a legitimate source of best practice in short-term intervention and is transferable to the school environment. 4. Although the researcher was a victim of violent crime at a school site, unbiased evaluation of data is possible. 5. People will respond honestly to the questionnaires. Study Format This dissertation was written in a five chapter format with the following organizational structure: I. Chapter 1-- includes the problem and its significance, the purpose, the research questions, definition of terms, and the study format. II. Chapter 2-- presents a review of the literature concerning issues related to 18 school violence citing three strains of thought on the topic, to include changes in the rate of violent crime in schools, causal factors and school responses. A second section provides a review of the literature addressing critical incident stress, post-traumatic stress disorder, grief counseling and crisis intervention methods. It provides a model for critical incident stress debriefing, to include crisis team structure and training and a detailed description of a research based crisis intervention protocol III. Chapter 3-- presents the methodology for the naturalistic investigation of this study. The data collection process includes the development of two questionnaires; one for the school employees and the other for the crisis intervention team; a set of interview questions for the personal and telephone interview process; and the examination of primary documents. Procedural safeguards for internal and external validity, reliability and objectivity are discussed, as well as, data analysis and limitations of the study. IV. Chapter 4-- includes the results of the data collection. V. Chapter 5-- includes the summary, conclusions, implications, policy recommendations, and recommendations for further study. Appendices include, the Florida Critical Incident Stress Debriefing Protocol, stages of stress, critiques of the incidents, recovery activities, guidelines for firearms of campus, guidelines for violence/weapons on buses, CISD information sheet, victim's rights with the media, district policies and protocols, recommendations from study groups regarding the recovery process, staff questionnaire, crisis team questionnaire, personal interview questionnaire, letters of transmittal, applications for critical incident stress debriefing teams and other data tables. In summary, the intent was to describe each district's crisis intervention policy and procedural protocol, to compare those policies and protocols to the crisis intervention of emergency service agencies and to evaluate the perceived effectiveness of intervention provided for school-based employees. 19 CHAPTER 2. REVIEW OF THE LITERATURE The review of the literature is divided into two sections; school violence and crisis intervention. The school violence section will explore the changes in rate of incidents, causal factors, and school responses. The crisis intervention section covers an historical perspective and definitions of crisis, stages of grief and critical incident stress, susceptibility to critical incident stress, psychological and somatic responses to critical incident stress, coping strategies, short-term intervention strategies and components, team establishment and training, and limitations thereof. School Violence 20 Changes in Crime Rate School violence is closely associated with crisis prevention and intervention, but how often does it occur and is there sufficient cause to implement vigorous victim assistance initiatives? There is little agreement on the primary causes, trends or solutions, but there is concurrence that school violence is a problem. Three opposing views about violent crime in schools surface in the literature. The most prevalent view is that violent crime is increasing at alarming rates, creating an unsafe environment for children and costing the tax payers millions of dollars annually. Gallup polls taken from 1954 to 1984 reveal American's long-term concern about discipline in public schools. Since 1969, in every year but one, discipline has been considered the biggest problem facing schools by at least a quarter of the respondents. Reports indicate that the nature of school discipline problems have changed over the past few decades. "In the 1950's, teachers thought that fighting, stealing, and disrespect toward authority were the most serious forms of student misbehavior. Violent assaults on teachers and pupils, gang warfare, burglary, extortion, and destruction of school property are included among the discipline problems of the 1980's" (Arsulich, 1979, p.23). Possible causes include gang influence, television aggression, poor home conditions, failing economy, changing family structure, drugs, large schools, bad teachers, irrelevant curriculum, student's rights legislation, unemployment and community influences. The United States Department of Justice Survey and the National Institute of Education Safe School Study are repeatedly cited throughout the literature (Chicago Board of Education, 1981). 21 The notion of a progressive worsening of crime and violence in the schools during the 70's and 80's is refuted by authors who cite the same two surveys. Their conclusions state that, "for theft from teachers and all offenses against students, crimes in schools as reported by the victims remained essentially level or declined. What increases there were occurred in the late 1970's in attacks on teachers and damage to their personal property" (Moles, 1987, p. 38). Factors suggested for this slight increase were mainstreaming of more disruptive students into classes with teachers who are less well-equipped to handle them, keeping youth in school rather than suspending or expelling them, heightened awareness and willingness to report attacks, higher proportions of male students, large classes, and community influences. In fact, teacher opinion polls show that problems of discipline and violence had declined in the early 80's. Some researchers go even further to explain that the public's perception of increased violence is a result of increased violence in the media. The contention is that one's view of the extent of violence is distorted by the concentrated overabundance of violence on the television and in the newspapers. There is also a notion that the statistics on assault are distorted because acts of mutual combat are reported inappropriately as assaults, which carries a more abusive connotation. The third camp suggests that although the percentage of disruptive students has remained relatively constant, increasingly violent. the crimes they commit are Florida statistics indicate a marked increase in the possession of firearms in schools. weapon of choice in schools. Guns may be replacing the knife as the Research indicates that approval of violent 22 behavior manifests itself as an attitude change over time. "The experience of victimization socializes individuals to a view of violence as constituting an effective strategy for resolving interpersonal conflict" (Dowd, 1981, p.351). "A variety of cultural influences produce a relatively homogeneous attitude toward violence and shape normative evaluations made by adolescents" (Bush, 1982, p.15). An antithetic effect emerges in attitudes towards violence after repeated exposures and creates an incremental tolerance to increasingly violent acts. There is consensus, however, that school violence is a concern and that many students and teachers are victims and do suffer personal harm and loss of possessions. The 1992 Justice Department figures indicated that 100,000 children go to school with guns every day. Crime, in any form, is a costly phenomenon that disrupts the educational process. Solid evidence exists that violence and fear of violence posses a serious threat to a learning environment. Apprehensiveness among students reduces concentration on assigned tasks and creates an atmosphere of mistrust. It fosters a long term deterioration of respect for authority due to a perception of incompetency or apathy toward protecting the innocent. Table 1 outlines a myriad of suggested causes for violence in the schools. Social problems typically are multidimensional in nature. No single issue causes the problem and subsequently no single solution alleviates it. Schools are a reflection of the social, economic and political environments of communities that feed them. Stephens (1985) compiled the majority of this list, however other suggestions were added from other sources. 23 Possible Causal Factors Table 1 Factors Possibly Associated With School Violence _____________________________________________________________________________ _ COMMUNITY INFLUENCES SCHOOL INFLUENCES _____________________________________________________________________________ _ Drugs Lack of discipline Gangs Poor leadership Poverty Poor teacher training Single-parent homes Irrelevant curriculum Divorce Poor teachers Child Abuse Student's rights Television aggression Poor security Inflation Poor architectural design Both parents employed Lack of authority Lack of respect for police Lack of funding Legislation Inconsistent policies Children's rights Lack of parental support Boredom Lack of community support Declining religious affiliation Lack of political support Anonymity of large populations High teacher/pupil ratios Failing criminal justice system Large schools Changing family structure Bussing Unemployment Integration Lenient gun control laws Credit requirements Credential dependent jobs Lack of respect Cultural differences Cultural insensitivities Armed forces requirements Mainstreaming Urbanization Drop-out programs Technology Overcrowding Pro-violent values Lack of cooperation btw. teachers and Prevailing prejudice administration Affluence Teacher Silence Insufficient HRS effectiveness Demands without voice or explanation Transient population _____________________________________________________________________________ _ Source: Stephens (1985), p.30. This study explores the more prevalent issues mentioned in the literature, not intending to suggest that resolution of these issues will solve the problem and placing no value on the degree to which they affect the problem. 24 School Responses "There is no simple solution. Generalizations based on existing theories or applied approaches are often either too global in nature or too specific" (Stephens, 1985, p. 33). another school. What works in one school may not work at all in Action must be based on the unique characteristics of a particular school or community. School districts can impact school violence with a variety of approaches, even though many community causal factors are outside their realm of control. The literature frequently cites student discipline policies, procedures and practices as a focal point in combating school violence concerns. "Structure of order, legitimate and effective governance, strong leadership, and fair, predictable enforcement of rules is crucial" (Stephens,1985, p.38). "Testimony collected by the Senate Subcommittee to Investigate Juvenile Delinquency in its 1975 hearing indicated teachers often resisted telling principals of their problems for fear of being considered unable to control their classrooms. Principals refrained from reporting the range of misbehaviors to the central office for parallel reasons" (Wayne, 1980, p. 4). "Victimization data from 26 American cities surveyed in 1974 and 1975 indicated that nine out of ten of the in-school victimizations suffered by students and four out of five of those suffered by teachers and others were not reported to the police" (Rubel,1978,p.18). "Historically, our nation's schools have distanced themselves from the criminal justice system" (Pitcher & Polland, 1992, p. 94). The most commonly cited explanations by administrators for unreported crimes, according to Rapp, Carrington, and Nicholson (1986) were the following: 25 1. Wish to avoid publicity and litigation. 2. Fear they will be viewed as ineffective. 3. Perception of some offenses as too minor to report. 4. Preference for relying on their own discipline system. 5. Suspicion the police and courts would not cooperate. The reasons that teachers do not report crime were similar: 1. Fear of being blamed or retaliation from the student. 2. Desire to avoid litigation. 3. Trouble identifying the offender. 4. Desire not to stigmatize the young offender. (Pitcher & Poland, 1992, p. 94) "Many educators appear to have an unrealistic or naive attitude in terms of interacting with the police and protecting their students' and staffs' safety" (Summerhays & Lindbloom, 1989, p. 50). Many principals still opt to handle offenses internally instead of involving the police. "Various social changes have diminished the authority of school officials which alter the options regarding school discipline. School officials must recognize when and how they should utilize police expertise and when they must submit to police jurisdiction over student-committed crime" (Nedurian, 1982, p. 198). A philosophical position prevalent in the literature is that the long tradition of excusing criminal behavior because the offender is a child must end. "Cultural differences, socioeconomic conditions, broken homes, and other problems are not grounds for allowing criminal acts to go unchallenged on school property" (Blauvelt, 1987, p.14). A contemporary theory of behavior places the blame squarely on the children's shoulders. The problem is children choosing to be violent. It suggests that "school administrators must recognize that their responsibility ends when the student makes a choice not to behave" (Morgenstern, 1980, p.6). responsiveness of the criminal justice system is crucial. The 26 Student's rights legislation features predominantly in the literature. "Student's rights advocates and court decisions have protected the rights of disruptive students, failing to consider the right of other children to learn in a disciplined structured place. The result has been a loss of teacher authority and the inability of schools to respond to criminal activity with an appropriate degree of punishment - thus erasing the distinctions between good and poor behavior" (Clegg, 1984, p. 17). Laws governing search and seizure, corporal punishment, due process, right to privacy, First and Fourteenth amendment rights all contributed to expanding the rights of criminal defendants, while crime rates escalated. Many states have begun to reverse that trend by enacting victim rights legislation. "In 1985 the Illinois Legislature revised its Juvenile Court Act and sections of the criminal code to get tough on juvenile crime and school related crime" (Menacker, 1989, p. 347). In 1982 California voters approved Proposition 8, known as "The Victim's Bill of Rights." The initiative added a safe school provision. In 1988, Florida passed Senate Bill 634 expanding the victim rights in litigation, notification and victim's assistance. These initiatives are a double edged sword. They work to protect the victims, but place more responsibility on the schools to provide for the safety and security of the children. Few articles fail to mention the impact of class size or school size as contributing to disorderly conduct. "Manning theory and social control theory, taken together, predict that larger schools will experience more disruption because a smaller proportion of the student population will be involved in meaningful activities. In addition, previous research suggests that larger schools experience more disorder because they cannot be managed as effectively as 27 small schools due to communication problems. Lack of staff involvement in decision making is likely to link school size to school disorder" (Gottfredson, 1985, p. 9). Public support for legislative funding is essential for this problem to be solved. Finally, improved campus security is inevitably included in safe schools research. Sound detection systems, security lock devises, crime analysis techniques, incident reporting alarm systems, resource teams, campus public safety education, architectural design, medal detectors, video surveillance equipment, teacher training, K-9 teams, and school resource officers are but a few viable alternatives schools may elect to incorporate. A common response is to create a school security officer stationed within the school. These police liaison programs serve to improve police - community relations, increase understanding of the police role and of the individual's responsibilities in the community, provide a sense of safety and security and provide a tremendous source of information regarding options, precautions and legal issues associated with the prosecution of juveniles. "Criminal justice personnel, police, and educators need to come to an agreement regarding roles and responsibilities of each agency" (Blauvelt, 1984, p. 5). To conclude this section, the tendency to view crime in schools as if it existed apart from crime in the community has two unfortunate consequences. "First, the blame is placed solely on the schools, or more precisely on school officials, administrators, and teachers. Second, solutions are almost always school related (Stephens, 1985, p. 40). Although many school related approaches have intrinsic value, reliance on school-related interventions may not significantly lower levels of school crime. 28 Table 2 reflects a compilation of the types of school related initiatives that have been attempted to combat crime in the schools. Stephens (1985) compiled the majority of this list, however other suggestions were added from other sources. 29 Table 2 Attempted Solutions to School Violence and Vandalism _____________________________________________________________________________ _ Student Oriented Diagnostic learning centers Part-time programs Group counseling Behavior modification: Contingency management Time-out Response cost Contracting Achievable reward criteria Participation in grievance resolution School-safety committee Regional occupational centers Academic-support services Student advisory committee Financial accountability School transfer Interpersonal skill training Problem-solving training Special student activities Individual counseling Security advisory council Escort service Victim education Arrests Alternative schools Youth re-entry program Buddy system Victim witness program Peer-tutoring corps Moral education Value clarification Teacher Oriented Aggression-management training Increased teacher-student non-class contact Firm, fair, consistent discipline Multicultural sensitivity training Compensation for victim expense Self-defense training Teacher-student-administration Carrying weapons group discussions Low teacher-pupil ratio Teacher-parent interaction Individualized teaching Legalization of staff use of force Curriculum Art and music courses Police courses Life skills courses Minischools Schools within schools Learning centers (magnet schools educational parks) TV course for expelled students Law courses Work-study programs Ideograph grading Equivalency diplomas Schools without walls Prescriptive tailored course Self-paced instruction sequences Victim avoidance Continuation centers (street course academies evening high schools) Administrative Skilled conflict negotiators Administration-police coordination Principal visibility and availability Aggression management training Democratized school governance Principal visibility and availability Multicultural sensitivity training Legal right handbook School safety committee Safe corridor programs School procedures manual Human relationscourse Written code of conduct 24 hr custodial service Effective intelligence network Relaxation of arbitrary rules (re: smoking, dressing, absences, etc.) 30 Physical School Alterations Electronic monitoring-weapon detection Decorative grillwork over windows Plexiglas or polycarbon windows paint Recess fixtures where possible Encourage student drawn murals Alter isolated areas to attract traffic Implement rapid repair of vandalism Removal of tempting vandalism targets Blackout of all lighting Cool colors on walls Reduce school size Intruder detectors Increase staff supervision Hard surface Personal alarm systems Tag all school property for ID Clean-up, pick-up, fix-up days Safety corridors (school-street) Pave graveled parking areas Install graffiti boards Bright colored lockers Reduce class size Close off isolated areas Extensive lighting Parent Oriented Telephone campaigns for PTA, SAC attendance Parenting skills training Parents as apprenticeship resources Antitruancy committee (parent, counselor, student) Parents as guest speakers Parents as work-study contacts Parents as mentors Parent literacy program Family education center Parent youth motivators Security Personnel Security personnel for: Campus public safety programs Crime analysis patrol, crowd control, record keeping, Police helicopter surveillance Identify security risks teaching (law),counseling, home visits Police K-9 patrol units Incident reporting (Continued on next page) Table 2 (Continued) Evaluate protective measures Develop security manuals Security safety teams Community Oriented Media coverage of vandalism costs Boot camps for disruptive youths Vandalism prevention education Open school to community after hours. Family back-to-school week HRS programs for disruptive students Public television programs (cable) Youth motivator, tutor programs Restitution programs Adopt-a-school programs Helping hand programs Neighborhood watch programs Neighborhood day School-juvenile court liaison Community newsletter Community education programs Interagency crisis referral teams Businessmen on school advisory committee State and Federal Oriented Uniform violence reporting systems National moral leadership State antiviolence advisory committee Gun control legislation Coordination of federal, state agencies Prosocial television programs Less restrictive child labor laws Victim rights legislation Safe school legislation Financial support ________________________________________________________________ Source: Stephens (1985), p. 35. Summary 31 How bad is it? The 1990 statistics indicate that the weapon of choice with youngsters has gravitated from knives towards guns. "Although school accidents that cause deaths are rare, crimes on campus have increased dramatically in the past 5 years. A recent U.S. Department of Justice survey 'found that 2 percent of students- or an estimated 400,000- had been the victims of a violent crime at school' (Lawton, 1991, p.14). "A study by the Center to Prevent Handgun Violence (1990), based solely on newspaper reports, found that from September 1986 to September 1990, at least 65 students and 6 school employees were killed with guns on school campuses across the nation. Another 201 individuals were wounded severely, and 242 were held hostage at gun point. (These numbers do not include similar incidents in which weapons other than guns were used.) Although the majority, 63%, of these gun-related incidents occurred on high school campuses, 37% were at junior high and elementary schools"(Oates, 1993, p. 6) "As for teachers, the toll is awesome and frightening. In 1986, physical attacks were made against 8,000 in every 100,000 teachers, more than double the rate of the year before" (David, 1989, p. 22). Understandably, the situation is having a profound effect on teachers. If schools are dangerous places for them to work, or if students' misbehavior prevents them from practicing their profession, many are wondering if they should teach at all. "According to the U.S. Department of Education, nearly onethird of instructors said that the problem has prompted them to consider leaving their jobs" (David, 1989, p. 22). "It has been documented that 85% of all disability retirements are a direct result of stressful occupations" (Moser, Scholar, Grorud, Fletcher, Jonczyle, 32 Nipp, Hoyt, & Whipple 1986, p.32). "Assaults on teachers have become so common, and in many cases so brutal, that some communities have developed programs to aid the victims. The therapy provided is similar to that given to veterans suffering from combat-related neuroses. Many teachers find that the assault, though devastating enough, is the first in a series of injuries. The emotional trauma stays with them the longest" (David, 1989, p. 23). The rate of violent crimes in Florida - the most crime-ridden state in the nation - increased 5.2 percent in 1989 over 1988 figures, according to statistics released August 20, 1990 by the Florida Department of Law Enforcement (FDLE). According to the FDLE statistics, a violent crime occurs every 3 minutes and 37 seconds. Florida's crime rate of 8,755.9 crimes per 100,000 population exceeds the nation's. Educators can not avoid the subsequent increase of violent crimes in the schools. The preceding discussion has established the perception that criminal activity in the nation's schools is a concern. Where there is crime there are victims. It follows that victim assistance may be needed. 33 Crisis Intervention Historical Perspective to Crisis Responses Oates (1993) provides an interesting historical perspective on death in American Schools: Deaths that affect the school community have occurred since the days of the one-room schoolhouse. Until recently, however, school officials usually ignored deaths or dealt with them in a matter-of-fact manner. In earlier times medical knowledge and sophisticated medical technology were limited. The mortality rates were high and most people died at home. Death was not a mystery, nor a taboo experience. Today, however, increased geographic mobility separates individuals from older relatives, and more people die in hospital intensive care units that at home. These two aspects of contemporary life- mobility and modern medicinehave removed healthy exposure to death and dying. Formalized plans for responding to death in the school community were rarely found before the late 1970's, and most of the early plans resulted from the rising incidence of youth suicide. By mid-1980, however, a growing number of educators recognized the need for comprehensive plans. Schools that have not experienced a tragic death probably will in the future. It is no longer a question of if there will be a death that affects a school campus, but rather when. The needs of students, teachers, staff and parents must all be considered. (p. 2-3) "Although it is difficult to know precisely how overall youth crime statistics affect the school, one can assume that the overall sense of physical and emotional safety in schools has been compromised"(Pitcher & Poland, 1992, p. 14). "Following violent deaths, many students and staff may exhibit fear and anger in addition to grief. When deaths occur on the school campus, whether due to disastrous accidents or criminal acts, the school's immediate and long- 34 term responses need to be especially well planned" (Oates, 1993, p. 6). The majority of articles reviewed in the PsycLit data base focused on crisis intervention with children. The elderly and schizophrenics featured second and third. Some articles spoke specifically to crises in schools but the focus was on intervention with children. Numerous articles addressed the effect of critical incidents on normal adult populations with a heavy focus on grief counseling and short-term crisis intervention. Detailed plans to prevent the formation of Posttraumatic Stress Disorder after abnormal life experiences in the work place were sparse. Maynard (1985) states that, "effective coping skills and patterns established throughout all phases of life continue to be called on when adults face a personal crisis. The emphasis on children seems to be embedded in the concept that children have not fully developed coping skills, therefore need additional assistance in certain traumatic situations (p. 40)". "Approximately 25% of those who experience a crisis never resolve it: children are at highest risk: and the sooner startled students can express their emotions, the better off they well be"(Pitcher & Poland, 1992, p. 127). It is important to note however, "in an evaluation of a crisis plan, two months after the death of two students, many teachers commented on how superbly the school handled the students and wondered why they did nothing for the teachers. Many felt devalued and cheated" (Petersen & Straub, 1992, p. 59). Although little is written detailing specific short-term crisis intervention methods for school-based employees, few articles fail to recognize the devastating effects critical incidents have on the school community, to include students, teachers, staff and parents. Definitions of Crisis 35 The focus of this study is crisis intervention for school based employees, therefore, first it is important to have a clear picture of what constitutes a crisis. The literature abounds with many and varied definitions. For example, there are more than one type of life crisis. Maher (1987) provides a concise delineation: 1. Dispositional crisis-- distress resulting from a problematic situation. 2. Anticipated life transition-- that reflect anticipated but usually normative life transitions. 3. Traumatic stress-- emotional crises precipitated by externally imposed stressors or situations that are unexpected and uncontrolled and that are emotionally overwhelming. It could be a single event or a series of events. 4. Maturational/developmental crises--attempts to deal with an interpersonal situation reflecting a struggle with circumscribed issues that have not been resolved in the past. 5. Reflecting psychopathy--emotional crises in which preexisting psychopathy has been instrumental in precipitating the crisis or which psychopathy significantly impairs or complicates adaptive resolution. 6. Psychiatric emergencies-- general functioning has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility. (p. 182-83) Item #3, traumatic stress, is our focus and the literature describes it in three different contexts; the event, symptomology, and the emotional response. Definitions that equate crises with disasters or critical incidents, i.e. the event or the causal situation, read as follows: "Disasters are defined as basic disruptions of the social context within which individuals and groups function or as a radical departure from the pattern of normal expectations" (Geil, 1991, p. 8). 36 "Critical incidents are recognized disasters or other crisis situations that evoke unusually strong emotions" (Walker, 1990, p.122). "Disasters can be construed as environmental stressors of some magnitude to be brought into play with mental stressors and health stressors to constitute a trinity of adversity" (Taylor,1989, p.5). Finally, "when crime escalates into serious injury, death, or life threatening situations, a crisis exists" (Mitchell, 1988a, p. 43). "Further attempts to define crisis have been made through symptomology: feelings of tiredness and exhaustion, helplessness, inadequacy, confusion, anxiety, disorganization of functioning in work relationships, vulnerability, suggestibility, and reduced defensiveness" (Pitcher & Polland, 1992, p. 8). The third focus of a formal definition of crisis is the emotional state and perceptions of the individual(s) involved. Maher & Zins, (1987) describe a crisis as "a time when one is in danger of becoming extremely impaired emotionally" (p. 177). One review of the literature by Auerback & Kilmann (1977) concluded, "across models there seems to be general agreement that crisis is a response state characterized by high levels of subjective discomfort at which the individual is at least temporarily unable to emit the overt or covert behaviors required to modify the stressfulness of his environment" (p. 1189). "Hans Selye, the father of modern endocrinology concluded, 'It is not what happens to you that matters, but how you take it.' In more clinical terms he stated, 'Thus in the final analysis, it can be seen that physiological reactions to psychosocial stimuli result from the cognitive interpretations and emotional reactions to those stimuli, not the stimuli themselves' "(Everly, 1989, p. 26) Pitcher & Poland (1992) summarized the literature by stating, "A few 37 points are consistent. One is that it is the perception of the individual that defines a crisis- not the event itself. Second, the individual in crisis has a very difficult time negotiating life while in this crisis state, however brief that state is. Third, a crisis state is not seen, in itself, as psychopathology, nor is it chronic. Crisis is a 'normal' reaction to an 'abnormal' stressor" (p. 9) Stages of Grief Response At this point it is appropriate to discuss the basic concepts of grief in that most people experience grief at some point in their lives and the grief response is closely associated with the traumatic stress response. Petersen & Straub (1992) adequately describe the generally held theories in the field of grief response with the following summary: Every person grieves somewhat differently in that one may move quickly from one emotion to another while a second might exhibit only one intense emotion over a long period of time. Both reactions are normal. The five generally recognized stages in a grief reaction are: denial, fear, anger, depression, and reorganization. 1. Denial Stage The denial experienced after a significant loss is the psyche's natural protection at work, preventing too much emotional impact from occurring all at once. The person is intellectually aware that a death has occurred but subconsciously suppresses the emotional response. 2. Fear Stage A serious tragedy can cause fear of a repeat incident. Individuals may experience hypervilgilence, watching for the next victimization. 3. Anger Stage Anger is the dominant emotion encountered and while some tragedies provide a target for the anger others do not. If there is no direct target, the individual will search for someone or something to blame and thereby justify their 38 angry feelings. 4. Depression Stage Depression can be manifested in two types of behavior. In the first type, most often associated with depression, the person cries frequently, is lethargic, withdraws from activities and lacks initiative. The second type of behavior, caused by but not generally associated with depression is avoidance. Depression serves a purpose. It is the psyche's way of protecting itself from too much emotional impact. Tragedy devastates the ability to cope with the changes incurred and saps the emotional energy needed to progress. Depression is an insulation from risktaking by allowing only certain things to be of great importance in life. This is helpful because it gives time to heal and rest. 5. Reorganization Stage Before people can once again organize their lives, they need permission to cease mourning and continue living (p. 77-84). 39 Table 3 Stages of Grief ________________________________________________________________ Denial/Shock Feeling of numbness Belief or feeling that deceased will return Insomnia/sleeplessness Loss of appetite (people literally forget to eat) Inconsistent behavior Bargaining with God Persistent dreams or nightmares Inability to concentrate Preoccupation without being able to identify with what Confusion (Continued on next page) Table 3 (Continued) Fear Nightmares Sleeplessness Easily startled Anxiety and restlessness Verbal expressions of false bravado Phobias Anger Irritability Provocative in fights Sarcastic remarks Anti-social behavior Refusal to comply with rules Guilt Self-destructive behavior Apologetic attitude Acting out in response to praise or compliments Depression Lethargy Decreased attention span Frequent crying Unkempt appearance Disinterest in activities Suicidal thoughts Withdrawal from friends Overeating or loss of appetite Self-deprecation Oversleeping or inability to sleep 40 Masking Depression Substance abuse Consistent restlessness Consistent inappropriate joking Involvement in high-risk behaviors Gains reputation of "party person" Sexual promiscuity Adoption of an "I don't care" attitude Reorganization Dreams of deceased become infrequent Joy and laughter return Planning for future begins Reinvestment in activities once dropped or forgotten ________________________________________________________________ Source: Petersen & Straub (1992) p. 86-7. Psychological Responses to Critical Incident Stress There is concurrence in the literature that trauma-inducing incidents occur in three phases. Petersen & Straub (1992) describe with incredible insight the stages of trauma-inducing incidents. 1. The Impact Phase The impact phase occurs immediately following an event and can last minutes or days. During this phase, the person is either functioning mechanically or is so stunned he cannot act at all. Denial of the effects is common, especially among men and boys with a macho attitude. The intensity of the effects is increased when the media, police and attorneys are involved. 2. The Recoil Phase During the recoil phase there is a great need to retell the story. People will become overreactive to any reminders of the event, such as a loud noise after a shooting. The emotional reactions begin during this phase and angry outbursts, bouts of uncontrollable crying, and panic attacks can occur. In cases involving victimization, there is usually an acute sense of helplessness. The necessary restoration of self-confidence is actually achieved through one of the most troublesome symptoms, the intrusive thoughts. Replaying 41 the incident over and over is the mind's attempt to make sense of what happened and thereby gain a sense of mastery over the event. Phobias and anxiety, sometimes directly related to the experience but more often a freefloating generalized uneasiness, persist because a basic trust in the world has been shattered. Victimization or watching someone being victimized shatters the assumptions with which we all build our lives. The destruction of these assumptions provides fertile ground for PTSD. The primary assumptions that are violated are those of invulnerability, that the world is meaningful, and positive self-image. Although news of shootings, accidents, and disasters are presented to us with every newscast, we live under the assumption that these calamities will not strike us. This sense of invulnerability provides a natural protection from stress and anxiety. However, when an incident occurs that shatters this assumption, we must change our beliefs to include the facts that 1) it can happen to me, and 2) the world is not as safe as I thought it was. Those who have felt the most invulnerable before an event occurs have the most difficult time adjusting, because the event shatters truisms that have never been questioned. Victims need to feel less vulnerable and will seek to make sense of what happened by assigning accountability and determining who is responsible for the event. It is ironic that victims who decide they did something which allowed the incident to happen are actually restoring a personal sense of control. 3. Resolution or Adjustment Phase Pre-crisis Functioning Level During this phase individuals slowly get over the initial strong emotional recoil. This period takes much longer than the period where anxiety and emotionality shoots up. After a period of time, most individuals adjust to the crisis event and the changes it may have brought. This is a slow process and takes from months to years (p. 90-92). Physiological Response to Critical Incident Stress The literature indicates that people respond with a fairly predictable 42 physical and emotional patterns, however, each individual varies in the intensity and duration of the response. As indicated in the aforementioned impact phase, initial physical response is an inability to move, accompanied by an emotional response of disbelief, denial and numbness. "This stage usually ends in a matter of seconds, giving way quickly to the fight-or-flight response. The body prepares for danger: the heart beats faster, adrenaline enters the system, and breathing is accelerated while a cataclysm of emotions erupts- rage, fear, terror, confusion. Finally, the body physically exhausts itself and the mind begins the slow process of emotional restructuring" (Petersen & Straub, 1992, p. 72). Table 4 Short-Term Effects of Crisis _______________________________________________________________ Physical Response: Frozen in place: shock, disorientation, numbness Fight-or-Flight response: adrenaline pumps, heart race hyperventilation occurs Exhaustion: when fight or flight can no longer be prolonged Coinciding Emotional Response: Shock: disbelief, denial Cataclysm of emotions: anger/rage, fear/terror, grief/sorrow, confusion/self-doubt Reconstruction of emotional equilibrium ________________________________________________________________ Source: Petersen & Straub (1992), p. 73 Somatic Responses to Critical Incident Stress It is interesting at this point to delve deeper into the relationship between the psychological stimuli and the physiological response. "Cognitive appraisal refers to the process of cognitive interpretation, that is 43 the meanings that we assign to the world as it unfolds before us. Affective integration refers to the blending and coloring of felt emotion into the cognitive interpretation. The resultant cognitive-affective complex represents how the stressors are ultimately perceived. In effect, this critical integrated perception represents the determination of whether psychosocial stimuli become psychosocial stressors or not" (Everly, 1989, p. 25). Everly describes the physiological response to an individual's cognition as an arousal, or neural activation that affects the various organs such as the skeletal muscular system, the endocrine system and the general neurological system. When there is a chronically high stimulation for prolonged periods a neuroendocirine response called "fight or flight" occurs. "The 'fight or flight' response (the neuroendocrine axis) is thought to be a mobilization of the body to prepare for muscular activity in response to a perceived threat" (Everly, 1989, p. 32). The most chronic and prolonged somatic responses to stress are the result of what Everly (1989) calls the endocrine axes which include the adrenal cortical axis, the somatotropic axis, the thyroid axis, and the posterior pituitary axis. He describes them as follows: a. The Adrenal Cortical Axis-- Activation of the hypothalamicpituitary-adrenal cortical system has been associated with the helplessness/hopelessness depression syndrome, passivity, the perception of no control, immunosuppression, and gastrointestinal symptomatology. b. The Thyroid Axis-- Hypothyroidal activity is an elevated thyroidal activity which increases general metabolism, heart rate, and blood pressure which is linked to depressive episodes. c. The Posterior Pituitary Axis-- Certain neural impulses stimulate the release of an anti-diuretic hormone, which as a result causes water retention. Recent research into the Type A behavior pattern has uncovered the role that 44 testosterone plays in the stress response. d. The Somatotropic Axis-- The anterior pituitary responds by releasing growth hormone (somatotropic hormone) into the systematic circulation. The role of growth hormone in stress is somewhat less clearly understood, however, research has documented its release in response to psychological stimuli (p. 35-37). Petersen & Straub (1992) mentioned panic attacks in the recoil phase of critical incident stress which merits some elaboration. Researchers have determined that a panic attack is an unprovoked surge of fear accompanied by at least four of the following symptoms: (Upjohn, 1992, p. 2) 1. 3. 5. 7. 9. 11. 13. 15. 17. Sweating Shortness of breath Heart palpitations Smothering sensations Trembling or shaking Tingling Hot or cold flashes Fears of losing control Accelerated heart rate 2. 4. 6. 8. 10. 12. 14. 16. Chest discomfort Unsteady feelings Choking Nausea Abdominal distress Feelings of unreality/detachment Faintness or dizziness Fears of dying or going crazy A panic attack usually lasts just a few minutes but can appear to last for hours, because its symptoms can be so overwhelming. An event such as a death or other critical incident may kick off the first attack, however, there are only theories as to the actual cause. "While many studies have examined the emotional components of panic attacks, more recent studies have shown that panic disorder's roots are physical as well as psychological" (Am. Psychiatric Asso., 1992e, p.5). Individuals can have a panic attack and not have a panic disorder. It depends on how many attacks one experiences in a given period of time. Untreated panic attacks can develop into a panic disorder which can produce other side effects. "Fear of the fear the attacks bring, or anticipatory anxiety, can be one unfortunate outgrowth. The sufferer never knows when 45 another attack will come, and is always steeled for it" (Am. Psychiatric Asso., 1992e, p. 3). "Whatever its causes- biologic or psychologic- panic disorder is associated with serious problems, such as the onset of depression, alcohol or drug abuse, and even suicide attempts" (The Upjon Co., 1992, p. 6). Susceptibility to Critical Incident Stress There is much said in the literature about an individual's susceptibility to critical incident stress disorders, categorized as personality-, environmental-, and biological-based elements. Personality-based susceptibility to stress arousal immediately brings to mind the Type A coronary-prone behavior pattern first associated with research by Friedman. Some of the descriptors of the Type A personality are, chronic time urgency, competitiveness, impulsive impatience, aggression and denial. behavior, ambition, immoderation, Powell (1984) concludes that "a characterologic insecurity is thought to give rise to an extraordinary need for power and achievement, perhaps as a means of compensating for or contradicting the feelings of insecurity. Power and achievement are related to control, and it has been found that Type A individuals possess not only high achievement motives but also an extraordinary need for control. The need for control and the fear of the loss of control may then account for the observed impatience, time urgency, and competitiveness." (p. 3) Mitchell (1991) claims there is a strong correlation between the Type A personality and the personality of the emergency service worker (firefighter, emergency medical technician, police officer) most likely to suffer from critical incident stress disorder. He indicates that 51% of firefighters die of a heart attack 46 due to stress related events. Those traits are: 1. Obsessive/compulsive- details 2. Perfectionist- must be perfect and highly self-critical if something goes wrong 3. Action oriented 4. Easily bored 5. High need for stimulation 6. Risk taker 7. Highly dedicated 8. Strong need to be needed 9. Difficulty saying no 10. Rescue personality 11. Family oriented 12. Driven by internal motivations 13. Generally high tolerance for stress/ ambiguity Many educators fit the description listed above. Adults in positions of authority often feel they must maintain a strong image. Emotionality or susceptibility to stress reactions may be perceived as a weakness in character, therefore they hide or suppress what are normal human reactions following crisis situations. Mitchell also established other determinants for acute stress which includes the following seven considerations: 1. 2. 3. 4. 5. 6. 7. 8. The nature of the event How much warning preceded the incident The ego strength of the individuals The coping styles of the individuals Prior mastery of a crisis experience Proximity and role one played in the incident Concurrent stressors The nature and degree of social support Since depression features predominantly as a crisis response it is appropriate to use Oates(1993) classification of the five predispositions to depression. These classifications of depression also capture the biological- and 47 environmental-based susceptibilities to critical incident stress. Biological makeup- Some people seem physiologically disposed to depression. A chemical or endocrine imbalance or a serious illness can cause depression. Life events- When someone suffers a great loss he or she may become depressed. The depression may return on the anniversary of the event. There is a difference in feeling sad as we often do, and a deep depression that doesn't go away. Old age- Older people become depressed more frequently than the young (related to life events). Medications- Some drugs cause depression (e.g. high blood pressure medicines, hormones, steroids, and certain anticancer agents). Personality type- People who are highly self-critical, very demanding, or passive and dependent are prone to suffer depression. People who have difficulty expressing their anger may become depressed. (p. 64-65) Posttraumatic Stress Disorder What differentiates Posttraumatic Stress Disorder (PTSD) from grief responses and critical incident stress responses? "PTSD is a constellation of symptoms resulting from a recognized stressor that would wake significant symptoms of distress in almost anyone" (Hayman, etal.,1980, p. 10). "Violence or its threat can result in serious emotional reactions that, if left unresolved, can lead to Posttraumatic Stress Disorder. Twenty-five percent of adults who suffer a traumatic or violent loss go through PTSD"(Petersen & Straub, 1992, p. 89). Mitchell states that in any given trauma 40-97% of the individuals exposed will develop symptoms similar to PTSD. "It is a common human problem and is a normal response to an abnormal event, but it can be devastatingly disruptive for years. In many cases, however, it 48 can be prevented" (Petersen & Straub, 1992, p. 89). "Conceptually the diagnosis can include two mental states that follow extreme stress; a). intrusive overreaction- characterized by repetitive or intrusive thoughts, disruptions of sleep patterns, hypervigilance, and unexpected strong emotion; and b). denial- characterized by over control, inattention, constriction of thoughts and emotions, amnesia. It is classified as an anxiety disorder" (Hayman, 1980, p. 16). "It is important to recognize the symptoms, understand why they occur and be aware of some steps you can take to prevent PTSD in the aftermath of a crisis" (Petersen & Straub, 1992, p. 89). Table 5 outlines the clinical description of Posttraumatic Stress Disorder. Table 5 Diagnostic Criteria for Posttraumatic Stress Disorder _____________________________________________________________________________ _ B. following The traumatic event is persistently reexperienced in one (or more) of the ways: 1. recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. 2. recurrent distressing dreams of the event. 3. acting or feeling as if the traumatic event were recurring includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes. 4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. 5. physiological reactivity on exposure to internal or external cures that symbolize or resemble an aspect of the traumatic event. C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: 1. efforts to avoid thoughts, feelings, or conversations associated with the trauma 2. efforts to avoid activities, places, or people that arouse recollections of the trauma 3. inability to recall an important aspect of the trauma 4. markedly diminished interest or participation in significant activities 49 5. feeling of detachment or estrangement from others 6. restricted range of affect (e.g., unable to have loving feelings) 7. sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span) D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: 1. difficulty galling or staying asleep 2. irritability or outbursts of anger 3. difficulty concentrating 4. hypervigilance 5. exaggerated startle response E. Duration of the disturbance is more than 1 month. F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. _____________________________________________________________________________ _ Source: APA (1994) p. 428-29 Coping Strategies Several references have been made to coping strategies throughout this review which makes it essential to know how coping strategies are defined and what these strategies are. "Coping is defined as efforts both action-oriented and intrapsychic, to manage (that is master, tolerate, reduce, minimize) environmental and internal demands, and conflicts among them, which tax or exceed a person's resources. Coping can occur prior to a stressful confrontation in which case it is called anticipatory coping, as well as in reaction to a present or past contrition with harm" (Cohen and Lazarus, 1979, p. 219). More recently, coping has been defined as "constantly changing cognitive and behavioral efforts to manage specific...demands that are appraised as taxing or exceeding the resources of the person" (Lazarus & Folkman, 1984, p.5). Everly (1979) indicates there are various styles of coping patterns, such as defensive coping, information seeking, and problem solving. He further states that: 50 this attempt to reestablish homeostasis can be either adaptive or maladaptive. a. Adaptive coping strategies reduce stress while at the same time promoting long-term health (for example, exercise, relaxation, proper nutrition.) b. Maladaptive coping strategies reduce stress in the short term, but serve to erode health in the long term (alcohol/drug, abuse, cigarette smoking, interpersonal withdrawal). The cognitive-affective domain is the critical causal phase in most stress reactions. (p. 44) Petersen & Straub (1992) do a good job of describing four coping strategies; redefining the event, finding meaning, changing behaviors, and seeking social support. 1. Redefining the event- assign causality that could have been avoided restores their own sense of control after experiencing the helplessness of watching heroic but unsuccessful efforts. 2. Finding Meaning- the process of the search for an answer is vital to restoring the meaning. People will devote themselves to something associated with the event and find meaning to the tragedy by aligning it with the endeavor. Others may search for a cause to champion and consciously assign meaning to the tragedy through the good they bring to the world. This reestablishes a person's belief in the order of the universe. 3. Changing Behaviors- if they identify those behaviors that originally led to a crisis and change them, the victims gain a sense of control over their environment and decrease their feelings of vulnerability. These changes in behavior also increase self-esteem because the victims see themselves no longer allowing any victimization. 4. Seeking Social Support-- Social support must be unconditionally available if it is to restore a benevolent view of life. This is vital since any negative tone or unavailability of support confirms the victims' questioning of their own selfworth and spawns a victim mentality. (p. 93-94) Historical Perspective of Short-Term Crisis Intervention 51 Given the large body of knowledge regarding the human stress response, is there an effective intervention to reduce the effects of traumatic stress? The literature overwhelmingly agrees there are methods to intercede and help individuals avoid the debilitating long term effects of critical incident stress. There are theories that "generally assumes that most people can take care of many problems in their lives. However, when equilibrium is upset by some stress, any person may temporarily be pushed off balance emotionally and show signs of disturbance. He will apply his usually coping mechanisms until he succeeds and the distress subsides. When the emergency is unique and the strain severe, he may not have any effective coping mechanism immediately available, so the person remains highly disturbed. Help is needed, and the help is most useful if provided as soon as possible" (Pitcher & Poland, 1992, p. 24). "Caplan noted that during or just after a personal crisis individuals appeared less able to cope with or negotiate the developmental demands in their lives, which in turn could lead to long-term disorganization or even mental illness. Since developmental crises could be anticipated, they could be prevented. If they could be prevented, probably some mental illness could be prevented, especially if it were sparked by these crisis situations. Thus the concept of preventive mental health was born"(Pitcher & Poland, 1992, p. 26). Klagsbrun, Kilman, Clark, Kutscher, Debellis, & Lambert (1989) contend that by recognizing high-risk situations that are likely to give rise to mental illness in the future, it is possible to apply preventive measures at the time and head off subsequent problems. (p. 12) "Many of the theorists in crisis intervention literature assume that longterm pathology can result from poorly resolved crises. If the individual copes in a 52 manner that is counterproductive in the long run, then he or she not only becomes entrenched in coping habits that are likely to perpetuate future crises but may also have difficulty negotiating the developmental tasks of that portion of his or her life. Another possibility is that the individual may 'get stuck' in the crisis state, an alternative that could lead to serious long-term depression or psychological malfunctioning"(Pitcher & Poland, 1992, p. 126). Kneisel & Richards (1988) described the intervention occurring after the suicide of an elementary school teacher. The intervention included a meeting with faculty, classroom discussions with the students most directly affected, and the availability of the school psychologist for individual meetings. In addition, a memorial service was held at the school. He argued "that such a broad, multifaceted response contributes to the healing process and serves to minimize mental health difficulties after such an event." (p. 165) Intervention techniques have been used in other work settings with the following conclusions: Morrison (1988) proposed a comprehensive approach to assist nurses to resolve the psychological effects of an assault in a psychiatric setting and to improve coping and professional functioning after the assault. He quoted M.J. Horowitz (1986) whose concept of the stress response syndrome provides a framework to understand a person's need to deny the emotional response to assault and to understand the phases of resolution. Benefits of using a crisis theory framework approach included, "(1) increased mobilization of resources within the system, (2) accurate reporting of assaults, and (3) increased retention of nurses." (p. 120) Sorenson & Brown (1990) studied violent victimization of college campuses and indicated crisis intervention helps the victim in "(1) regaining a 53 sense of competence, (2) accepting any uncontrollable results of the assault, (3) taking adaptive actions, and (4) reestablishing a sense of continuity and meaning in life".(p. 58) "It is important to provide early intervention work which offers help within the normal environment to facilitate a natural healing process. The interventions should take victims through the stages from shock to acceptance and ensure, where possible, that progress is not arrested or blocked. The results of using this system with victims of 40 holdups over 2 years show the interventions helped individuals through the acute distress, facilitated a return to normal functioning, and aided the general recovery process"(Manton & Talbot, 1990, p. 508). So if intervention is preferred, then what interventions are effective? There are a myriad of long-term intervention therapy methods to deal with personal crises, however, with the increase over the years in demand for services, short-term therapy techniques became the only costeffective alternative for many mental health budgets that were increasingly losing their funding in the 1970's. Some research suggested that short-term therapy was more effective than long-term psychotherapy, especially in light of the preventive aspect of the treatment. Further, the necessity of limiting psychotherapeutic treatment to coordinate with the financial limits of insurance agencies and individuals appeared appealing. Twenty years later with the tremendous increase in the incidence of crisis in the past few decades, the now traditional mental health system is overwhelmed and shortterm intervention is not merely an alternative treatment but the sole realistic treatment option our society has (Pitcher & Poland, 1992, p.27). The literature indicates there is concurrence on certain general observations in the field of short term crisis intervention. 54 1. Reactions to crises such as feelings of helplessness and anxiety are thought to be normal rather than pathological. 2. Techniques are focused on returning the individual to his or her 'normal' or 'pre-crisis' state as quickly as possible. 3. The therapy or intervention is basically short-term and helping methods are characterized by repeated brief contacts with the individual during this time. 4. Attempts are made to avoid encouragement of ongoing dependency on the service provider and encourage appropriate supports available to resolve the current crisis and to avoid future crises. 5. People in crisis are more receptive to outside help because they have exhausted their own resources. Thus, the kind of help such people receive during this crucial time can exert a strong influence on the crisis outcome (Pitcher & Polland, 1992, p. 29). Short-Term Intervention Strategies The focus now changes to what short-term intervention strategies are effective to restore normalcy to the workplace for instructional and noninstructional staff of a school immersed in a crisis situation? How can an organization assist its employees in the recovery process to diminish the negative emotional effects of a school crisis? While not all crises can be averted, school systems can prevent them from being compounded due to carelessness, negligence, or lack of information. When crises occur, they can be magnified or minimized depending on how well the school staff has followed appropriate policies and has been trained in appropriate procedures. "The task is first to identify and assess the relevant variables, and then to develop, apply, and monitor the appropriate interventions. Simultaneously the aim is also to encourage strategies for the prevention as well as the alleviation of stress " (Taylor, 1989, p. 4). Other variables are to help them "understand the 55 impact of what has occurred, mobilize existing coping mechanisms or learn new coping mechanisms, and relieve them of other unrelated stressors. (Baldwin, 1978, p. 538) "The overall hope is to reduce the number of victims to the bare minimum, and to help them to become survivors who can live with their experiences" (Taylor, 1989, p. 20). Although articles exist in the ERIC data base about PTSD, there are a very few found about critical incident stress or critical incident stress debriefing. Most school crisis plans reviewed listed victim assistance as a consideration, however little research was found citing the specifics of such assistance. As stated earlier the PsycLit data base is filled with research a large portion devoted to children, however, the emergency services literature abounds with research on the effects on normal adult personnel involved with crises, along with specific protocols and procedure to deal with trauma. The literature supports the effectiveness of the Critical Incident Stress Debriefing techniques, therefore, it is redundant for educators to "re-invent the wheel" ignoring the abundance of information available from a group of professionals who face traumatic events as a daily routine. "Firefighters face more than physical risk. The psychological consequences of exposure to trauma in the fire service can result in high levels of turnover, inefficiency, long-term emotional difficulties and other life-disrupting problems. More than other groups, fire service professionals are recognizing the dangers associated with trauma and working to ensure that their personnel are protected psychologically" (Bergmann & Queen, 1986, p. 18). There is a traditional attitude of denying stress caused by trauma and such reaction prevents personnel from being adequately prepared to deal with this stress. This only prolongs and compounds the problem. 56 An overwhelming concurrence exists in the literature that Critical Incident Stress can cause debilitating psychological problems if left untreated and those who participate in Critical Incident Stress Debriefing Programs (CISD) are better protected from the effects of that stress in both their personal lives and their vocations. The work of Mitchell, assistant professor with the Emergency Health Sciences Department at the University of Maryland features predominately in the literature. Dr. Mitchell specializes in crisis intervention and critical incident stress debriefing and has facilitated many CISD teams around the United States and abroad. He has developed a program of protocols and procedures to be used by firefighters, Emergency Medical Service (EMS) workers, and police officers which has been duplicated in each of the departments' policies and procedures manuals listed in the Bibliography. Schools can produce a researched based plan of action by adapting the emergency service protocols for critical incident stress, to our environment, in a concerted effort to mitigate long term trauma syndromes experienced by our workers. The most comprehensive educational crisis intervention plans found in the literature paralleled the Critical Incident Stress Debriefing (CISD) protocol developed by Mitchell. Appendix "A" is a copy of the State of Florida Protocols and Procedures Manual adopted July 13, 1989, titled "Critical Incident Stress Debriefers of Florida, Inc." Each of the ten different emergency service protocols reviewed followed a similar format, however, this report included the most specific information to guide a CISD team. Although the verbiage and administrative titles follow a firefighter's profession, one can easily substitute educational titles and adapt situations to school based environments to make a comprehensive 57 document for school districts. Most people in helping positions forestall their reactions in order to fulfill their responsibilities and offer assistance to others. Educators epitomize the helping position and their needs should be an important consideration. Components of Crisis Intervention Strategies The literature concurs that the procedures for staff members should contain two components: defusing and debriefing. Defusing. Basically the defusing process involves the ventilating of thoughts and emotions immediately after a crisis. "It is crucial to schedule a meeting for the faculty at the end of the day, after the students have left, in order to discuss the day's happenings. Giving support to so many children for an entire day is very draining. Teachers also create emotional bonds with their students and are thereby affected by the loss. Allowing them time to discuss ways they might recover from the crisis before facing the students again the following day is important. A guidance counselor or school psychologist could brief the teachers on what to expect of the students during the next few weeks and explain how the teachers can help. The support you provide for your staff at this time will enhance the growth of cohesiveness in the student body as well" (Petersen & Straub, 1992, p.91). NOTE: Refer to Appendix A for defusing details. Debriefings. "Debriefings are specially structured group meetings between the persons directly involved with the critical incident and CISD team members. It is a confidential, non-evaluative discussion of the involvement, thought, reactions and feelings resulting from the incident. It serves to mitigate the stress impacts resulting from exposure to a critical incident through ventilation of 58 feelings, along with educational and informational components. It produces a therapeutic effect by assisting participants to understand their stress response" (Florida CISD, 1989, p. 3). Within the first three days, optimally the first, set aside time for the faculty members to have their debriefing. There are two components of the debriefing sessions where the educational literature departs from the emergency service literature. First, the emergency service protocols indicate attendance should be mandatory. They emphasize attendance is mandatory, however, participation is not. The educational literature consistently indicates the debriefings are attended voluntarily. Secondly, educational literature indicates debriefings can be co-facilitated by both the guidance counselor and the principal and to encourage all the crisis team members to participate. Mitchell's protocol discourages attendance by the "Chief" in firefighters debriefings (unless the workers specifically request his attendance) due to the inhibiting effects inherent in the mistrust of management in most organizations. The Peer Support Personnel are key to Mitchell's model. NOTE: Refer to Appendix A for debriefing details. Pitcher & Poland (1992) makes a salient point about coping strategies that should be explained at a debriefing session: it is very important to notice the patterns of stress in yourself. Teaching under the best of circumstances is a stressful profession. It is normal that under disaster or crisis conditions, when you are managing your own personal reaction together with those of your students, at times it will feel overwhelming. Everyone is strongly encouraged to take care of him- or herself by taking the following steps: 1. Don't take on any new school projects or extra work at school. Just keep your day as simple as possible. 59 2. Have students or assistants correct papers, take care of duplicating, or manage other time-consuming tasks. Choose your lessons with this in mind. 3. Do as many 'whole-class' activities as possible. This cuts down on lesson plans and discipline problems. 4. Set aside time at the end of the day, or if necessary twice each day (before lunch and before going home), to do special fun things. Students can work for this by behaving properly. This cuts down on the number of times you may need to reprimand students. 5. Take time to discuss the event and compare personal reactions with the other members of the staff who were involved in the experience. 6. Take time to relax and do things you find pleasant. Getting away for a few hours with close friends is often helpful. 7. Try to avoid making changes until you have adjusted. Stick with your regular routine, your regular bank, your regular job, and schedule. Any change creates stress, even if it is a positive one. 8. Remember any of the feelings or reactions described are normal reactions to crisis or disaster and will subside with time. If you are able to discuss them with friends or family, they may subside more quickly. It is not a sign of weakness, but rather an indication of good judgment to seek assistance from peers or mental health professionals. 9. Get regular exercise or participate in a regular sport. Activity soothes anxiety and helps you to relax. 10. Get some information and develop a plan regarding how you and your spouse will talk to and support your own children. 11. Keep your sense of humor and appreciate the positive side of your situation as much as possible. Remind yourself that this will be easier to do as time goes on (p. 193). It is important to remember the crisis team must also be debriefed. The team would have to be of stone not to be emotionally affected by the decisions, the events and the responsibility taken on the day a crisis occurs. Kast & Whitcher (1990) "states it is essential to grasp the implications of the aspect of countertransference feelings the crisis intervener experiences as an integral aspect of crisis intervention. First, the unconscious of the analysand 60 communicates with that of the analyst; second, one's unconscious is infected by the emotions of another person, especially in crisis situations, which are determined by strong emotions; and finally, this infection must be dealt with." (p. 87) "The crisis intervener often develops masking techniques in order to maintain effectiveness with clients. Eventually these masking techniques take their toll on the crisis intervener, who finds it increasingly more difficult to stay attuned to his/her feelings. This suggests the need for support groups in which the individual can regularly and freely ventilate the suppressed/masked feelings to avoid build-up and burnout" (Maynard, 1985, p. 40). "Therefore, the second level of debriefing should be a time for the crisis team to also share its emotional reactions with each other. Although your first instinct may be to just get away and go home, giving yourselves a few minutes to ventilate will insure your emotional readiness for the next crisis, should one occur.(Petersen & Straub, 1992, p. 60). There is a legitimate concern of how one determines the degree of severity of a crisis and who should be debriefed, in that no two crises are the same. Going through the debriefing process unnecessarily or failing to act when there is a legitimate need can diminish employees' confidence in the system. Table 6 can be used to assist in making this decision. Table 6 Determining Expected Degree of Trauma ________________________________________________________________ Step 1: Circle the number(s) in each square beside any word or phrase that describes this death. Total circled numbers within each square. Step 2: Add triangle totals. Then add one point for each additional person who died or was critically injured in this event to determine a grand total:_____ (Note: points can be subtracted if the death occurs when school is not in session.) --------------------------------------------------------------------------------------------------------A. WHO B. HOW C. WHERE 61 STUDENT Murder/Suicide (6) At school (4) *popular/well known (6) Accident (3) Local community (2) *other (3) Natural Causes: Other (1) TEACHER/OTHER STAFF *unexplained (4) *popular/well known (4) *short-term illness (3) Degree of Trauma *under 32 years old (2) *long-term illness (2) High 12+ *not well known (1) Moderate 8-11 Total__________ Total___________ Total_________ Low 0-7 _____________________________________________________________________________ _ Source: Oates (1993) p. 21 Assigning a point value for crisis evaluation may seem a bit rigid but no system works without human interpretation. Establishing School Crisis Intervention Teams The next dilemma facing a school system is how to establish a crisis intervention team. (The most detailed and comprehensive work to date is that compiled by Mitchell in the emergency service literature. see Appendix "A") However, Purvis et al, (1991) provides the following description of the elements repeatedly suggested in the educational and mental health literature for establishing an intervention team for a school system: Determining Goals Goals may be broad or specific. Broad goals for crisis teams are 'to share information, to insure that a support network is established for those who may be directly or indirectly affected, and to start laying ground work by the crisis team to prepare for what needs occur at school (Scottsdale Unified School District #48, 1989) Specific goals might include (a) returning the scholastic environment to levels of control conducive to social and academic advancement, (b) maintaining contact between school staff and community resources to ensure the completion of the first goal, and (c) developing a triad of parents, students, and administrators working together to meet the needs of the individuals and school system (Washington Community High School #308, 1988). 62 Performing a Needs Assessment After goals are established a needs assessment should be performed to determine whether problems exist that require special attention. Finding Model Programs Often model programs portray positive experiences of the program that can be used in the justification for the program, the incentive for membership, and the development of goals and objectives of the program. Furthermore, programs with more experience can serve as a guide to building the framework for such a team in administrative areas, communication networks, training programs, and other areas. Finally, model programs can illustrate possible deficient areas of crisis teams that need improvement. Developing a Membership Pool The school should decide the roles of members needed to participate on the team and designate the administrator of the program, The membership should not be viewed as static; in contrast, members should be added as particular crises warrant their services. (Nation, 1988). Possible members of the team might include the superintendent, principal, school psychologist, school counselor, school social worker, school nurse, special education teachers, teachers, the transportation director, custodian, maid, cafeteria workers, coach, and secretary. Ad hoc members might include a lawyer, a law enforcement officer involved in youth services, a translator in schools with large populations of speakers of other languages, a public health director, and a member of the clergy. Community or police victim advocates, community mental health directors, or members of community crisis intervention teams for emergency service personnel are viable team members. All must be willing to devote a good deal of time to the team and be of the emotional makeup to deal with crises. Developing a Training Program Manuals on psychological skills training for school officials can serve as a guide to teaching basic skills, specific facts about certain crises, and referral strategies. Different mental health agencies and universities, working with the school's psychologist, can provide assistance. Team 63 members should be instructed in intervention strategies, prevention strategies, the signs and symptoms of high-risk groups, guidelines and steps to intervene during emergencies, referral procedures, and follow-up activities. Preparing and Maintaining a Resource List A resource list can provide the team with a link to state and community agencies who can assist school officials in pooling together information, skills, and persons outside the school for prevention, intervention, and follow-up strategies. In addition, agencies can provide counseling programs, crisis management, and peer-group formations. Establishing a Communication Network It is important to work out, in advance, how the communication is to be made and whom to turn to if the person is not immediately available. A staff meeting should be called as soon as possible. The media must also be informed and dealt with by the crisis team. The public has a right and a need to know and understand the crisis that has occurred. A spokesperson should be designated to speak with the media, and no other parties related with the school should comment to members of the media. Comments made to the media should be brief, factual, and unbiased. The crisis team should compile a list of media personnel, their media source, phone numbers and addresses. Press releases can be mailed after a crisis occurs. School officials, school attorneys, and school psychologist should edit the statement prior to its release for accuracy and psychological impact on the readers. A facility should be designated to facilitate the press. Designating a Base of Operations The crisis team must establish an school's campus as a base of operations. should be properly equipped with telephones, telephone directories, emergency power, (hand-carried) two-way radios. area on the The location papers, pens, and portable Planning Crisis Team Meetings Develop meeting agenda, appoint a record keeper, update meeting books, establish a flow of communication, establish responsibilities and goals, establish follow-up meetings, plan for faculty and staff involvement, discuss team policies, review prevention and intervention strategies, 64 and discuss follow-up results. (p. 331-39) 65 Training for Crisis Intervention Teams The notion of training is mentioned repeatedly throughout the literature and deserves further inspection. Historically, "crises that were presented in the community mental health center and hospitals to social workers, physicians, and clinical psychologists were very much the same as those that arose in the schools. The idea of psychologists working in the schools in a preventive, consultative mode was a novel concept, especially in contrast with the more traditional testing roles of the educational psychologist. Thus, paralleling the growth of community emphasis and focus on prevention, a major genesis of school psychology and mental health consultation must evolve. To date, school psychology has only barely begun to assemble a 'little black bag' of useful methods for managing crises in schools"(Pitcher & Poland, 1992, p. 29). "Crisis team members must be trained in crisis intervention. It is, however, the actual experience of helping individuals through grief in their lives that provides the confidence and comfort needed to reduce the anxiety and hysteria in some crises. Members must be familiar with the strategies for preventing Posttraumatic Stress Disorder and must continuously update their skills" (Petersen & Straub, 1992, p. 126). "School psychologists are often unsuited to the role of consultant: by lack of training, experience, and practice" (Claborn & Cohen, 1973, p. 15). The literature indicates that the majority of the crisis teams established within school districts include school psychologists, guidance counselors and social workers among others. As evidence of the aforementioned quotes, there is concern for the extent of training and practical experience team members have 66 in critical incident debriefing. The majority of daily routine work performed by these individuals involves testing, course selection planning, and referrals to community agencies. They are generally the obvious choice for a crisis intervention team as long as they have up to date training and practical experience. Table 7 is a comprehensive list which encapsulates the essential concepts in the training of crisis workers. Table 7 Essential Concepts in the Training of Crisis Workers ________________________________________________________________ Knowledge 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Crisis theory and principles of crisis management. a. Origins and development of crisis. b. Manifestations of crisis- emotional, cognitive, behavioral, and biophysical. c. Duration and outcomes of crisis, including effective and ineffective crisis coping. d. Steps of the crisis management process- assessment, planning, implementation, and evaluation. e. Application of the crisis management process to special groups at risk for crisis. Suicidology, including principles of lethality assessment. Victimology, including assessment of assault potential and victimization. Death, dying, and grief work. Principles of communication. Ethical and legal issues regarding suicide, crime and victimization. Voluntary and involuntary hospitalization criteria. Identification and use of community resources in crisis work. Team relationships in crisis work. The consultation process and its place in crisis management. Principles and structures for record keeping. Attitudes 1. 2. 3. 4. 5. Acceptance of and non-judgmental response to persons different from self and toward controversial issues. Balanced, realistic attitude toward oneself in the helper role, for example, not expecting to "rescue" or "save" all potentially suicidal people or to solve all the problems of the distressed person. A realistic and humane approach to death, dying, self-destructive behavior, victimization, and other human issues. Dealing with emotionally laden issues. Coming to terms with one's own feelings about death, dying, and potential for violence, insofar as these feelings might deter one from helping others. Skills 1. Applying the techniques of formal crisis management--assessment, planning, 67 implementation, evaluation (including assessment of victimization and risk of suicide and/or violence toward others). 2. Communicating--listen actively, question discreetly, respond empathetically, and advise and direct appropriately. 3. Mobilizing community resources efficiently and effectively. 4. Implementing policy and keeping records accurately and efficiently. 5. Implementing the procedures for voluntary and involuntary hospitalization when indicated. 6. Using the consultative process. 7. Carrying out these crisis management steps while withholding judgment on controversial behaviors and not imposing values on the person in crisis and his or her family. _____________________________________________________________________________ _ Source: Pitcher & Poland (1992), p. 206-7 Limitations of Crisis Intervention Teams CISD is not a panacea and the literature lists several considerations that must be considered in developing a crisis intervention plan. Petersen & Straub (1992) point out, The fact remains that most school districts in America are not large and frequently do not have sufficient funding for such professional teams. These systems build their crisis teams from staff members who hold other positions: guidance counselors, school psychologists, health education teachers and administrators. When a crisis occurs, substitutes are provided to allow these staff members the time to respond to the crisis in their own and neighboring schools. Availability is a major issue in establishing a systemwide crisis team. Would personnel be available for just one or two days or could the school depend on them for the lengthy, in-depth follow-up? Realistically, how soon could the personnel on the crisis team respond to a call? Who would be in a position to drop everything and respond in minutes? in hours? Are there others to share the workload but who would not respond until the next day? When members of your crisis team are involved in one school for important scheduled activities, such as testing, are they in a position to postpone any activity in case of a crisis? To whose directives will the crisis team respond in an emergency? What preliminary permissions need to be obtained for the crisis team member to be released from his 68 or her routine duties? (p. 65) As stated on page 17 of Appendix "A", a hesitancy exists for emergency service CISD teams to provide specialty debriefings. For example, District #1 has a full functioning CISD team, and it would seem the school district could simply request their services and expertise should a crisis occur. One reason for the hesitancy is the liability the agency may incur when working with employees of another agency. Also the concept of "Peer Support Personnel" suggests the best individuals for this role exhibit intimate knowledge of the system, workers and process plus be perceived as trustworthy and well liked. This element sighted as essential in the aforementioned protocol would be missing without a school district initiative. Third, Appendix "B" illustrates the various symptoms of stress and when they would most likely occur. The vast majority will occur as a delayed reaction, weeks or months after the incident. Follow up debriefings and sufficient school based personnel trained to recognize the symptoms of stress are essential. Maher & Zins (1987) cites some interesting ethical and legal issues: Ethical issues are: 1. confidentiality, responsibility, and client welfare 2. preventive activities proceed on the basis of the probability of an occurrence. We may be wasting their time-weighing the cost of the program against the probability of helping someone. Is there a justifiable trade off for the small number who may be helped is a politically sensitive exercise. Legal Issues are: 1. whether participants in a prevention activity who later do develop crisis have indeed been injured by the prevention activity. 2. Tort actions have not yet taken place in situations in which crisis counseling and intervention have not proved successful. If intervention is unsuccessful is that a breach of contract? (p. 21) 69 Mitchell warns community CISD teams not to charge any fees, maintain the right of refusal, make sure to have informed consent, be careful about advice offered outside the confines of the model, maintain confidentiality, and incorporate the team for tax breaks and protection from suits initiated against individuals. He further suggests team members carry personal insurance as well. Although some of his suggestions do not apply to school district teams, they are salient considerations. Further concerns are contradictory assertions arguing crisis intervention strategies "are based largely on clinical and informal case study data. In fact, there is not a great deal of conclusive research that establishes the effectiveness of crisis intervention practices since crisis is not a homogeneous or welldelineated concept, and since crisis intervention techniques vary of a number of factors (the service provider, the service recipient, the setting, the techniques), it is difficult to get an empirical 'fix' on the big picture. A great deal of further research is required with regard to setting, technique, and specific goals"(Pitcher & Poland, 1992, p. 31). Although this is quite a strong statement, the fact remains it is "difficult to design experiments in which people in crisis are given an alternative placebo treatment, because their need is so great. One should proceed on the best practice and should not experiment with individuals in crisis" (Maher & Zins, 1987, p. 12). There is debate regarding who should be responsible financially for this type of employee assistance program. Some argue that the employer should bear the burden because they will benefit from the improved rate of employee return to service and normalcy, as well as the decreased rate of employee "burn out". Others feel insurance companies are the greater benefactor, as there is 70 evidence Workman's Compensation costs are decreased due to early intervention. There is dichotomy in the research about the use of school personnel for school crisis intervention teams. As Clayborn & Cohen stated, most school psychologist, counselors, and social workers are ill-trained to perform CISD with adults and have little or no practical experience with the type of critical incidents described. This argument would support the need to use well trained, practiced community or regional teams. However, most agencies, whether they be school districts, hospitals, police departments, or fire departments, have been reluctant to have "outsiders" working within their organizations. Hoff (1989) purports comprehensive and interdisciplinary facets of helping people in crisis is everybody's business and not just the specialty of any one helping profession. Mitchell has stated the human resource is the most valuable resource the work place possesses. Any effort designed to protect or enhance the human resource ultimately benefits the organization and the public that is served. The final "point worth making is that given any calamity with its associated trauma, we can learn from the experience. Being able to review the events of our personal lives and our society in an intelligent fashion enables us to adapt behaviors which will increase the quality of human existence. This is the essence of education. If there are changes which will accomplish the objective of safer more effective schools, those changes should be implemented"(Lowe, 1987, p. 4). Summary 71 The focus of the preceding discussion is three fold; the first is grief, critical incident stress, and post-traumatic stress, three human response syndromes to crisis. Each is similar with definable stages in a progression of emotional, psychological, and somatic responses. There is evidence, left untreated, critical incident stress can develop into posttraumatic stress, a debilitating mental disorder. Short-term crisis intervention is the second focus as a strategy to diminish the intensity and duration of the various symptoms associated with critical incident stress. Defusing and debriefing sessions with traumatized individuals has two goals; it allows for controlled ventilation of emotions and serves as an educational tool to prepare them for the possibility of experiencing very predictable emotional, psychological and somatic reactions as a result of their trauma. Key to the sessions is the message that these are normal reactions that normal people have after experiencing an extremely abnormal event. Finally, the research explores the notion of establishing crisis intervention teams to deal with employees of the school system. Pre-planning, communication, selection and training of the teams are key to the discussion. 72 CHAPTER 3. METHODOLOGY Introduction Various types of crises have an impact on the function of the school; such as, social events and issues, economic changes, environmental crises, medical crises and deaths. natural disasters, Some crises or critical incidents are so traumatic they alter the consciousness of a school and community for many years. The issue of school violence is not new, but the more recent phenomenon of firearms at school has increased confiscations, subsequent expulsions, serious injuries, and deaths. Relatively few homicides have occurred on campus in past history; however, statistics may change with the increased occurrence of violent crime in the community and subsequent increases in the schools. When a major crisis occurs at school the staff is expected to take action 73 immediately and to regain control of the situation. Children's needs are the primary concern as schools stand "en loco parentis". No matter how traumatic the situation, the children come first, a natural reaction for most due to the protective, nurturing nature of their profession. The premise of this study is that school employees can incur debilitating emotional damage from trauma associated with school violence. "Research on bereavement suggests that homicide bereavement is more severe than bereavement for suicide, natural death, or accidental death. The trauma to the victims of violent crime often invokes an emotional response in excess of grief and closely resembling Posttraumatic Stress Disorder (Bixler, 1985, p. 3)." The stress is exacerbated by the necessity of the victims to return to the scene of the crime every day and the tendency to deny or to steel themselves against the natural human responses to stress in an effort to care for the children. Since the teachers must be the primary care-giver for the children, it seems reasonable the school district should take responsibility for looking after the needs of its employees, in as proactive a fashion as it cares for the children. Emergency service professionals have recognized the need for employee assistance and have incorporated effectively short-term crisis intervention strategies as a routinized protocol. The literature indicates that worker burnout and workman's compensation claims decrease as a direct result of this proactive initiative. The crisis team members require extensive training and practical experience in defusing and debriefing strategies, as well as periodical continuing education sessions. It is the contention of this researcher that schools can benefit from the research conducted in the emergency service field and can institute more 74 aggressive employee assistance programs to deal with the ever increasing possibility of traumatic incidents in the schools. A comprehensive crisis plan would need to address guidelines for handling weapons in school, plans to handle the inevitable media blitz, and victim assistance or crisis intervention plans for children, staff, and family during the incident, immediately after, and months post-incident, to facilitate the recovery of the school and community. The purpose of the study was to describe, compare, contrast, and evaluate crisis intervention procedures provided for school-based employees of three school districts in which a critical incident occurred. The questions that gave purpose to this study were: 1. 2. 3. What was the nature of the crisis intervention procedures for staff members in the three school districts? How do the provisions for employee crisis intervention compare and contrast with those provided by emergency service agencies which routinely face critical incidents? What was the perceived effectiveness in caring for the emotional and psychological needs of the adults involved in the crisis and what component (s) of the policy or protocol contributed to that perception? The research was a naturalistic investigation designed to describe and understand the phenomenon and the circumstances surrounding the phenomenon. The inherent nature of a critical incident prohibited conventional inquiry. An event cannot morally be staged, anticipated or manipulated; therefore, expost-facto inquiry must be used to examine the event, the process developed to deal with the event, and any change that occurred because of the event. "Naturalistic investigations must meet the same aspects of rigor as the scientific method, to include internal validity, external validity, reliability and objectivity" (Guba, 1981, p. 25) 75 Assumptions There are several assumptions the researcher has made in the design of this study: 1. Although people have been traumatized and a period of time has passed since the incident occurred, they will remember enough information about the incident to make the results valid. 2. The instruments developed will gather dependable data. 3. The Emergency Service Protocol and Procedures manual is a legitimate source of best practice in short-term intervention and is transferable to the school environment. 4. Although the researcher was a victim of violent crime at a school site, unbiased evaluation of data is possible. 5. People will respond honestly to the questionnaires. Population Three school districts were selected from the state of Florida. Each experienced a critical incident at one of their schools. One involved an incident where a student shot and killed an assistant principal and wounded a teacher and another assistant principal. A second dealt with the abduction and murder of a student after exiting a school bus. The third experienced a shooting where a custodian killed a fellow worker. In each District, the Superintendent was contacted by the department chairman of the Educational Leadership Department of the University of South Florida to brief them on the purpose of the study and receive their permission to 76 be included in the study. The researcher then obtained written permission from each of the three districts. 77 Study Design Denzin (1970) defines triangulation as, "the use of multiple methods in the study of the same object." (p. 301) Some methods he lists are survey, interview, observation, performance records, and physical evidence. Each method alone "is potentially biased and has specific to it certain validity threats. Ideally, we should like to converge data from several different data classes, as well as converge with multiple variants from within a single class." (p. 307) He further states, "by triangulating data sources, analysts can efficiently employ the same methods to maximum theoretical advantage." (p. 301) The triangulation of data sources and the across-method triangulation process selected by the researcher provided the context and convergence for the structure upon which the final theories, recommendations and interpretations emerged. Pursuing the aforementioned triangulation method the researcher assessed the utility and potential effectiveness of various data collection methodologies and data sources and decided on the following four techniques: questionnaire, personal interview, telephone interview, and extraction of data from district documents. The rationale was as follows: 1. Data collected from questionnaires administered to school employees were used to develop data that could lead to global impressions about the extent of critical incident stress semiology experienced, the nature of crisis intervention they experienced, and their perceptions of the effectiveness of the intervention. Including some open ended questions that solicited comments not addressed in the closed ended questions. The respondents were asked to remain anonymous to reduce their inhibitions in their response. 2. A second source of data constituted the crisis team members who responded to the incidents. Again the anonymous questionnaire was used in an analysis of the interventions crisis members delivered, the extent of training they had debriefing adults, and their perception of the 78 effectiveness of the care delivered. 3. Personal interviews were conducted with individuals who played key roles in the design, implementation and/or evaluation of the crisis plan used in each incident. The data gathered from this third source provided insight into the district's perception of the effectiveness of their plan, changes that may have occurred as a result of the incidents, and perceived strengths and weaknesses of their crisis plan. 4. The fourth source of data collection involved primary documents produced and distributed in each district. The contents of the documents were useful in confirming other data collected and comparing policy vs. practice. Validity and reliability safeguards were built into the study through the triangulation of data collection methods, i.e. structured questionnaires, structured interview questions and primary documentation, as well as triangulation of data sources, i.e. school employees, crisis team members (both school-based and community-based), policy makers, documents, and the comparison of incidents at three different sites and levels of instruction. Instrumentation Two questionnaires were developed by the researcher for anonymous responses and a third for use in the personal interview. The Questionnaire items were developed in the following fashion. First, the researcher developed a questionnaire for school-based employees, (see Appendix E) using the Florida Critical Incident Stress Debriefing (CISD) protocol as a basis for best practice. This protocol was developed for use with emergency service personnel and was derived from research based data. (Critical Incident Stress Debriefers of Florida, Inc.) (see Appendix A) NOTE: The researcher attended a four day training session 79 sponsored by the Miami Dade Firefighter's Association and obtained certification in advanced critical incident stress debriefing by instructor Jeffrey Mitchell, Ph.D., University of Maryland, who features prominently in the literature. Items of the questionnaire were designed to gather information about the extent to which respondents experienced symptoms of critical incident stress, the intervention methods the respondent experienced, and the respondent's perception of the effectiveness of the methods in the recovery process. The first three questions simply established occupation, education level, and gender. Definitions of a "Critical Incident" and "Critical Incident Stress Debriefing (CISD)" were included to orient the respondent to the focus of the questionnaire. The Florida CISD protocol indicates the types of intervention that should be conducted, the time frame for the sessions, and the size of the groups. Therefore, the fourth question required the respondent to indicate the type of intervention experienced, the time frame for each intervention and the size of the group involved. Next, a description was provided of the three distinct phases of critical incident stress and the respondent checked the type of symptom(s) experienced and in which phase(s) it occurred. The list of symptoms were drawn from the Florida CISD Protocol and supported by the literature. The remainder of the closed ended questions were designed to gather information about the respondent's perceptions of the effectiveness of the intervention experienced. There were three open ended questions for respondents to list perceived strengths and weaknesses of the intervention provided and the most difficult aspects of returning to normal functioning. Additional comments were 80 encouraged. The researcher developed a second questionnaire to compile information about the training and experience of the crisis team members deployed to assist with the recovery of each school. (See Appendix D) Questions generated for this instrument were designed to gather data from the crisis team workers about intervention methods used, their perceptions of the effectiveness of the intervention provided, their crisis intervention training and their comfort level with said training and/or experience to effectively perform as a member of a crisis team debriefing school employees. The first two questions identified the respondent's job and education. The next four questions assessed the respondent's type of crisis intervention training, the amount of continuing education in CISD, the amount of practical experience with any type of crisis intervention, and the amount of experience conducting a formal CISD session. The responses were compared to the education and practical experience recommended in the Florida CISD protocol. The next question determined the crisis intervention delivered by each respondent. The breakdown used in the staff questionnaire; i.e., type of intervention, time frame for each intervention, and group size, was parroted in the crisis team questionnaire for consistency. The remainder of the closed ended questions focused on the respondent's perception of the effectiveness of the intervention delivered, corresponding to the same questions asked of the school's staff. Identical to the staff questionnaire, there were three open ended questions for the respondents to list perceived strengths and weaknesses of the intervention provided and the most difficult aspects of returning the staff to normal functioning. Additional comments were encouraged. 81 Crisis teams consisted of both School Board employees and collaborative outside agencies, therefore, unique and parallel perspectives were gleaned from each. Nine personal interviews were conducted with individuals who played key roles in the design, implementation and/or evaluation of the crisis plan used in each incident. The common ground for the interviewees was contained in the contribution to the crisis plan implemented as it related to the care of the teachers, administrators and staff members in each incident. Everyone interviewed knew the subject well. The candidates for personal interviews in each district were: 1. 2. 3. The district level administrator responsible for the creation and implementation of the school district's crisis plan. This individual held a key position to make recommendations for services provided as the recovery process proceeds, as well as recommendations for improvement of the District's plan as a result of the incident. The Principal of each school affected by the incident because they served as a pivotal point for all activities conducted in their school. A crisis team leader who was directly involved at the scene, organized, and implemented the district's crisis plan. Identical interview questions were used for both the personal interviews and telephone interviews. The telephone interviews were used when the geographic distance made the personal interview impractical. The researcher designed a single series of questions for all interviewees. (See Appendix C) A structured interview technique was developed for several reasons, but primarily for standardization. "As a qualitative method of gathering data, the interview, when structured, can be a tool for internal validity" (Guba, 1981, p. 31) The interview methodology provided leads for other information more readily obtained than by the questionnaire process alone. Careful attention 82 was taken in the structure of the interview questions because the topic was sensitive to those closest to the tragedy and it was essential respondents did not feel threatened by the inquiry, implying any negligence on their part to provide the best possible care. The content validity of the three data collection instruments was established by three individuals representative of the groups to be surveyed. "Content validity is the degree to which the (questionnaire) items represents the content that the (questionnaire) is designed to measure" (Borg, 1989, p. 250). The researcher selected an individual from each of the three categories of respondents, instructed them on the purpose of the study, and requested they evaluate the instruments for content validity. Two of the individuals had a doctorate in education which lent credibility to their evaluation. The individuals read the questions and responded as to what data they thought the question intended to gather. If the perception was not what the researcher intended, suggestions for improvement were solicited. Other colleagues were consulted on the structure, grammar and context of the instrument, to include, the University of South Florida dissertation committee and the Director of Policy, Research and Planning for District #1. To test the validity and reliability of the project, a pilot study was conducted, selecting individuals representative of the populations queried. Five school employees, three crisis team workers, and one district administer were selected for this pilot. These individuals were excluded from the main study. The technique for administering the questionnaire during the pretest was essentially the same as planned for the main study. Individuals were instructed to use additional space to comment on any questions that were unclear and/or ambiguous to them. General impressions were solicited to ensure the instrument 83 gathered the information as it was intended. The researcher checked the percentage of replies obtained, read the comments concerning the questionnaire, and did a brief analysis of the pretest results. The researcher was careful not to shift the theoretical concerns or objectives after this early data collection and analysis. All comments were evaluated by the researcher and committee chair to determine if any changes should be made to the instrumentation or design. Finally, primary documents were examined for further substantiation, to include: 1. District Crisis Plans 2. Minutes of meetings 3. Memo/Handouts 4. Critiques of the incidents by the Board 5. Personnel policies and procedures Procedures The researcher personally contacted the principal of each school to inform them of the study and answer any questions or concerns they had. A questionnaire was mailed to each staff member employed at the schools at the time of the incidents and each crisis team member, with a self addressedstamped envelop for return of the survey. All school personnel and crisis team members were included because the population of study was relatively small. A letter of transmittal accompanied each questionnaire. (See Appendix F) The researcher scheduled the nine interview appointments. Originally, tape recordings of the interviews with the permission of the subjects was proposed. The taped recordings were to supplant note taking during the interviews and be reviewed at a later date. Salient points were to be retrieved and documented for data collection purposes. It was also to be used as an 84 internal audit. An independent evaluation of the recordings would assess whether the interviewer accurately summarized the data and whether any questions or discussion by the interviewer biased the interviewee. None of the interviewees were comfortable with recording their responses and the interviewer did not insist on compliance. inhibited if their It was likely the responses would have been hesitancy was ignored reducing the effectiveness of the interviews. The researcher contacted and requested copies of documents from each district that related to the district's crisis plan or the incident itself. Data Analysis Frequency distribution tables display the closed form questionnaire responses. Interview responses, open form questionnaire responses, and documentation were coded and categorized. A constant comparative method of comparing incidents applicable to each category, integrating categories, and delimiting the theory afforded dependability, confirmability, and transferability as the interpretation lead to working hypotheses and final theories. The issue of objectivity or neutrality was of particular concern in that the researcher was a victim of one of the incidents; therefore an internal audit was performed by a professional colleague to provide assurances that the conclusions made by the researcher were valid and substantiated. As the investigator identified recurrent themes and classified them into categories, a second investigator examined or "audited" the data to make recommendations for improvements and quality control and to determine if similar conclusions were derived. 85 Limitations The following are limitations of the study: 1. Although short-term crisis intervention has been utilized for a number of years, the research completed in the school environment has focused primarily on the student population. There are limited studies regarding crisis in the work place from which to compare, plus the school environment provides unique problems for employees. Focus on teachers' emotional needs are generally tertiary to student and community needs. 2. Although patterns can be established by gathering data from three different districts, the results cannot be generalized to the entire population. 3. The incidents varied by the district crisis intervention policies and procedures, the nature of the trauma, and the relationship of the victims to the school community. 4. This was a retrospective study which is inherently limiting and there was a considerable difference in the time that lapsed between each incident and the study. Victims may be at very different stages of the grieving process, creating a difference in the responses. 5. There was no psychological profile of staff members to account for individual differences in staff personalities and prior life experiences. CHAPTER 4. RESULTS Introduction Chapter 4 is organized into four sections: Data sources, incidents and interventions, comparison between Emergency Medical Service agency and district procedures, and the perceived effectiveness of the interventions provided. 86 87 Data Sources Surveys Mailed and Received Information collected from questionnaires administered to school employees was used to develop information that could lead to impressions about the extent of critical incident stress semiology experienced, the nature of crisis intervention they experienced and their perceptions of the effectiveness of the intervention. Open ended questions solicited respondents comments and the respondents were asked to remain anonymous. Table 8 represents the number of staff surveys received by respondents and the number returned. Table 8 Staff Surveys Sent and Returned _______________________________________________________________ District 1 District 2 District 3 __________________________________________ Surveys Sent 138 86 72 Surveys Returned 70 27 12 _______________________________________________________________ The second data source drew responses from the crisis team members who worked the incidents. Again the anonymous questionnaire was used in an analysis of the interventions crisis members delivered, the extent of training they had debriefing adults, and their perception of the effectiveness of the care delivered. 88 Table 9 displays the number of surveys received by crisis team respondents and the number returned. Table 9 Crisis Team Surveys Sent and Returned _______________________________________________________________ District 1 District 2 District 3 __________________________________________ Surveys Sent 48 27 12 Surveys Returned 21 16 7 _______________________________________________________________ Survey Response Rates Table 10 shows the percentage of the staff and crisis team population that responded to the surveys for Districts 1, 2, 3, and the pilot. 89 Table 10 Percentage of Staff and Crisis Team Responses to the Surveys for Districts 1, 2, 3 and the Pilot Study _______________________________________________________________ District 1 District 2 District 3 Pilot _______________________________________________________________ Staff 50.7% 31.5% 17.0% 40% Crisis Team 43.8% 59.3% 58.0% 33.3% ________________________________________________________________ The crisis team and staff response rate fell between 30% and 60% in all cases except the staff of District 3. It is likely the low staff response rate was partly due to a disruptive controversy that existed between the principal and the community prompting the Superintendent to request that the distribution of surveys be delayed until after school was out for Summer break. Therefore, unlike the other two districts, the staff did not have the opportunity to interact with the principal regarding the survey. The principal of District 2 indicated certain staff members decided to respond to the survey only after confirming the legitimacy of the project, which supports the notion that the principal's availability enhances the response rate. Table 11 presents the gender of staff respondents for all three districts. 90 Table 11 Percentage of Male and Female Staff Respondents _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ Male 34.3% 7.4% 9.1% Female 65.7% 92.6% 90.9% ________________________________________________________________ In all cases the percentage of male and female respondents reflected the percentage of each in the general population of each school. Interviews Conducted Personal interviews were conducted with individuals who played key roles in the design, implementation and/or evaluation of the crisis plan used in each incident. The crisis team leader, a district level student services administrator, and a school based administrator were interviewed from each district. The data gathered from this third source provided insight into the district's perception of the effectiveness of their plan, changes that may have occurred as a result of the incidents, and perceived strengths and weaknesses of their crisis plan. Documents Examined The fourth source of data collection involved primary documents produced and distributed in each district. District 1 documents included a critique of the incident, the crisis plan prior to the incident, the crisis plan after the incident, 91 guidelines for firearms on campus, guidelines for violence /weapons on buses, handling campus emergencies, and minutes to crisis team meetings postincident. The District 2 document was the Crisis Intervention Team Program for Dealing with a School Wide Loss/Crisis. District 3 documents included a crisis intervention plan and the Incident Review Committee Final Report. The contents of the documents were useful in confirming other data collected and comparing policy vs. practice. Staff Respondent Demographic Data Table 12 displays the occupation of the respondents for all three districts. Table 12 Percentage of Staff Respondents' Occupations ________________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ Teachers 81.4% 81.5% 90% Guidance 4.3% 0% 0% Support 12.0% 11.1% 10.0% Administrators 1.4% 3.7% 0% Other 0% 3.7% 0% ________________________________________________________________ Generally the percentage of respondents reflected the general population of each school. The administrators and guidance counselors in District 3 and guidance counselors in District 2 are the exception. District 3 had only 2 92 administrators and one guidance counselor none of which responded. District 2 included their guidance staff in the list of crisis team members, therefore were not included in staff statistics. Table 13 pictures the level of education of the respondents for all three districts. Table 13 Percentage of Staff Respondents' Educational Level _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ High School 10% 3.7% 9% Associate 2% 3.7% 0% Bachelor's 41% 63% 45.5% Master's 40% 22.2% 45.5% Ed. Specialist 4.2% 3.7% 0% Doctorate 1.4% 0% 0% Other 1.4% 3.7% 0% ________________________________________________________________ Again these percentages mirror the general population of each school. Those with Vocational degrees responded to the "other" category. Crisis Team Respondent Demographic Data Table 14 represents the occupational breakdown of the crisis team respondents for all districts. 93 Table 14 Percentage of Crisis Team Respondents' Occupations _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ School Psychologist 42.9% 12.5% 0% School Social Worker 19% 18.8% 0% School Counselor 9.5% 56.4% 57.1% Mental Health Professional 9.5% 0% 0% Social Worker 4.8% 0% 0% Victim Advocate 0% 0% 14.3% Police Officer 0% 0% 14.3% Emergency Service Provider 0% 0% 0% Other 14.3% 12.5% 14.3% ________________________________________________________________ These figures reflect the occupations in the general population of the crisis team members surveyed. Table 15 reflects the level of education of the crisis team members. Table 15 Percentage of Crisis Team Respondents' Level of Education _____________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ High School 0% 0% 0% 94 Associate 0% 0% 0% Bachelor's 4.8% 6.3% 14.3% Master's 61.9% 50% 42.9% Ed. Specialist 19% 25% 14.3% Doctorate 4.8% 6.3% 28.8% Medical Doctor 0% 0% 0% Other 0% 0% 0% ________________________________________________________________ The high percentage of respondents with a master's degree is appropriate in that the majority of each districts' teams were comprised of school guidance counselors and school psychologists which require a master's degree in the state of Florida. District 3 had a higher percentage of respondents with doctoral degrees probably a reflection of the use of the state CISD team in the recovery process. Table 16 represents the type of crisis intervention training respondents experienced. 95 Table 16 Percentage of Crisis Team Respondents' Crisis Intervention Training _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ None 4.8% 6.3% 0% College Courses 23.8% 37.5% 57.1% Grief Counseling 47.6% 56.3% 57.1% 1-15 Hrs. of C.I. Training 42.9% 31.3% 28.8% 16-30 Hrs. of C.I. Training 19% 12.5% 14.3% More than 30 Hrs. of C.I. Training 19% 37.5% 42.9% Beginning CISD Certification 4.8% 0% 14.3% Advanced CISD Certification 4.8% 0% 0% Other 4.8% 0% 14.3% ________________________________________________________________ Grief counseling was highest across all three districts. Districts 2 and 3 were similar showing higher percentages of respondents with more than 30 hours of crisis intervention training. Districts 2 and 3 also had higher percentages of those with college courses on crisis intervention than District 1. This may be due to the higher percentage of respondents in District 2 and 3 with Educational Specialists and Doctoral degrees. It is noteworthy that a few respondents in District 1 and 2 felt they had no training in crisis intervention. A low percentage of respondents had beginning or advanced CISD 96 training overall and District 2 had no CISD trained personnel at all. Table 17 depicts the type of continuing education crisis team respondents experienced. Table 17 Percentage of Crisis Team Respondents' Continuing Education in Critical Incident Intervention Training _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ None 33.3% 25% 14.3% 6 College Semester Hrs. Every 5 Years 0% 0% 0% 1-10 Hrs. of In-service per Year 61.9% 56.3% 57.1% 11-20 Hrs. of In-service per Year 0% 12.5% 28.8% More than 20 Hrs. of In-service per Year 0% 6.3% 0% Other 4.8% 0% 0% ________________________________________________________________ From 14.3% - 33.3% responded they had none. The vast majority in all three districts had 1 - 10 hours of in-service. Districts 2 and 3 had 1.5% and 28.8% respectively who had 11-20 hours of in-service per year, and only District 2 had any individuals with more than 20 hours per year. Table 18 addresses the amount of on-the-job experience performing 97 critical incident intervention. Table 18 Percentage of Crisis Team Respondents' On-the-Job Experiences Performing Critical Incident Intervention _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 1-10 Hrs. per Year 52.4% 43.8% 42.9% 11-20 Hrs. per Year 23.8% 18.8% 14.3% 21-30 Hrs. per Year 9.5% 12.5% 0% More than 30 Hrs. per Year 9.5% 25% 28.8% Other 4.8% 0% 14.3% ________________________________________________________________ Across all three districts the majority (42.9% - 52.4%) had 1-10 hours of experience per year. Again Districts 2 and 3 had a much higher percentage than District 1 of respondents with 30 or more hours per year. District 2 had a series of traumas at the school in the study which may explain their high rate, and District 3 included the state CISD team members in their data, which would explain high on the job experience in that district. Table 19 shows the experience respondents had with conducting a formal CISD session. Table 19 Percentage of Crisis Team Respondents' Experience Conducting a Formal 98 Critical Incident Debriefing Session _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ None 52.4% 18.8% 42.9% Practice Sessions in Training 14.3% 6.3% 14.3% 1-2 per Year 19% 62.5% 0% 3-10 per Year 9.5% 6.3% 28.8% More than 10 per Year 4.8% 6.3% 0% Other 0% 6.3% 0% _______________________________________________________________ In that only 5% and14% respectively, indicated they were trained in CISD, predictably Districts 1 and 3 had a majority (52.4% and 42.9% respectively) who had never conducted a debriefing. With the inclusion of the state CISD team, it follows that 28.8% of District 3 respondents had lead 3-10 CISD sessions per year. The responses for District 2 are questionable, in that no respondent indicated any training in CISD, and yet 62% felt they had conducted 1-2 CISD sessions per year. Incidents and Interventions District 1 Critique of the Incident The initial critique was conducted February 17, 1988, six 99 days after the February 11 gun incident at (the school). The sequence of events which led to the death of (one assistant principal) and the wounding of (another assistant principal) and (an intern teacher) was reviewed. Those present concurred that the school-based personnel acted appropriately: 1. Upon receiving information that a student was on campus with a gun, they attempted to identify the student and locate him. They could not involve the School Resource Officer (SRO) because he was out ill that day. 2. (An assistant principal) attempted to talk the student out of the lunch area and away from other students. 3. When he realized the student was going for the gun, he used force to pin his arms to his side, take him down and gain possession of the gun. He achieved this objective with the help of other assistant principals. 4. There was no prior knowledge of a second student with a gun. When a second student drew a gun and began shooting and the situation got out of control, the assistant principal, sought help from campus police. 5. As the two students (one with a gun) ran from the building, they were confronted by two members of the (local police department) who had been called previously by an administrator to remove a trespasser. (District 1 Critique of the Incident, 1988, p. 232). District 1 Interventions and Crisis Plan Appendix L, Page 232, items 6-11 summarize elements of the district's crisis plan that were implemented as a result of the incident. "6. The administrative team had a written emergency plan which was followed on a step-by-step basis." This refers to Action Document C -- Serious Injury Check List of the district's crisis plan in Appendix L. The school's emergency plan included instructions to teachers published in the teacher's handbook. Essentially, any teacher in class was to stay in class and those teachers with planning periods and a few designated men (largely coaches) were to report to the office/mall area 100 to assist administrators as necessary. There were two registered nurses on staff who also responded to medical emergencies. As item 6 indicated, "Teachers assisted in clearing hallways by bringing into their classrooms students they found out in the halls and concourse." "7. The [local police department] took control of the crime scene as the school was in their jurisdiction. 8. Buses were requested and the school was evacuated by the staff in an orderly fashion. 9. Both students were apprehended. 10. A quick response team of school personnel were assigned to the school the following day, providing additional supervision and counseling for students and teachers." Most of the quick response team arrived at the scene of the incident within an hour. The make up of the quick response team is listed on page 7 of the district's crisis plan in Appendix L. In total the Student Services Department listed fifty-one individuals (largely school social workers, school psychologists, school counselors, and some administrators who had previously worked at the school) who assisted in the days that followed. 11. "Both the [local police department] and the Sheriff's office offered victim assistance. The [local police department] Victim assistance officer provided support on an ongoing basis with students and staff, providing follow-up services as well. Other community organizations offered counseling and assistance of various kinds." The critique of the shooting gave a thumbnail sketch of the plan, but the District 1 Recovery Activities in Appendix G give further insight to services delivered directly to staff members. 101 1. A faculty meeting was held after the school was evacuated to review the incident. The shooting occurred on a Thursday and it was decided that although many students may stay home, school would remain in session the following day. 2. The next morning another faculty meeting was held to review procedures for the day. 3. A large number of crisis team members were present the day following the shooting (February 12), to counsel students and staff. It is of interest to note the administrator's responsibilities as it applies to staff on page 13 of Appendix L, Action Document B - Departmental Check List: a. Keep staff updated on events and circumstances. b. Identify faculty/staff who are in need of mental health support services. Utilize guidance, district office, community counseling, employee assistance program. c. Emphasize the need to provide hard facts in reducing rumors. d. Administrators should be highly visible to show their presence, support, and control of the situation. e. Provide hope for the future by announcements of activities and future meetings. 4. The following week, February 15-19, additional assistance was requested. School Board members, administrative personnel, teacher union representatives and subject area supervisors arrived to assist teachers. 5. The crisis team met at the end of each day to assess the day's activities and determine the next day's plan. Each day, teacher handouts were distributed with the day's procedures. 6. Thursday February 18, the most critically injured administrator died and memorial activities were discussed with faculty. 7. February 18 information on risk management information assistance was distributed to staff members. March 7 mini- faculty meetings were held during teachers' planning periods to distribute crisis information. 8. 9. March 7 a local mental health professional conducted a CISD session with the four assistant principals on duty the day of the incident. 10. March 9 mini- faculty meetings were held again to update teachers on crisis and insurance information. Mental Health coverage was part of a HMO health insurance option for school employees. It covered a specific 102 number of visits per year with a mental health professional. 11. March 15 debriefing sessions were held with some teachers, custodial and cafeteria staff. Interviews were conducted by this researcher with three key individuals in District 1; a crisis team leader, an assistant principal, and a student service department administrator. The full summary of each interview is listed in Appendix K. Additional information about the intervention provided to staff was brought to light. 12. A full crisis team was at the school for two weeks and two district psychologists visited the school once a week for several months after the incident. The school psychologist and social worker assigned to the school were there on a regular basis. 13. One district psychologist held 3-4 sessions with teachers on a voluntary basis. 14. CIT members went into some classes where the teachers couldn't handle student questions. 15. Outside mental health professionals conducted large and small group counseling, as well as, one-on-one sessions. 16. At faculty meetings: a. teachers were briefed on the psychological and physiological reactions to be expected, b. they were strongly encouraged to refer one another for counseling if they recognized a colleague having problems, c. they were made aware that even those who did not witness the incident could be affected and that some may have reactions due to prior unresolved problems, d. all interventions were strictly on a voluntary basis. 17. Administrators were advised to be flexible and provide latitude for staff members. A classroom visitation schedule was developed for systematic observation and assistance by crisis team members. 18. 19. The police department's victim advocate officer worked extensively with school administrators and the school resource officer. She: a. advised them of sound intervention strategies, b. helped identify and counsel staff members showing signs of stress, and made follow-up visits through the year. c. She helped organize a process to shuttle scores of deposed 103 d. e. witnesses to and from the trial one year later, advised staff in a large group meeting of what to expect from the judicial proceedings. made periodic visits to provide support for the principal and assistant principals. District 1 Staff Survey Results The staff respondents found numerous strengths in the district's crisis plan. 1. Nine responses spoke to the speed of the Quick Response Team. One said, "I was impressed by the number of administrative and guidance personnel people who were immediately sent to the school." 2. Three mentioned caring, concern and compassion as a strength of the crisis team. 3. Two mentioned handouts and counseling were mentioned once. 4. One respondent stated he was well advised and another felt [the crisis team] seemed to stay as long as they were needed. Another added, "Those who were most stressed had help without intruding on those who preferred to get past it as soon as possible." 5. Two saw the only strength as the adequate coverage for the children. 6. Twelve stated they felt there was no plan. one-on-one counseling and group 28% of the staff felt the crisis intervention for staff was effective. Many of those who responded to the survey seemed to use it as a vehicle to vent anger and frustration, therefore, many comments seemed very bitter and sarcastic. Even so, many of the concerns voiced by the staff were echoed by the crisis team, but not necessarily in the same order of frequency. 1. The problem mentioned most frequently was the pressure or unrealistic 104 expectation to get back to "business as usual." Comments reflecting this sentiment were, " "Teachers were unable to do anything but go on as usual as if nothing happened."; "You were treated as if feelings of anxiety and stress were abnormal and you should be able to go on without any problem."; "Students were allowed to stay home the following day to grieve and collect themselves, teacher/staff were not." 2. The second most frequent comment dealt with bitterness over the perceived lack of support by the central administration. Typical of this feeling were comments like, "The administration of the school was left to twist in the wind of the popular press by the county administration."; "The Superintendent should have been there." (The Superintendent remained at an out of town meeting the day after the shooting.); "I will never forget the [area] superintendent speaking to the faculty and crisis counselors before school began the day after the shooting. He thanked the social workers and psychologists for coming to help but then reminded them that providing this help would be no excuse for neglecting their regular reports. He demeaned the efforts of the crisis counselors and almost seemed to blame our school for disrupting the normal routine." 3. The third most common response reflected the perception that there was no plan at all. 4. 69% of the respondents indicated they felt the district should have done more to support the teachers. The written comments expand this perception. One said, "No one should have to go through what we did alone." Another said, "It was as if we had to complain in order to get help." And another stated, "We gave loads of support to all the students and we were drained ourselves with no support." 5. Nine comments dealt with concerns about follow-up. One responded, "My depression and anger lasted as long as it did (at least three years) in part because no one in the school system even made an effort to identify or help teachers who had this type of reaction to the shooting." Another said, "No help with very long term follow-up. Many teachers since that time seem to be cynical and depressed and angry about teaching." Even though 59% felt follow-up was inadequate, 13% were comfortable with the district effort. 6. Six lodged complaints about the media's insensitivity or the district's lack of preparedness for the media onslaught. 7. Six voiced concerns about the length of time it took to let the staff know what was happening the day of the shooting. There was pandemonium and teachers were stuck in their rooms with hysterical children wondering 105 what was going on. 8. Six comments addressed the helpless feeling of not having answers to questions posed by students, family, and community. Some felt they still had questions about what happened that day or what became of the assailants. One respondent explained, "Lack of an immediate explanation to faculty and staff as to what really happened [was problematic]. Unfortunately , rumor, hearsay, and sensational media coverage obscured the truth for much too long." 9. Four spoke to what they viewed as a lack of compassion for the staff and even among the staff. One said, "Even today the district does not understand what we went through. You had to be there to understand no one does - no one cares." Another explained, "We were hurting and we felt no one genuinely cared." 10. Three comments indicated respondents felt only the victims and witnesses were cared for by the intervention team. For example, "They assumed that if we weren't directly involved (i.e., victims or a witness) that our reactions were insignificant." 11. Three respondents felt their duties or schedules made it impossible to access help. One suggested, "It would have been helpful to have one person assigned to staff. They [crisis team members] were so busy with students I found it difficult to see one." 12. Two respondent's comments indicated they were not comfortable talking with the crisis team members. Interestingly, there was a 34/54% split between those who were and were not comfortable talking with the team, yet it was a 41/25% (yes/no) split when asked if they trusted the crisis team to be confidential about any topic they might discuss with them. 13. Only 3% felt their family was adequately informed about the behaviors they may expect to observe from a staff member as a result of the incident. Three comments addressed this. One respondent elaborated on her seven year old daughter's concern for her safety. The child didn't want her to go to work, had recurring nightmares, and contrived ways for her mother to escape should it happen again. Another said simply, "Someone should have informed victim's family about short term and long term affects." 14. 21% of the respondents felt crisis team members were adequately trained and three comments related to crisis team or teacher training. One respondent eloquently commented on teacher training, "Today's schools are a potential war zone. Just as it would be irresponsible to send an 106 untrained civilian into bloody battle, it is similarly irresponsible to send teachers, staff and administrators into a threatening environment without the appropriate preparation. As such, a formalized crisis intervention program should be a standard part of the professional orientation process. Further, there should be a district library publication that details the mental and physical effects of critical incident stress syndrome. This should be distributed to all involved immediately following any violent event." 15. Though staff members were not specifically asked if they thought debriefing should be mandatory, three comments addressed that issue. One stated, "I don't think it should have been left up to us if we wanted to speak with someone. I think it should have been mandatory." Another said, "The school system needs to remember that sometimes those who seem to be coping well are really not coping at all." One related the experience of being a Vietnam Veteran and how he did not get help initially because he didn't know he wanted it. It took him seven years to sleep normally again. 16. Three comments addressed this study itself. One said, "Thank you for asking - 6 years later - we're asked." Another indicated the survey distressed her but she'd fill it out if she thought it would help someone else. One respondent suggested a survey such as this should have been administered as part of the intervention process. The respondents were asked about the hardest part of returning to normalcy. 1. The number one difficulty was restoring the sense of safety and security that was lost. Added to that were nine who mentioned overcoming fear and two specifically mentioned a lingering problem of fear of public places or large crowds. Related to that, six mentioned disruptive students and the teacher's fear of disciplining them. One said, "Realizing that when I stand for correct behavior, I might be a target too." One teacher even suggested she was not a good teacher anymore and tragically two teachers left the profession because of the shooting, three questioned whether they made the right choice to be a teacher, one decided against becoming an administrator and one refuses to touch a walkie-talkie such that no one would mistake her for an administrator. 2. Fifteen respondents felt the most difficult part was passing by the crime scene. Many victims can choose to avoid the place they were victimized, but staff members must return to the scene of the crime every day. 107 3. Seven had difficulty dealing with their anger and six the sadness of the realization that the slain administrator was really gone. 4. Five reiterated the difficulty in pretending everything was okay. 5. Other symptoms mentioned were guilt for not being able to help the victims or prevent the incident from occurring, trouble with lack of concentration, exaggerated startle response, and changed awareness. One replied, "[The most difficult part] was overcoming feeling that now I'm different. People who were not there could not and can not to this day understand our feelings." 82% indicated there were certain triggers that still bring back unpleasant thoughts or reactions about the incident. District 1 Crisis Team Survey Results The crisis team respondents cited numerous strengths in the district's plan. (Appendix L) 1. Quick response time to the school topped the list. Central administrative staff, school based administrators, student services personnel, as well as, the thirty five buses normally serving the school arrived within a half an hour of the incident. The majority of the district's Quick Response Team were attending the Superintendent's meeting when the incident occurred and campus police were able to get team members through the traffic jam already forming around the school. 2. The respondents acknowledged the plan focused on students, but several comments indicated the team was available to staff members. One school psychologist wrote, "Personnel were available to staff to help with difficulties and provide appropriate resources for assistance in the community." A second said, "An effort was made to make contact with all staff members." 3. Whereas twelve comments addressed a weakness in planning and organization, three comments voiced support of the daily organization and planning. One respondent felt, "We have a well outlined plan, with sample copies of letters and other information." "Another said, "We met daily after staff and students went home to discuss problems, concerns, and issues and to plan the next day's strategies." 4. Similarly there were eleven comments critical of the follow-up while three 108 cited follow-up as a strength. "Crisis team members were on site months after the incident," said one respondent. 5. Three comments indicated the crisis team showed commendable caring and concern and two felt the crisis team was aware of and tried to attend to staff needs. 6. Two comments supported the notion that crisis team members were well qualified and had unique skills contrary to the twenty-two who felt they were ill-trained. Overall, 33% of the crisis team members felt the intervention provided to staff members was effective. Written comments solicited from crisis team members gave further insight. Regardless whether queried about effectiveness, follow-up, weaknesses, or suggestions for improvement, several common themes emerged. 1. Crisis team members felt ill-trained to handle an incident of such magnitude. When asked specifically about training, only 9.5% felt they had adequate training. The following comments are representative of the general concern: "Many members had little or no training and members were not required to have specific training to participate."; "There was virtually no training except what one may have had in graduate school in dealing with counseling and personal relationship issues, etc."; "All of us were learning as we went along and few, if any had training in CISD. As a member of the district, I had no training and simply responded from a gut level hoping I was doing the right thing."; "A crisis intervention team should be identified by the district that would include trained district staff as well as staff from community agencies. Training specified to CISD is imperative." 2. Planning was an issue. On one hand, there were comments such as, "We have a well outlined plan, with sample copies of letters and other information." On the other hand there were comments like, "No one really in control."; "A more formal plan needs to be established with specific strategies, planning, follow-up, etc." ; "I have been involved in other crisis situations and it seems the individual schools do not have a realistic plan."; "When many of us arrived the day after the incident a plan was formed as we went through the day's events. It seemed to work, but we 'played it by ear.'" A suggestion for improvement was to let the crisis team know what the plan is (as opposed to just letting members know who is on the team)." 109 3. Crisis team respondents voiced a concern about follow-up both for staff members and crisis team members. Only 9.5% of the respondents felt follow-up was adequate. Those who were not comfortable with the efforts made statements such as, "[The District] should provide follow-up debriefing sessions to the helpers so that their own emotional status has not been compromised," [There should be] aggressive follow-up with staff to check how they are doing during the crisis, a couple of weeks after the crisis, a couple of weeks after the crisis, a couple months after the crisis, and a year after the crisis."; It is essential that ongoing follow-up and support be provided to staff. 4. Another common statement dealt with the fact the focus of the intervention was on the students, for example, "The concentration of effort appeared to be toward students," and "There appeared to be little in the plan offered to teachers." 28% of the respondents felt the district provided sufficient support for staff members. 5. Only 9.5% of the crisis team felt staff debriefings were effective or held at appropriate times, as evidenced by these statements; "Debriefing for helpers came a long period of time after the incident."; "I did not get debriefed! After working with such an emotionally charged group, I had some difficulty working through some of my own feelings."; and "Debriefings for staff were held much later than recommended by CISD trainers." 6. Visibility and support from the Central Administration was an important element for crisis team members. Lack of meaningful participation in recovery activities by the Superintendent and the immediate cabinet was viewed negatively. At least one top level administrator was perceived as exerting pressure to bring intervention activities to premature closure. 7. Other issues mentioned included the need to evaluate the impact on other schools and their need for staff and family intervention and for more community involvement. Only 9.5% of the respondents felt family members were well informed and 39.4% felt the district's plan provided effective and timely coordination with community agencies. When the crisis team was asked about the most difficult aspect of returning to normal the responses grouped as follows: 1. Four responses dealt with fear, safety, and security. As one respondent put it, "The bubble was traumatically burst." 2. Three respondents were most troubled by the pressure to get back to 110 "normal," not allowing time for the grief process. 3. Two spoke to failure to debrief staff and crisis team members. 4. Two felt the victim's lingering condition and the pending court case, in essences lack of closure, was most difficult. 5. Two viewed media attention as an obstacle to a return to normalcy. 6. Overcoming anger over the lack of support by the Central Administration was difficult for one. 7. Accepting the change brought about by such a traumatic event was not an easy task for school and community. There were four questions on the crisis team survey which focused specifically on debriefing: Were debriefings effective? Were they timely? Were they mandatory? Should they be mandatory? Only 9.5% of the respondents felt the debriefings were effective or timely. No one thought they were mandatory and 66.7% felt they should be mandatory. Those respondents who were familiar or had been trained in Mitchell's model of crisis intervention were among the 66.7% who felt it should be mandatory. Once the formal questioning was complete the respondents were interested in what the researcher felt should occur. As Mitchell's model was discussed, all but one of the actively employed respondents across all three districts asked for more information, in that they had never heard of Mitchell's work or had heard of him but were not familiar with the protocol. The written responses to the question, "Understanding that mandatory attendance at debriefings does not mean mandatory participation, do you feel debriefings should have been mandatory for staff members," brought out the main arguments for and against this issue. 23.8% felt debriefings should not be mandatory and their reasons were: 1. "Some staff may prefer to arrange for their own support." 111 2. 3. "[It] could detract from the benefits due to resentment related to being forced." "All staff members are not affected the same way or need the same support." Responses supporting mandatory attendance could be categorized as follows: 1. The most frequent response dealt with the notion that in traumatic situations people do not always realize how they have been affected. "Being required to attend initial debriefings will assist those who think they do not need help," said one respondent. 2. Secondly, some simply will not attend voluntarily even if they suspect they need to because of their role as a "caregiver" or as one respondent states, "Teachers have been conditioned to feel they must always be in control." To ask for help is to admit there is something out of their control. 32.9% of the staff respondents indicated at some point they felt a need to talk to someone about their reactions to the incident, but were afraid people might think they were emotionally weak. 17.1% felt they must keep their feelings private for fear their immediate supervisor may think them incompetent. 3. One respondent saw mandatory debriefings as a way to cover district liability. "No one could ever say, 'No one did anything for me!'" 4. Two respondents did not elaborate, but simply indicated past experience, "common information base, and knowledge of style/types of support," lead them to believe all should be required to attend. District 1 Interview Summary For the total summary of each interviewee's session refer to Appendix K. When asked about provisions for employees, there was consensus that crisis interventions were student focused, but counselors were available for staff. There had been an attempt at an employee assistance program, but it never came to fruition. The Board had negotiated mental health coverage in one of its HMO options which provided for a finite number of visits to a mental health 112 professional per year. The district's philosophy considered it a function of student services to provide assistance to employees in school crises if they asked for it. The following items were listed as areas that failed to meet staff needs: 1. It was perceived there was pressure by central administration to back out of the school to "get things back to normal" against crisis team members' better judgment. Also, central administration kept referring to the shooting as "an isolated incident" which was perceived by staff as a way to "sweep the incident under the carpet." 2. There was insufficient follow-up. They would have provided it had they been asked but they failed to encourage it. 3. Crisis team members felt inadequately trained to handle an incident of such magnitude. 4. CISD came too late. Areas that adequately met the needs of staff were: 1. Lists of outside agencies were available. 2. Handouts with stress reaction were distributed. 3. Counselors were available to teachers. 4. Once the CISD was held it was perceived as helpful. 5. The team responded in a caring manner. 6. There was an organized way to respond. There was some planning with outside agencies before the incident. Several mental health facilities agreed to provide services on site, on a referral basis, and to wave parent permission in an attempt to respond in a timely manner to student crises. During the incident several agencies offered their assistance with free counseling sessions. A local mental health professional conducted CISD with 113 selected staff members. The victim advocate from the police department worked closely with the school during the incident and for months afterward. After the incident they discussed agencies that were viewed as helpful, but no attempt was made to contact them in regard to future planning. No one really felt adequately trained to handle the incident. Most had a good deal of counseling experience and did a very good job. There were numbers of recommendations as a result of the experience gained from the incident: 1. Crisis team members should be rotated to avoid "burnout". 2. Workshops were attended by student services personnel outlining CISD steps and two school psychologists attended Mitchell's beginning CISD training. 3. Crisis team members should be debriefed more often. 4. A plan was developed to screen volunteers for future crises. 5. There should be more follow-up for staff. 6. Staff should be more involved in the decisions about crisis intervention. 7. Key central administrative staff should be available at the school. 8. 9. A plan was developed to assist the school throughout the trial. Ground rules were established with the press about access to the students and the schools grounds. Some areas yet to be addressed are: 1. The plan has not been reviewed recently. 2. Schools may not have updated their in-house crisis plan. 3. Training sessions should be held with all administrative staff and student services personnel. 4. Communication is difficult with limited telephone lines in the schools. 114 News media could be used more effectively to disseminate accurate information. The assistant principal (who is now a high school principal) voiced concerns about school based administrators knowledge base regarding the district's crisis plan. She was unaware of any changes that resulted from the incident and felt her experience was her only framework for tackling another such incident. District 2 Interventions and Crisis Plan There were no documents produced to critique the incident in the District 2 school or to list recovery activities. The personal interviews (Appendix K) and the crisis plan (Appendix M) are the supporting documentation for what occurred. 1. The victim was abducted after exiting the school bus after school. 2. School officials were notified in an effort to locate the child. 3. A telephone tree was used to notify staff of the incident prior to reporting to work the following day. 4. The district coordinator was contacted and arrived the following morning to assist the school based crisis team. 5. A faculty meeting was held in the morning before school to provide staff information about the abduction, to advise staff of reactions students may have, and to review procedures for identifying and referring student to the crisis team. The district crisis plan provided CIT materials packets with teacher handouts, sample letters to faculty, and signs. 6. A crisis team member followed the class schedule of the abducted child to help the teachers deal with student's questions and reactions. 7. The district listed 27 individuals as crisis team members who assisted throughout the incident. The school psychologist was the team leader. Other school based crisis team members included, guidance, occupational specialist, school social worker, school resource officer, school nurse, and 115 attendance assistant. 8. Additional CIT services were requested and other school psychologists, school social workers and local clergy were enlisted to counsel students. 9. The crisis team for students offered their services and made sure staff knew they were available for them. Mostly the staff came to the crisis team instead of the crisis team approaching staff. 10. One counselor and psychologist went to those most closely involved and checked with them periodically. 11. There were two or three group debriefing sessions with teachers and two sessions with the assistant principals. These meetings were largely information sharing opportunities. 12. Crisis team members made referrals to outside mental health agencies, but there was no way to know if staff followed through with it. 13. Six days passed before the child's body was found. Media coverage of the abduction was extensive. The funeral followed eight days later. Crisis team efforts were increased during both of these time periods. 14. A debriefing meeting was held at the end of each day. The team consulted with the principal and reconvened with all persons involved in providing services to review the day's activities and to determine if further CIT services were needed. District 2 Staff Survey Results In District 2, 65% of the staff respondents felt the crisis intervention for staff was effective. Staff members articulated numerous strengths in the crisis plan. 1. The team's availability to staff members was mentioned most frequently. For example, one respondent stated, "The team was consistently at the school and available for the staff members. Other staff members were available to take over the class if you had to leave." Another said, "We were reminded that the counselors were there for us as well as the kids." 2. 63% of the respondents felt follow-up was adequate. There were three 116 comments implying adequate follow-up in the sense that the crisis team stayed as long as there was a need. 3. Three respondents spoke of a sense of unity that emerged as the staff pulled together during the crisis. 4. The crisis team arrived the morning after the news broke which was noted by three respondents. 5. Two respondents stated they felt well informed as to the many different ways the students may react. When asked if they felt well informed about reactions they themselves may experience, 63% of the staff respondents answered affirmative. 6. There was sufficient time allotted for staff to "talk, time to be with the students, and time to be with each other. Time was given for those who wanted to go to the funeral and as mentioned earlier, teachers could take time from class if they needed it. 7. Two respondents commended communication. One felt they, "constantly received feedback with one another." 8. Other singular remarks characterized the team as patient, caring, supportive, understanding, good listeners, and non-condemning. 9. It was perceived they were, "able to make decisions at the school level regarding schedules, reporters, memorial services, etc." 10. There are numerous references to religious issues in District 2. One respondent said, "It helped tremendously when the principal read scripture and offered prayer and a moment of silence, as well as, adding ministers to the crisis team." The issue most frequently stated as a weakness was availability of crisis team members to staff. 1. Interestingly enough, availability was also the most frequently mentioned strength of the plan. One staff member stated, "They weren't available when I was. Two office staff members commented that crisis team members weren't available to them. Two respondents perceived the intervention to be superficial. One said, "We need less superficiality and more depth." Another corroborated, "We were told it was available. The reality of getting more than a superficial 'talking to' was much different." 2. Four respondents felt the team did a good job and there were no 117 weaknesses. 3. Three said they weren't affected emotionally other than feeling sorry for the girl and her family. 4. 33% of the staff respondents indicated the district should have done more for the staff. Three written responses related to support of staff. One said, "Teachers are expected to handle anything." Another suggested, "They might have given certain readable materials as some might have found it helpful but would never have asked." 70% of staff respondents indicated they felt comfortable consulting with crisis team members and 74% felt they could trust them to be confidential. 5. Similarly three comments addressed follow-up. One respondent suggested there were teachers who still needed assistance. Another said, "Perhaps they could have waited until the 'after' or 'delayed' period and told us we handled things well...it still wouldn't have helped the pain, but it may have let us know we were appreciated and supported us in a difficult time. It is important to note that four incidents occurred at the school in a relatively brief period of time. In early February a seventh grader was beaten, then in October this incident occurred, a month after another seventh grader accidentally shot and killed himself, and a teacher slowly died of A.I.D.S. Two respondents felt more support should have been available for these incidents as well. 6. Other singular comments suggested more ministers and a rabbi should have been added to the team, that facts about the assailant should have been communicated to squelch rumors, administrators were overburdened and didn't have time to grieve, some students abused the counseling as an excuse to be out of class, and only those directly working with kids really know how depressing it was. None of the comments specifically addressed training but 48 % indicated they felt the crisis team was adequately trained. Two related issues shared the top spot on the list of the most difficult part of returning to normalcy. They both dealt with fear. 1. Staff members feared for the safety of their own children. They could not believe such a horrible act could be committed in their community, but once it did, it really struck home for those with children of their own. One respondent said, "[It was difficult] letting go of the fear for my daughter (who looks like and is the same age as the victim). Getting rid of the guilt 118 for being a single parent who has a latchkey child like the victim. 2. The second of the two issues was fear, in general, because the killer has yet to be found, therefore the episode lacks closure. 3. Four respondents indicated student behavior was difficult to deal with. One respondent stated, "Dealing with the upset student population and the aggressive actions of the male population in particular." 4. Three respondents spoke to the difficulty they found in striking a balance between allowing the grieving process to play out and moving on. One replied, "...needing to offer a semblance of order without appearing hard hearted or cold. Another found it difficult because, "not everyone was ready to return to "normal" functioning at the same time. 5. Then again two respondents questioned if anything would truly be "normal" again. One respondent was troubled by intrusive thoughts and another stated the difficulty lies in , "people like you asking me to relive it just when things start to seem normal." 81% of staff respondents indicated there were still certain triggers that brought back unpleasant thoughts or reactions. 6. Two explained the on going media coverage and sensationalism would not let it rest. District 2 Crisis Team Survey Results 75% of the crisis team respondents felt crisis intervention provided for staff was effective. Unlike the other two districts, the number of comments about strengths out numbered the comments about weaknesses. 1. Provisions for extra help on campus was at the top of the comment list. "The principal provided floating substitutes for several days for relief if needed." It is interesting to note there were fifteen college interns on staff at the time. In that it was used as a learning experience for them, it would follow they added to the extra hands available to assist. 68.8% of the crisis team respondents felt the district provided sufficient support for staff members. One respondent observed that although they announced the availability of crisis team members to staff, they tended to reach out to their own support staff. 119 2. Communication was seen as a strength. Staff meetings and telephone trees were spotlighted twice each. One respondent said, "Daily faculty meetings prior to school and after school each day provided good flow of information downward." Another said, "informing the staff members as soon as possible and telephone trees are two wonderful things we do." 3. Several respondents commented on the plan itself. "A clear crisis plan was developed in the district," stated one respondent. Another said, "There is a plan and general guide to follow in crisis resolution, debriefing, and follow-up which is helpful." And thirdly, "The district crisis team also follow the schedule of the 'hurt' student and the teacher can leave to seek help any time." 4. 68% of the crisis team respondents felt the team had adequate training. One respondent wrote, "We had a well coordinated team of professionals who had experience in this area helping us work through the stages." There were those who had concerns about lack of experience and reported statements by some team members who felt ill trained to deal with an incident of this magnitude. 5. Quick response time was mentioned by two respondents and; 6. Again there was a positive comment about the inclusion of clergy on the crisis team. Of the comments about weaknesses in the plan follow-up was mentioned most frequently. 1. 43.8% felt there was adequate follow-up in the weeks following the incident. One respondent who felt follow-up was adequate said, "It was provided but not accessed much." The following are some suggestions offered for improvement: a. provide follow-up information to clergy who assisted b. provide assistance to those who may have needed to talk later on c. provide designated times for staff sessions d. convene a couple small group meetings to discuss the aftermath e. conduct more debriefings for crisis team members 2. Second on the list of comments was more relief for staff and crisis team members. One school psychologist said, "they needed to relieve us school based personnel more. We were exhausted after days of counseling for the abduction, then the murder, and finally the funeral." Another respondent brought up a point that is key to the issue of the composition of crisis teams and of which there seems to be little 120 consensus. She said, "Outsiders need to step in and do the majority of the counseling work. I was asked to do too much counseling when I was grieving." There are those who don't want outsiders and feel school based staff are the most appropriate crisis team members because they are familiar with the school community. One school counselor stated, "In my experience, most faculty members do not want to talk to someone they don't know. They instead want to reach out to people they know within their own school. " A staff member criticized the school counselors for not doing a better job, and a social worker criticized the crisis team leader for stressing the importance of taking breaks explaining it was reflective of a lack of desire to be in that important position. Another staff member felt they should have been talking to Doctors not district or school based personnel. 3. Two crisis team respondents felt the district's plan was student focused and more emphasis should be directed toward staff members. One suggested a schedule should be devised to pull teachers from class to be debriefed. Another suggested a crisis team member should be designated to float from class to class specifically tuning in to the reactions of teachers and its impact on students. A third commented time should be set aside to debrief crisis team members. 4. Two felt there should be staff in-service and better training of administrators at the school level regarding adult grieving reactions and way to relieve stress. 5. Two indicated space for counseling was a problem. 6. One respondent brought up another issue key to crisis plan development. Just who should be responsible for staff crisis intervention. He said, "I'm not sure the plan specifically includes services to staff members. Perhaps the best thing ... is to promote its Employee Assistance Plan to meet mental health needs of its employees. 7. A school counselor remarked, "Informing family members of the staff's experiences during that day is definitely a needed activity. Only 37.5% of the respondents felt family members were adequately informed. The most difficult part of returning to normal functioning brought out a comment common to all three districts - they were not sure things would ever return to "normal". 1. Two mentioned everyone was overloaded. period of time was too stressful. Three incidents in a short 121 2. Two mentioned the media coverage was intrusive and returning to normal could only begin to occur once they left. 3. Dealing with difficult student cases and getting students back into class was mention by two respondents. 4. One felt it was difficult because, "some staff members didn't realize that weeks after the incident counseling would still be necessary." 5. Another brought up the balancing act between too much intervention and not enough. The difficulty for her was, "wanting to do special things to remember the victim but not wanting to trigger more emotions. When asked specifically about the debriefings held for staff members, 68.8% of the crisis team respondents felt the debriefings were effective, 81.3% felt the timing of debriefings was appropriate, 18.8% thought debriefings were mandatory, and 48.1% thought debriefings should be mandatory. Two who argued against mandatory debriefings essentially felt large group faculty meetings for dissemination of information was appropriate but it should be optional for processing the information. One felt some people have adequate coping skills and support to debrief privately and lack of time is a factor with debriefings. Several comments were made in support of mandatory debriefings. a. One said, "based upon previous experience, debriefings are critical to recovery." Others were more specific with reasons, such as, b. "Those who resist it the most may need it the most." c. "It's important to get information to teachers whether they want it or not." d. "Another staff member may ask a question that may be beneficial to the quiet person." 11% of staff respondents indicated at some point they felt a need to talk to someone, but were afraid people might think they were emotionally weak. 122 e. "[Debriefings should be mandatory ] to build consistent information, assist with reactions, and show some extra attention. 123 District 2 Interview Summary The provisions for staff in a school crisis are similar to District 1. The district crisis team and school crisis team, composed of school counselors, school psychologists, and school social workers, are primarily dispatched to deal with children, however, they are expected to help and reinforce their availability to staff. Staff meetings are held daily to disseminate information and deal with rumor control. The systematic delivery of training to staff members familiarizes staff with key issues related to crisis intervention and postvention. This is designed to make the staff members more comfortable with their knowledge and ability to handle crisis situations. There is no employee assistance program designed for crisis intervention. The district's philosophy stems from the fact there have been no funds for large scale employee intervention. There is a notion that an adult should know when they need help and know what to do to help themselves. They do recognize that teachers must care for the children and sometimes suppress their own feelings, therefore, student services feel it is their responsibility to address the needs of the staff even though their focus is on children. There were several areas where the respondents felt the district felt failed to meet the employees' needs: 1. The incident went on for so long without closure, that crisis team members got burned out. 2. They should have had formal and immediate debriefing sessions with the crisis team. 3. They did not have the capacity to relieve teachers from classroom duties to receive services in a more timely manner. 124 4. It was difficult to strike a balance between intervention and business as usual. People got sick of the focus, but reacted negatively to anything that minimized their anxiety. 5. There was no relief for the principal. She had to steel herself for each day's battle because she felt she could not fall apart during her school's needy period. There were numerous factors of the intervention the interviewees felt adequately met the needs of staff: 1. Counselors were available to teachers. 2. Crisis team members management. 3. They brought in clergy for secular needs. 4. They made referrals to outside agencies, although there was no way to know if they actually followed through. 5. Crisis team members were debriefed. 6. Counselors were designated to follow the student's schedule to assist in each classroom. 7. Faculty met daily to prepare for the next day's activities. 8. They have a "cook book" approach with crisis team packets that contain sample letters to faculty and parents, sample announcements, signs for rooms where counseling is held, handouts regarding symptoms to expect of children, and clear steps to follow. One phone call sets everything in motion. distributed literature on grief and stress There was no specific planning that occurred with community agencies before the incident. A prior incident gave them a good idea of those who were of substantive assistance and those who seemed to be "ambulance chasers". Internally they determined who they might ask for assistance in the future. It was felt that because they were a rural school district, they probably had more expertise on their own staff. 125 During the incident the SRO served as a liaison between school and law enforcement, clergy seemed to provide a great deal of comfort, and the director of mental health facility at the University of South Florida served as a consultant. There was some disagreement about training. One interviewee cited the training that has been provided by several reputable mental health professionals, as well as, the systematic training of staff and specific session for principals. She explained they had not been trained in formal debriefings but felt they were very effective in their informal debriefings. The principal surmised most felt they needed more training. She acknowledged they all had Master's degrees and a clinical background, but felt more reactionary than proactive. The changes they have considered are to rotate crisis team members and not wait until they request it and have a psychologist not assigned to the school as a team leader. They stressed the team leader did an excellent job, but they felt the closer you are to the school staff the more stressful the task becomes. District 3 Critique of the Incident (The assailant) was hired 12/88 [as a custodian of the elementary school] and had satisfactory evaluations. Monday, 9/25/89 (he) made threats against several co-workers and (the victim's wife) in (the victim's) presence. The threats were not communicated to the school office or other custodians. Wednesday, 9/27/89 (the assailant) told a teacher that a good friend was upset with his wife because she was having an affair: he threatened to kill his wife, kids and co-workers. The teacher told him to tell the authorities, but the story was not reported to the school office by the teacher because it was not taken seriously. Thursday, 9/28/89 (the assailant) talked to the teacher mentioned on the 27th and indicated the problem was resolved and everything was fine. (The victim) related the previous threats to at least one custodian. The threats were communicated to the assistant principal by one of the custodians who had heard about them from 126 another custodian. Two custodians were concerned and two others indicated they thought he was kidding. When the principal called in from a meeting late in the day she was told about the threats and she asked the assistant principal to set up a meeting with (the assailant) for the following day. Friday, 9/29/89 the principal met with (the assailant) and he indicated the threats were kidding in nature and the principal informed him that this was not appropriate behavior. There was no unusual reaction to the verbal reprimand. Monday, 10/2/89 (the assailant) came to the office and indicated he wanted to resign, making reference to being blamed for the events of the previous week and that he was going back to visit his Dad in Missouri. The principal had him fill out the appropriate paperwork. (The assailant) appeared very calm but was overheard saying he had to tell someone off. (The assailant) got in his car and drove around to the rear of the cafeteria. As he entered the cafeteria a worker alerted a custodian that (the assailant) had a gun. The custodian ran to the office to alert the administration. A custodian told (the assailant) to leave which he did, but returned and shot (the victim). The head custodian convinced (the assailant) to go outside with him. Outside (the assailant) fired two shots at or above the children on the playground before leaving the school grounds. He was stopped and arrested several miles from school a short time later (District 3 Critique of the Incident, 1989, p 3-4). District 3 Interventions and Crisis Plan The District had no written crisis plan and the steps taken throughout the incident and recovery showed savvy, intuitive good common sense, and excellent leadership skills by the principal. The critique describes the events as follows: Initial Response 1. Custodian notified the school office of the incident. 2. Assistant principal immediately called 911 at 11:38 a.m. 3. Sheriff's department responded immediately and arrived on the scene in eight minutes. 4. Principal simultaneously initiated lock-down procedures over the intercom, a procedure that had been reviewed and practiced with staff previously. 127 5. Lunchroom instructional aides and PE teachers evacuated students to classrooms. 6. Elementary Director and Superintendent's offices were notified by telephone. 7. Superintendent designated and dispatched a crisis team which included: Deputy Superintendent, Assistant Superintendent for schools, Elementary Executive Director, and Community Relations Officer. Within the First Hour 1. Crisis Communication Plan was implemented including notification of other schools and media relations planned activities. 2. Administrators worked with Sheriff's Department to coordinate on site activities. 3. School Resource Officers from other schools were called in to assist. 4. Counselors, psychologists and social workers from around the district were called to the school for student, parent, and staff counseling and support. 5. Students in all classes were assured they were safe by a Sheriff's deputy. 6. Counselors were given details of the incident and brief orientation prior to being assigned to classrooms to deal with children's questions, concerns and needs. 7. Staff and administrators from other schools and Board members coordinated parent traffic, calls, food, and other logistical details and provided follow-up support. 8. Parents were encouraged to let their child/children remain at school until normal dismissal and teachers attempted to return to a normal routine as soon as possible. 9. Risk management, insurance, and workers' compensation offices were notified and at the scene. 10. Attempts were made to contact parents of all the children who were directly involved in the incident to advise them of a meeting the next morning and to answer questions. 11. Staff worked to coordinate getting all the children home. After the School Day Ended 1. Follow-up calls were made to latchkey children to determine their well being. 2. A faculty meeting was held immediately after school to discuss the incident and future plans. 3. A parent meeting was scheduled for the next morning and evening to deal with parent concerns. 4. Counselors were available until 10:00 p.m. the night of the incident, individual counseling provided during the day for several weeks following, and a list of volunteer counselors and home phone 128 numbers was sent home. 5. Mental health professionals from the community were utilized to work with parents and students, as well as, faculty and staff. 6. Administrators, teachers, and staff responded in a calm and professional manner on the day of the shooting and following despite the normal reactions of shock, denial, and disbelief. Following the Day of the Incident 1. School counselors worked with children needing individual assistance on an ongoing basis. 2. The state crisis team and other professionals worked with faculty and staff as part of district and school initiated follow-up activities and provided additional in-service training for counselors, school psychologists and school social workers. (District 3 Final Report, 1989) From the interviews the following additional information was obtained: 1. Counselors were expected to take most of the burden of diagnosing student needs. They were available to take over a teacher's class if the teacher needed a break. 2. There was an employee assistance program but it was not part of the crisis plan. 3. There is a Fall orientation for all new teachers. They are given materials with names and numbers of agencies who will help with personal problems. 4. The district discourages school people going to school people for counseling. 5. Within 30 minutes there was a counselor and police officer in every classroom. 6. Occupational specialists, guidance counselors, school psychologists, and school social workers all responded to the scene. 7. Three principals who were personal friends of the school's principal, heard about the shooting and decided on their own to respond to the scene. One brought his custodial staff with him, one went to several fast food establishments and secured food for the children, and one manned the front office. 8. The local police secured the crime scene and the principal had to insist, 129 after heated discussion, to have children addressed by police officers in their own classroom settings, instead of in a mass meeting in the courtyard. 9. Teachers with children of their own attending the school were notified of their well-being and relieved to check on them as soon as possible. 10. The principal gave each teacher a journal to use as a therapeutic instrument to ventilate feelings. 11. A couple of weeks after the incident the State CISD team called the principal and offered their services. They had one large meeting with teachers in the morning and broke into smaller groups the rest of the day. 12. The principal approached the Board Attorney and requested he sit with each teacher through the depositions as she felt the teachers should have someone on their side to advise them and provide support. District 3 Staff Survey Results There was a very limited response from the staff of District 3 for reasons articulated earlier. Even so, there are some distinct parallels to Districts 1 and 2 as you read through staff results. 60% of the staff respondents felt the crisis intervention was effective. 1. The most frequent observation was the quick response of the crisis team. One said, "Within two hours every classroom had a counselor and police officer talking to students and teachers. 2. Other strengths mentioned, "After school we had large group sessions which went on for a couple of weeks. 3. The crisis team members were excellent listeners, sympathetic, and compassionate. 80% of the staff respondents felt comfortable consulting with the crisis team and 80% felt they could trust the crisis team to be confidential about topics discussed. No specific comments were made about crisis team training, but 33% felt team members were adequately trained to deal with staff members. 4. Support was available after school hours and the principal gave each 130 teacher a journal and encouraged them to write down their feelings. 5. One respondent wrote, "We were made to feel we were experiencing normal reactions and would continue to have a variety of reactions. We were made aware of the availability of professionals who would respect our fears as well as our confidentiality. 50% of the respondents indicated they felt adequately informed about possible psychological, physical and/or emotional reactions they may experience. The comment occurring most frequently about weaknesses with the plan related to follow up activities. 1. Even though 60% thought the intervention was effective only 30% felt follow-up was adequate. One respondent said, "I for one, didn't think I needed help until many months later - then no one was there. It wasn't even discussed anymore." Another reiterated, "I wish that once a month a team would be on campus where teachers could 'drop in' and talk, for about six months after an incident. That way we'd be more apt to seek help than making an appointment off campus after hours." Still another said, "I appreciate this survey. I hope the administration in our county receive a copy of the results. This survey has made me realize how affected I still am by the incident." 2. Two respondents made comments about insensitivity by the Central Administration in regards to the difficulties that occurred this year with the community. One teacher said, "I felt very patronized by the administration at the county level this school year as did other teachers." Another explained she tried to discuss with the Superintendent that, "I felt our faculty was particularly vulnerable because of the shooting. I was told to quit being fearful, that none of the belligerent parents were capable of shooting anyone." 3. Only 6% of the respondents felt the district should have done more to support the staff, however, one respondent indicated support staff were overlooked when it came to interventions. 4. 50% of the respondents felt family members were adequately informed about the behaviors they may expect to observe as a result of the incident. One respondent suggested, "I'd like for spouses to be given a group meeting presentation of what our reactions could be. My husband got tired of my anxieties and thought I was a nut when I kept a rash for a year and then had anxiety attacks 10 months after the fact. Six of the thirteen comments from staff about the most difficult aspect of 131 returning to normal functioning had to do with fear. 1. 2. Fear of it happening again, fear of open places, and scrutinizing people for signs of psychological disturbance. One teacher wrote,"[It was difficult] having to be back in charge of young children immediately. There was no time for me to work through any fears I had. I just wanted to lock myself and my family in our home and never go outside where it was 'not safe'." Related to that two found it unsettling returning to the scene of the crime. Two felt guilt was the hardest to shake, one because she had been on the interview team that hired the assailant, and one because the respondent knew the assailant personally and began to doubt her ability to judge children's needs or adult's feelings if she could not see this incident coming. There were several teachers on staff with their own children in other parts of the building at the time of the shooting. One respondent felt guilty for staying with her class, knowing her own child was in danger in the cafeteria. 3. One felt continued anger over someone hurting her "family". 4. Another found it difficult to strike a balance between being sympathetic to those closest to the incident and her desires to put the incident behind her. A tree had been planted in remembrance of the victim It had died and needed to be removed as the dead tree served as a trigger for one respondent. 80% of the respondents indicated there were still triggers that brought back unpleasant thoughts or reactions about the incident. District 3 Crisis Team Survey Results There was a 58% response rate from District 3 crisis team members, however, the district could only come up with twelve names and addresses of crisis team members. A very comprehensive list of participants was received from Districts 1 and 2, so it is worth noting District 3 could not reproduce a complete listing of individuals who responded to the scene. There were a number of guidance counselors and occupational specialists excluded from the 132 list. This has the potential to skew the results from District 3, however, this is not to discount the information from those who did respond. 57% of the respondents felt the crisis intervention for staff members was effective. There were only three positive comment about the district's plan however. 1. Two dealt with the quickness of the response. One wrote, "[The district] offered immediate relief so teachers could check on their own children." Another said, "Professionals were dispersed to the site and remained there until late that night. 2. The third comment was, "I worked for the principal who was eager that everyone be helped." There was consensus that the district had no crisis plan at the time of the incident. 1. As one put it, "They just yelled, 'help'." Suggestions were that there should be a written plan, staff need to be debriefed, and safety procedures should be discussed and implemented. 2. Three comments addressed training. One school counselor said, "The total school community needs training in crisis intervention. There are frequent cases of violence around the district. [Training] should be on going and required. Twenty-nine percent of the respondents felt crisis team members were adequately trained. 3. Forty-three percent of crisis team respondents felt there was adequate follow-up. A loss counselor who disagreed said, "There was not enough over a long enough period of time." Another said, "[Staff] need to be debriefed as you would anyone who has witnessed an event of this magnitude." 4. Forty-three percent of the crisis team respondents felt the district provided sufficient support for staff members and 43% felt the families were adequately informed about behaviors to expect from their spouses. The most difficult part of returning to normalcy was dealing with children's and parent's fears. It took on-going support to assure the children that the school was safe. 133 When asked specifically about the debriefings, 67% felt crisis team members conducted effective debriefings, 67% felt debriefings were held in a timely manner, 20% thought debriefings were mandatory, and 100% felt debriefings should be mandatory. Arguments for mandatory attendance were: a. Those least likely to attend need it the most. b. Whether they participate or not, they will be exposed to others having similar problems. c. Experience and training. 134 District 3 Interview Summary There was no plan at the time of the incident and there was general admiration for the intuitive savvy with which the principal orchestrated the recovery. She was clearly in charge and made many appropriate strategic decisions which helped the recovery. In her own school she had a planned lock down procedure which became a model for all other schools in the district after the incident. There was an employee assistance program for drug and alcohol abuse but no other provisions for employees past materials distributed to new employees listing outside mental health agencies offering free of charge first visits. Counselors were dispatched primarily for the children, but were available to staff upon request. Since there was no plan, the comments served as suggestions for a plan: 1. The principal felt school should have been closed the following day to allow staff time to recoup. 2. She felt something should be done for everyone whether they think they need it or not. She said, "It is not sufficient to say, 'Is everybody okay?' People inevitably respond, 'Yes', whether they mean it or not." 3. The principal needs administrative assistance. It is too much to handle alone. 4. There needs to be a plan to coordinate any investigation. Most people have little experience with the judicial system and depositions and trials are very stressful. 5. The public relations official should take the lead role in media management. 6. Police agencies should meet with school officials prior to any incident to develop a clear understanding of the needs of both agencies. 135 There were numerous steps taken which were helpful to staff members: 1. One principal brought his custodial staff to assist in clean up. 2. The state CISD team held debriefings two weeks post-incident. 3. Guidance counselors were on the scene and in every classroom within thirty minutes to help teachers with classes. 4. Counselors were available for teachers. No communication occurred with outside agencies prior to the incident. During the incident numerous mental health practitioners offered assistance. A mental note was made of those who were helpful and those who were opportunists. The state CISD team was most helpful. They held a large group meeting in the morning and broke into smaller groups the rest of the day. Changes that were made as a result of the incident were as follows: 1. A plan was developed and approved by the Board. 2. Insurance provisions have been made so employees can get long term counseling from outside agencies for no cost in the event of a critical incident. 3. More training has been provided in crisis intervention for student services and school based staff. There had been some activities offered in the past but were voluntary. As part of Blueprint 2000 training will be school based. 4. The National Safety Counsel evaluated the entire district and most safety issues were addressed. Issues cited were largely physical in nature (lighting, fences, etc.) 5. 6. The plan emphasized better record keeping. Sample forms, letters and signs were developed. The plan has not been updated since 1988, which was the only comment about the weaknesses in the present plan. 136 Comparison Across Districts of Interventions Delivered There were numerous similarities and differences in the interventions delivered from one district to the next. Similarities 1. There was a quick response to the scene with school psychologists, school guidance counselors, school social workers, and administrators. District 1 and 2 dispatched administrators as part of the plan. District 3 administrators came on their own initiative. 2. Faculty meetings were held at the close of the day to review how students may react, give out information about the incident, and develop a plan of action for the following day. 3. Faculty meetings were held the next morning to solidify the day's plan of action. 4. The crisis team was under the umbrella of student services and the main focus was on students. 5. Staff was made aware that the crisis team was available for them as well. 6. Memorial activities were developed for the victims. 7. School was open for business the day after the event. 8. Crisis team members went into classrooms. 9. Teachers had the opportunity to be relieved if necessary. 10. Crisis team members met at the close of each day to deliberate the next steps. 11. 12. There was no employee assistance program to address staff needs. CISD defusings were not conducted 3-8 hours post-incident. 13. Any staff involvement in any intervention activity was voluntary. 137 14. Stress response literature of some sort was distributed to staff. 15. No provisions were available for spouse or family notification of stress reactions to expect from employees. 16. CISD debriefings were not conducted for staff members 24-72 hours postincident. Differences 1. The violent act occurred on campus to an employee with a gun resulting in a death in Districts 1 and 3. The violent act occurred off campus to a student in District 2. 2. Districts 2 and 3 schools were relatively rural in comparison to District 1. 3. In District 3 voluntary staff debriefings by a trained CISD team were held about 2 weeks after the incident. In District 1 a trained mental health professional conducted a formal debriefing four weeks post-incident with cafeteria, custodial, and administrative staff. District 2 had no formal CISD debriefings. 4. Districts 1 and 3 received offers of assistance from outside agencies postincident and made determinations which ones were helpful and would be contacted in the future. District 2 had made that determination previously. 5. Districts 1 and 3 had key central administrative staff who either left town or did not return to town, which was perceived as a lack of support. District 2 had no such complaints. 6. District 2 had a plan that had been tested and refined, District 1 had a draft of a plan that had not been fully tested, and District 3 had no plan at all. 7. District 1 felt school counselors and psychologists should have taken more leadership in the crisis team efforts. District 2 felt it may be better to have someone not associated with the affected school be the team leader. 8. Districts1 and 3 included community mental health professionals in their crisis intervention. District 2 did not see a need for outside mental health professionals except on a referral basis, but did include clergy in their intervention efforts. 138 9. Each district varied in how much training was available, who was trained, and what kind of training was provided. District 2 had the most comprehensive training available for staff. All student services personnel had training in crisis intervention, grief counseling, and high risk suicidal students. They had a plan for school psychologists to systematically train teachers in crisis intervention. Also, all principals had their own workshop on crisis intervention. Districts 1 and 3 had training available on the same topic but not all student service personnel had received the same training. Crisis intervention workshops were offered to all district staff during staff development days, however, that topic is only one of scores of topics one may choose to attend according to interest. Interventions Delivered and Received in Each District Crisis team members were asked what strategies they personally delivered to staff members. Staff members were asked to mark the intervention strategies they personally experienced. The following summarizes the data in tables 20-25. Tables 20, 22, and 24 show the percentage of crisis team respondents who delivered one-on-one counseling, small group counseling, and large group counseling; at the scene, 1-3 weeks post-incident, 1-3 months post-incident, 4-12 months post-incident, and more than a year post-incident. Tables 21, 23, and 25 show the percentage of staff respondents who felt they received one-on-one counseling, small group counseling, and large group counseling; at the scene, 1-3 weeks post-incident, 1-3 months post-incident, 4-12 139 months post-incident, and more than a year post-incident. Table 20 Percentage of Crisis Team Respondents who Delivered One-on-One Counseling at Various Time Intervals _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ At the Crisis Scene 76.2% 62.5% 14.3% 1-3 Weeks After 57.1% 43.8% 42.9% 1-3 Months After 4.8% 25% 14.3% 4-12 Months After 4.8% 12.5% 0% More Than 1 Year 9.5% 18.8% 14.3% ________________________________________________________________ 140 Table 21 Percentage of Staff Respondents who Received One-on-One Counseling at Various Time Intervals _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ At the Crisis Scene 10% 7.4% 9.1% 1-3 Weeks After 12.9% 7.4% 36.4% (Continued on next page) Table 21 (Continued) District 1 District 2 District 3 _______________________________________________________________ 1-3 Months After 4.3% 7.4% 9.1% 4-12 Months After 5.7% 3.7% 0% More Than 1 Year 1.4% 0% 0% ________________________________________________________________ 141 Table 22 Percentage of Crisis Team Respondents who Delivered Small Group Counseling at Various Time Intervals _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ At the Crisis Scene 33.3% 62.5% 42.9% 1-3 Weeks After 23.8% 43.8% 14.3% 1-3 Months After 4.8% 6.3% 0% 4-12 Months After 4.8% 0% 0% More Than 1 Year 0% 0% 0% ________________________________________________________________ 142 Table 23 Percentage of Staff Respondents who Received Small Group Counseling at Various Time Intervals _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ At the Crisis Scene 12.9% 7.4% 9.1% 1-3 Weeks After 21.4% 7.4% 18.2% 1-3 Months After 4.2% 14.8% 9.1% 4-12 Months After 7.1% 7.4% 9.1% More Than 1 Year 1.4% 7.4% 0% ________________________________________________________________ 143 Table 24 Percentage of Crisis Team Respondents who Delivered Large Group Counseling at Various Time Intervals _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ At the Crisis Scene 9.5% 25% 0% 1-3 Weeks After 4.8% 18.8% 14.3% 1-3 Months After 0% 6.3% 0% 4-12 Months After 0% 0% 0% More Than 1 Year 0% 0% 0% ________________________________________________________________ 144 Table 25 Percentage of Staff Respondents who Received Large Group Counseling at Various Time Intervals _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ At the Crisis Scene 30% 70.4% 90% 1-3 Weeks After 27.1% 63% 63.4% 1-3 Months After 7.1% 25.9% 9.1% 4-12 Months After 1.4% 18.5% 9.1% More Than 1 Year 2.8% 7.4% 0% ________________________________________________________________ 76% of the District 1 crisis team engaged in one-on-one counseling at the scene of the incident. At first glance that would seem to be a substantial amount of attention directed toward staff members, however, only 10% of the staff members responded in kind. There seems to be a disparity. If 76% of the crisis team respondents (16) counseled one teacher the day of the incident, it would amount to approximately 23% of the staff not 10%. 57% (12) counseled one-on-one 12.9% (9) of the staff, 1-3 weeks after. The disparity is not so great in this instance. Small group number at the scene show even greater disparity. If 33% of the crisis team (7) held small group activities, even if small groups were defined as 2, that would equal 20% not 12.9%. Small group 1-3 weeks later is more feasible with 5 crisis team members administering to 15 staff members. Large group counseling follows the same general pattern. The number of crisis team members delivering service and staff receiving 145 services show tremendous disparity in District 2. 62.5% (10) felt they delivered one-on-one and small group counseling to 7.4% (2) staff members at the scene of the incident and 43.8% (6) worked with 7.4% (2) staff members one-on-one and in small group 1-3 weeks later. Large group makes more sense with 25% of the crisis team working with 70% of the staff. With the small sampling of staff in District 3, it is difficult to draw too many parallels except to say a pattern exists where increases and decreases in the percentage of crisis team members felt they rendered services in the same instances where staff member percentages increased or decreased. There are several thoughts on what could cause large disparities in the comparison described in Districts 1 and 2: 1. More than one crisis team member could have talked to the same teacher. 2. What crisis team members thought was one-on-one counseling was not recognized as such by the teachers. 3. Teachers simply failed to recall the counseling. 4. Crisis team members failed to distinguish between services they rendered to staff and that of the entire school community, or 5. Those who did receive the counseling did not happen to return the survey, although all other statistics indicate the sample was representative of the general population at the school. Comparison Across Districts of Crisis Team and Staff Perceptions of Services Received and Delivered 146 Crisis Team Districts 1 and 2 show the largest percentage of crisis team respondents participated in one-one-one, small and large group intervention for at the scene category (76.2% - 62.5%), with a smaller but substantial percentage 1-3 weeks later (57.1% - 43.8%). District 3, however, showed higher percentages of participation 1-3 weeks later for one-on-one and large group intervention. That would follow because a larger percentage of District 3 crisis team respondents were the State CISD team that arrived about two weeks after the incident. The principal handled any large group meetings the day of the incident. 1-3 months later percentages drop drastically in Districts 1 and 3 (0%14.3%) for one-on-one, small and large group intervention. This would support the data indicating the vast majority of the crisis team was dismissed from service no later than 3 weeks post-incident. District 2 varies in that 1-3 months later 25% were still participating in one-on-one interventions, although small and large group had fallen off to only 6.3%. This most likely is because the incident in District 2 did not come to closure as quickly as Districts 1 and 3. One crisis team member in District 1 participated in a small group meeting 4-12 months post-incident but all other respondents no longer delivered small or large group intervention from 4 months to present. One to three crisis team participants were still involved with one-on-one counseling more than a year later in each district. Staff 147 Districts 1, 2, and 3 all held faculty meetings the day of the incident. It is curious that in District 1 only 30% of the respondents perceived that as large group intervention, where in Districts 2 and 3, 70% and 90% respectively responded to that question. The same trend occurs in the time period 1-3 weeks later. Districts 2 and 3 report 63% involvement in large group activities, whereas, District 1 had only a 27% response rate. Consistently very small percentages of staff (0%-18.2%) recalled one-onone or small group counseling during any of the time periods across the board. The only exception is the period 1-3 weeks post-incident in District 3 where 36.4% indicated one-on-one and District 1 where 21.4% indicated small group. Tables 26 and 27 show the percentage of crisis team respondents who distributed CISD literature and community mental health resources and the percentage of staff respondents who received such literature. 148 Table 26 Percentage of Crisis Team Respondents who Distributed CIS Information, Mental Health Agency, or Other Handouts _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ CISD Handouts 23.8% Lists of Mental Health Resources 23.8% 25% 14.3% 43.8% 28.8% Other Handouts 14.3% 12.5% 28.8% ________________________________________________________________ 149 Table 27 Percentage of Staff Respondents who Received CIS Information, Mental Health Agency, or Other Handouts _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ Stress Reaction Handout 44.3% 7.4% 27.3% Verbal Information on Stress Reactions 22.9% 40.7% 54.5% Stress Relief Handout 25.7% 7.4% 18.2% Verbal Information on Stress Relief Methods 20% 33.3% 27.3% List of Mental Health Resources 15.7% 14.8% 18.2% Other 3.7% 0% 10% ________________________________________________________________ Obviously CISD type literature was indeed distributed in all three districts. It is interesting that a very small percentage (14.8% - 18.2%) of staff respondents recalled receiving it. No greater than 54.5% and as low as 22.9% recalled any verbal discussion of stress reactions and not greater than 33.3% and as low as 20% recalled discussion on methods to relieve stress. Similarly, no greater than 44.3% and as low as 7.4% recalled receiving a stress reaction handout and no greater than 25.7% to as low as 7.4% recalled any literature on stress relief methods. 150 Who Staff Consulted About Reactions to the Incident Respondents were asked with whom they consulted about their emotional or psychological reactions to the incident. Table 28 indicated spouse, other family members, colleagues and close friends were overwhelmingly the source of comfort for staff respondents. Table 28 Percentage of Staff Respondents who Consulted with Various Individuals About Reactions to the Incident _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ Crisis Team Members 24.3% 22.2% 36.4% Spouse 68.6% 70.4% 81.8% Other Family Members 68.6% 55.6% 36.4% Colleagues 77% 63% 72.3% Close Friends 68.6% 14.8% 63.4% Family Physician 7.1% 0% 0% Mental Health Professional Suggested by Crisis Team 0% 0% 0% Psychologist of Own Choice 2.8% 7.4% 9.1% Counselor of Own Choice 2.8% 7.4% 0% Psychiatrist of Own Choice 0% 7.4% 0% Clergy 11.4% 22.2% 0% 151 Other 2.8% 0% 0% ________________________________________________________________ The highest percentage of responses in Districts 2 and 3 (70.4% and 81.8% respectively) was spouse, followed by colleagues and other family members. The highest in District 1 was colleagues (77%) with 68.8% selecting spouse, other family member and close friends. The percentages drop consistently across all three districts (22.2% 36.4%) who consulted with crisis team members. District 2 shows a 22.2% response to clergy which follows the repeated mention of clergy throughout the study of District 2. A few individuals went to psychologists, psychiatrists, doctors, or counselors of their choice, with no one selecting the option of a Mental Health Professional suggested by the crisis team. District 1,2, and 3 Staff Symptom Summary Similarities in the symptoms experienced by staff members exist between the three districts. Tables 29- 40 display the percentage of staff respondents who experienced various symptoms in each district. The symptoms are arranged in descending order of frequency in reference to the "delayed stage". Table 29 Percentage of District 1 Staff Respondents Experiencing Delayed Symptoms in Descending Order of Frequency ________________________________________________________________ District 1 _____________________________________ 152 Type of Symptom During After Delayed ________________________________________________________________ Grief 37.1% 64.3% 34.3% Anxiety 48.6% 45.7% 25.7% Anger 25.7% 35.7% 21.4% Awareness 5.7% 27.1% 20% Depression 10% 30% 17.1% Suspiciousness 7.1% 22.9% 17.1% Fear 28.6% 35.7% 15.7% Shock 31.4% 27.1% 15.7% Overwhelmed 18.6% 28.6% 14.3% Intrusive Images 5.7% 18.6% 12.9% Disturbed Thinking 7.1% 17.1% 12.9% Apprehension 11.4% 25.7% 12.9% Hypervigilance 8.6% 21.4% 12.9% Changed Alertness 12.9% 27.1% 12.9% Fatigue 10% 41.4% 11.4% Lack of Patience 7.1% 21.4% 11.4% Poor Concentration 11.4% 30% 10% Confusion 21.4% 17.1% 10% Irritability 5.7% 17.1% 10% Blaming Someone 10% 10% 10% Hyperalertness 11.4% 24.3% 10% Agitation 4.2% 12.9% 8.6% Withdrawal 7.1% 11.4% 7.1% Inability to Rest 8.6% 20% 7.1% Loss of Control 7.1% 8.6% 7.1% Nightmares 11.4% 20% 7.1% Intensified Startle Reflex 2.8% 8.6% 7.1% Uncertainty 21.4% 22.9% 7.1% Weakness 5.7% 8.6% 7.1% Severe Panic 5.7% 4.2% 5.7% Emotional Outburst 5.7% 12.9% 5.7% Continued Table 29 Continued Type of Symptom During After Delayed ________________________________________________________________ Teeth Grinding 4.2% 7.1% 5.7% Guilt 5.7% 5.7% 4.2% Inappropriate Responses 4.2% 11.4% 4.2% Nonspecific Bodily Complaint 1.4% 2.8% 4.2% Dizziness 2.8% 2.8% 4.2% Rapid Heart Rate 25.7% 17.1% 4.2% 153 Poor Attention 10% 20% 4.2% Chills 0% 2.8% 4.2% Denial 11.4% 11.4% 2.8% Headaches 1.4% 8.6% 2.8% Change in Activity 4.2% 7.1% 2.8% Poor Problem Solving 2.8% 1.4% 1.4% Poor Abstract Thinking 2.8% 2.8% 1.4% Loss of Orientation 8.6% 2.8% 1.4% Pacing 4.2% 7.1% 1.4% Change in Appetite 0% 1..4% 1.4% Increased Use of Alcohol 0% 4.2% 1.4% Difficulty Breathing 2.8% 1.4% 1.4% Poor Decisions 2.8% 2.8% 1.4% Memory Problems 5.7% 7.1% 1.4% Difficulty Identifying Things 4.2% 4.2% 0% Muscle Tremors 2.8% 4.2% 0% Thirst 1.4% 2.8% 0% Change in Sexual Functioning 0% 2.8% 0% Antisocial Acts 2.8% 0% 0% Nausea 1.4% 1.4% 0% Erratic Movements 0% 1.4% 0% Changed Speech Patterns 1.4% 0% 0% Profuse Sweating 1.4% 0% 0% Visual Difficulties 1.4% 0% 0% Chest Pain 0% 1.4% 0% Vomiting 0% 0% 0% Fainting 0% 0% 0% ________________________________________________________________ Table 30 Percentage of District 2 Staff Respondents Experiencing Delayed Symptoms in Descending Order of Frequency ________________________________________________________________ District 2 _____________________________________ Type of Symptom During After Delayed ________________________________________________________________ Grief 74% 63% 51.9% Intense Anger 40.7% 51.9% 25.9% Suspiciousness 44.4% 37% 25.9% Anxiety 66.7% 51.9% 18.5% 154 Depression Irritability Emotional Shock Uncertainty Fatigue Changed Awareness Fear Lack of Patience Feeling Overwhelmed Agitation Blaming Someone Poor Concentration Confusion Changed Alertness Headaches Apprehension Nightmares Intrusive Images Guilt Poor Attention Disturbed Thinking Inability to Rest Emotional Outburst Hypervigilance Intensified Startle Reflex Change in Activity Chest Pain Withdrawal Table 30 (Continued) 29.6% 14.8% 55.6% 33.3% 40.7% 25.9% 29.6% 25.9% 22.2% 14.8% 14.8% 37% 29.6% 33.3% 25.9% 22.2% 14.8% 11.1% 3.7% 37% 25.9% 22.2% 14.8% 11.1% 7.4% 7.4% 3.7% 3.7% 25.9% 29.6% 25.9% 33.3% 44.4% 25.9% 22.2% 25.9% 18.5% 14.8% 14.8% 25.9% 29.6% 22.2% 18.5% 22.2% 11.1% 11.1% 7.4% 18.5% 22.2% 22.2% 11.1% 7.4% 3.7% 3.7% 7.4% 3.7% 18.5% 18.5% 14.8% 14.8% 14.8% 14.8% 11.1% 11.1% 11.1% 11.1% 11.1% 7.4% 7.4% 7.4% 7.4% 7.4% 7.4% 7.4% 7.4% 3.7% 3.7% 3.7% 3.7% 3.7% 3.7% 3.7% 3.7% 3.7% (Continued) Type of Symptom During After Delayed ________________________________________________________________ Memory Problems 3.7% 3.7% 3.7% Denial 22.2% 11.1% 0% Rapid Heart Rate 18.5% 11.1% 0% Hyperalertness 14.8% 7.4% 0% Nausea 14.8% 3.7% 0% Poor Decisions 14.8% 0% 0% Poor Abstract Thinking 11.1% 3.7% 0% Severe Panic 11.1% 0% 0% Poor Problem Solving 7.4% 3.7% 0% Loss of Orientation 7.4% 0% 0% Visual Difficulties 7.4% 0% 0% Teeth Grinding 7.4% 0% 0% 155 Pacing 7.4% 0% 0% Erratic Movements 3.7% 3.7% 0% Weakness 3.7% 3.7% 0% Difficulty Identifying Things 3.7% 0% 0% Nonspecific Bodily Complaint 3.7% 0% 0% Inappropriate Responses 3.7% 0% 0% Vomiting 3.7% 0% 0% Loss of Control 3.7% 0% 0% Change in Appetite 3.7% 0% 0% Muscle Tremors 0% 0% 0% Difficulty Breathing 0% 0% 0% Thirst 0% 0% 0% Dizziness 0% 0% 0% Profuse Sweating 0% 0% 0% Chills 0% 0% 0% Fainting 0% 0% 0% Change in Speech Patterns 0% 0% 0% Increased use of Alcohol 0% 0% 0% Change in Sexual Functioning 0% 0% 0% Antisocial Acts 0% 0% 0% ________________________________________________________________ Table 31 Percentage of District 3 Staff Respondents Experiencing Delayed Symptoms in Descending Order of Frequency _______________________________________________________________ District 3 __________________________________________ Type of Symptom During After Delayed ________________________________________________________________ Suspiciousness 9% 36% 36% Guilt 18% 27% 36% Nightmares 0% 27% 36% Anxiety 45% 36% 27% Uncertainty 18% 36% 27% Feeling Overwhelmed 9% 36% 27% Changed Awareness 18% 27% 27% Memory Problems 0% 9% 27% Grief 27% 54% 18% Fear 27% 36% 18% 156 Loss of Control Hyperalertness Denial Hypervigilance Apprehension Intrusive Images Withdrawal Irritability Intensified Startle Reflex Lack of Patience Inappropriate Responses Confusion Fatigue Emotional Shock Changed Alertness Disturbed Thinking Poor Concentration Severe Panic Poor Attention Blaming Someone Inability to Rest Change in Activity Table 31 (Continued) 9% 18% 18% 9% 9% 18% 9% 0% 0% 0% 0% 36% 0% 27% 27% 18% 27% 9% 9% 0% 0% 9% 36% 27% 27% 27% 27% 18% 9% 9% 9% 0% 0% 45% 45% 27% 27% 27% 18% 18% 18% 18% 18% 9% 18% 18% 18% 18% 18% 18% 18% 18% 18% 18% 18% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% (Continued) Type of Symptom During After Delayed _______________________________________________________________P oor Decisions 9% 9% 9% Agitation 0% 9% 9% Intense Anger 0% 9% 9% Depression 0% 9% 9% Difficulty Identifying Things 0% 9% 9% Change in Appetite 9% 0% 9% Change in Sexual Functioning 0% 0% 9% Increased Use of Alcohol 0% 0% 9% Visual Difficulties 0% 0% 9% Dizziness 0% 0% 9% Nonspecific Bodily Complaint 0% 0% 9% Rapid Heart Rate 36% 36% 0% Pacing 18% 18% 0% Nausea 18% 0% 0% Loss of Orientation 9% 9% 0% Teeth Grinding 9% 9% 0% Headaches 9% 9% 0% Muscle Tremors 0% 9% 0% Difficulty Breathing 0% 9% 0% 157 Weakness Poor Problem Solving Poor Abstract Thinking Change in Speech Patterns Erratic Movements Chest Pain Thirst Vomiting Profuse Sweating Chills Fainting Antisocial Acts Emotional Outbursts 0% 0% 0% 9% 0% 0% 0% 0% 0% 0% 0% 0% 0% 9% 9% 9% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% ________________________________________________________________ Examining the delayed mode, of the 64 symptoms listed, grief, anxiety, suspiciousness, fear, feeling overwhelmed, and changed awareness were rated in the top 16 most frequently experienced symptoms in all three districts. Depression, intrusive images, intense anger, apprehension, lack of patience, fatigue, emotional shock, hypervigilance, and uncertainty were in the top 16 symptoms of two districts and in the top 32 of the third district. Disturbed thinking, changed alertness, irritability, blaming someone, and poor concentration fell in the top 16 for one district and in the top 32 for the other two districts. No one in any district had problems fainting, in during, after, or delayed modes. Vomiting, thirst, profuse sweating, chills, and antisocial acts were not experienced in any mode in two of the three districts. Erratic movements, chest pain, dizziness, difficulty breathing, changed speech patterns, increased use of alcohol, change in sexual functioning, and emotional outbursts were not experienced in any mode in at least one of the three districts. It is interesting to determine the types of symptoms experienced most frequently by respondents and secondly compare the number of symptoms each 158 respondent experienced in the during, after, and delayed phases. Table 32 shows the percentage of respondents that experienced none of the symptoms, 13 of the symptoms, or 4 or more symptoms in each of the three phases. Some similarities and differences become apparent. 159 Table 32 Percentage of Staff Respondents Experiencing Zero, 1-3, or 4 or More Symptoms in the During Phase _____________________________________________________________ During ______________________________________________ District 1 2 3 _______________________________________________________________ 0 Symptoms 20% 3.7% 27.3% 1-3 Symptoms 37.1% 22.2% 36.4% 4 or More Symptoms 42.9% 70.4% 36.4% ________________________________________________________________ "During" the incident Districts 1 and 3 show similarities and District 2 respondents react somewhat differently. Districts 1 and 3 have 20% and 27.3% respectively who experienced no symptoms during the incident, 37.1% and 33.4% experienced 1-3 symptoms, and 42.9% and 36.4% experienced anywhere from 4 to 34 symptoms. Table 33 displays an analysis of variance computed on the average number of symptoms experienced in each district at each phase. 160 Table 33 Analysis of Variance on the Average Number of Symptoms Experienced During Each Phase Ho: M1=M2=M3 _______________________________________________________________________________________________ During After Delayed ________________________________________________________________________________ N Mean SS MS F PR>F Mean SS MS F PR>F Mean SS MS F PR>F _________________________________________________________________________________________________ ____________________ District 1 70 4.29 5.39 8.33 District 2 27 3.59 10.33 8.15 District 3 11 6.82 5.55 9.64 Total 108 7.09 491.61 245.81 4.68 .0113 8.70 18.85 9.43 .17 .8433 4.90 82.74 41.37 1.17 .3153 _________________________________________________________________________________________________ ____________________ It was interesting to note the null hypothesis was rejected at the .05 significance level, in that there was a significant difference in the mean number of symptoms respondents experienced at the "during" stage in District 2. The difference could be attributed to the fact in Districts 1 and 3 the incident occurred on campus revealing the horror of the atrocity for all to see. In District 2 the violent act occurred off campus and the only evidence of violence may have come from news reports. This could explain the difference in the onset of symptoms. District 1 had 20% experience no symptoms during the incident, 37.1% 161 experienced 1-4 symptoms - with mode of 2, and 42.9% experienced at least 4 and up to 34 symptoms - with a mode of 4 symptoms. District 3 was similar with 27.3% who experienced no symptoms during the incident, 36.4% experienced 1-3 symptoms - with a mode of 2, and 36.4% experienced at least 4 and up to 22 symptoms - with a mode of 9, 10, 12, and 22 symptoms. District 2, however, had only 3.7% with no symptoms during the incident, 22.2% experienced 1-3 symptoms - with a mode of 2, and 70.4% experienced at least 4 and up to 32 symptoms - with a mode of 4 and 22 symptoms. All three districts showed similarities in the "After" phase, defined as the time immediately after the incident as the realization of the magnitude or severity of the incident is finally perceived. Table 34 Percentage of Staff Respondents Experiencing Zero, 1-3, and 4 or More Symptoms in the After Phase _______________________________________________________________ After ____________________________________________________ District 1 2 3 _______________________________________________________________ 0 Symptoms 5.7% 3.7% 18.2% 1-3 Symptoms 24.3% 25.9% 27.3% 4 or More Symptoms 68.6% 66.7% 54.5% ________________________________________________________________ 81.8% - 92.6% of the respondents for all three districts experienced some type of clinical symptom of critical incident stress, and 54.5% - 68.6% of those 162 experienced at least 4 and up to 32 symptoms during this stage. This stage had the fewest respondents experiencing no symptoms. In District 1, 12.9% experienced 2, 8.6% experienced 5 or 8, and 5.7% experienced 0, 1, 3, 4, 5, or 19 symptoms. In District 2, 14.8% experienced 2, 11.1% experienced 3 or 4, and 7.4% experienced 5, 10, or 22 symptoms. In District 3 18.2% experienced 0 or 3, and 9.1% experienced 2, 5, 10, 15, 16, 23, or 29 symptoms. The delayed phase is important because symptoms can occur weeks, months, or years after the critical incident. Table 35 Percentage of Staff Respondents Experiencing Zero, 1-3, or 4 or More Symptoms in the Delayed Stage ______________________________________________________________ Delayed _______________________________________________ District 1 2 3 _______________________________________________________________ 0 Symptoms 28.6% 37% 18.2% 1-3 Symptoms 37.1% 25.9% 27.3% 4 or More Symptoms 34.3% 33.3% 54.5% ________________________________________________________________ District 3 had the lowest percentage of respondents experiencing no symptoms (18.2%) and the highest percentage who experienced at least 4 and up to 33 symptoms in this stage (54.5%). District 2 had the highest percentage of those who experienced no symptoms (37%) and was similar to District 1 with 33.3% who experienced at least 4 and up to 22 symptoms, where District 1 had 163 34.3% who experienced at least 4 and up to 23 symptoms, each with a mode of 5 symptoms. In all three districts over 11% of the staff experienced 10 or more symptoms in the delayed phase. A Pearson Correlation Coefficient was calculated to compare the number of symptoms individuals experienced to their responses to questions 7-18. Those with more symptoms during the incident tended to have more symptoms after (r=.54304 p<.01) and delayed (r=.28649 p<.01). The more symptoms respondents experienced during the incident the more they tended to feel afraid they would be perceived as emotionally weak (r=.19808 p<.05) and still have certain triggers that bring back unpleasant memories and reactions (r=.28142 p<.01). The more symptoms respondents experienced after the incident the more they tended to keep their feelings private (r=.22973 p<.05), thought the district should have done more to support staff (r=.26471 p<.05), and still have certain triggers that bring back unpleasant memories and reactions (r=.31270 p<.01). The more symptoms respondents experienced in the delayed phase, the more they tended to feel people would think them emotionally weak if they revealed their feelings about their ability to cope (r=.24657 p<.05), they must keep their feelings private (r=.23996 p<.05), they were not adequately informed about symptoms after the incident (r=.23091 p<.05), the district should have done more to support staff (r=.27353 p<.05), and there are still certain triggers that bring back unpleasant memories and reactions (r=.23840 p<.05), . Proximity to the Incident 164 Question 6 of the staff survey deals with the respondent's proximity to the incident. For Districts 1 and 3 response options ranged from; witnessed the shooting, helped in the cafeteria post-incident, remained in classrooms, to , not in the building that day. District 2 options were; "she was one of my students this year, I knew her family, I knew her as a student in the school , I did not know her personally." It was of interest to determine if there were differences in the way respondents reacted in accordance to their proximity to the incident. A difference in reactions would lend itself to a rationale for predetermined groups for debriefing. The mean number of symptoms during , after, and delayed was calculated across all three districts, compared to the proximity to the incident, and is displayed in Table 36. An analysis of variance was computed using the mean number of symptoms experienced by each respondent in the during, after, and delayed stages in accordance to their proximity to the incident. The null hypothesis was rejected at the significance level of .05 because indeed, the closer the respondents were to the incident, the more symptoms they tended to have in the during, after, and delayed stages. 165 Comparison with EMS Agency Procedures Table 37 displays the elements of Mitchell's CISD model and indicates which of these elements each district provided for their employees. Table 37 Comparison Between CISM Model and District Interventions ______________________________________________________________ Districts ____________________ Elements 1 2 3 _______________________________________________________________ An intervention team for employees Pre-incident education for all employees 16 hrs. training in CISD for all CT members Ongoing training 4 times/ yr. all CT members Mental health professionals on team Clergy on team Peer support on team Team leader Written responsibilities for CT members On-scene intervention Defusing all affected employees w/i 3-8 hrs. CISD debriefing all affected employees w/i 24-72 hrs. Mandatory employee attendance at debriefing 7 phase approach to formal debriefing 3- 40 participants - 1 CT member/10 participants Crisis reaction & coping styles handouts Debrief CT members daily Spouse debriefing Follow-up debriefing (6 wks., 6 mos., and/or 1 yr.) Follow-up meeting with all participants Follow-up individual consultations Table 37 (Continued) x x x x x x x x x x x x x x x x x x x x x x x x x x x x x 166 CT report and critique of services rendered x x Referrals to outside agencies x x x Community outreach programs x x x _______________________________________________________________ Mitchell's model provides critical incident stress management (CISM) for employees. Nine general categories include: a CISD team for employees, preincident education, on-scene support services, CISD defusing, CISD debriefing, follow-up services, spouse debriefing, CISD training and continuing education for crisis team members, and community outreach initiatives. 1. None of the districts had a CISD team predominately for employees. Each deployed a crisis team for the students with the expectation they should make themselves available to staff members if needed. 2. There was no pre-incident education for employees regarding CIS or the goal and objectives of the crisis team in the event of a school wide crisis. The most any employee received was a verbal explanation of lock down procedures with an outline of staff responsibilities in the teacher's handbook. 3. No district had an internal team trained in CISD. Districts 1 and 3 eventually requested assistance from outside agencies with individuals trained in CISD. 4. No district provided ongoing training for crisis team members four times per year. District 2 provided the most training overall, but there was no organized plan for periodic CISD related training. 5. Mitchell's model specifies the make-up of the crisis team There must be a team leader, a mental health professional and peer support personnel. A team leader has many responsibilities but primarily organizes the CI effort. Each district had a team leader. In Districts 1 and 2 the team leader was a school psychologist. In District 3 the principal was instrumental in organizing the crisis team once they arrived. 6. Each district had mental health professionals on the team, in the form of the school psychologists. These individuals were well qualified as mental health professionals, however, the amount of clinical experience varied. The vast majority of their duties related to testing for special programs, therefore, more practical experience and training would be needed for them to function adequately in CISD sessions. 167 7. The trained peer support personnel are key to Mitchell's model. He feels a team member familiar with the profession of focus is essential for the success of the debriefing. In a school setting the peer support personnel can be the school psychologist, school social worker, school counselor or teacher. Just because a teacher is debriefed does not mean a teacher must be the peer support member on the team. It would not be appropriate, however, to have a teacher as a peer support member for an administrator's debriefing. 8. Mitchell indicates it is appropriate to have clergy on the crisis team. District 2 had clergy as part of their response and there were several positive comments about their contribution. 9. Districts 1 and 2 had crisis plans with responsibilities outlined, however, Mitchell provides far more detail leaving less room for free-lance decision making. District 3 had no written plan. 10. All three districts provided on-scene intervention to staff members exhibiting overt reactions to the incident. 11. There was some formal debriefing that occurred in all three districts, however, none included all employees or was provided in the time frame suggested in Mitchell's model. 12. All districts had appropriate sized groups and distributed crisis information handouts. 13. Debriefings for crisis team members were conducted daily for some members in District 2. Some members complained they were not debriefed, therefore, the debriefings must not have been all inclusive. District 1 debriefed CT members more than once, but again, not all inclusive or daily. 14. No district had any provisions for spouse debriefing or formal follow-up debriefings with staff. 15. Each district had some type of follow-up meeting for staff members, largely in the form of a faculty meeting where CI was a topic on the agenda. Here again the focus was on the students. 16. Districts 1 and 2 had a few individual consultations, but not to the extent Mitchell suggests. 17. Each district made referrals to outside agencies, but there was no follow- 168 up for those individuals and each district used community resources as a result of the incident, but did not have a program as Mitchell suggests. Perceived Effectiveness Summary of the Strengths, Weaknesses, and Perceptions of Crisis Intervention Effectiveness from Staff Across Districts Table 38 shows the percentage of staff respondents answering "yes" to survey questions 7, 8, 9, and 10. Table 38 Percentage of Staff Respondents Answering "Yes" to Questions 7-10 _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 7. Did you need to talk but were 30.9% 11.1% 20% afraid people would think you emotionally weak? 8. Did you keep feelings private 14.7% fearing your supervisor would think you incompetent? 0% 10% 9. Were you comfortable consulting with the crisis team? 33.9% 70.3% 80% 10. Did you trust the crisis team to be confidential? 41% 74% 80% _______________________________________________________________ Questions 7 and 8 were similar in their content. Question 7 asked if they felt a need to talk about their ability to cope, but were afraid people might think them emotionally weak. Question 8 asked if they felt they should keep their feelings private for fear their boss may think them incompetent. A Pearson's Correlation Coefficient was computed to determine if there were any tendencies in the way respondents answered the questions of the staff survey. There was a 169 positive correlation (r=.40237 f<.01) between questions 7 and 8. Those who tended to answer yes to 7 tended to answer yes to 8. Districts 1 and 3 respondents answered similarly to both questions (#7: 32.9% and 27.3%; #8: 17.2% and 18.2%) where District 2 respondent's percentage of yes answers were much lower. Questions 9 and 10 were also similar, in that they asked if the respondent was comfortable talking with the crisis team about their reactions to the incident and did they feel they could trust the crisis team to be confidential about topic they may discuss. There was a strong positive correlation (r=.80420, f<.01) between questions 9 and 10. Those who tended to answer yes to 9 tended to answer yes to 10. In this case Districts 2 and 3 answered similarly with a high percentage that answered yes (72.7%-74%) and District 1 was much lower (28.6%-35.7%). Overall there was a strong negative correlation at the .01 significance level between questions 7/8 and questions 9/10. Those who kept their feelings private or feared appearing emotionally weak, tended to feel uncomfortable and or not trust the crisis intervention team and visa versa. Table 39 indicates the percentage of staff respondents answering "yes" to questions 12, 13, 14, and 16. Table 39 Percentage of Staff Respondents Answering "Yes" to Questions 12-14, and16 _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 12. Was CI effective? 28.4% 65.3% 60% 13. Was there adequate follow-up?13.2% 62.9% 30% 14. Was CT adequately trained? 20.6% 48.1% 33.3% 170 16. Should the district have 65.7% 33.3% 63.6% provided more support? ________________________________________________________________ Question 12 was a key question to the survey; "Did you feel the crisis intervention was effective?" The "yes" responses were quite different: District 2 (70.4%), District 3 (54.6%), and District 1 (27.1%). Question 13 asked if respondents felt follow-up was adequate. Those responding "yes" created the same order of districts; District 2 (62.9%), District 3 (27.3%), and District 1 (12.9%). Where nearly two-thirds of District 2 felt followup was adequate, less than one-third of Districts 1 and 3 respondents felt it was adequate. Question 14 takes a little different turn. When asked how respondents felt about the training level of the crisis team members, District 3 scored highest with 54.5% followed by District 2 (48.1%) and District 1 (20.6%). Question 16 asked respondents if they felt the district should have done more to support staff members. Districts 1 and 3 aligned once more with a "yes" response of 65.7% and 63.6% respectively. District 2 only had one-third of the respondents who felt more support for staff was in order. Table 40 displays the number of staff respondents who answered "yes" to survey questions 15 and 17. Table 40 Percentage of Staff Respondents Answering "Yes" to Questions 15 and 17 _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 15. Did you feel well informed about reactions you may have? 39.4% 62.9% 50% 171 17. Were families adequately informed? 2.9% 29.6% 50% _______________________________________________________________ Questions 15 and 17 asked how well informed respondents felt they and their family were about the possible psychological, physical, and/or emotional reactions they may expect post-incident. Districts 1 and 3 scored similarly in both questions with 37.1% and 45.5% respectively feeling well informed themselves but only 2.9% and 9.1% feelings their family members were informed. District 2 scored considerably higher in both circumstances. 66.7% felt well informed themselves and 29.6% felt their families were informed. Even so, across all three districts, less than 30% felt their families were adequately informed, which may have ramifications when the individuals staff members most frequently consulted about their emotional and/or psychological reactions to the incident were in fact family members. 172 Table 41 Percentage of Staff Respondents Answering "Yes" to Question 18 _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 18. Are there still triggers? 82.4% 81.4% 80% _______________________________________________________________ Across the board all districts answered question 18 the same. From 80%81.8% still find there are triggers that bring back unpleasant thoughts or reactions about the incident. Summary of the Strengths, Weaknesses, and Perceptions of Crisis Intervention Effectiveness from Crisis Team Members Across Districts Table 42 shows the percentage of crisis team respondents who answered "yes" to survey questions 8, 9, 10, 11, 12, and 17 Table 42 Percentage of Crisis Team Respondents Answering "Yes" to Questions 8-12 and 17 _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 8. Was CI effective? 75% 57% 9. Was there adequate follow-up? 9.5% 43.8% 43% 10. Was CT adequately trained? 9.5% 68.8% 29% 11. Was there sufficient support? 28.6% 68.8% 43% Table 42 (Continued) 33.3% 173 District 1 District 2 District 3 _______________________________________________________________ 12. Were families adequately informed? 9.5% 37.5% 43% 17. Was there effective coordination with community agencies? 39.4% 62.9% 20% ________________________________________________________________ Question 8 for the crisis team asked if crisis intervention for staff members was effective. In nearly identical proportions to the staff responses, 75% of the crisis team respondents in District 2 said "yes", 57% in District 3 and 33.3% in District 1. When asked about the adequacy of follow-up in question 9, in Districts 2 and 3, 43% of the respondents felt it was adequate, however, the response rate dropped to 9.5% in District 1. Crisis team members were asked to evaluate their own training level in question 10. In District 2, 68.8% felt adequately trained unlike Districts 1 and 3 where only 9.5% and 29% respectively felt adequately trained. Interestingly, a larger percentage of staff members gave crisis team training a thumbs up in Districts 1 and 3, where it was just the opposite in District 2. Similar patterns continue when asked if the school district provided adequate support for staff members in question 11. District 2 stood out with 68.8% that felt the district provided sufficient support, where Districts 1 and 3 response rates were only 28.6% and 43% respectively. Question 17 asked if they felt the district's plan provided effective and timely coordination with community agencies. Once again a large percentage (62.9%) in District 2 responded "yes" and Districts 1 and 3 had a much lower percentage of 39.4% and 20% respectively. 174 Table 43 displays the percentage of crisis team respondents who answered "yes" to survey questions 13-16. Question 13 asked if respondents felt crisis team members conducted effective debriefings for staff members and question 14 asked if the timing of staff debriefings was appropriate. Question 15 asked if debriefings were mandatory and question16 inquired if respondents felt debriefings should be mandatory. Table 43 Percentage of Crisis Team Respondents Answering "Yes" to Questions 13-16 _______________________________________________________________ District 1 District 2 District 3 _______________________________________________________________ 13. Did the CT conduct effective 9.5% debriefings? 68.8% 67% 14. Were the debriefings timely? 9.5% 81.3% 67% 15. Were debriefings mandatory? 0% 18.8% 20% 16. Should debriefings be 20.6% 48.1% 100% mandatory? _______________________________________________________________ In further comparison, Districts 2 and 3 showed high percentages (68.8% and 67%) who felt the crisis teams conducted effective debriefings. District 1 respondents' assessment fell to 9.5%. Districts 2 and 3 responded positively to the timing of the debriefings with 81.3% and 67% respectively. District 1, again, had only 9.5% who felt debriefings were timely. Although some individuals felt debriefings were mandatory in Districts 2 and 3, the personal interviews revealed they were not. Since Mitchell's model strongly urges mandatory attendance at debriefings, it was interesting to note 175 that in District 3, 100% of the crisis team respondents felt debriefing should be mandatory. A large percentage of that team had CISD training. District 1 had 66.7% who felt it should be mandatory. A few on that team had CISD as well. Less than half (48.1%) in District 2 agreed with mandatory debriefings and none of the respondents indicated they had CISD training. In summary, the results of the study indicated employees were greatly affected, exhibiting symptoms of critical incident stress and post traumatic stress months and even years after the incidents. The breakdown of coping mechanisms was the impetus for several respondents to change their career path. There was a significant difference in the average number of symptoms respondents experienced according to their proximity to the incident and there was a significant difference in the average number of symptoms experienced in the during phase according to the nature of the incident. There were services provided to staff members that were perceived as effective and largely absence of services contributing to a perception of ineffectiveness. This indicates there are actions employers can take to assist employees in mitigating the adverse affects of workplace trauma. CHAPTER 5 CONCLUSIONS AND RECOMMENDATIONS Summary 176 The Problem Various types of crises have an impact on the function of the school; such as, social events and issues, economic changes, environmental crises, medical crises and deaths. natural disasters, Some crises or critical incidents are so traumatic they alter the consciousness of a school and community for many years. The issue of school violence is not new, but the more recent phenomenon of firearms at school has increased confiscations, subsequent expulsions, serious injuries, and deaths. Relatively few homicides have occurred on campus in past history; however, statistics may change with the increased occurrence of violent crime in the community and subsequent increases in the schools. When a major crisis occurs at school the staff is expected to take action immediately and to regain control of the situation. Children's needs are the primary concern as schools stand "en loco parentis". No matter how traumatic the situation, the children come first, a natural reaction for most due to the protective, nurturing nature of their profession. The Significance of the Problem The premise of this study is that school employees can incur debilitating emotional damage from trauma associated with school violence. "Research on bereavement suggests that homicide bereavement is more severe than bereavement for suicide, natural death, or accidental death. The trauma to the victims of violent crime often invokes an emotional response in excess of grief 177 and closely resembling Posttraumatic Stress Disorder (Bixler, 1985, p. 3)." The stress is exacerbated by the necessity of the victims to return to the scene of the crime every day and the tendency to deny or to steel themselves against the natural human responses to stress in an effort to care for the children. Since the teachers must be the primary care-giver for the children, it seems reasonable the school district should take responsibility for looking after the needs of its employees, in as proactive a fashion as it cares for the children. Emergency service professionals have recognized the need for employee assistance and have incorporated effectively short-term crisis intervention strategies as a routinized protocol. The literature indicates that worker burnout and workman's compensation claims decrease as a direct result of this proactive initiative. The crisis team members require extensive training and practical experience in defusing and debriefing strategies, as well as periodical continuing education sessions. It is the contention of this researcher that schools can benefit from the research conducted in the emergency service field and can institute more aggressive employee assistance programs to deal with the ever increasing possibility of traumatic incidents in the schools. Purpose of the Study The purpose of the present investigation was to describe, compare, contrast, and evaluate crisis intervention procedures provided for employees of three school districts in which a critical incident occurred. For the purpose of this study, a critical incident was defined as a line of 178 duty death or serious injury, mass casualty or multiple serious injury, homicide or suicide. Crisis intervention refers to the methodology or procedural protocol implemented to restore normal job and personal functioning to individuals who have experienced a critical incident. A case study design was developed that included participant interviews, questionnaires and an analysis of public document resources. Each district's crisis intervention policy and procedural protocol is described, compared to policies and protocols used by the emergency service agencies, and evaluated in terms of perceptions of the effectiveness of care provided. Study Questions This study addressed the following questions: 1. What was the nature of the crisis intervention procedures for staff members in the three school districts? 2. How did the provisions for employee crisis intervention compare and contrast with those provided by emergency service agencies which routinely face critical incidents? 3. What was the perceived effectiveness in caring for the emotional and psychological needs of the adults involved in the crisis and what component (s) of the policy or protocol contributed to that perception? Assumptions There are several assumptions the researcher has made in the design of this study: 1. Although people have been traumatized and a period of time has passed 179 since the incident occurred, they will remember enough information about the incident to make the results valid. 2. The instruments developed will gather dependable data. 3. The Emergency Service Protocol and Procedures manual is a legitimate source of best practice in short-term intervention and is transferable to the school environment. 4. Although the researcher was a victim of violent crime at a school site, unbiased evaluation of data is possible. 5. People will respond honestly to the questionnaires. Results Results indicated that employees were greatly affected, exhibiting symptoms of critical incident stress and posttraumatic stress months and even years after the incidents. The breakdown of coping mechanisms was the impetus for several respondents to change their career path. There was a significant difference in the average number of symptoms respondents experienced according to their proximity to the incident and there was a significant difference in the average number of symptoms experienced according to the nature of the incident. There were services provided to staff members that were perceived as effective and largely an absence of services that contributed to a perception of ineffectiveness. This indicates there are actions employers can take to assist employees in mitigating the adverse affects of workplace trauma. Conclusions 180 Central to the purpose of the study was to evaluate the effectiveness of the crisis intervention delivered to staff members in each of the incidents. Staff and crisis team members agreed in nearly identical proportions about the effectiveness of the crisis intervention. 181 Table 44 Comparison Between Staff and Crisis Team Respondents of Perceived Effectiveness ______________________________________________________________ Staff Crisis Team ____________________________________ District 1 27.1% 33.3% District 2 70.4% 75% District 3 54.6% 57% ________________________________________________________________ What was it about each incident and the intervention provided for staff that caused District 2 to feel so much better about the circumstances than Districts 1 and 3? One difference that cannot be ignored is the nature of the incident itself. Respondents in Districts 1 and 3 were directly exposed to the violent, bloody, life threatening event at their workplace, to one of their fellow employees. The incident in District 2, although very traumatic, did not occur on campus, in view of or to any staff members. This difference may be substantiated by the statistics on the average number of symptoms were experienced in the during, after, and delayed stages. A significant difference in the number of symptoms experienced in the "during" stage in District 2. Earlier discussion from Petersen and Straub suggested denial and depression are two methods by which the psyche attempts to protect itself from too much emotional impact. Intellectually, the person is aware of what is going on, but subconsciously suppresses the emotional response. To observe 182 the violent act is more intense than hearing about it; therefore, it is reasonable to surmise onset of a subconscious numbing occurred much sooner in staff members from Districts 1 and 3 to neutralize the intensity of the trauma. The proliferate of symptoms were allowed to surface in the "during" stage in District 2 due to the relatively less immediate breech of the respondent's sense of safety and security. Perhaps it would follow that since the trauma was at "arms length" from District 2 respondents, they were less traumatized and therefore their own coping mechanisms were less compromised. "The most powerful means of coping with excessive stress is by avoiding the source of the stress, or at least reducing exposure to such stressors (Mitchell & Everly, 1993, p. 29)." This may have been a second contributor to the difference between districts. Respondents from Districts 1 and 3 could not escape the source of the stress. They had to return to the scene of the crime every day. This may have detracted from or was counter productive to efforts to intervene. Another area where District 2 stood apart from 1 and 3 was the organization of the plan itself. The crisis team packets had materials ready for duplication, individual responsibilities defined, with avenues for clear communication. Plus, principals were themselves trained in crisis intervention. They were apprised of the district's plan, why certain elements were included in the plan, what to expect of others, and what was expected of them. District 3 had no plan and District 1's plan was still in draft form, untested and refined. A fourth issue of note is the perception of support. Respondents in Districts 1 and 3 mentioned incidents where they felt the central administration let 183 them down. In District 1 it was a failed parent meeting with little central administration support, the Superintendent out of town and not returning immediately, and an assistant superintendent exerting pressure on the crisis team to curtail activities prematurely. District 3 had a public relations officer who went to a dinner meeting the evening of the incident while school based administrators handled media and community questions until 10:00 p.m., and an elementary supervisor who left town for a week to attend a workshop. Few respondents had experienced an incident that equaled the trauma thrust upon them, and to have it occur in the school setting where control and safety are paramount, added to the shock. Anything central administration did to minimize the school's situation was perceived negatively. Whether by luck or design, District 2 had no parallel circumstances. Since all three districts distributed stress reaction handouts, the key to respondents feeling more informed in District 2 and to lesser degree District 3, may be the result of the verbal presentation of the material. A higher percentage of staff respondents recalled a verbal presentation of stress reactions and stress relief methods in Districts 2 and 3. The staff respondents' perception of follow-up was substantially different in District 2. This could be due to the length of time it took to bring the incident to closure. The crisis team remained at the school for a longer period of time by the nature of the incident itself. Other than the duration of the stay, there was no other evidence of substantially different follow-up from which to draw conclusions. It is curious that District 3 was rated higher than District 1 in most all categories, when District 3 had no plan at all. The district personnel who responded in the first two weeks had similar training, the response to the scene 184 was quick and formidable, with numerous school psychologists, counselors, and social workers, and there were similar complaints about lack of support. What attributes to the difference? The major difference was the debriefings held for all staff members, by a well trained, experienced critical incident stress debriefing team, two weeks postincident in District 3. District 1 conducted formal debriefings with select groups of people a month post-incident. The timing was poor and the groups were not all inclusive. Districts 2 and 3 were aligned on issues regarding the perceptions of the debriefing effectiveness and staffs' reaction to the debriefing teams. High percentages of staff members felt comfortable with crisis team members, felt they could trust them to be confidential, and perceived them to be adequately trained. High percentages of crisis team respondents felt debriefings were effective and timely, although the debriefings were not held in the time frame suggested in the Critical Incident Stress literature. The purpose of crisis intervention is to return individuals to normal functioning as soon as possible. One goal of CISD "is to prevent or mitigate PTSD and other stress related syndromes (Mitchell & Everly, 1993, p 42.)." Did the interventions provided mitigate long term symptoms? The variables in the interventions and type of crises were not similar enough to make a defensible conclusion. Even though Districts 1 and 2 were at opposite ends of the spectrum on most all issues, the percentage experiencing delayed symptoms were comparable. District 3 had the highest percentage of respondents experiencing delayed symptoms, even though CISD was conducted. This might suggest that CISD may do nothing to mitigate symptoms or that none of the districts provided adequate intervention to produce a 185 measurable effect on the percentage of respondents experiencing delayed symptoms. One measure that was not explored was the duration of delayed symptoms. There was no way to determine if there was a significant difference in the length of time respondents experienced delayed symptoms, thereby determining one intervention better than another. What is or should be significant to an employer is the percentage of employees who experienced four or more symptoms of critical incident stress months and years post-incident. Thirty-three to 55% of the schools' staff experienced four or more symptoms in the delayed stage and another 26% to 37% had one to three symptoms in the delayed mode. This can have a negative impact on employee morale, job satisfaction, and productivity. Implications Several implications emerge from the findings and conclusions of the study: 1. The literature and this study suggest that there is a way to mitigate long term effects, to make employees feel supported, to return individuals to normal functioning in a shorter period of time, and to reduce workman's compensation costs. 2. It is well worth the effort to invest in an organization's most valuable resource-- its employees-- to reduce the potential impact of PTSD. 3. Knowledge is indeed a very powerful tool. Employees should know the elements of the plan, the rationale behind it, and how to prepare themselves for its implimentation. It can not only assist the employee in recognizing and addressing their own stress reactions, but also the reactions of their colleagues, 186 family and the students. 4. Investing the time and resources in designing a comprehensive paln and then carrying out in-service training to implement the plan properly is a worthwhile endeavor for school districts and other formal organizations. 5. The program should be integrated with the organization's EAP. Policy Recommendations It is recommended school districts develop a Critical Incident Stress Management (CISM) program for employees. "Organizations which attempt to deal with traumatic stress by utilizing a single focused strategy, such as the development of only an educational program, or only the provision of debriefing services are doomed to failure. A more sensible approach to traumatic stress management is a multi-focal or comprehensive approach which includes a strategic plan for a wide spectrum of stress control programs (Mitchell and Everly, 1993, p. 185)." CISM for school districts should contain the following components: 1. Pre-incident education 2. CISD team for employees 3. On-scene support services 4. CISD defusing 5. CISD debriefing 6. Follow-up services 7. Spouse debriefing 8. Crisis intervention training for all employees 9. Community outreach initiatives 187 Pre-Incident Education It is essential that all employees are made aware of the crisis intervention program, the philosophy driving it, involvement expectations, and outcome goals and objectives. Employee handbooks should have an overview and specific responsibilities outlined; however, distribution of such materials is not sufficient. In-service must be conducted for review, discussion, assignment of responsibilities, and practice of lock-down and quick response procedures. Many police agencies have policies whereby officers go on administrative leave while an internal review board investigates a shooting. This occurs regardless of the circumstances, thus eliminating any stigma associated with being taken off duty, debriefings or investigations post-incident. Schools should also have a policy dictating procedures following a school related critical incident. Debriefings would be expected and no stigma would be associated with participation in such activities. Employees and administrators alike should know that CISD is not psychotherapy, nor is it investigative. It "uses some techniques common to counseling, but is not counseling nor psychotherapy nor a substitute for psychotherapy (Mitchell and Everly, 1993. p. 60)." When there is a violent crime on campus as traumatic as a shooting death or injury, school should be closed for students the following day. This would provide an opportunity for debriefing activities for staff, substantive planning for the return of students, contact with community agencies, and assemblage and dissemination of accurate information for the media and community. Crisis plans should have updated materials with lists of mental health 188 facilities, victimization materials, and sample letters to parents (with the appropriate information inserted) that need only to be copied and distributed before students are dismissed the day of the incident. Parent Handbooks or Board Policy and Procedures manuals should outline the expectation that school could be closed for students, so staff would have the opportunity to deal with their own emotional needs before they are expected to shoulder the reactions of the children. Crisis team packets should also have updated Workman's Compensation and HMO informational handouts for distribution to staff. 189 CISD Team for Employees It is insufficient to have a crisis team for students with the expectation that they make themselves available to the staff. There should be a team trained to deliver pre-incident education, training, CISD, and follow-up specifically for staff members. Teachers and staff members should not feel their needs are an afterthought. They accept the responsibility of guiding and caring for the children by the nature of their chosen vocation, but likewise they expect the administration to look out for the well being of the employees. Staff must be aware that should a crisis occur, a team has been trained in CISD and will respond specifically for staff. It is recommended several school districts within a geographic area pool their resources and create one CISD team for the group. Local teams can provide on-scene support and defusings while the debriefing team is contacted and deployed to the scene. It is felt that an agency should not use their own people to provide services to its own traumatized workers. "This is especially important since it is believed that psychological support services provided by people who are too well known to the recipients may be psychologically unsound both for the recipient and for the provider of the services (Mitchell and Everly, 1993, p. 11)." Generally, licensed clinical psychologists in school districts can serve effectively on CISD teams for staff in leiu of outside mental health professionals or as peer support personnel. As suggested above, it would be advanageous to use individuals not familiar with the staff of the affected school. There may also be mental health professionals or clergy in the community who could be included on the CISD team. 190 "It is of extreme importance that whoever provides critical incident support services, whether they be peer or professional support personnel, be properly trained in critical incident stress management, post-traumatic stress disorder, and in the techniques of intervention. Despite the best intentions, interventions by those who are untrained in critical incident stress, may result in harm to those who are the recipients of such services (Mitchell and Everly, 1993, p. 10)." On-Scene Support Services The immediate assistance provided by quick response teams is essential. Quick response team members should know precisely their responsibilities as they arrive on the scene. Throwing masses of people at a school with no clear responsibilities can add to the confusion instead of helping the situation. Administrators should assist in the office answering telephones, organize orderly dismissal of students, copy and distribute materials, assist police officers where appropriate with securing the crime scene, set up a communication center away from the crime scene, and maintain order under the guidance of the principal. Student services personnel should be sent to all classes with the task of calming the children. Specific counselors, psychologists, or social workers, trained in CISD should be assigned specifically to the staff members to observe and assist where needed. Only one-on-one support should occur on scene. Small group defusings or debriefings should be conducted later. CISD Defusings 191 Defusings should be a part of CISM. Before employees go home, a CISD team should conduct small group defusings. It may only last 20 to 45 minutes, but allows employees an opportunity to talk about the trauma they have just experienced. The goals of defusing are: 1. A rapid reduction in the intense reactions to a traumatic event. 2. A 'normalizing' of the experience so that people can return to their routine duties as quickly as possible. 3. A re-establishment of the social network of the group so that people do not isolate themselves from each other, but instead, see that their reactions are similar to one another. In recognizing similarities to others, people are often more willing to help each other in troubled times. 4. An assessment of the personnel to determine if a full debriefing is necessary. There are several other objectives which are also of importance in the provision of a defusing. equalization of the information about the incident available to all of the personnel restoration of cognitive processes which have been disrupted by the incident provision of practical information for stress survival affirmation of the value of the personnel establishment of linkages for additional support development of expectancies about recovery (Mitchell and Everly, 1993, p. 111). The three schools of study held a large group faculty meeting where information about the incident, stress reactions and management, and plans for the next day were discussed. Dissemination of information in large group meetings is appropriate, but the next step can be small group defusings. It depends on the size of the staff and nature of the incident. 192 Defusings are shorter and more informal than debriefings with three stages; introduction, exploration, and information. The introduction sets the tone and rules for the meeting, exploration provides an opportunity for participants to discuss the experience they just had and the information step is the teaching phase with practical stress survival skills, answers to questions, acceptance and summary of the exploration phase, closing comments and methods to contact the crisis team members. CISD Debriefings Critical incident stress management must include formal debriefing sessions for staff members. "A full debriefing is the most desirable follow-up service if it appears that the defusing was ineffective in resolving the main issues for the majority of the group. It is also the most logical step for an entire group which is seriously affected by the power of an extremely traumatic event (Mitchell and Everly, 1993, p. 120)." The goals of CISD are: 1. Mitigate the impact of the critical incident on those who were victims of the event, be they: a. primary victims, i.e. those directly traumatized by the event, b. secondary victims, such as [those] who witnessed or managed the traumatic event, and c. tertiary victims, i.e. family, friends, and those to whom the traumatic event may be indirectly communicated. 2. Accelerate recovery processes in people who are experiencing stress reactions to abnormal traumatic events. The CISD process is considered one of the most important mechanisms to reduce the potential of Post Traumatic Stress Disorder (PTSD). It allows people to verbalize their distress and form appropriate concepts about stress reactions before false interpretation of the experience are fixed in their minds. Secondary objectives are: 193 education about stress, stress reactions, and survival techniques emotional ventilation reassurance that the stress response is controllable and the recovery is likely forewarn people about the signs and symptoms which might show in the near future. reduction of the fallacy of abnormality establishment of positive contact with mental health ` professionals enhancement of group cohesiveness enhancement of interagency cooperation screening for people who need additional assessment or therapy referral for counseling or other services as necessary (Mitchell and Everly, 1993, p. 61-2). The debriefings should take place 24-72 hours post-incident if possible. If school is closed the day after the incident the CISD could be managed most effectively at that point. Should there be a situation where school can not be closed, there are other alternatives for staff debriefings. Selected teachers from other schools, curriculum supervisors, and other appropriate supervisory personnel should amass a schedule to cover teachers' classes such that all teachers could be systematically debriefed throughout the day or days to come. Substitute teachers should be used to cover classes for the selected teachers from the non-affected schools. Teachers should be grouped by proximity to the incident. If there is a large group of staff members who were in their classrooms when the incident occurred, they can be divided by subject area or grade level depending on the natural grouping in the staffing structure. It is essential no staff member be overlooked. Support staff members (clerical, custodial, cafeteria, guidance, and administration) must have the same opportunity to debrief as instructional staff. There are seven phases to a formal debriefing which are designed to move participants from a cognitive level through an emotional level and back to a 194 cognitive level. The phases are: Introduction, Fact, Thought, Reaction, Symptom, Teaching, and Re-entry. The introduction phase is crucial to the process because it sets the stage for the rest of the session. The objectives of the introduction are to: point out the team members introduce the team leader establish the leadership of the team explain the purpose of the meeting explain the process motivate the participants reduce resistance explain the guidelines of the CISD gain the cooperation of the participants answer primary concerns and limit anxiety announce the first set of questions to come encourage mutual help (Mitchell and Everly, 1993, p. 86-87). The fact phase is a description of the facts and is not as distressing as trying to talk about feelings. Essentially the leader is asking participants to recall what happened from their point of view. If participants begin to get emotional, the team members should save them by interrupting, acknowledge the emotion, validate that the emotion is appropriate, and move on to another person. "The thought phase represents a transition phase from the cognitive domain to the affective (emotional) domain (Mitchell and Everly, 1993, p. 95)." Participants are asked what was their first thought or most prominent thought once things settled down. The reaction phase may solicit the most powerful emotional response. Participants are asked what the worst part of the incident was to them. The team no longer goes around the room with the discussion and it becomes more freelance. 195 The symptom phase is also a transition phase where the team tries to move the group toward more cognitively oriented information. In this phase participants are asked to describe any symptoms they experienced in conjunction with the incident or what it was like for them between the incident and the debriefing. Sometimes participants will be averse to reveal symptoms they may have had because they think they are the only ones with this feeling or the symptom is abnormal or a sign of weakness. If so, team members may have to suggest symptoms and ask for a show of hands of those who have had that experience. The teaching phase is extremely important. It is cognitive material and serves as a tool to educate the participant about stress responses and stress survival strategies. The notion that these are normal responses that normal people experience when exposed to an abnormal life event must be reinforced during this phase. There are some limitations to what can be taught during this phase. "Teaching somewhat complex techniques like meditation, progressive muscle relaxation and academically oriented cognitive restructuring strategies can be inappropriate at this point. It takes about five exposures to the techniques of stress management skills before they can be learned adequately (Mitchell and Everly, 1993, p. 100)." Stress management workshops may be a good follow-up exercise for this concept. The re-entry phase is designed to allow participants an opportunity to bring up any topic they would like more information about or discuss topics not yet introduced. Team members provide appropriate handouts, answer questions, and make summary comments. Follow-up Services 196 "People without follow-up may feel abandoned and uncared-for (Mitchell and Everly, 1993, p. 106)." The need for follow-up activities and the feeling of being abandoned were two themes echoed in all three districts. Along side those themes was a third concern with striking a balance between providing enough support and cessation of services so victims can get on with normalization. This dilemma occurs because coping styles are diverse and the time frame for recovery differs by individual. It is an important function of the crisis team to help employees understand this concept and show tolerance for one another. Administrators and supervisors should be sensitive to the fact that stress will cause people to react negatively to situations that normally would not bother them. Dissension and/or squabbles may erupt post-incident and must be handled with understanding and compassion. Follow-up activities can include: telephone calls to each participant, referrals for therapy, drop in visits, individual consultations, additional meetings with sub groups (six weeks, six months, one year) post-incident, distribution of CISD stress handouts, journal articles on CISD, Workman's Compensation and HMO information, stress workshops, chaplain visits, surveys or asking staff what is needed, a personal thank you from central administration, and informal forums with the superintendent during mini-faculty meetings where concerns can be voiced and action initiated. Critical incidents resulting in criminal cases present unique problems. Most people have had little or no experience with the judicial system and need to be briefed about legal proceedings. If defense attorneys or attorneys for claimants in suits against the district take depositions from staff members, an attorney from the district should accompany and advise them. If prosecuting 197 attorneys take depositions, staff members should understand the purpose of the deposition and be given the option of administrative or peer support. If staff members must testify in court, the prosecution should prepare the witness for trial, but visible support from the school district is suggested. Crisis team members should receive similar follow-up services. Debriefing the team is essential because members can experience a tremendous drain working such emotionally charged recovery processes. Crisis team members should also be rotated during the intervention period to minimize "burn out". Follow-up reports compiled by the entire crisis team, will serve to refine the crisis plan and provide members another opportunity to ventilate and discuss issues still unresolved. A debriefing is not a cure, but preventative medicine. It is an assessment tool more than a treatment. Follow-up is not a peripheral, but part and parcel of the CISM package. Spouse Debriefings The study punctuates the need for support for the tertiary victims. Spouses, other family members, and colleagues were the individuals staff members confided most often about their emotional reaction to the incidents. Yet very low percentages of respondents felt these individuals were well informed about the reactions they may expect to observe in their loved ones post-incident. Family members were ill-equipped to recognize stress reactions, understand the recovery process, or mitigate their own fears about the safety of their spouse, parent, or family member. 198 Spouse or significant other debriefing should be part of CISM. The same principles apply as the CISD team endeavors to inform participants of the details of the incident, allow ventilation of feelings, and provide educational information on critical incident stress reactions and stress relief strategies. Crisis Intervention Training for School Employees It is critical the Central administrative staff have an understanding of the principals and theory of critical incident stress. Without their assistance, the program will not have the support it needs to be effective. In other words, if they do not see there is a problem, it is unlikely they will see a need to fund and support a program. The entire student services department for the district should have a minimum of Beginning CISD certification. (Advanced CISD certification would be preferable.) Continuing staff development activities should be provided each year on topics of grieve and loss, high risk suicidal individuals, crisis intervention and practice CISD sessions. The school psychologists and/or school social workers should then systematically provide in-service training to the staff of the schools they serve. Staff training would focus on elements of the district crisis plan, critical incident stress reactions, PTSD, stress relief methods, research supporting the need for CISD, goals and objectives of CISD, individual school crisis plans, high risk suicidal individuals, and grief and loss. School based administrators should have their own training, to include the aforementioned topics plus group processes and human communication skills. Principals must understand the necessity of keeping materials in the crisis 199 packets and personnel assignments up to date, as well as conducting emergency response practice sessions with the staff. Two calls should initiate the whole crisis response plan: the first to 911 (if there is a medical emergency) and the second to a designated administrative office. In District 1 the campus police security system is staffed 24 hours a day, 7 days a week. Personnel in this office are trained to take emergency calls and glean the information necessary to notify and dispatch appropriate personnel to the scene. Principals should make certain the crisis phone number and the school crisis plan is readily assessable in a number of different places in the school. The District 1 Assistant Principal recalled the frustration of searching frantically through a file cabinet for the school's crisis plan amid total chaos. The multi-district CISD team members should have Advanced CISD certification. Team members should have four staff development sessions in crisis intervention per year. Follow-up sessions with responding teams should be documented and shared with other team members at regular team meetings. Critiques of the crisis intervention will provide valuable information for future crises. "In addition to the regular educational sessions which take place during team meetings, team members should have at least eight hours of continuing education per year at regional, national, or international conferences on stress, crisis interventions, or other related topics (Mitchell and Everly, 1993, p. 195)." Community Outreach Programs There are numerous contacts and relationships that should be fostered within the community before a crisis ever occurs. 1. Law Enforcement Agencies. Even if a school system has their own 200 campus police, the local municipality or sheriff's department will respond to a crisis within their jurisdiction. Each principal should know their local police chief and have an understanding of one another's responsibilities. Plans for rapid intervention can be developed when the officers know the building and have clear lines of communication with the school. A School Resource Officer (SRO) program is a powerful instrument to promote positive, cooperative relations between school, community, and law enforcement. 2. Media. A school crisis is news. The news media will respond to the scene and almost as fast as emergency medical personnel. Schools should anticipate this and plan accordingly. A positive relationship must be developed with local news media before a crisis occurs. They can be as damaging as they can be helpful in a crisis situation. An understanding must be reached about access to campus, students, and information. Providing honest, factual information is best practice. The principal or public relations department should handle all news communications. Most schools have limited telephone lines and the news media can be a valuable tool for communication with the community during the aftermath of a crisis. Statements made by school officials should not speculate on motive when a crime is involved. False speculation can prove harmful when the case goes to court. A difficult balance must be maintained between reassuring the public the school is safe and the acknowledgment a problem exists. If it appears an incident is being "swept under the carpet", the media can become suspicious prolonging their coverage, the staff can feel their pain and fear is being minimized, and a healthy recovery process is inhibited. 201 3. Mental Health Professionals and Agencies. All three districts learned from their experiences which agencies were helpful. Prior planning with local agencies is invaluable to the recovery process. School administrators should not be burdened with determining the legitimacy of adhoc offers from mental health professionals who are later perceived as "ambulance chasers". Cooperative agreements can be negotiated whereby mental health professionals with CISD training can be part of the CISD team and provide staff support services thereafter. Other student issues should be addressed as well. School districts should negotiate mental health coverage with insurance carriers such that follow-up care is affordable for employees. For employees who remain uncomfortable with crisis team members this provides a viable alternative. Plus CISD is not a substitute for psychotherapy nor is all the work of helping someone going to be completed during the debriefing. 4. Clergy. Separation of church and state may make some uneasy with the inclusion of clergy in intervention planning. The fact remains they have a strong influence in the community and can be a good resource for additional assistance. Clergy trained in CISD should be a consideration as a crisis team member. It is recommended that inclusion of all denominations be considered. Other Considerations Developing a comprehensive CISM program may seem like an overwhelming and expensive venture, but it doesn't have to be. As stated earlier it is recommended several school districts within a geographic area pool their resources and create one CISD team for the group. Local teams can provide onscene support and defusings while the debriefing team is contacted and 202 deployed to the scene. Training would be the greatest initial expense. When a crisis occurred, the cost to supply substitutes and per diem expenses for crisis team members from other districts would be the responsibility of the host district. Funds could be obtained from several sources; district operating funds, grants, State Safe Schools moneys, fund raising, educational foundations, and workman's compensation programs. The legal liability to the individual that may cause community emergency service CISD teams to balk at specialty debriefings of agencies outside the emergency service field, would not be an issue for a consortium of school districts. Employees are covered by Board liability insurance. "Up to [this time] no known law suits have occurred which involve CISM teams and none are known to be in preparation for litigation. The record so far, especially in light of the fact that over 15,000 debriefings have been provided since 1983, is a good one (Mitchell and Everly, 1993, p. 190)." Should debriefings be mandatory? A large percentage of the crisis team respondents felt the debriefings should be mandatory, however, districts must respect the right of refusal. "In some cases personnel are ordered into a debriefing for the good of the individuals and the organization. Since part of the debriefing is an educational session, the mandating of the debriefing can be appropriate (Mitchell and Everly, 1993, p. 190)." No one can be made to talk and it is the responsibility of the administration to encourage participation. School districts must be prepared to address the issue of personnel transfers from affected schools. Despite every crisis intervention effort, some employees will feel compelled to transfer to another school site or other duties altogether. As stated earlier, many victims have the option of avoiding the scene 203 of the crime as a remedy for stress. When the scene of the crime is one's workplace, avoidance is impossible. Changing jobs may be an employees only recourse. An employee can feel victimized a second time by the employer if they are not mindful of this dilemma. Recommendations for Further Study True experimental designs with comparable control groups and empirical data are difficult to achieve in a field such as traumatic stress. The true test of the efficacy of Mitchell's model adapted to the school environment would require a single staff divided into a control group and numerous experimental groups where the control group received no CISM services and the other groups each received different elements of the model and/or combinations of the model elements. Since training and pre-incident education are a part of the model, plans would have to be in place before the incident and then wait around for an incident to occur. Obviously, this is not a feasible study. The only realistic study to test the model is to compare incidents of equal magnitude where one school has many or all the benefits of the CISM model and another has none. Additionally, it is of interest to examine the length of time respondents experienced delayed symptoms and compare that to the type of intervention they received. This would provide more data to determine if CISM does indeed return workers to normal functioning in a more expedient fashion Also, a study should be done to examine costs associated with the recovery process in like incidents where interventions varied. Items such as workman's compensation costs, HMO or personal physician costs, absenteeism and sick days used, legal fees, lost productivity, and other costs associated with 204 crisis team activity should be investigated. A comparison should be made to the cost of implementing a CISM program. This would provide more data to determine if CISM does indeed reduce overall medical costs. Unfortunately, human suffering alone many times will not warrant action, where fiscal impact will. Therefore, more research must be done to punctuate and justify the need for CISM programs in the educational field. 205 BIBLIOGRAPHY American Psychiatric Association. (1988a). Anxiety disorders. Washington, DC: APA Joint Commission on Public Affairs and the Division of Public Affairs. American Psychiatric Association. (1988b). Depression. Washington, DC: APA Joint Commission on Public Affairs and the Division of Public Affairs. American Psychiatric Association. (1988c). Manic-depressive disorder. 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A Master's degree, or above, in mental health (mandatory for clinical directors; preferred for all others) 2. Completion of a 16-hour CISD training program. 3. Exposure to public safety disciplines is mandatory. 4. Participate in cross training (Police, Fire, EMS, etc.) Local Team Coordinator The team coordinator is responsible for the overall management of the CISD Program and its implementation, specifically, the job description of the Team Coordinator is to: 1. Oversee the functioning of the CISD Program. 2. Solicit volunteers for the program. 3. Represent the CISD Program before service and community organizations. 4. Assist in the CISD Team selection process. 5. Assist in the training of the team, the providers, administration, and the public. 6. Answer requests for CISD assistance or training. 7. Evaluate requests for debriefings. 8. Dispatch the CISD Team. 9. Provide debriefing of the debriefers when necessary or requested. 10. Solicit support from appropriate agencies. 11. Establish a Peer Review Board. 12. Hold periodic team meetings. 13. Maintain quality control. 14. Set up training sessions, seminars, in-services, and continuing educational programs. 15. Maintain record of individual and team activities. 16. Establish a network of CISD services for other agencies. APPENDIX A. (Continued) 17. Keep abreast of current research, findings, and theories of 216 18. emergency service stress, occupational stress, critical incident stress, and related topics. Act as liaison with emergency service administrators. Clinical Director The clinical director is the mental health professional responsible for overseeing the delivery and quality of the counseling services. The clinical director's specific job description is to: 1. Offer quality assurance for professional CISD Team members. 2. Represent CISD programs before the public. 3. Monitor the debriefing process. 4. Assist in establishing cross training programs for CISD Team members, both mental health and peer. 5. Assist the team coordinator in establishing protocols for debriefings, defusings and peer support programs, as well as spouse programs. 6. Review reports and records of team activity. 7. Assist in the selection of Peer Review Board members. 8. Maintain an updated list of referral sources. 9. Make follow-up debriefing contacts, if necessary. 10. Offer clinical support and guidance to the team coordinator and team members. 11. Must have professional liability insurance, or covered by agency. Mental Health Team Members The mental health professionals who assist the CISD Team will be volunteers who assist primarily in the debriefing process and in program development. They may also be available for individual referrals. Specifically, the mental health professionals will: 1. Assist with all debriefing processes. 2. Assist with training of peer support group. 3. Make recommendations for the program. 4. Assist in CISD Program development. 5. Assist in developing referral sources. 6. Represent the CISD Program. 7. Complete necessary paperwork (activity reports, training records, etc.) APPENDIX A. (Continued) 8. Make themselves available as a referral source (if desired). 9. Make post debriefing contacts and suggest further counseling as necessary. 10. Complete cross training requirements. 11. Become familiar with various emergency service operations. 217 12. 13. 14. Serve as a member of the Peer Review Board as assigned. Attend team meetings and in-services. Must have professional liability insurance or covered by agency. Peer Support Personnel The peer support personnel assist in the debriefing process and may be involved in the development and delivery of other programs. Their duties will include: 1. Initiate contact with service personnel who have responded to a critical incident. 2. Estimate number of persons involved. 3. Perform initial assessment of the need for a debriefing. 4. Contact coordinator, but do not begin debriefing process. 5. Attend team meetings and continuing education. 6. Make post debriefing contacts as assigned. 7. Assist the team coordinator as required. 8. Serve as a member of the Peer Review Board as assigned. 9. Assist in the development of CISD programming. 10. Be aware of their limitations and seek guidance and assistance where appropriate. Operational Guidelines Peer Support Network: The basis for the entire CISD process is the peer. The local team coordinator should encourage each agency to identify individuals to be trained as CISD peers. This group of trained personnel will then be able to make initial contact in the event of a Critical Incident or be available to provide support to an individual who is experiencing an acute or cumulative stress reaction. The peer support network integrates with the CISD Team, providing peer members to the team or by acting as a liaison to the inter-agency CISD team. On Scene Support Services: Support services and interventions may be utilized during a critical incident. These may occur at or near the scene of operations. In most cases, APPENDIX A. (Continued) these services will be provided by peer support personnel, although mental health team members may be requested and required if the situation warrants. On the scene support may consist of the following types of services-1. One-on-one counseling to those emergency service workers showing obvious signs of distress as a result of the incident of their participation. 218 2. Advice and counsel to incident commander or his liaison on topics of stress management, specifically, insures related to the critical incident. 3. Demobilization of personnel being disengaged from the scene. 4. Control victims, survivors, and families to insure the work of the emergency services are not impeded until more appropriate agencies arrive to assume responsibility for these individuals. Peer Support Personnel Engaged at the Scene: Any peer support member who is dispatched to a critical incident as a member of an emergency services organization is primarily responsible for operating with the organization. For example, peer support-firefighters who accompany their units to the scene will serve in the capacity designated by their fire commander. This holds equally true for all emergency service personnel involved at an incident. While performing assigned duties, it may be possible for the Emergency Service Providers to observe the scene for situations that may increase the potential for stress affect. It may also be possible, while performing one's duties, to observe personnel for signs of obvious distress. While these are not the primary functions of these persons at this time, appropriate disclosure of their observations may provide insight to command officers. If the need to make recommendations to command becomes obvious, or if the peer suspects that the potential is unusually high for the development of acute stress reactions, the peer may suggest to the commander that he consider calling the CISD team. Even if the commander designates the peer's function, as CISD on-scene support, the peer support personnel may request additional team members to be dispatched to the scene. The rationale for this action would be: 1. To keep the team coordinator advised of the activity and insure continuity. 2. It may be inappropriate for the peer to provide services to his own units. 3. It may prove to be too "draining" for the peer who is or has been engaged in service to carry out the functions of on scene support APPENDIX A. (Continued) activities. 4. It may not be in the emotional best interest of the peer member to provide the services in this situation. 5. The task may be too involved for one or two team members to handle effectively. 6. The peer support member's unit may be disengaged before onscene support activities are completed. Peer Support Personnel Dispatched to the Scene: CISD team members dispatched to the incident scene by the Team 219 Coordinator may rendezvous so they may go to the scene as a unit. Every attempt should be made to have the team escorted to the scene by an Emergency Service Agency to permit easy access to the incident scene. If this is not possible, the team members may take the minimum number of vehicles required to transport the team to the scene. On Scene Team Leadership: Once on the scene, one member may act a team leader and report to the command post. This member should advise the commanding officer of the number of support personnel and request direction from the officer. The team leader should advise the officer of where the team will be located and what they will be doing. The team leader should act as liaison between the command and team throughout the incident when possible. Therefore, any recommendations and observations of any team members should be made to the team leader who will in turn report to the commander. It may be ideal if team members can arrange "report times" to offer information to the team leader and so that the team leader will not be interrupting the command operation any more than necessary to make reports. Additional On Scene Considerations: 1. All CISD team members acting on behalf of the program should wear CISD ID at all times while on site, going to the site, etc. 2. Team members should be appropriately dressed with protective clothing to enter internal perimeter including proper shoes/boots, protection helmet, etc. 3. No team members should go inside the internal perimeter unless requested to do so by a commanding officer. 4. The team leader should keep track and know where all team members are during the operation. 5. Except in extreme circumstances, the team leader will be the liaison between command and the team. 6. The team leader should assign tasks to team members as required. 7. CISD operations should be set up in a safe area, out of the inner perimeter and out of view of the scene. 8. Communications between team members, especially between command liaison and CISD operations, should be established using portable radios or cellular telephones if possible. 9. Food and drink should be obtained for the rehabilitation area if not provided by command. 10. Warm, dry clothing should be provided for severely affected personnel that are "taken out of service." Guidelines for On Scene Support and Intervention 220 One-on-one Interventions: 1. One-on-one interventions should be provided only to those workers displaying OBVIOUS signs of distress and who are receptive to assistance. Signs of obvious distress include: a. crying, b. shock-like state, c. unusual behavior (may include a change in cognitive skills), d. acting out behaviors (punching, screaming, kicking, etc.) 2. The interventions should take place when the personnel are not actively engaged in service activities. 3. The interventions will usually last 5 to 15 minutes in length. 4. The interventions should take place in a neutral atmosphere or in a position out of view, sight, or sound of operations when possible. 5. Interventions should focus on the immediate (here and now). 6. No "group" interventions in the field! 7. Distressed individuals should show signs of improvement within 15 minutes of the intervention process. 8. It is recommended that all persons receiving one-on-one interventions be given an additional 15 to 30 minutes rest period after the intervention is completed. 9. Restoring a provider to service will depend upon how well he/she is functioning and/or feeling after the intervention and rest period. Some considerations include: a. If a provider is very distressed and 15 minutes of one-on-one seem ineffectual, consideration foe immediate removal should be given. b. If a provider is displaying psychotic behavior, immediate removal is indicated. c. If a distressed provider has calmed, but is still very distressed or again becomes distressed during the rest period, removal is most likely indicated. d. If a distressed provider is in any way injured, removal to a hospital or medical area is indicated. e. If a distressed provider receives intervention, begins to improve in the given 15-30 minutes rest period, and upon rechecking is determined able to return to service, the recommendation to command will be that the provider should assume lighter duty away APPENDIX A. (Continued) from the most stressful assignments, and that he should not return to his/her previous function. f. Removal sites may include the most appropriate of: home, hospital, medical area, or new/lighter duty. NOTE: It is generally a wise idea to have medical personnel assess the vitals of distressed individuals and assess them for injuries. 221 Advice and Counsel to Command: Team members may offer advise and counsel to a command officer when appropriate, but have no command authority. All decisions are the responsibility of the commanding officers. The team should neither take or assume any position of command or authority for incident management. Some considerations for minimizing stress effects and maximizing performance may include: 1. Rotation of staff. a. Two hours of duty then a 15-30 minute rest period will decrease possibility of injury, decrease fatigue, and decrease intense emotional drain. NOTE: If the crew is almost finished with a task, let them complete the task before changing their duty assignment. b. When rotating crews, it is suggested that part of the old crew be replaced with part of the new crew. This will permit the new crew to learn the task and maintain continuity of work. Once this is accomplished, the remaining members of the old crew will be replaced by the rest of the new crew. c. If it is not possible to five crews a rest period, rotate them to lighter duty. Crews should go from intense duty to medium duty to light duty. Those at light duty should work their way up to intense duty. d. Four hours of duty without a break will cause extreme emotional and physical fatigue (this includes command officers). e. Maximum exposure should be no longer than 12 hours at the scene regardless of rest/rotation sequences. This is especially true if the possibility exists that the same personnel may have to resume duty at the scene the next day. 2. Command may need to alter normal procedures during lengthy operations. An example may be: During a lengthy operation of many hours of days, it may be necessary to allow workers to sleep at or near the scene during rest period. 3. Caffeine products should not be offered to crews until after four hours of operation. Water and juices should be served throughout. (avoid caffeine and sugar). APPENDIX A. (Continued) Assisting Victims, Survivors, Families: Although assisting victims, survivors, and families is not the primary function of the team, it may be necessary to provide interim support to these individuals so that the emergency service crews may perform their duties without being hampered. The team should maintain a listing of victim resources during on scene operations and call these services if warranted and approved by command. The team may initially need to provide a staging area for families to 222 meet away from the operation site and out of the way of the emergency service workers. Once on the scene, management of these persons should be turned over to the appropriate victim support agency. Demobilization Process Demobilizations may be reserved for large scale, highly intense or unusual events that last a minimum of eight hours. The objectives of a demobilization are to: 1. Provide a place for disengaged (not returning to the incident) units to rest, get something to eat and drink away from the site in a comfortable atmosphere before returning to quarters of home. 2. Provide information on possible stress related effects. 3. Provide a place command officers to give closing remarks or incident updates, if appropriate. 4. Provide a resource for initial ventilation of feelings, if necessary. Guidelines for Demobilization services: Make sure the unit will not be returning to the incident before initiating demobilization services for that unit. The demobilization center can be located in any large room where it is possible to carry out the above activities. Demobilization services may be handled by several mental health team members and peer support members not needed or engaged in incident activities. The process may be as follows: 1. Command should determine if a demobilization site will be established. 2. All disengaging personnel should be processed through the demobilization center as a unit. 3. Upon arrival at the center, a team member should meet each arriving unit and usher them to a corner of the room. Units should be kept together, and the combining of differing types of units (i.e.. truck vs. pumper, patrol vs swat, etc.) should be discouraged. 4. The demobilization lecture should take no longer than 15 minutes and may consist of the following information: a. Recognition of the workers efforts and their fatigue. APPENDIX A. (Continued) b. State objectives as a desire to give the workers a chance to rest, eat, and "unwind" before going home or back to quarters. c. If it is probable or possible that a formal debriefing will take place, tell them how they will be informed about location, time, etc. d. Inform the workers: -Some of them may have no reaction to this event and that's OK and not an abnormal reaction. 223 -Some of them may have a delayed reaction and that's OK too. -Some of them may already be experiencing some uncomfortable feelings as a result of the event, and this too is normal. -Some of the most commonly reported reactions to this type of event are: 1. recurrent and intrusive recollections of the event, 2. recurrent dreams of the event, 3. sudden acting or feeling as if the traumatic event were reoccurring, because of an association with an environmental or ideational stimulus, 4. numbing of responsiveness to or reduced involvement with the external work, beginning some time after the trauma as shown by at least one of the following--a. markedly diminished interest in one or more significant activities, b. feeling of detachment or estrangement from others, c. constricted affect, 5. symptoms that were not present before the trauma--a. hyperalertness or exaggerated startle response, b. sleep disturbance, c. guilt about surviving when others have not, or about behavior required for survival, d. memory impairment or trouble concentrating, e. avoidance of activities that arouse recollection of the traumatic event, f. intensification of symptoms by exposure to events that symbolize or resemble the traumatic event, g. depression, h. anxiety. -Distribute the prepared "Information Sheet" and refer to its content (see Appendix C) -Encourage them to get something to eat or drink. -Dismiss them to return to service/quarters. 5. One team member should remain available to meet with the next incoming group. 6. All team members should be given the same information to all groups, therefore, it will be necessary for the demobilization team to meet and develop and outline/script to insure continuity. Defusing Process Defusings are performed after the incident and after the unit has returned to the station. The purpose is to offer information, support, allow initial ventilation of feelings, to set up or establish a need for a formal debriefing, and to stabilize APPENDIX A. (Continued) crew members so they can go home or back in service. It is similar to a "mini debriefing", but is not as detailed or as long. Defusing Guidelines: 1. Defusings may be done immediately after the event. The ideal time frame is from 3-4 hours post incident to the end of the same day. The key is immediate intervention. 224 2. Defusings are a "group" process (as opposed to one-on-one) and all persons of the unit involved in the incident should attend the defusing. 3. Defusings should last no longer than 45 minutes. 4. Defusings may be performed by peer support persons who are well aware of his/her personal limitations. They should call for support from a mental health member or senior peer if the situation warrants. Peers directly involved with the operations should not perform defusings for the group. 5. Defusings should be held in a comfortable atmosphere, free from distractions and interference. All parties should remain in the defusing until its conclusion. 6. The format for the defusing may be as follows: a. Introduction- Ask the group to tell you what happened. b. Ask the group- "What were their reaction?" c. Allow freedom of discussion to take place on the possible signs and symptoms of stress they may or may not experience and information on what they can do about it. d. Make sure each person has the Informational Handout and knows how to get in touch with the Team Coordinator, yourself, the clinical director, or other team members. e. Allow initial ventilation of feelings. Acknowledge the feelings, validate the feelings, and move on. Do not probe or dwell, it is much too early after the critical incident to discuss feelings. f. Keep the session informal but to the point. Do not allow the crew to lapse into a critique of operations. The defusing team member's primary function is to facilitate and direct the session. Formal Debriefing Process: Debriefings are specially structured group meetings between the persons directly involved with the critical incident and CISD team members. It is a confidential, non-evaluative discussion of the involvement, thought, reactions and feelings resulting from the incident. It serves to mitigate the stress impacts resulting from exposure to a critical incident through ventilation of feelings, along APPENDIX A. (Continued) with educational and informational components. It produces a therapeutic effect by assisting participants to understand their stress response and it will accelerate normal recovery process in normal persons suffering normal affects after an encounter with an abnormal situation. Debriefing Goals: 1. Provide stress education. 225 2. Provide a mechanism for ventilation of feelings before they can do harm. 3. Provide reassurance that what they did was appropriate, what they are experiencing is normal, and that they will recover given time. 4. Forewarn those who have not yet been impacted that they may be impacted later and inform them of ways to deal with it. 5. Reduce the fallacy of "uniqueness". 6. Reduce the fallacy of "abnormalcy". 7. Provide positive interaction between mental health professionals and emergency providers. 8. Add or restore group cohesiveness. 9. Assist inter-agency cooperation. 10. Help set up a prevention program. 11. Screen those that may not yet be ready to return to service. 12. Make referrals for those individuals requesting or requiring additional services. Debriefing Guidelines: The team coordinator and/or the clinical director may evaluate the need for a debriefing when one has been requested. Some of the considerations should include: 1. The number of individuals affected. If less than 3, Individual or Small Group Consults may be arranged and lead by a mental health team member. 2. The symptoms that are being reported by the participants in the event. Continuation of symptoms of acute or delayed stress are an indication that a debriefing is probably necessary. 3. Any noted or reported change in behavior of the participant (s) in the event. 4. Any regression of behavior in the participant (s) in the event. 5. Do symptomatic persons need a formal debriefing, or just opportunity to talk it out with peers or administration? 6. Do the circumstances warrant a debriefing, are the symptoms pronounced, or is the group seeking information of stress management? APPENDIX A. (Continued) 7. Other factors and considerations pertinent to the event, the persons involved, and the signs and symptoms expressed. 8. Debriefings should be recommended for the following events: a. Death of an emergency service provider in the line of duty. b. Serious injury to an emergency service provider in the line of duty. c. Mass/multi casualty incidents with serious injury or death. 226 d. Suicide of an emergency service worker. e. Civilian killed during emergency service or police operations. 9. If the event of a line of duty death initial defusings and formal debriefings may be performed. The initial defusings should begin within hours of the incident and end the day before the funeral. All formal debriefings should not be conducted until after funeral or memorial services have been completed. Spouse debriefings should also be scheduled after the funeral. 10. Team size should be 2-6 members per debriefing. The size of the team will be dependent upon the size of the group. The rule of thumb of 1 team member for each 10 personnel will be generally employed for each event. In the event that the team arrives and finds that there are few participants and several team members, the team leader will request extra team members to leave the debriefing and return at the end. It should be understood by all members that this may occur at the last moment. Debriefing Participation: Any person directly involved in the operation of the event, or any person for whom the event has elicited an unusually strong reaction would be debriefed. Command should be encouraged to make the debriefings mandatory for units closest to the incident. It may be necessary to perform several debriefings for one incident dependent upon the nature of the event, the numbers to be debriefed, the types of units, or the nature and extent of their involvement in the event. Persons not directly involved in the event will (in most cases) not be debriefed. The exception to this will be the serious injury or death of a unit member, children, members of the family (participants or survivors), victims, or members of the press should not attend the debriefing. If services are needed for these persons, referrals of alternative services may be provided. Debriefing Location: The debriefing may take place in any area that is large enough to accommodate the number anticipated, is free from distraction and interruption, that is fairly comfortable, where it is possible to place all participants in a circular seating arrangement without visual interference, and that offers a sense of neutrality. APPENDIX A. (Continued) Debriefing Timing: Debriefings should take place 24-72 hours after the event. It may be necessary to match the schedules of those participating in the debriefing with those of the team members involved in the debriefing. We do not want to place any undue hardship on any party, but priority for time will have to be given to the participants. Since our aim is to return them to a pre-event state, it would not be advisable to expect them to make major adjustments in schedules to 227 accommodate a time that may be more convenient for team members. Every attempt will be made to accommodate the schedules of all parties involved. Debriefing Leadership: Debriefings are led (facilitated) by a mental health or experienced peer support team member. Co-Leaders may be mental health members or experienced peers. Peer support personnel are valuable members of the debriefing process. They are the ones the participants may identify with as the ones who most understand their reactions, feelings, and concerns. Number of Participants in a Debriefing: A formal debriefing should not be held for less than 3 persons. When there are less than 3, on-on-one consults or a mini-group session should be used. The ideal debriefing group size is between 3 and 20 participants. If a group is over 40, consider dividing into two smaller groups (you will need enough team members). In groups of over 40 participants, the procedures for the debriefing process must be modified to contain a greater educational element and less psychological intervention. Formal Debriefing Process Components: Pre-Debriefing Activities- Team Meeting: 1. Team members responding to a debriefing should, when possible, travel to the debriefing site together. 2. The goals and objectives of the pre-debriefing meeting are: a. To permit the team members the opportunity to go over all facts, rumors, and data concerning the incident. b. To visit the incident site, if necessary. c. To review any videos, newspaper articles, reports, etc. about the incident. d. To talk to key personnel to become aware of any other facts about the incident not previously known (to reduce the chance for "surprises" during the debriefing process.) e. To develop a strategy for the debriefing--- Determine who is the leader -- Develop any signs or signals to be used during the debriefing APPENDIX A. (Continued) 3. -- Establish team member roles f. To set up the seating arrangement. g. To make sure the participants are out of service during the debriefing process. Seating Arrangements-- Chairs should be placed in a circle. They should be close enough to accommodate all participants but not be uncomfortable. Extra chairs should be placed in the circle for team 228 4. members and extra chairs should be placed in the circle or in close closed proximity to accommodate late arrivals. Doors to the debriefing area should be closed but not locked. Hall Monitor-- A peer should act as the hall monitor. The hall monitor insures that only people that belong in the debriefing are allowed into the room. The hall monitor can also check on persons who have left the debriefing and not returned. The monitor should attempt to "negotiate a return" of these persons to the debriefing. He should not attempt to force the return of any individual not wishing to return. The hall monitor may offer one-on-one counseling and should offer names and phone numbers for referral services to this person if the person does not desire to return to the group. Introductory Phase: During the introductory phase, the team leader would set the rules for the debriefing, introduce the team members and give a brief description of what will take place during the debriefing process. He will state the purpose of the debriefing and the team's involvement. Rules for the Debriefing-1. You do not have to talk during the debriefing, but if you do, what you may say may help reassure and support your colleagues. 2. This meeting is strictly confidential. No notes will be taken and no recordings will be made. It is important that we make a pact of trust among everyone here that no one will disclose any information about anyone or anything said during the debriefing. 3. No breaks are taken during the debriefing process. If you need to use the facilities, please attend to your personal needs but then return to the group. 4. No one talks for another. You may only comment about your own thoughts, feelings or reactions. 5. You so not need to say anything that may legally incriminate you, or offer information that may be necessary for any investigation or litigation. APPENDIX A. (Continued) 6. All radios and pagers are turned off and all personnel should be out of service. 7. No one has rank during the debriefing process. Everyone is equal. 8. This is not a critiques of operations. We are not here to place blame. 9. The CISD team is not part of any investigating agency. We are APPENDIX A. (Continued) 229 only interested in your welfare. 10. Look around the room, If someone is here that should not be here, please let me know before we begin. These include press, and any others not directly involved in the incident. 11. Feel free to ask questions. Fact Phase: During this phase the leader may ask the members of the group to go around the circle and state their name, what their role was, and what happened. This will serve to recreate the event and present the pertinent facts surrounding the incident. NOTE: This is a very important component of the process. take enough time for fact finding. If this proves to be especially difficult for a participant, acknowledge and validate their feelings and move on to the next person. Give that individual an opportunity to speak later in the debriefing. Thought Phase: This phase requires the participants to conceptualize what they have heard and seen. The leader may ask the participants to share their first "thought" about the event. During this phase, the participant may be taking the information supplied during the fact phase from the general state and applying it to a more personal state of thinking. The leader should acknowledge, offer reassurance, and move on to the next participant. No probing should take place. Reaction Phase: After the process of taking the incident from the outer environment and into the cognitive, the leader may ask the participants to share their reactions to the incident. He may ask them to describe what each person sees as the worst part of this incident. The leader should not probe except to get clarification on a specific issue. During this phase the peer support members should not talk, offer reassurance, suggestions, experiences, etc. The leader will facilitate this phase solely unless he signals or requests assistance. 230 APPENDIX A. (Continued) Symptom Phase: After the participants have been able to bring the impact of the event to a personal level and lave been able to identify some personal reactions to it, the leader may then ask the group to share information on any physical, emotional, cognitive, or behavioral signs or symptoms they be experiencing, i.e., "How did you know this event was different? I know when something really gets to me, I don't sleep well and my stomach gets upset." The leader may want the participants to share items that happened during or shortly after the event, a few days later, and in the present. Teaching Phase: After the signs and symptoms have been expressed, the leader (with support from other team members) will offer reassurance that these are normal reactions. It is during this phase that information will be offered on positive coping methods, on issues specifically raised and general coping methods, on issues specifically raised and general information on stress management. The leader may also invite the participants to ask any specific questions about the management of stress that they may have. Re-entry Phase: This is the time to "wrap up any loose ends," offer additional reassurances, answer any outstanding questions, offer the opportunity for participants to say anything they did not get a chance to say, and give the participants the opportunity to restate anything they may have said before. It is also during this phase that the leader may wish to bring out an emotion that may be present, but as yet, has not been expressed. During this phase, the participants may wish to develop a "plan of action." They may wish to develop a preventative program, determine what they would like to do to make things better, or investigate information and educational resources. The team members will provide support for their decision and offer guidance and information. The team members should be careful not to support or endorse all actions if they recognize the potential for adverse consequences, i.e. political, legal, etc. The availability of follow up counselling and other resources should be provided to the participants at this time, along with any educational handouts. APPENDIX A. (Continued) Post Debriefing Activities -Team Meeting: 231 After the debriefing has ended, the team should remain to talk to the participants and assist them in resolving any outstanding issues. They may also want to mentally note anyone they feel may need to be referred for additional services and will bring these people to the attention of the mental health team members if they feel such a suggestion would not be well received or appropriate coming from them. The post-debriefing time is a critical time in establishing a feeling of normalcy, of establishing a sense of continued trust and support for the team, and for making sure that those who may need additional help and support are given the appropriate resources to receive it. After the formal debriefing and post debriefing activities, the team members should need and discuss the debriefing strategy used, any concerns, topics and issues. Recommendations for follow-up services should be noted and the activity report should be completed by the team leader. Follow Up Services The goals of follow up services are: 1. Insure that any participant we feel may need, or who requests additional support is given the resources to investigate his/her options. Thus, we will provide a referral source of names and services to those individuals. 2. Demonstrate to all participants their welfare is important to the team members and to the agency. 3. To reinforce the idea that they have resources for support, they are not alone. Individual Consults Individual consults usually take the form of a small group debriefing session in those instances where only 1-3 members of a unit have experienced or are impacted by a critical incident. A second type of individual consult is in the form of referrals to mental health clinicians for those requiring this type of service. Peer involvement in these services is to: 1. Assist as a peer support member in small group debriefing sessions. 2. Provide names and numbers to participants requesting APPENDIX A. (Continued) additional services. 232 Spouse Debriefings In the event of a major incident, especially a line of duty death, the entire emergency service community is affected. This includes the family, friends and other significant individuals of the emergency workers. A group debriefing conducted by CISD team members experienced with spouse support may be held after the funerals or memorial services have been conducted. The debriefing is open to all significant individuals affected by the incident. The family members of the fallen workers are not included in these programs because they will have needs that are very different from the needs of the survivors. Speciality Debriefings It is not the policy of the CISD team to provide intervention or debriefing services outside of the emergency services. If a request for service is initiated by an outside organization, every attempt is made to seek alternative sources of support for these groups. 233 APPENDIX B. CRITICAL INCIDENT STRESS INFORMATION SHEET You have experienced a traumatic event or a critical incident (any incident that causes personnel to experience unusually strong emotional reactions which have the potential to interfere with their ability to function either at the scene or later). Even though the event may be over, you may now be experiencing or may experience later, some strong emotional or physical reactions. It is very common, in fact quite normal, for people to experience emotional aftershocks when they have passed through a horrible event. Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Some times they may appear a few hours or a few days later. And, in some cases, weeks or months may pass before the stress reactions appear. The signs and symptoms of a stress reaction may last a few days, a few weeks or a few months and occasionally longer depending on the severity of the traumatic event. With understanding and the support of loved ones the stress reactions usually pass more quickly. Occasionally, the traumatic event is so painful that professional assistance from a counselor may be necessary. This does not imply craziness or weakness. It simply indicates that the particular event was just too powerful for the person to manage by themselves. Here are some very common signs and signals of a stress reaction: Physical Cognitive Emotional Behavioral ----------------------------------------------------------------------------------------------------------------------------- --fatigue blaming someone change in activity guilt nausea confusion anxiety changed speech muscle tremors poor attention grief withdrawal twitches poor decisions denial emotional outburst chest pain* heightened alertness lowered alertness severe panic difficulty breathing* poor concentration fear suspiciousness elevated BP memory problems uncertainty change in usual rapid heart rate hypervigilance loss of control communications thirst difficulty identifying depression changed appetite headaches familiar objects inappropriate alcohol consumption visual difficulties or people emotional inability to rest vomiting higher or lower responses antisocial acts grinding teeth awareness of apprehension nonspecific bodily weakness surroundings feeling overwhelmed complaints dizziness intense anger profuse sweating poor abstract thinking agitation irritability pacing startle reflex intensified shock symptoms* loss of time, place, erratic movements changed sexual function fainting person orientation disturbed thinking poor problem solving chills intrusive images nightmares hyperalert to nvironment *definite indication of the need for medical evaluation APPENDIX B. (Continued) 234 Things to Try: WITHIN THE FIRST 24-48 HOURS periods of strenuous physical exercise, alternated with relaxation will alleviate some of the physical reactions. Structure your time - keep busy. You're normal and having normal reactions - don't label yourself crazy. Talk to people - talk is the most healing medicine. Be aware of numbing the pain with overuse of drugs or alcohol, you don't need to complicate this with a substance abuse problem. Reach out - people do care. Maintain as normal a schedule as possible. Spend time with others. Help your co-workers as much as possible by sharing feelings and checking out how they are doing. Give yourself permission to feel rotten and share your feelings with others. Keep a journal, write your way through those sleepless hours. Do things that feel good to you. Realize those around you are under stress. Don't make any big life changes. Do make as many daily decisions as possible which will give you feeling of control over your life, i.e., if someone asks you what you want to eat - answer them even if you're not sure. Get plenty of rest. Reoccurring thoughts, dreams or flashbacks are normal - don't try to fight them - they'll decrease over time and become less painful. Eat well-balanced and regular meals (even if you don't feel like it.) For Family Members and Friends: Listen carefully. Spend time with the traumatized person. Offer your assistance and a listening ear if they have not asked for help. Reassure them that they are safe. Help them with everyday tasks like cleaning, cooking, caring for the family, minding children. Give them some private time. Don't take their anger or other feelings personally. Don't tell them that they are "lucky it wasn't worse" - traumatized people are not consoled by those statements. Instead, tell them that you are sorry such an event has occurred and you want to understand and assist them. Information provided by: Jeffrey T. Mitchell, PhD. APPENDIX B. (Continued) When and How do we Observe Critical Incident Stress? There are three distinct times in which critical incident stress is 235 manifested. The first is during the incident; this usually results in physical stress, or exertions. The exceptions are of the severe or mass casualty type, wherein personnel are so totally overwhelmed that they may function "without thinking". Symptoms of this type of critical incident stress include quick heart beat, fast breathing, tight stomach, and a dry mouth. The second time critical incident stress may be manifested is called postincident, as the realization of the magnitude or severity of the incident is finally perceived. Symptoms of this are headaches, dizziness, irritability, anxiety, and depression. A third type is the delayed post-incident stress. This may occur weeks and months after the critical incident. Symptoms of this are chronic fatigue, ulcers, hypertension, coronary heart disease, insomnia, repeated and intrusive memories of the event, recurrent dreams, sudden feeling of the event happening again. There is a fourth type of stress that has been identified, and that is accumulated stress. Because it is not an integral part of Critical Incident Stress, it is not discussed here. 236 SYMPTOMS OF STRESS AND TIME OF OCCURRENCE Symptoms Irritability Chronic Fatigue Pounding of the Heart Chest Pain Crying Spells Poor Concentration Forgetfulness Dizzy Spells During x After x Delayed x x x x x x x x x x x x Anxiety Restlessness Easily Startled Insomnia Tremors Stuttering Grinding of Teeth Profuse Sweating Frequent Urination Diarrhea Neck and Back Ache Frequent Headaches Loss of Appetite Increased Smoking Increased Alcohol/Drug Use Nightmares (Moser etal., 1986) x x x x x x x x x x x x x x x x x x x x x x x x x x x 237 APPENDIX C. INTERVIEW QUESTIONNAIRE Name: ____________________________________________ Position _________________Number of years served in this capacity_____ 1. What training in crisis planning or crisis intervention have you had? 2. What role did you have in the recovery process of the incident? 3. Did the agency you represented have a crisis plan in place that outlined specific employee assistance procedures for those involved in a critical incident or crises? What was it? (Outside agency respondent only) 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. (District respondent only) 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? 8. Describe the planning that took place between outside agencies and the school district prior to the incident? 9. Describe the communication between agencies and the school district before, during, and after the crisis? 10. Did you feel crisis team members had adequate training to be effective? 11. Were there any changes made as a result of the experience gained from the incident? What were they? 12. What were your data sources for creating the present plan? 13. What are the strengths of the present plan? 14. Are there any weaknesses in the present plan? What are they? APPENDIX D. QUESTIONNAIRE FOR CRISIS TEAM MEMBERS 238 CRISIS TEAM 1. How would you describe your job at the time of the incident? _____ School Psychologist _____ School Social Worker _____ School Counselor _____ Mental Health Professional _____ Social Worker _____ Victim Advocate _____ Police Officer _____ Emergency Service Provider _____ Other ___________________ 2. What is your highest level of education at the time of the incident? _____ High School Diploma _____ Associate Degree _____ Bachelor's Degree _____ Master's Degree _____ Educational Specialist _____ Doctorate _____ Medical Doctor _____ Other ________________________ Critical incidents are described as: line of duty death or serious injury; multiple or mass casualty with serious injury or death; suicide or homicide. 3. What describes your critical incident intervention training? (Check all that apply) _____ None _____ College Courses _____ Grief Counseling _____ 1-15 hours Crisis Intervention Training _____ 16-30 hours Crisis Intervention Training _____ More than 30 hours Crisis Intervention Training _____ Beginning Critical incident Stress Debriefing (CISD) Certification _____ Advanced CISD Certification _____ Other _____________________________ 4. What describes your continuing education in critical incident intervention training? (Check all that apply) _____ None _____ 6 College Semester hours every 5 years _____ 1-10 hours of In-service per year _____ 11-20 hours of In-service per year _____ More than 20 hours of In-service per year _____ Other _____________________________ 5. What describes your on-the-job experience performing critical incident intervention? _____ 1-10 hours per year _____ 11-20 hours per year _____ 21-30 hours per year _____ More than 30 hours per year _____ Other ______________________________ 6. What describes your experience conducting a formal critical incident debriefing session? _____ None _____ Practice sessions in training _____ 1-2 per year _____ 3-10 per year _____ More than 10 per year _____ Other _______________________________ 239 APPENDIX D. (Continued) The following questions refer to the services you performed as a crisis team member SPECIFICALLY FOR THE TEACHERS, ADMINISTRATORS, AND/OR STAFF MEMBERS for the school incident in question. 7. Mark all the intervention strategies you personally conducted. _____ One-on-one counseling at the crisis scene _____ One-on one counseling 1-3 Weeks after the incident _____ One-on one counseling 1-3 Months after the incident _____ One-on one counseling 4-12 Months after the incident _____ One-on one counseling more than 1 Year after the incident _____ Small Group (3-20) CISD debriefing at the crisis scene _____ Small Group (3-20) CISD debriefing 1-3 Weeks after the incident _____ Small Group (3-20) CISD debriefing 1-3 Months after the incident _____ Small Group (3-20) CISD debriefing 4-12 Months after the incident _____ Small Group (3-20) CISD debriefing more than 1 Year after the incident _____ Large Group (over 20) CISD debriefing at the crisis scene _____ Large Group (over 20) CISD debriefing 1-3 Weeks after the incident _____ Large Group (over 20) CISD debriefing 1-3 Months after the incident _____ Large Group (over 20) CISD debriefing 4-12 Months after the incident _____ Large Group (over 20) CISD debriefing more than 1 Year after the incident _____ Distribution of Critical Incident Stress Information Sheets _____ Distribution of a list of Mental Health facilities and/or options _____ Other __________________________________________________________ 8. Did you feel that the crisis intervention provided for the staff members of the school was effective? _____ Yes _____ No _____ I don't know If you answered "No", what were your concerns?_____________________________________ _____________________________________________________________________________ 9. Did you feel there was adequate follow-up for staff members in the weeks following the incident? _____ Yes _____ No _____ I don't know If you answered "No", what were your concerns?_____________________________________ _____________________________________________________________________________ 10. Did you feel all crisis team members had adequate training to provide crisis intervention for staff members? _____ Yes _____ No _____ I don't know If you answered "No", what were your concerns?______________________________________ 11. Did you feel the school district provided sufficient support for staff members after the incident? _____ Yes _____ No _____ I don't know 12. Do you feel the families of the staff members were adequately informed about the normal behaviors they could expect to observe as a result of the incident? _____ Yes _____ No _____ I don't know 13. Did you feel the crisis team conducted effective debriefings for staff members? _____ Yes _____ No _____ I don't know 240 APPENDIX D. (Continued) 14 Did you feel the timing of the staff debriefings was appropriate? ____ Yes _____ No _____ I don't know 15 Were debriefings mandatory for all staff members? ____ Yes _____ No _____ I don't know 16. Understanding that mandatory attendance at debriefings does not mean mandatory participation, do you feel debriefings should have been mandatory for staff members? ____ Yes _____ No _____ I don't know What is the basis of your opinion?_______________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 17. Did you feel the school district's crisis plan provided effective and timely coordination with community agencies? _____ Yes _____ No _____ I don't know 18. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 19. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 20. What were the most difficult aspects of returning the school's staff to normal functioning? 241 21. Please list any other suggestions to improve the school district's crisis plan as it relates specifically to staff members. Thank you for your assistance with this survey. APPENDIX E. QUESTIONNAIRE FOR SCHOOL STAFF MEMBERS SCHOOL STAFF MEMBERS 242 1. How would you best describe your job at the time of the incident? _____ Teacher _____ Guidance _____ Support Staff _____ Administrator _____ Other ____________________________ 2. What is your highest level of education at the time of the incident? _____ High School Diploma _____ Associate Degree _____ Bachelor's Degree _____ Master's Degree _____ Educational Specialist _____ Doctorate _____ Other_____________________________ 3. Gender _____ Male _____ Female Critical incidents are described as: line of duty death or serious injury; multiple or mass casualty with serious injury or death; suicide or homicide. Critical Incident Stress Debriefing is a program designed to restore normal job and personal functioning to normal people who are experiencing normal reactions and normal symptoms of distress after being exposed to a highly abnormal event. The following questions refer to the services provided for you in the incident at your school. 4. Mark the intervention strategies you personally experienced. (Mark all that apply.) _____ One-on-one counseling at the crisis scene _____ One-on one counseling 1-3 Weeks after the incident _____ One-on one counseling 1-3 Months after the incident _____ One-on one counseling 4-12 Months after the incident _____ One-on one counseling more than 1 Year after the incident _____ Small Group (3-20) debriefing at the crisis scene _____ Small Group (3-20) debriefing 1-3 Weeks after the incident _____ Small Group (3-20) debriefing 1-3 Months after the incident _____ Small Group (3-20) debriefing 4-12 Months after the incident _____ Small Group (3-20) debriefing more than 1 Year after the incident _____ Large Group (over 20) debriefing at the crisis scene _____ Large Group (over 20) debriefing 1-3 Weeks after the incident _____ Large Group (over 20) debriefing 1-3 Months after the incident _____ Large Group (over 20) debriefing 4-12 Months after the incident _____ Large Group (over 20) debriefing more than 1 Year after the incident APPENDIX E. (Continued) _____ Receipt of Information Sheets about stress reactions to critical incidents _____ A group or personal explanation about stress reactions to critical incidents _____ Receipt of Information Sheets describing methods to relieve stress _____ A group or personal explanation of methods to relieve stress _____ Receipt of a list of mental health professionals to contact privately _____ Other __________________________________________________________ 243 There are three distinct phases in which critical incident stress is manifested. The first is during the incident when physical stress or exertion occurs. The second phase occurs immediately after the incident, as the realization of the magnitude or severity of the incident is finally perceived. The third is delayed post-incident stress. This may occur weeks, months or years after the critical incident. 5. Please check any symptoms you experienced during, after and/or delayed as a result of the incident at your school. *Hyperalertness- an exaggerated state of an alertness to ones environment or surroundings. *Hypervigilant- an exaggerated state of watchfulness which can result in sleeplessness. Ever watchful and alert. *Intrusive Images- Images and/or thoughts that plague ones consciousness. *Withdrawal- avoidance of previously enjoyable activities or people. APPENDIX E. (Continued) 6. How close were you to the actual incident? {alternate question for District #2} _____ I witnessed it _____ I helped in the mall area immediately after _____ I was elsewhere in the building and stayed with the students awaiting instructions _____ I was not in the building that day _____ Other ________________________________________________________ 7. Did you ever feel a need to talk with someone about your ability to cope with the after affects 244 of the incident, but were afraid people might think you were emotionally weak? _____ Yes _____ No _____ I don't know 8. Did you ever feel you must keep your feelings private for fear your immediate supervisor might perceive you as incompetent? _____ Yes _____ No _____ I don't know 9. Did you feel comfortable consulting with crisis team members working at your school in relation to your own emotional or psychological reaction to the incident? _____ Yes _____ No _____ I don't know 10. Did you feel you could trust the crisis team members to be confidential about any topic you might discuss with them? _____ Yes _____ No _____ I don't know 11. Please check the individuals with whom you consulted about your emotional or psychological reactions to the incident. (Check all that apply.) _____ Crisis Team Members _____ Spouse _____ Other family members _____ Colleagues _____ Close friends _____ Family Physician _____ Mental health professional suggested by the crisis team _____ Psychologist of your own choosing _____ Counselor of your own choosing _____ Psychiatrist of your own choosing _____ Clergy _____ Other_________________________________________ 12. Did you feel that the crisis intervention provided for the staff members of the school was effective? _____ Yes _____ No _____ I don't know 13. Did you feel there was adequate follow-up for staff members in the weeks following the incident? _____ Yes _____ No _____ I don't know APPENDIX E. (Continued) 14. Did you feel the crisis team members had adequate training to provide crisis intervention for staff members? _____ Yes _____ No _____ I don't know 15. Did you feel well informed about the possible psychological, physical and/or emotional reactions you might have after the incident? _____ Yes _____ No _____ I don't know 16. Did you feel the school district should have done more to provide support for staff members after the incident? _____ Yes _____ No _____ I don't know 245 17. Do you feel your family was adequately informed about the behaviors they may expect to observe in you as a result of the incident? _____ Yes _____ No _____ I don't know 18. Do you still find there are certain triggers that bring back unpleasant thoughts or reactions about the incident? _____ Yes _____ No _____ I don't know 19. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 20. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 21. What were the most difficult aspects of returning to normal functioning for you? APPENDIX E. (Continued) Please feel free to make any additional comments and thank you for your participation in this study. 246 Thank you for your assistance. 6. What best describes your relationship with the victim? (District 2 alternate question) _____ She was one of my students this year _____ I knew her as a student in the school _____ I knew her family _____ I did not know her personally 247 APPENDIX F. LETTERS OF TRANSMITTAL District 1 Crisis Team Nancy Blackwelder 6507 Debbie Ln Pasadena, FL 33707 Dear «First Name», I hope your year is progressing smoothly. Mine has been busy with some activities related to my dissertation topic, "CRITICAL INCIDENT STRESS DEBRIEFING FOR SCHOOL EMPLOYEES." I am a doctoral candidate at the University of South Florida in Educational Leadership and an administrator for Pinellas County Schools. Enclosed is a questionnaire that is being sent to all who were deployed to (District #1 school) to assist with the aftermath of (the incident), (date of incident). This is the last portion of my research and your input is highly valued. Participation is voluntary and you can choose not to participate. All replies are to be confidential and anonymous. Please do not sign the survey. A selfaddressed, stamped envelope is enclosed for your convenience. I would like to have all replies as soon as possible, and not later than May 31, 1994. The questionnaire is simple and should require about 15 minutes of your time. If you have a problem with a question, please feel free to leave it blank. If you have additional comments, please include them on an additional sheet of paper when you return this survey. If you would like a copy of the results of the study, send your request with your name and address in a separate envelope to the address listed above and I will be glad to send you the information. I thank you in advance for the time you will spend on this survey. Sincerely, Nancy Blackwelder 248 APPENDIX F. (Continued) Districts 2 and 3 Crisis Team Nancy Blackwelder 6507 Debbie Ln Pasadena, FL 33707 Dear «First Name», Let me introduce myself-- I am a doctoral candidate at the University of South Florida in Educational Leadership and an administrator for Pinellas County Schools. I have been working on a dissertation topic, "CRITICAL INCIDENT STRESS DEBRIEFING FOR SCHOOL EMPLOYEES." Enclosed is a questionnaire that is being sent to all who were deployed to (District #2 and #3 school) to assist with the aftermath of (the incident), (date of the incident). This is the last portion of my research and your input is highly valued. Participation is voluntary and you can choose not to participate. All replies are to be confidential and anonymous. Please do not sign the survey. A selfaddressed, stamped envelope is enclosed for your convenience. I would like to have all replies as soon as possible, and not later than May 31, 1994. The questionnaire is simple and should require about 15 minutes of your time. If you have a problem with a question, please feel free to leave it blank. If you have additional comments, please include them on an additional sheet of paper when you return this survey. If you would like a copy of the results of the study, send your request with your name and address in a separate envelope to the address listed above and I will be glad to send you the information. I thank you in advance for the time you will spend on this survey. Sincerely, Nancy Blackwelder APPENDIX F. (Continued) District 1 Staff Members 249 Nancy Blackwelder 6507 Debbie Ln Pasadena, FL 33707 Dear «First Name», I hope your year is progressing smoothly. Mine has been busy with some activities related to my dissertation topic, "CRITICAL INCIDENT STRESS DEBRIEFING FOR SCHOOL EMPLOYEES." I am a doctoral candidate at the University of South Florida in Educational Leadership. Enclosed is a questionnaire that is being sent to all staff members who were employed at (District #1 school) at the time of (the incident), (date of the incident). This is the last portion of my research and your input is highly valued. Participation is voluntary and you can choose not to participate. All replies are to be confidential and anonymous. Please do not sign the survey. A selfaddressed, stamped envelope is enclosed for your convenience. I would like to have all replies as soon as possible, and not later than May 31, 1994. The questionnaire is simple and should require about 15 minutes of your time. If you have a problem with a question, please feel free to leave it blank. If you have additional comments, please include them on an additional sheet of paper when you return this survey. If you would like a copy of the results of the study, send your request with your name and address in a separate envelope to the address listed above and I will be glad to send you the information. I thank you in advance for the time you will spend on this survey. Sincerely, Nancy Blackwelder APPENDIX F. (Continued) Districts 2 and 3 Staff Members 250 Nancy Blackwelder 6507 Debbie Ln Pasadena, FL 33707 Dear «First Name», Let me introduce myself-- I am a doctoral candidate at the University of South Florida in Educational Leadership and an administrator for the Pinellas County School District. I am working on a dissertation topic, "CRITICAL INCIDENT STRESS DEBRIEFING FOR SCHOOL EMPLOYEES." Enclosed is a questionnaire that is being sent to all staff members who were employed at (District #2 and #3) at the time of (the incident) (date of the incident). This is the last portion of my research and your input is highly valued. Participation is voluntary and you can choose not to participate. All replies are to be confidential and anonymous. Please do not sign the survey. A selfaddressed, stamped envelope is enclosed for your convenience. I would like to have all replies as soon as possible, and not later than May 31, 1994. The questionnaire is simple and should require about 15 minutes of your time. If you have a problem with a question, please feel free to leave it blank. If you have additional comments, please include them on an additional sheet of paper when you return this survey. If you would like a copy of the results of the study, send your request with your name and address in a separate envelope to the address listed above and I will be glad to send you the information. I thank you in advance for the time you will spend on this survey. Sincerely, Nancy Blackwelder APPENDIX G. CRITIQUE OF DISTRICT 1 INCIDENT Introduction We learn from experience. Some times we are fortunate enough to be able to learn form the experience of others. An event occurs in another school system, or a new issue causes emotional reactions somewhere else in the nation; we analyze, discuss, gather as much data as is available and develop procedures by which we may react effectively when the issue comes our way. Other times, we are not that fortunate and an event occurs in this district with unforeseen consequences, or trauma beyond that which was expected. In those 251 occasions, it is customary that the event be critiqued developing guidelines, recommendations or suggestions that may help those who find themselves in a similar situation. To name a few, this approach has been utilized following the racial disturbances or the early years of desegregation, the tornado which took lives and destroyed (an elementary school), Hurricane Elena which caused school shelters to be open days rather than the hours usual to our past experience. The loss of a life of one of our administrators from a gun incident in one of our schools is a new experience for this district. The tragedy of that event compels us to review carefully the circumstances leading to the event, the event itself and the post incident services we extended to those touched by the event. In no way is the critique meant to second guess those involved. Those present at the initial critique commend the administrators and teacher who acted to remove the danger of a student with a loaded firearm from the premises, the school personnel who effected as orderly a dismissal of students as possible following the incident, those who arrived on the scene giving immediate assistance to students and staff, and those who worked at the school during the days following the incident under very traumatic conditions. The initial critique involved the Operations Team, School Resource Officer, Chief of Campus Police, Director of Risk Management, Executive Assistant Superintendent of Curriculum and Instruction, Executive Assistant Superintendent of Administration, Associate Superintendent and Superintendent. Subsequent conversations with (District #1) school staff and central staff who supported them, parent groups and law enforcement officials have contributed to the information contained herein. Initial Critique The initial critique was conducted February 17, 1988, six days after the February 11 gun incident at (the school). The sequence of events which led to the death of (one assistant principal) and the wounding of (another assistant APPENDIX G. (Continued) principal) and (an intern teacher) was reviewed. Those present concurred that the school-based personnel acted appropriately: 1. Upon receiving information that a student was on campus with a gun, they attempted to identify the student and locate him. They could not involve the School Resource Officer (SRO) because he was out ill that day. 2. (An assistant principal) attempted to talk the student out of the lunch area and away from other students. 3. When he realized the student was going for the gun, he used force 252 to pin his arms to his side, take him down and gain possession of the gun. He achieved this objective with the help of other assistant principals. 4. There was no prior knowledge of a second student with a gun. When a second student drew a gun and began shooting and the situation got out of control, the assistant principal, sought help from campus police. 5. As the two students (one with a gun) ran from the building, they were confronted by two members of the (local police department) who had been called previously by an administrator to remove a trespasser. 6. The Administrative Team had a written emergency plan which was followed on a step-by-step basis. Teachers assisted in clearing hallways by bringing into their classrooms students they found out in the halls and concourse. 7. The (local police department) took control of the crime scene as the school was in their jurisdiction. 8. Buses were requested and the school was evacuated by the staff in an orderly manner. 9. Both students involved were apprehended. 10. A quick response task team of school personnel were assigned to the school the following day, providing additional supervision and counseling for students and teachers. 11. Both the (local police department) and the Sheriff's Office offered victim assistance. The (local police department) Victim Assistance officer provided support on an ongoing basis with students and staff, providing follow-up services as well. Other community organizations offered counseling and assistance of various kinds. APPENDIX G. (Continued) All those involved were commended for their actions. Participants agreed there was no one procedure which could be followed in all situations involving a weapon because the situations vary and judgment must be utilized as the situation develops. Most situations will have some unique factor. As an example, the (District 1) incident was the first time that, once identified, the student chose not to surrender the gun to a school official, and it was the first time a second gun, previously undetected, was present. Each school should have a plan which is communicated to staff and particularly understood by the administrators assigned to the school. Not meant to be all inclusive, but in general, the plan should have the following elements: 1. Suspicion of a gun should be reported immediately to the administrator in charge of the school and on the premises. 2. The administrator should glean as much information as possible 253 from the person reporting the gun. The following information may become important: a. Did you see the gun, or did someone else tell you about it? b. How do you know it is a real gun and not a toy? c. Do you know if the person has bullets for the gun, and if so, is it loaded? (Always assume a gun is loaded.) d. Where is the gun--in a locker, car, or on the person? e. How did the student gain possession of the gun--brought it from home, stole it, or given to him by another student? f. Does any of the student's friends have a gun? g. Do you know why the student brought the gun to school? 3. The SRO or, if none, the campus police should be notified and the course of proposed action discussed with them. The Police Department in the jurisdiction where the school is located should be notified or 911 called. 4. The individual, alleged to have a gun, should be isolated from other students or faculty if at all possible. 5. Those responsible for taking the gun should be prepared for the unexpected. They should have in their mind what they will do if the student runs, if the student goes for the weapon, if the student can not be isolated, or if a second gun appears. 6. Sufficient adults should be involved to provide backup, control the environment and to restrain if restraint is necessary. 7. If restraint is necessary, and the gun is not yet in the school personnel's possession, make sure the hands of the suspect can be APPENDIX G. (Continued) seen; pin the arms to the body while the gun is being sought. The following recommendations were made in addition to having the school plan: 1. Officers are trained to deal with deadly force, therefore if time permits, it should be the SRO, campus police officer or a police officer from the police department having jurisdiction who first approaches the suspect. They should, whenever possible, have backup. 2. If an SRO is assigned to the school, but ill, in court or otherwise to be absent, the police agency supplying the SRO should provide a substitute. The school system should contact the various agencies to ascertain their willingness for such an arrangement. 3. Metal detectors were not seen as a practical solution to the problem. Most high schools and middle schools have far more entry points than does (the school) which is appreciably built under one roof. The modern school program has student and adults going and 254 coming all day long. As an example, DE, DCT, CBE, offerings at (vocational schools), field trips, volunteers, medical and dental appointments, etc. The detectors would have to be manned all day long, or the program becomes much more restrictive--not permitting programs which cause students to exit school. This would be out-oftouch with current student needs. Portable detectors also have their limitations. As an example, had a detector been used in (the school) situation, school personnel would not have known any more than they already knew, the student probably had a gun, The scenario which followed the challenge to the student would likely have been the same. 4. Fire drills and evacuation techniques for the most part are not practical as the suspect merely walks outside with the rest of the student body. The suspect should be isolated, not put with more students. 5. The follow-up services were effective. Students and staff had the availability of counseling services. Many private and public services offered their expertise in addition to the extra school personnel assigned. Temporary administrative help was assigned to the school to fill the void left by the death of one experienced assistant principal and the hospitalization of another. The Risk Management and Personnel Departments responded quickly providing insurance APPENDIX G. (Continued) and other benefit information to the victims, or their families. The only concern expressed about the follow-up services was the length of time they remained at (the school.) In this instance, since the assistant principal remained in critical condition, it was impossible for six days to return to a normal operation. An incident cannot come to closure while the fate of a victim is still uncertain. Following the initial critique, comments were mixed as to the need for prolonged services versus the need "to get back to normal" as the additional people were a constant reminder of the tragedy. These opposing opinions should be weighed in future traumatic events involving a school. 6. Crimes in schools involving guns should be prosecuted to the full extent of the law. Schools, a Mirror of Society Information which followed the incident, which came from the news media and a survey of districts by the Florida School Board Association (FSBA) and the Florida Association of School Administrators (FASA) indicated that gun incidents at schools are on the rise. This is compatible with our own situation in (District #1). There were more incidents this year than last year. Violence is common in 255 television programming and motion pictures. Child abuse and spouse abuse statistics are frightening. The new media keeps assault, batteries, and homicides ever present on our minds. Actual murders and executions have been shown of T.V. The illicit drug traffic has put guns into the hands of more young people. School violence in the cities of the North has been a national concern. It is reasonable to believe that with guns as easily obtainable as they are and the somewhat glorification of guns and violence in our society, we will see more of them in schools. As this is a societal problem, there seemed to be a concurrence among those involved in the discussion following the incident that the Legislature and Congress should evaluate their gun restriction laws. The emphasis should be on more responsibility for gun owners and less availability to those who have a history of irresponsibility, criminal activity or mental or emotional problems. The School Board should have a mandatory expulsion for unauthorized possession of a gun on campus, particularly where any weapon is involved. School security and safety for students and staff should be a top priority. The following was recommended by one group or another and seems to be reasonable expectations; 1. Student Crime Watch plans should be reemphasized. APPENDIX G. (Continued) 2. Teachers and other school staff should take an active role in maintaining safe schools rather than leave it to a few administrators and SRO, considering the size of our campuses and the number of entry points. Teachers should be utilized on at least a rotating basis during the operations period to be in the hallways and areas commonly visited by both students and intruders. Safety is everyone's business. 3. There should be an intercom code for danger which tells teachers to remain in their rooms with doors shut, keeping students out of hallways. 4. Attendance should be closely monitored with parents being notified of student absence. Computer assisted phoning or use of volunteers was suggested to help with the logistics of this problem. 5. Suspensions which keep students out of school and unsupervised should be held to a minimum and only utilized when the offense is violence, drug or alcohol related or defiance of authority so as to make it impossible to supervise the students. Alternatives to suspension such as the intervention center, detention, Saturday School or work details should be utilized. 6. Through the cooperation of HRS, the Juvenile Welfare Board and other social agencies, a communication system should be devised that will inform the school of young people exiting psychological and/or emotional problem care so that schools will have a better history of the student and can, thereby, deal with them effectively. 256 Keeping the Incident in Perspective The gun incident was a tragic and traumatic incident. It happened at (the District #1 school), but it could have happened at any school. Yet, it is the first and only incident where a faculty member died as a result of a gunshot would or, for that matter, any faculty member was wounded by gunfire. No student was shot or has ever been shot in our schools. Many more students have died as a result of car accidents or suicide. Guns are and may well become an increasing problem, but they are not our only problem. Though no student died from being shot by another student, one student did die as a result of being hit by another student in an incident in another school. Beginning early in elementary school and going through secondary school, we attempt to educate young people to have a good self-concept, be able to say "no" to drugs and alcohol, do not drive or ride with someone else under the influence, be responsible and dependable. Considering the growing fun danger in our society to young people, not only evidenced by the (school) APPENDIX G. (Continued) incident but by the number of accidental shootings caused by children playing with guns, we should add another caution to our curriculum; guns are dangerous, unless supervised by an appropriate adult, leave them alone, don't borrow them, don't steal them, don't touch them. DISTRICT 1 RECOVERY ACTIVITIES Faculty and Administration February 11 February 12 February 12 February 12 February 15 February 15-19 February 15-19 February 18 February 18 February 24 February 24 February 25 March 1 Faculty meeting to review incident Faculty meeting - Procedures for the day Crisis Intervention Team Counseling Collection for "Warm Fuzzy Book" Parent Meeting -"Assisting with Grieving Process" Teacher handouts for days procedures Requested School Board Members, administrative personnel, Teacher's union representatives, subject area supervisors to assist teachers. Memorial activities Information on Risk Management Assistance Parents' presentation to the School Board Parent task force meeting Guidance Coordinator invited to join county's Crisis Intervention Team Letters from Guidance Department to feeder schools concerning needs assessment due to incident 257 March 7 March 7 March 9 March 9, 16, 23 March 9, 23 March 14 March 14, 16 March 15 March 16 March 22 Mini- faculty meeting. "Crisis Information" Debriefing session - Administrators Mini- faculty meeting- "Crisis Information update, Insurance Information" Recovery Committee Meeting Memorial Committee Meeting Second semester open house Distribution of parent survey Debriefing session - Teachers Debriefing session - Staff Parent workshop- "Coping: Parents and Teens in Turmoil" APPENDIX G. (Continued) Students February 12 February 12 February 12 February 12-16 February 16 February 17 February 18 February 22 February 22 February 23 February 24 February 29 March 2 March 4 March 9 March 9, 16, 23 April 12 Marquee messages Collection for floral arrangements for the injured Graffiti Wall Student body cards to injured and their families Student Spirit Decoration - mall area Student suggestions for recovery plan collected through homeroom Memorial Activities Input for recovery plan from Principal's Student Advisory Committee Spirit Hearts Spirit Ribbons Spirit Assembly Student Government Bumper Sticker Sale Thank you notes to crisis team from students Celebration of life dance Spirit Ring Recovery Committee Meeting Student Government Leadership Conference Parent Organizations February 11 February 18 February 24 February 24 March 7 March 10 Parent Volunteer Assistance for crisis PTSA input for recovery committee Parent task force meeting Parents presentation to School Board SAC input for recovery plan Parent survey committee meeting 258 March 14 March 9, 16, 23 March 22 in PTSA, SAC assistance with Open House Activities Recovery committee meeting SAC parent workshop - "Coping: Parents and Teens Turmoil" ------------------------------------------------------------------------------------------------------------ 259 SUGGESTED ADDITIONAL ACTIVITIES Additional parent volunteers Parent volunteer workshop: "Assisting with Attendance" Parent/Student lunch Parent Breakfast Student/Teacher lunch Additional parent seminars/workshops NCCJ communication workshop Freshmen orientation activities Freshmen seminars Activities hotline School Cookout, Fall 1988 260 APPENDIX H. CRITIQUE OF DISTRICT #3 SHOOTING CRISIS Initial Response 1. 2. 3. 4. 5. 6. 7. Custodian notified the school office of the incident. Assistant principal immediately called 911 at 11:38 a.m. Sheriff's department responded immediately and arrived on the scene in eight minutes. Principal simultaneously initiated lock-down procedures over the intercom, a procedure that had been reviewed and practiced with staff previously. Lunchroom instructional aides and PE teachers evacuated students to classrooms. Elementary Director and Superintendent's offices were notified by telephone. Superintendent designated and dispatched a crisis team which included: Deputy Superintendent, Assistant Superintendent for schools, Elementary Executive Director, and Community Relations Officer. Within the First Hour 1. Crisis Communication Plan was implemented including notification of other schools and media relations planned activities. 2. Administrators worked with Sheriff's Department to coordinate on site activities. 3. School Resource Officers from other schools were called in to assist. 4. Counselors, psychologists and social workers from around the district were called to the school for student, parent, and staff counseling and support. 5. Students in all classes were assured they were safe by a Sheriff's deputy. 6. Counselors were given details of the incident and brief orientation prior to being assigned to classrooms to deal with children's questions, concerns and needs. 7. Staff and administrators from other schools and Board members coordinated parent traffic, calls, food, and other logistical details and provided follow-up support. 8. Parents were encouraged to let their child/children remain at school until normal dismissal and teachers attempted to return to a normal routine as soon as possible. 9. Risk management, insurance, and workers' compensation offices were notified and at the scene. 10. Attempts were made to contact parents of all the children who were directly involved in the incident to advise them of a meeting the next APPENDIX H. (Continued) morning and to answer questions. 261 11. Staff worked to coordinate getting all the children home. After the School Day Ended 1. 2. 3. 4. 5. 6. Follow up calls were made to latchkey children to determine their well being. A faculty meeting was held immediately after school to discuss the incident and future plans. A parent meeting was scheduled for the next morning and evening to deal with parent concerns. Counselors were available until 10:00 p.m. the night of the incident, individual counseling provided during the day for several weeks following, and a list of volunteer counselors and home phone numbers was sent home. Mental health professionals from the community were utilized to work with parents and students as well as faculty and staff. Administrators, teachers, and staff responded in a calm and professional manner on the day of the shooting and following despite the normal reactions of shock, denial, and disbelief. Following the Day of the Incident 1. 2. School counselors worked with children needing individual assistance on an ongoing basis. The state crisis team and other professionals worked with faculty and staff as part of district and school initiated follow up activities and provided additional in-service training for counselors, school psychologists and school social workers. Specific Facts (The assailant) was hired 12/88 and had satisfactory evaluations. Monday, 9/25/89 (he) made threats against several co-workers and (the victim's wife) in (the victim's) presence. The threats were not communicated to the school office or other custodians. Wednesday, 9/27/89 (the assailant) told a teacher that a good friend was upset with his wife because she was having an affair: he threatened to kill his wife, kids and co-workers. The teacher told him to tell the authorities, but the story was not reported to the school office by the teacher because it was not APPENDIX H. (Continued) taken seriously. Thursday, 9/28/89 (the assailant) talked to the teacher mentioned of the 27th and indicated the problem was resolved and everything was fine. (The victim) related the previous threats to at least one custodian. The threats were 262 communicated to the assistant principal by one of the custodians who had heard about them from another custodian. Two custodians were concerned and two others indicated they thought he was kidding. When the principal called in from a meeting late in the day she was told about the threats and she asked the assistant principal to set up a ;meeting with (the assailant) for the following day. Friday, 9/29/89 the principal met with (the assailant) and he indicated the threats were kidding in nature and the principal informed him that this was not appropriate behavior. There was no unusual reaction to the verbal reprimand. Monday, 10/2/89 (the assailant) came to the office and indicated he wanted to resign, making reference to being blamed for the events of the previous week and that he was going back to visit his Dad in Missouri. The principal had him fill out the appropriate paperwork. (The assailant) appeared very calm but was overheard saying he had to tell someone off. (The assailant) got in his car and drove around to the rear of the cafeteria. As he entered the cafeteria a worker alerted a custodian that (the assailant) had a gun. The custodian ran to the office to alert the administration. As custodian told (the assailant) to leave which he did, but returned and shot (the victim). The head custodian convinced (the assailant) to go outside with him. Outside (the assailant) fired two shots at or above the children on the playground before leaving the school grounds. He was stopped and arrested several miles from school a short time later. Review Committee Recommendations The following elements are recommended to be included in the district wide Crisis Plan: 1. A predesignated response team with one person clearly identified as having the authority and responsibility for on site decision making. 2. A process for getting facts out quickly to the staff at the school or site, other schools, parents and media. 3. Common requirements for school level plans which include practiced lock down procedures, a district wide signal code, emergency contact numbers, and other instructions and strategies as needed at the specific site or for different grade levels. 4. Provision for a cadre of school counselors and professionals who are APPENDIX H. (Continued) 5. 6. 7. trained in community crisis and disaster response. Prior arrangements and strategies for bringing additional telephone lines to the site and providing cleared lines for incoming calls from concerned parents. Strategies for two way communication of site during the crisis with hand held radios. Strategies for affected students who have parents who are staff or 263 8. 9. 10. 11. 12. teachers at the site or at other schools or locations in the district. Ways to provide assistance to spouses, extended families, former coworkers and other secondary victims. Materials prepared ahead of time for parents and staff to help them prepare for, predict and respond to student or peer problems. The inclusion of outside crisis teams and other professionals for technical and other assistance as needed. Coordination of the district crisis plan with the disaster preparedness plan and the emergency responders in the community, including police, fire, medical and emergency management. Long term follow-up and debriefing with affected school administrators, staff and parents, especially around anniversary or other trigger events. The following improvements in district policy and or procedures were recommended for the future: 1. 2. 3. 4. 5. 6. 7. 8. 9. Finger print check should be required for all new employees or any current problem employee. Employee ID badges and visitor sign in and badges should be required at all school sites. All school sites should have "No Trespassing" and "All Visitors Must Report to the School Office" signs on the perimeter fences and school buildings with clearly marked directions to the school office. All threats by employees or students must be documented and reported to school administrators, school resource officer or law enforcement agency, and district level administration. Additional training should be mandated for all school and district administrators regarding safety, crisis planing, discipline, confrontation and self protection, and ways to identify potential employee problems. Training should be provided to all staff on how to deal with difficult or problem persons as well as the availability of counseling and other assistance, particularly during stress periods or at evaluation time. A system wide review of within school communications, with immediate steps to provide two way communication to all classrooms as soon as possible. Some type of radio communication should be provided for staff doing before or after school supervision, while on field trips, or on a playground away from the school building. Automatic closing and self locking doors should be provided on all outside entrances where feasible, especially in the rear of buildings or to custodial or equipment areas. 264 APPENDIX I. WRITTEN COMMENTS FROM STAFF SURVEYS DISTRICT 1 19. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 1. 2 None I was able to cope with my own feelings and emotions partly because I felt it necessary to help others- co-workers and students. I really don't remember being questioned or offered any extra help except by our own school counselors. 3. They had a bunch of people present- shock and preoccupation with students seemed to keep them and me from seeking personal council. 4. None 5. I don't remember any plan. 6. Response. 7. None. Just a sorry group of do-gooders. 8. Immediate help. Time for receiving help. 9. They were there quickly and made their presence and function know to all. 10. Caring, concern, disbelief. 11. The meeting with the representative from the Sheriff's Dept. was helpful, but in no way was it enough. We should have been told more about what we would be experiencing in the days, weeks and months following the shooting. 12. I didn't feel there were any great strengths in what they offered. 13. None. 14. None. 15. Quick response. 16. None. 17. Those most involved- administrators, teachers on duty in the cafeteria, received the most help, I would assume. The rest of us do not really know what was offered to these people nor what they took advantage of. 18. The students were adequately taken care of during and after the incident. Strength was immediate response to crisis. 19. I was impressed by the number of administrative and guidance personnel people who were immediately sent to the school. 20. I was well advised. 21. What plan? As far as I know we were on our own. 22. Staff was close for each other--lots of hugging and talking. 23. None. APPENDIX I. (Continued) 24. None. 265 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. Immediate response. Handout materials and group discussions. Those who were the most stressed had help without intruding on those who preferred to get past it as soon as possible. None. There was no help or time for staff to even accept reality. None Providing help. It was fast. I remember vaguely some one-on-one counseling that was beneficial, and I remember some handouts on how to handle stress and other emotions one may feel while dealing with a crisis. Crisis team was alert and caring The only strengths I saw was pertaining to students. I feel there was adequate coverage for them. The district did have a crisis team there, but mainly for the students. I saw great compassion in those who came to counsel the students. (social workers and psychologists were wonderful with the young people. None. It didn't take long for them to get to the school. They seemed to stay as long as they were needed. 20. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 1. We didn't have an intervention plan! I felt that the school district really let us down and that support wasn't offered. 2. If my memory is correct most of the help was offered to students. It may have been helpful to staff if something similar to this survey (in writing) had been used. 3. No where obvious "combat veterans". 4. Maybe more follow up. 5. I don't remember any plan. 6. Needed to talk to professionals (Doctors) not the school's crisis team. Be told what might happen months after the shooting. 7. Confusion. An attitude of let's get back to work. No school family. 8. No help with very long term follow-up. Many teachers since that time seem to be cynical and depressed and angry about teaching and lack of APPENDIX I. (Continued) 9. administrative willingness to discipline students. Many of us feel the students run the school and that the shooting was just one piece of evidence of lack of adult control. Did not participate. 266 10. 11. None. a. Lack of a crisis intervention workshop as a standard part of in-service training. This kind of training should be pro-active, not reactive. b. Lack of an immediate explanation to faculty and staff as to what really happened. Unfortunately, rumor, hearsay, and sensational media coverage obscured the truth for much too long. c. Lack of preparedness for media onslaught after a critical event caused unnecessary anxiety for all school employees and students. 12. It would have been helpful to have one person assigned to staff. They were so busy with students I found it difficult to see one. In addition you were expected to be at your job (desk), mine being a position that could not be left without coverage, therefore I could not leave to talk with someone. (staff) 13. No follow through--no emphasis on criminal act of students involved-allowing the press to video the custodian mopping up blood. 14. I don't know about staff not directly involved in the incident, but I wonder if those involved could have been treated with more compassion. 15. Not bringing the team in earlier. The staff was left to feel they could cope with anything. You were treated as if feelings of anxiety and stress were abnormal and you should be able to go on without any problem. You were afraid to share your feelings for fear of retaliation. We were hurting and we felt no one genuinely cared. We were given a lot of lip service but that was all. 16. I sat in my classroom in an outside building for over an hour after the incident not knowing what was going on in the main building. All I knew was rumors from students who ran out of the building when the shooting started. The next day and week it seemed students were the focus of the intervention team. Staff members did not have much opportunity to talk to a counselor. 17. Faculty members received little support and I feel we needed help as much as students. The crisis happened, intervention for one-two weeks, crisis over--- this type of situation needs long term attention and follow up on faculty members. 18. Everything I witnessed was professional. 19. Lack of support services in dealing with everything. 20. No one really approached us individually. APPENDIX I. (Continued) 21. 22. 23. I don't think it should have been left up to us if we wanted to speak with someone. I think it should have been mandatory. a. Waited too long before crisis intervention team talked with those involved. b. Someone should have informed victims family about short term and long term effect. We had to wait in our rooms with the students until the last bus left. We 267 had no idea if the gunman was still on the loose or not. We also had no idea how serious the victims were hurt until our debriefing after the last bus left. We did not know what was happening when we ere stuck in our rooms. 24. a. Needed immediate staff support. b. Needed mandatory debriefing for short period. c. Needed longer for those who'd like to continue. d. We gave loads of support help to all the students and we were drained ourselves with no support. 25. The people I talked to- in order to get a debriefing team in kept putting me off, saying everyone was O.K. I knew they were not. The only meeting a small group had was a good beginning but was never followed up. 26. Administration of school was left to twist in the wind of the popular press by the county administration. 27. a. No real follow up after incident b. Many of us never got information on what happened to the boys involved. We all started to feel that an educators life wasn't worth much when the boys were released so soon. c. A feeling of worthlessness set in for many teachers. Lack of organization. d. So many administrators running around from other school areas seemed to make it worse. 28. Too many constant reminders. One could not ignore the situation and function without being interrupted with numerous counseling and lecture meetings. 29. Family not told personally-only on TV- who was hurt. Teachers unable to do anything but go on as usual as if nothing happened Returning to the scene of the crime daily not being safe No gun policy then or even the next few years--even now. #1 care for students, "don't talk to press" Still no way to get help to the classroom- non-functioning intercom. APPENDIX I. (Continued) 30. 31. 32. 33. 34. There was not a very strong plan in effect at that point. I was so busy working to take care of the counselors etc. that I had no time to think of myself and my staff. We were too busy with coffees, lunches, etc. Did the district have an intervention plan previous to this incident? The school employees do not then or now have the training or skills required to cope with a c0-worker being needlessly shot. Students have been in the school with guns since then and nothing is done. I feel the assistant principal died for nothing!! Inadequate. I think the system assumed that the only ones who needed 268 individual and\or long term counseling were those directly involved and, to a lesser extent, those who were in the mall when it happened. Through their actions, they made me feel like I ought to be okay within a short period of time but I suffered from depression for at least 3 years. I've only felt okay within the last 2 years or so. 35. There was no pan for staff members. All focus was on students. Staff was expected to cope and not cause further problems 36. Very little was done for faculty during the next week and no follow up in the following months. Teachers were expected to move along normally as if nothing happened. As far as I can remember a flyer was given to us with the symptoms of stress and told us to seek help- that is all. 37. No substitute SRO when the SRO is absent. 38. No communication on how to handle questions from other teachers from other high schools and community members who tried to put the blame on the fact they the incident occurred at our school as if this shooting could not have happened at another high school or middle school. 39. We did not receive enough counseling is small groups or individually. All focus was basically on the students. 40. The crisis team was there, but I felt the county officials hung us out to dry by ourselves. If there presence, concern, etc. was at our school it was not passed on to the faculty. The night of the community meeting, the Superintendent should have been there!!! 41. I myself was unaware of any intervention for faculty or staff relating to the incident. 42. CI geared to students not staff 43. District expected staff members to be strong. 44. Lack of emotion. 45. The return to normal functioning put undue stress on teachers. The low attendance the following day turned each class into a small group counseling session: however most teachers were not trained to handle APPENDIX I. (Continued) 46. 47. 48. 49. 50. such a severe crisis. The district appeared to be so caught off guard by this incident that it really had no plan. Even though the district did have a crisis team here, I don't think many of us felt comfortable airing our feelings in front of students. There was more concern for students and their family's reactions than those of the staff. You mean we had a plan? other than the brass strutting around? More time and personnel counseling needed to be made available to the staff. I will never forget the superintendent speaking to the faculty and the crisis counselors before school began the day after the shooting. He thanked the social workers and psychologists for coming to help but then he reminded them that providing this help would be no excuse for 269 neglecting their regular reports. He demeaned the efforts of the crisis counselors and almost seemed to blame our school for disrupting the normal routine. 51. The evening meeting held for parents was a disaster. It did nothing to relieve anxiety and allowed negative aspects of the situation to be highlighted. 52. No one should have to go through what we did alone. It was cruel and I still feel anger over it. This survey had brought the grief and anger to the surface again. I am though willing to do it if it will ever help someone else. We needed intensive help for all faculty and administration. We received very little. We were expected to help the students heal and I can remember putting my arms around one young lady who just sobbed on my shoulder. I wanted to cry too. I can remember actually swallowing the intense feelings in order to help her. It was a long time before those feelings came back to the surface. I feel say now just remembering. We felt lost and alone. It was as if we had to complain in order to get help. When help came, it was not enough. We needed major intervention to help us deal with the horror. We also needed help to help the students. They hurt so badly and we as teachers had to literally swallow our pain to help them. Of course, it surfaced later. Everyday for 2 years, I thought about it. Two years! We felt that the "higher" administration left us hanging. Token appearances were made, but it was easier for them to turn their backs on us and let us grieve alone. I could only talk about this with those who were here at school. I couldn't talk about it with my family. No one else could relate to this horror. I felt a kinship with Vietnam Veterans. 53. The fact that there was no known plan. APPENDIX I. (Continued) 54. 55. 56. 57. 58. People who were in the building on that day have had no follow-up. It seems as though we are to act as if it never happened. The district needs to work on a crisis plan for staff members. Did they have a plan? Do they have a plan now? I believe the school system's response was woefully inadequate. My depression and anger lasted as long as it did (at least 3 years) in part because no one in the school system even made an effort to identify or help teachers who had this type of reaction to the shooting. They assumed that if we weren't directly involved (ie. victims or a witness) that our reactions were insignificant. Frankly, at that time and even today, I don't think the school system cared about us one jot or they would have made a greater effort to deal with teachers who felt like this. I was never aware of any one on one counseling. The school system needs to remember that sometimes those who seem to be coping well are really not coping at all. They are out there helping others because they cannot help themselves. When I went to one of the debriefings after the 270 59. 60. 61. 62. shooting, I was made to feel unwelcome by my colleagues and like I was overreacting since I had not been a witness. For the first time in my life I thought that I understood why people committed suicide since the bad feelings would be gone. Luckily I am a fairly rational person and recognized that those were irrational thoughts. Not very thorough-surface only. Felt uneasy about accessing. Some should have been mandatory. I think they should have talked to as many adults as they could. I understand they were busy with students but many adults needed help as well. 21. What were the most difficult aspects of returning to normal functioning for you? 1. I still have a difficult time relating with a student who has had a weapons charge. 2. Walking through the mall area where I saw (victim "a") sitting with (victim "b's") head cradled in her lap. Knowing the (recent) past history of offenders being released from mental hospitals only because of lack of insurance. Seeing blood stained sidewalk and bullet holes outside of door which was close to my office. Knowing the deceased would not return. 3. The difficulties I had relative the experience were more a rehash of another series of traumas I went through long before. The earlier APPENDIX I. (Continued) 4. 5. 6. 7. 8. experience was during a time much longer, deeper, and more life altering than the "District 1" one. I'm sure those people lacking my history would have great opportunity for stress. Not having information to answer others questions. I had to get past that feeling of guilt that I could have done more for the injured assistant principal. I still (at times) look at the spot where (victim "b") was shot- see (victim "a" on the floor- where she was. I can see victims "a" and "b" being wheeled out the doors. I still (at times) look out the windows (doors) and think of the assailant with the smirk on his face and wonder why the police missed when shooting at him. I still hurt especially when I see (victim "b"'s) picture. At first not a problem. Five years later I'm out of control so I decided to retire from teaching and want no part of education. Realizing that when I stand for correct behavior, I might be a target too. Lack of standards and overt permissiveness lead to chaos and students continuing poor behavior. No consequences or greatly delayed consequences mean behavior problems continue. We want the adults to 271 regain control so education can continue. 9. Constant memo's offering help for weeks after the event (by guidance). It was like salt rubbed in the wound. Those who needed help had already been informed and did not need those reminders. 10. Not have the deceased at school. 11. I had difficulty walking past the site of the shooting; this lasted for a very long time. I also felt guilty about having been absent that day; I felt that I could have done something to help my students and my colleagues. Finally, I felt so depressed by my own and my students lack of answers that I found it difficult to experience joy in anything until the end of the school year. 12. Saying "It's over" (almost like "who cares anymore") 13. For a long long time loud noises would scare me to death. For a long long time I was afraid to walk in the main all area. I would find myself sitting gazing off into space for a long time. 14. Realization-- knowing the deceased was not with us anymore. Realizing that this happened in my school--un heard of! 15. Relating to those directly involved in the incident. 16. Overcoming the sadness and melancholy of the tragedy. 17. Fear for safety is mostly in control. 18. Trying to put things back into perspective. The feeling of emptiness and insecurity you felt. I felt vulnerable and unprotected. It was hard to get APPENDIX I. (Continued) 19. 20. 21. 22. 23. 24. 25. back to "business as usual." Those of us in the immediate area felt the moment of chaos and fear the most. To see the trauma on the faces of those around the area still haunts me. Certain events, even now, trigger a flood of memories. Disciplining students and reacting to threats from students. I wondered if I chose the right profession. It is not a lucrative profession, nor is it a safe one. Teachers must be compensated for a job that has become very challenging and dangerous. a. Dealing with loud noises. b. Dealing with students with behavior problems. c. Worrying about students with book bags and if there might be a weapon in it. Memories- a. guilt of not saying a better good-bye. b. Discomfort in public places. c. Not knowing who had a gun and who didn't. a. Wondering if it might happen again soon. b. Moving about in the area where the shooting occurred. c. Explaining the "whys" to students without becoming emotional. Resuming normal relationships with students and with some co-workers. Returning to lunchroom duty and expecting the incident to happen again and again. 272 26. 27. 28. 29. Loss of feeling that schools are a basically safe place. No difficult aspects. Fright of the future. Uncertainty of job (career choice). Trying to function in a normal way during the week immediately after the shooting and before the funeral. 30. Dealing with disruptive students and not knowing if they are going to come back and try to kill you. 31. Fear of similar incident occurring. 32. They kept acting as though the deceased would pull out of this in a few days, when probably they knew from the beginning that he was braindead. It would have been better for us if they had disconnected the life support systems sooner. 33. People talking, looking for answers and no information being shared. I'm still questioning things that happened and would like answers. The TV pictures were very insensitive. 34. It felt like there was a ghost at school Insane as it may sound, it seemed like demons were released at the school. 35. a. Always being on edge waiting for some other student to bring a gun. b. My reactions sail to fights that occur. APPENDIX I. (Continued) 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. c. Not wanting to be alone late at school after hours. Walking past the scene. Having the media intrude. Having to tell outsiders where I worked, knowing they would question, comment and even joke. It was embarrassing and not something I cared to discuss and explain regularly. Facing friends who could have been hurt made me emotional. The crying and emotion filled school was often too tense. Fear, safety, being a target, no help, noone caring, no acceptance of possibility of recurrence by upper administration, being expected to do anything. Crisis team members concentrated and made a big deal of working with students, many of whom simply took advantage of the situation to stay out of class. Dealing with idiot kids. I became more angry than anything else throughout the incident. So overcoming this anger was the most difficult. Being in the mall area. Concentration Fear I could not walk by the spot for at least 10 days. One year later I teared up trying to talk about this needless death. I felt like the shooting and its ramifications extended far longer for me because of other stressful issues. 273 46. No change in school's protection for faculty either in the physical plant or discipline of students. 47. Handling guilt feelings that if I had been in the mall that I could have prevented it some way, but also fear that if I had, I would have been harmed also. 48. Overcoming a feeling that now I am different. People who were not there could not and can not to this day understand our feelings. 49. Again, I was angry and upset by all the questions I had to answer about the incident after it happened. I found myself defending our school everywhere I went as a good school where a tragic event happened that could have happened anywhere. 50. I had a severe relapse of a back problem about 2 weeks after the incident and was off work for 2 weeks. I was never able to collect compensation for this time because in the confusion the day of the incident and several days afterward, I never filed an accident report. This whole situation I felt was not handled well by the administration or the district. APPENDIX I. (Continued) 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. Staying focused. Grief is always a hard thing to handle, even if it is for someone outside your family. I feel the media coverage was excessive, but also necessary, this had not happened before and I feel the more knowledge we have the better off- we can get back to normal sooner. I feel this affected family members of faculty as well. My daughter at the time was young (7 years old) She had the most difficulty returning to normal. She was always questioning my safety, and thinking up ways for me to escape in case this should happen again. She didn't want me to go to work anymore and for months had several recurring nightmares. She felt where I sat I was an easy target and would tell me to hide under my desk for safety if it happened again. Concentration. Large groups of staff or students in one area bothered me. Students were allowed to stay home the following day to grieve and collect themselves, the teachers\staff were not. One aspect was walking past the spot where the assistant principal and the others were shot. Thinking about the incident and the suffering it caused bothered me. Also, I don't feel like we were given a grieving period. We were expected to go on as usual. I also found it difficult to discuss it with outsiders. I wish the Superintendent himself had come and talked to our faculty in a warm caring way. I feel that the staff's feelings were virtually ignored by the district. Encountering other people or students having difficulty and not knowing what to do or say. Since I have witnessed a revolution in Guatemala and an earthquake, 274 though small- this was not so bad for me personally. I was not in the mall at the time. In my room I was too busy keeping the kids in line and grabbing others, bringing them in as they stampeded down the corridor to think about myself at all at the time. I had a special closeness with that particular group after that- we shared something. I'm pretty tough it seems- so I wasn't ever afraid for myself. I felt the surviving shooting victims were treated badly. 61. While I grieved for the loss of a friend and the loss of innocence for so may students affected by the shooting, I felt I continued to function normally. 62. I was not near the incident. I was in my classroom, therefore I do not have a visual memory which I think was a benefit to me and my class. I think the confusion and after- working with students and their concerns APPENDIX I. (Continued) 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. was the most difficult. Returning to the basic functions of teaching were nearly impossible. I hurt so badly from what had happened. We all were wounded, students, faculty, and administration. We felt open and vulnerable. To return to normal function when the wound was still open was the most difficult thing. We had no closure to the problem. I don't think we ever did. Going back to the building the next day. Often incidents which are normal, everyday incidents will trigger an unusual response, for example: Recently when a parent showed up unexpectedly and had the people in the front call for me, my response was to imagine that she was there with a gun to shoot me. I had rapid breathing, increased heart rate and was very frightened. All she really wanted was to tell me that her daughter wouldn't be in for detention. I replaced the slain assistant principal. This was extremely difficult. It took me two weeks before I could go in to his, now my office. Thinking about what happened. How it could have been avoided. Loss of secure feeling. Change in perspective. Fear in disciplining students. Coming back to school the next day. Walking in the mall area during lunch. COMMENTS 1. I'm a Vietnam veteran. I suffered from PTSD for seven years after my return from Vietnam. I did not get help initially. I didn't know I wanted it. All I wanted was "out". I wanted to get back "to the world" as I remembered it. My head had changed in Vietnam. It took me seven years to sleep normally again. I had this as a background. I had seen experience was more of a flashback than a first time experience in seeing 275 trauma like that. 2. Ask for a moment of silence on anniversary (not acceptable behavior), but we recognize others not close to us. Example MLK. Such a waste, the youth today are undisciplined and no one seems to be able to speak their mind. 3. Since the event and change in administration, the school has tended to be more immediate in debriefing and forestalling rumors. A lot needs to be done to remove violent students from the mainstream. 4. Today's schools are a potential war zone. Just as it would be irresponsible to send an untrained civilian into bloody battle, it is similarly APPENDIX I. (Continued) 5. 6. 7. 8. 9. 10. 11. irresponsible to send teachers, staff and administrators into a threatening environment without the appropriate preparation. As such, a formalized crisis intervention program should be a standard part of the professional orientation process. Further, there should be a district library publication that details the mental and physical effects of critical incident stress syndrome. This should be distributed to all involved immediately following any violent event. I never want to experience anything like it again. Its difficult to explain exactly how I felt. There were so many feelings. I would like to say that I felt the remaining available administrators handled the closing of school that day very well considering what everyone had been through. Most of the psychological effects probably would fade if the media would stop using the incident as an example every time an incident of school violence occurs elsewhere. Staff and students suffer from a negative image. The incident also helped me to decide not to continue pursuing an administrative career. I still hyperventilate when in lectures on weapons in schools or when I see weapons taken from students. I never felt the "system" truly understood the impact of that happened that day and how it affected us. When the county administrators arrived the next day, they were "glad handing" everyone, laughing and talking and I just wanted them to go away and leave us alone. I never want to experience anything like this again. I don't think any amount of counseling can return the loss of security I have experienced since that day. Each year, each new class, I try to size up my students and figure out which ones I think could turn violent and at both a conscious and subconscious level try not to push the issue if a confrontation should arise with a student. This was my first year teaching. This event has strengthened my character and I believe made me the teacher I am today... I care! The victims who survived should have received more support from the school board, such as a permanent position in which they'd feel at ease. I felt sorry for the people shot, I prayed for them, I believe the boys responsible should be locked up and never released. 276 12. I suffer from migraine headaches and had one of the worst ones ever in my life that afternoon. It started while I was waiting in the room with the students. 13. I'm angry on how the district handled things for us, and I'm afraid it wouldn't be any better today if something would occur. Our district has a way of pushing things away that they don't want to deal with. 14. Some rituals of rededication and blessing by spiritual member of the APPENDIX I. (Continued) 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. community (of all kinds) would have helped. I feel that our schools still don't have a handle on school safety. Students are still bringing weapons to school and many are not discovered. Teachers need more respect by administration in the roles they play. There were 3 incidents , the shooting, a plane crash and a car accident within the same month. I will not touch a walkie-talkie. 3 deaths ! 2 injuries. Thank you for asking--6 years later--we're asked. Recovering from exhaustion from trying to provide service to staff/students/colleagues. Walking through or past the incident area. I was surprised at the intensity of the anger I felt as I began to answer your survey. I've been trying to deal with it for the past three hours and still haven't managed very well. Whenever I read about the shooting or something like this survey happens I get angry all over again. I was taking a class at a state university for the SCAT program where we discussed how to defuses situations and "listen" to a person's problem. The teacher totally lost credibility with me as she did not practice what she preached at all. I had a paper due a couple of days after the shooting and I forgot it-- too bad, so sad for me-- she didn't even hear me say why. The SCAT program has become BS in my mind. The day before receiving your questionnaire, I was in Tallahassee and heard sounds like gun shots and I was instantly back to the date of the incident! It never goes away does it? Just filling out this form has brought back the emotions, anger, fear, etc. TEARS!! I'm so glad you are doing this study. I have not been a good teacher since the incident. I detest the gutless wonders who let this happen and its going to happen again. An student at another school was found with a gun the other day. Was he arrested? NO! I feel safe at the legal system's protection of criminals and the lack of concern for educators. Even today the district does not understand what we went through. We have the same feelings as I guess returning veterans have- you had to be there to understand- no one does- no one cares. Just last month we had a practice crisis plan. It was a joke. We are trained- we could help tell 277 others what to expect- no one asks. 25. I felt that if I cried I wouldn't be able to stop. The first month or two after the incident I wouldn't talk about it with anyone except staff members. I wish the school district would have sent a questionnaire to the staff to see APPENDIX I. (Continued) how we were doing. DISTRICT 2 Written Responses to the Staff Survey 19. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. They seemed to be very concerned about the staff's mental well being and wanted to help them as much as they could. Calm, unified. Teachers who wanted or needed to do so were given the time off to attend the funeral. Talked to us a little. Efficient, available, there were many of them. Their availability to us. I felt, however, the school's counselors did a great job and it helped tremendously when the principal read scripture and offered prayer and a moment of silence - as well as adding ministers to the crisis team. They were all very available and strong. Unity - strong bonds became stronger. They came in and told me what to expect the students to do and gave em some type of lose structured plan to handle them the best I could. Availability to students and teachers. The general public was told that crisis team intervention was being made available. This gives parents a sense of security or feeling of well-being concerning the district taking care of tough situations. We were told it was available. The reality of getting more than a superficial "talking to" was much different. They were there, immediately and stayed as long as needed. Present the day after the news. Had a plan. Constantly received feedback with one another. Did follow-up. Very patient-- good listeners. 278 19. The team was consistently at the school and available for the staff APPENDIX I. (Continued) 20. 21. 22. 23. 24. 25. 26. members. Other staff members were available to take over the class if you had to leave. Pulled together, closer as a staff-- communication of feelings toward each other and how to help students and each other increased greatly. We were given time to talk, time to be with the students, time to be with each other. We were reminded that the counselors were there for us as well as the kids. The counselors/crisis team came many times and stayed as long as there was a need. We were able to make decisions at the school level regarding schedules, reporters, memorial services, etc. We were well informed as to the many different ways our students might react. Immediate presence of crisis team for students. Knowing they were available was a relief. Very supportive, understanding, and non-condemning. 20. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 1. Counseling was available for the teachers of the victim, and the students at the school. I and the other office staff members did not have any counseling. 2. I was a part-time member of the office staff. I never received any counseling from the crisis teams on campus. Although the counseling provided for the students was excellent, I feel that the faculty and staff, or at least the office staff, were overlooked. This was quite unfortunate since many of the staffers knew the victim for many years before the incident. 3. Very little done for staff members - particularly administration. 4. None 5. No rabbi was available. Priests and ministers were on the site. 6. I've never been through a crisis like this before, but I thought the crisis team did a very good job. 7. I saw none, I can recall. 8. We need less superficiality and more depth. A quick fix is their goal. Just the statement that a crisis team is available seems to be the way to solve situations. There was also no follow up by guidance counselors who one would think could pick up the slack. Saying you're doing something doesn't make it so. 9. They weren't available when I was and I had kids to cope with first. APPENDIX I. (Continued) 279 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. Was not sure of ongoing crisis intervention. Rumors-- we heard several different things about suspects, etc, but we were not informed of the facts. Perhaps they could have waited until the "after" or "delayed" period and told us we handled things well and we deserved a day off with pay, but it still wouldn't have helped the pain, but it may have let us know we were appreciated and supported in a difficult time. Administration at our school were not able to grieve properly due to media and stressful situations related to school. Some students abused freedom to seek counseling. They might have given certain readable material - as some might have found it helped, but would never have asked. Did not see/talk to these people. Needed to be available for the other 2 incidences. In early February one of our 7th graders was beaten, then this incident happened. A month after, another 7th grader accidentally shot and killed himself. I feel a lot of these questions will be answered with these other incidences in mind as well. Only those directly working with these kids every day really knew how depressing it was. It was as though we had to be strong for 150 other students all the time. No one asked us how we were doing. As teachers, we're expected to handle anything. I was not close enough to see any specific needs that were not met. Certain staff members still need help one year after the incident. I'm not sure, I wasn't counseled by them. I didn't need it. I think there were enough counselors to help the teachers (staff) but maybe not enough for the students! 21. What were the most difficult aspects of returning to normal functioning for you? 1. 2. Putting the thoughts of the incident out of my mind. I was affected by the incident because I am a mother and I wouldn't want something like this happening to my son, it was difficult trying to stop thinking about it! But, I tried to be considerate of others who were more affected by the incident. 3. Letting go of the fear for my daughter (who looks like and is the same age as the victim. Getting rid of the guilt for being a single parent who has a latchkey child like the victim. 4. The most difficult was related to the children: not knowing who was good friends with her, since she was not on our team: not knowing whose fears APPENDIX I. (Continued) were aroused; and needing to offer a semblance of order without appearing hard-hearted or cold. 280 5. 6. Things have never been completely normal since. Trying to get the students back on task because the crisis did go on for about one month-- the abduction, the finding, and the funeral. 7. Not knowing who murdered the victim- that he may still be out there. Having it brought up over and over - not letting it rest. Also because of the students reactions, it made returning to normal difficult. A lot of stress was also added being around the other very upset children. 8. I don't know if I'll ever be as I was before! 9. Students were upset - some acted out because of stress, some used this for an excuse to act out. 10. Looking at her desk in my classroom. Seeing the hurt and fear on the other students faces. The one after another situations- 1st missing, then dead, then funeral, the tree dedication, then will we find her murderer and knowing he's still out there to catch- plus people like you who keep asking me to relive it just when things start to seem normal and the kids haven't talked about it in a while. 11. I was not sure of the true effect on my students who were extremely close to the victim. Extra cautious. Anger-- why would someone want to hurt this petite girl. Eerie-- I used to see her each day and speak to her and her group of friends. 12. That we are the object of on going publicity of a sensational nature. That the killer has yet to be found. There is no closure. That the children associate the tragedy to the school. That I want to forget but for the safety of my own children, myself and my students, I can't. I don't have much respect for our guidance department or feel they can be very effective. 13. Dealing with the upset student population and the aggressive actions of the male student population in particular. 14. The constant awareness that the new teams were at school keeping the incident fresh in everyone's mind. 15. Not having the victim in class, dealing with her parents and close friends. I see her parents and little sister often and I still feel uncomfortable around them. 16. I live in the victim's community and practice her faith in a different church. The worst is having a daughter of the exact same age and thinking the what ifs. I have a younger daughter as well and am very reluctant to leave them home alone. I'm good friends with the victim's Mom's good friend so the topic comes up often. It is so tragic and I often picture that APPENDIX I. (Continued) aerial view of her body being found and think of my daughters. It 17. nauseates me. I'm still angry that the killer hasn't been found and scared he may still be around. Not everyone ready to return to "normal" functioning at the same time. 281 18. 19. 20. 21. Not knowing who killed her and if he's still out there is difficult for all of us. We lost another student just a few months after her. He died of an accidental gun shot while handling a loaded gun. We had very little emotional energy left with which to mourn him. We were drained by then. Looking at other girls in my room who were in the classes the victim was in - innocent and loving and thinking any of them could possibly be gone next year. I felt sadness that these children were facing such a hard realization about life; horror that this happened 2 miles from my home; fear for my own 3 children. Self preservation. Dealing with students in class discussions. COMMENTS 1. I felt like the police were incompetent as they did not take a report from me after I drew a picture of the truck and gave it to the SRO. The truck was behaving in a suspicious manner. 2. The only reason I did this survey was to help others who may at some point need to go through what I have. I do feel that you could have and should have brought this to a faculty meeting and asked up personally. I still feel pain when I think about the victim and it was quite a shock to receive this by mail at home and not in person or at school. 3. Basically, I wonder if the district really cares, or just says it does. And I don't really think they care about me at all, just about averting another "situation". It's like damage control to protect that image, you know! 4. Having 3 incidents and then followed by 4th, I feel that the staff did a marvelous job. 5. This subject still brings tears to my eyes and pain to my heart. She was not one of my students, but some of my closest friends were her teachers and she was quite popular so all of the students were affected. I don't mind filling this out and I hope it helps. It would have been better if we had been "warned" it was coming. It was quite a shock to get something like this in the mail. 6. I think the outpouring of help/concern from the communities around us was most beneficial. The school pulled together and everyone supported APPENDIX I. (Continued) 7. 8. each other. Students who were in classes with the victim the year before came back just for hugs and a cry. The crisis team was needed while they were present but the bulk of the healing had to be done within our own school community. We couldn't have handled the first day without them! I did not know the student- I was saddened and shocked, but I was not personally affected like some of the teacher/staff who knew her. I did not know the victim. Her case is upsetting and sad. However, it did 282 9. not affect my life in anyway. I was not emotionally involved. I felt sorry for her family and it made me think how awful it would be if something so terrible happened to my daughter. My daughter is almost two and I never turn my back on her in fear that she may be taken from me. It's sad the world has come to this. In addition to the 3 student's who were affected we also watched as one of our own teachers was slowly dying from A.I.D.S. His disease was kept quiet and when he died, October 1993, very little was said and no support or crisis intervention was done for his co-workers. DISTRICT 3 Written Responses to the Staff Survey 19. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 1. The principal gave each teacher a journal and asked us each to write about the shooting. It's meant to be for the emotional lows and highs of our life. 2. The immediate attention faculty and students received was excellent. Within two hours every classroom had a counselor and police officer in the classroom talking to students and teachers. After school we had large group sessions, which went on for a couple of weeks. 3. Excellent listeners, sympathetic, compassionate. 4. We were made to feel we were experiencing normal reactions and would continue to have a variety of reactions. We were made aware of the availability of professionals who would respect our fears as well as our confidentiality. 5. There was an immediate response to the school by this team. Support APPENDIX I. (Continued) 6. 7. was also available after school hours by calling a phone number at the school. There were a lot of crisis counselors on the school grounds immediately following the shooting. They called us all together and let us know what was going on and what to expect from the children. They were there immediately; counseled students, parents, teachers, and administrators. 20. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 283 1. 2. 3. 4. 5. 6. After the initial sessions, we received no further attention. This year the same school had a group of parents who harassed the principal and certain faculty members. When I tried to discuss with the Superintendent that I felt our faculty was particularity vulnerable because of the past shooting incident in the cafeteria, I was told to quit being fearful. That none of the belligerent parents were capable of shooting anyone. I didn't experience any. None that I witnessed I wish that once a month a team would be on campus where teachers could "drop in" and talk, for about six months after an incident. That way we'd be more apt to seek help than making an appointment off campus after hours. During, and immediately following the shooting, counselors were available to help. I think we were all so focused on the children, however, that there wasn't much question as to how to help the staff. I, for one, didn't think I needed help until many months later-- then no one was there. It wasn't even discussed anymore. Support staff members that were directly involved were overlooked. I feel more could have been done. I'm not sure what. 21. What were the most difficult aspects of returning to normal functioning for you? 1. A letter from another school in California, with a similar killing, meant the most. Talking about the killing helped me the most. When ever it comes up in class (ex-with a new student), we stop everything and talk about all the facts of the incident. 2. I have noticed that I am now courteous, but rather abrupt (not friendly) with all our custodians. APPENDIX I. (Continued) 3. 4. 5. 6. A fence for the back P.E. playground, that separates it from the cafeteria delivery area, has finally been installed; however, the gate broke and it was removed. It needs to be reinstalled. A tree was planted on the primary playground "in the victim's memory." Unfortunately this tree has died. It is now a "trigger" for me. It needs to be removed. Trusting people- I still find myself scrutinizing people- checking body language besides words. Overcoming my sense of guilt in having ;hired the murderer. Over coming my torn feelings of, "I must stay with my class," and knowing my daughter was in the cafeteria and might be attacked while I stayed with my class. I was torn between my role as a teacher and my role as a mother--the teacher role won out but it feels horrible to not try to go and protect your child. 284 7. 8. 9. 10. 11. 12. 13. 14. To get over the anxiety of walking on to the school campus and through my classroom door. To get over the anger of someone hurting my "family". To be sympathetic to people who were closer to the incident- I just wanted to put it behind me. Since the two men involved were close to me personally, I doubted my ability to judge children's needs or adult's feelings if could not see this incident coming. I teach Physical Education -outside- where we saw the man with the gun. I was very uncomfortable being out in the open where some other idiot could drive up with a gun. The question still remains: Who else could go over the edge because of what you do or say? Having to be back in charge of young children immediately. There was no time for me to work through any fears I had. I know I just wanted to lock myself and my family in our home and never go outside where it was "not safe". I still battle this feeling. Going back into the cafeteria where the shooting took place. COMMENTS 1. My class was not involved other than a long waiting period of staying locked up. I didn't need any professional support and didn't seek any. 2. I appreciate this survey. I hope the administrators in our county receive a copy of the results. I felt very patronized by the administration at the county level this school year as did other teachers. This survey has made APPENDIX I. (Continued) 3. 4. 5. me realize how affected I still am by the incident. If I think at all about the incident I can remember add pieces of the dayfilmstrips, the students' confusion, comments from the teacher I work with, "Code Blue" coming over the intercom, locking my door, hysterical parents, yellow plastic tape stretched around the cafeteria. I think I'll put it away now. I was not at the school at the time of the shooting. I started teaching there in January of 1991. I took over the job of the teacher who had a mental breakdown. She was one of the teacher's in the cafeteria and witnessed it. Apparently she was having continuous nightmares and decided to retire. Also, I work with a teacher's aid who also witnessed the incident. She is still working at our school and still discusses it and has frequent nightmares. I'd like for spouses to be given a group meeting presentation of what our reactions could be. My husband got tired of my anxieties and thought I was a nut when I kept a rash for a year and then had anxiety attacks 10 months after the fact. 285 286 APPENDIX J. WRITTEN COMMENTS FROM CRISIS TEAM SURVEYS DISTRICT 1 8. Did you feel that the crisis intervention provided for the staff members of the school was effective? YES / WHY 1. But only in the fact that it was immediate if teachers asked for it. Usually it was when discussing a student's concern that teachers expressed a need to talk. NO / WHY 1. There appeared to be very little planning and consistency. (Had Mitchell) 2. Not enough trained/ experienced personnel on site. 3. I think our efforts were scattered and the staff were not assisted until 3 to seven days later. 4. It wasn't long enough, but I am not sure of the role of Risk Management on the district level. 5. The debriefing for the crisis team was helpful, but I don't know what was provided for the staff. 6. Most concerns are only with students not staff. 7. Concentration of effort appeared to be towards students 9. Did you feel there was adequate follow-up for staff members in the weeks following the incident? If you answered "No", what were your concerns? YES / WHY n/a NO / WHY 1. There appeared to be very little planning and consistency.(Had Mitchell) 2. Not enough trained/ experienced personnel on site. 3. Staff was reluctant to admit they needed help too. 4. I was not aware of organized debriefings for staff. The district team had a debriefing session, but it was held almost 6 weeks later. 5. Most concerns are only with students not staff. 7. Concentration of effort appeared to be towards students APPENDIX J. (Continued) 287 10. Did you feel all crisis team members had adequate training to provide crisis intervention for staff members? If you answered "No", what were your concerns? YES WHY n/a NO / WHY 1. Many members had little or no training and members were not required to have specific training to participate. (Had Mitchell) 2. There was virtually no training except what one may have had in graduate school in dealing with counseling and personal relationship issues, etc. 3. Some of the guidance staff expressed their feelings of inadequacy in this area. 4. We had never had anything like that happen before. 5. Inadequate CISD training at the time. This incident served as impetus to get CISD for staff members of psychological services. 6. I certainly had minimal training considering the magnitude of the incident. 7. Different levels of training and participation by community volunteers, some of which had no experience with this type of situation. 8. Not enough training prior to incident. I felt little prepared to deal with this situation. 9. The backgrounds of the members varied, but I'm uncertain how many had CISD. I know I didn't. 10. School crisis team was just forming. CISD at that time was focused more on EMS personnel not teachers etc. 16. Understanding that mandatory attendance at debriefings does not mean mandatory participation, do you feel debriefings should have been mandatory for staff members? What is the basis of your opinion? YES / WHY 1. Because of the varying stages of each individuals emotional turmoil. Every person needs appropriate information- short term and long term. 2. I feel people do not always realize how much they are effected by these situations and need a push to attend. 3. No one could ever say, "No one did anything for me!" 4. Listening to others and being made aware of "normal" reactions later APPENDIX J. (Continued) may have been helpful for those who did not feel they needed it at the time. 5. As teachers talked with me many were in shock or denial. 6. Teachers have been conditioned to feel they must always be in control. 288 Even if people think they don't need CISD, being required to attend initial debriefings will assist those who think they don't need help. 7. It indirectly impacted all staff involved. Many are "care takers" themselves and won't ask for help. 8. Everyone had reactions to the incident whether they admitted it or not. 9. Experience. 10. Common information base and knowledge of styles/types of support. NO / WHY 1. Some staff might prefer to arrange for their own support. Any involved should have been encouraged to take care of themselves and told what type of reactions needed professional attention. 2. Since the whole school community was effected by the incident, it should have been highly recommended, but not mandatory. Mandatory participation could detract from the benefits of a CISD due to resentment related to being forced to attend. 3. I someone is unwilling to attend, it is doubtful that they will benefit if they are mandated. Personal benefits should be stated beforehand and staff encouraged to attend. 4. All staff members are not affected the same way, or need the same support. 18. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 1. Use of qualified (ie.) M.S.W. social workers and psychologist on teams. 2. Quick response. 3. A great deal of immediate help offered. 4. I feel that the individual crisis team members had many individual/unique skills to help deal with issues that were affecting staff. However, this was more of an individual characteristic that the members had professionally in their previous training than something provided by the district. 5. Personnel were available to staff to help with difficulties and provide appropriate resources for assistance in the community. 6. Counseling services were offered many times when the crisis was current and there was follow- up months later. APPENDIX J. (Continued) 7. Staff met in small groups and were "updated" in situations as much as possible. 8. Crisis team members were on site months after incident. 9. Crisis team members were very aware of staff needs as well as student needs and attempted to provide informal opportunities as well as those specifically requested. 10. An effort was made to make contact with all staff members. 289 11. We were called at home and asked to be there the next morning. We were given our job assignment and a place to do it. From my perspective, all went smoothly. 12. There were many caring people, both within the school staff and county level, that provided valuable assistance. 13. It was a quick response 14. It tried to attend the needs of staff. 15. There was good follow through on recommendations. 16. Immediate. 17. Speed of response. 18. Members were empathetic and supportive. 19. The crisis team had a strong commitment of caring and concern. We met daily after the staff and students went home to discuss problems, concerns and issues and to plan the next day's strategies. 20. We have a well outlined plan, with sample copies of letters and other information. 21. The plan at that time appeared focused towards students. 19. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 1. I feel that ongoing intervention is very much needed overtime and that with school personnel staff that is very difficult due to their other job responsibilities and commitments to a number of schools. 2. Perhaps because so many school people showed up from other schools, it was chaotic at times and their knowledge of students and their familiarity with the school was not used as fully as it might have been. This would have made staff who were able to function feel frustrated and discounted. 3. What really is the plan? I again feel that there are many competent professionals working for the school district who were using their previous training and people skills t deal with a very tragic situation. The plan itself was crisis intervention. 4. Reluctance of Central Administration to be on site to offer support in APPENDIX J. (Continued) early part of crisis. 5. One bossy, take charge Assistant Superintendent came the second week after the crisis. She seemed to think that one week of counseling was enough for everything to return to "normal". 6. The plan was not formulated at the time of the incident. We mainly drew from our experience with grief counseling which is not the same as Post Traumatic shock. In other words, we were not adequately prepared nor adequately trained to handle the incident. Also I don't believe there was adequate follow-up and support provided afterwards for the staff. 7. Not enough people. 290 8. When many of us arrived the day after the incident a plan was formed as we went through the day's events. Counselors were dispatched to classes and small groups as needed. It seemed to work, but we "played it by ear." 9. Debriefings for the staff were held much later than recommended by CISD trainers. 10. Debriefing for the helpers cam a long period of time after the incident. 11. I did not get debriefed! After working with such an emotionally charged group, I had some difficulty working through some of my own feelings. 12. No one really in control. 13. Not nearly enough preparation or training. 14. This was a new plan which had no experience behind it to draw from. All of us were learning as we went along and few, if any had training in CISD. As a member of the district team I had no training and simply responded from a gut level hoping I was doing the right thing. 15. There is little effort to five teachers long term help and/or information. 16. There appeared to be little in plan offered to teachers. 20. What were the most difficult aspects of returning the school's staff to normal functioning? 1. This was one of the most difficult weeks I ever remember working. 2. N/A- At the end of the week we were ( and did) return to our normal assignments. 3. Letting go of the pain and fear. 4. The victim's lingering condition. 5. Anger at Central Administration for not being there. 6. Continued press/television coverage. 7. Fear that it could happen again. 8. I don't know because I was not assigned to provide services to the APPENDIX J. (Continued) school after the incident. However, my sense at the time of the incident was that there was a tremendous sense of loss of safety and security. The bubble was traumatically burst! 9. Time was not allocated adequately for debriefing. 10. What is normal? Will it ever be the same? Accepting change in staff was difficult. Trying to act as if things were normal was difficult. Feeling "safe" was difficult. 11. Media 12. Pending court cases. 13. The crisis team focused mostly on student needs. I feel more could have been done fro staff members because the expectation was business as usual. Some of the staff members I worked with felt they should be handling things better. In reality the incident brought up all kinds of other, 291 unrelated problems that staff were trying to cope with. 14. Time. Everyone in administration wants to return to "normal" as quickly as possible, and not take time to deal with the grief process. 15. Not enough screening and debriefing for educators and support. 21. Please list any other suggestions to improve the school district's crisis plan as it relates specifically to staff members. 1. A more formal plan needs to be established with specific strategies, planning, follow-up, etc. 2. More formal and specific training for the employees sent to help. 3. Even today, the district's plan for CISD appears to be haphazard, loosely organized, and without follow-up considerations.(Had Mitchell) 4. To realistically have a plan. 5. To let the crisis team know what the plan is (as opposed to just letting members know who is on the team. 6. To provide on-going training or support to keep crisis team members aware of what plan is in effect and how the plan can truly work if needed. 7. To provide follow-up debriefing sessions to the helpers so that their own emotional status has not been compromised. 8. I have been involved in other crisis situations (suicide, death of student in auto accident, etc.) and it seems the individual schools do not have a realistic plan. It seem that when the psychologists and social workers arrive on the scene, other helpers (eg. guidance counselors) go about their business as if the professionals have arrived and they can take care of the crisis. The people who work at the schools should take responsibility since they are closer to the students and the itinerant persons should act as a support to them (not in place of them) to help with APPENDIX J. (Continued) serious individual crisis situations. 9. More opportunities for the crisis team to encounter training for crisis intervention. 10. Each school should have their won (small) on site trained team. Other teams could be called in as needed. 11. Aggressive follow-up with staff to check how they are doing during crisis, a couple of weeks after crisis, a couple of months after crisis, a year after crisis. 12. The crisis affected more schools than the one where it happened. Administrators had worked in other schools before this incident and those staffs needed the same services. 13. Central Administration should be highly visible and supportive during all phases of crisis, but not try to "take charge" as they really don't know that school, nor have they had necessary CISD training. I feel that the school's administration and staff were left "hanging". 14. The crisis plan needs to be practiced. Team members need to meet 292 regularly and plan. A written plan tucked in a manual and forgotten is not much better than no plan at all. 15. I believe the decision was made after this incident to have a crisis intervention team from outside the school system to handle all future crisis situations. I heard this was a decision made by a central administrator, who on the day after the incident, stood around in the school, did nothing to assist and generally got in the way. I feel people in the crisis situation needs to see familiar faces, and talk to people they know. 16. I have been gone from the district for 4 years and you at least have a plan! This district has something on paper and it has not been tested. We always deal with the students but do not sometimes understand that the impact on staff is also powerful when a crisis occurs. Many adults just use denial when it comes to their own feelings. 17. I feel that there may be a need to involve families more. 18. There should be more than a crisis plan. Everyday, teachers are confronted with hostile kids, break up fights, get injured, and have their lives threatened. Here are some personal examples: a. A student at a high school comes to me and points out a student/non-student who robbed him at gun point the day before. b. I break up a fight with the Assistant Principal at a severely emotionally disturbed center, and am pulled to the floor by my hair. c. Non-students came into the a high school with baseball bats and start beating on kids in the hall. There is an on-going need to help teachers who have to deal with these APPENDIX J. (Continued) "non-crisis" situations. This brings back some pretty bad memories. I still feel the impact this had on my life. In 1989 a stray bullet bounced off the hood of my truck as I drove on the interstate. I always wanted to move, but this incident encouraged action. 19. (The district's plan is to be reviewed and updated this summer.) It is essential that on-going follow-up and support be provided to staff. 20. They need to be alerted to the kinds of symptoms they may experience and given opportunities to meet with skilled counselors both on and individual and small group basis. 21. For those who need or request it, periodic follow-up should be available for up to one year afterward. 22. A crisis intervention team should be identified by the district that would include trained district staff as well as staff from community agencies. Training specified to CISD is imperative. 23. Prevention/early education of all staff to various types of crises and signs and symptoms of stress etc. 24. Quicker access to community support/intervention professionals educated/trained in CISD style model, and access for follow-up. 293 DISTRICT 2 Written Responses to the Crisis Team Survey 8. Did you feel that the crisis intervention provided for the staff members of the school was effective? If you answered "No", what were your concerns? YES / WHY n/a NO / WHY 1. As a team, we made ourselves available to students, parents and administration first. 2. Most faculties are not prepared for tragedies and end up responding as directed by people who are trained in these areas. 9. Did you feel there was adequate follow-up for staff members in the weeks following the incident? If you answered "No", what were your concerns? APPENDIX J. (Continued) YES / WHY 1. It was provided but not accessed much. NO / WHY 1. I am a local clergy member who was not called with any follow up information. 2. At times, faculty reacted to stress with stoic feelings and actions. They may have needed to talk later. 3. There could have been designated times for sessions 10. Did you feel all crisis team members had adequate training to provide crisis intervention for staff members? If you answered "No", what were your concerns? YES WHY n/a NO / WHY 1. Lack of experience. 2. Some team embers stated they did not feel adequately trained. 3. 50- 70% had adequate training. 16. Understanding that mandatory attendance at debriefings does not 294 mean mandatory participation, do you feel debriefings should have been mandatory for staff members? What is the basis of your opinion? YES / WHY 1. There is important information to get to the teachers whether they want to hear it or not. 2. I believe this is important to build cohesion and consistent information as well as assist staff with its reactions. 3. Based upon previous experience, I believe debriefings are critical to recovery. However, some staff members refused and did not attend-said they didn't have time, had other responsibilities, or simply did not show up. 4. In this case all staff members were directly/indirectly involved. 5. Another staff member may ask a question that may be beneficial to the quiet person and the answer maybe what they needed to hear. 6. I think the faculty would benefit from a little extra attention that the district might bestow upon them. 7. Those who resist the most may need it the most. APPENDIX J. (Continued) NO / WHY 1. Some people have adequate coping skills and support to debrief privately. Sometimes time is a factor in debriefing. 2. Only if framed as a discussion at a faculty meeting-- not a "mandatory debriefing". I DON'T KNOW 1. What I'm calling a debriefing was actually a large group faculty meeting with open discussion. I believe everyone attended, but am not sure. I have mixed feelings about it being mandatory. I think it should be mandatory for dissemination of information but optional for processing of it. 18. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 1. There is a plan and general guide to follow in crisis resolution, debriefing and follow up which is not helpful. 2. Quick response. 3. Well trained team members. 4. Principal added strong guidance and direction to process through announcements to staff and students. Additional out-of-school crises team members added support and provided relief for in school staff. Having a room and counsel for staff members and bringing clergy in. 5. Additional staff was provided and on stand by if needed. 6. A clear crisis plan was developed in the district. 295 7. A lot of support from district staff was provided-- when I called for back up especially the day after her body was found. 8. Worked together as a team. 9 Responded in a timely manner. 10. The principal and her staff were very efficient in coordinating crisis team and volunteers. 11. Phone tree. 12. Faculty meetings. 13. Informing the staff members as soon as possible and telephone trees are 2 wonderful things we do. 14. The district crises team (DCT) also follow the schedule of the "hurt" student and the teacher can leave to seek help anytime. 15. The team helped tremendously in the few days just after the tragedy. 16. The school's principal provided floating substitutes for several days-available for relief as needed. APPENDIX J. (Continued) 17. Daily faculty meetings prior to school and after school each day provided good flow of information downward. 18. Although we announced that district crisis team members were available to staff members, they tended to reach out to their own support staff, which makes sense. 19. The school's administrative staff was very responsive to teachers as far as I could see. 20. Great professional staff. 21. We had a well coordinated team of professionals who had experience in this area helping us work through the stages. 19. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 1. I'm not sure that there is follow up with debriefing post crises. 2. Staff members weren't familiar with some of the CIT members. 3. Staff members in command who stressed taking breaks and thinking of self: while this is important for crisis team members to observe, I found it draining and reflective of a lack of desire to be in this important position on the part of the leadership. 4. none. 5. They needed to relieve us school based personnel more-- we were exhausted after days of counseling for the abduction, then the murder, and finally the funeral. 6. Space is sometimes a problem. 7. I'm unaware of space or personnel set aside for faculty. Crisis members arrived at varying times and no coherent plan was evident to me. I'm unaware of specific instructions given to staff as to what to expect and how to deal with it. 296 8. Not informing family members of the staff's experiences during that day is definitely a needed activity. 9. More debriefing needs to be conducted among DCT members. 10. I never heard of any follow-up concern by the district. 11. It would be helpful to have the district convene a couple of meetingspreferably smaller group to discuss the aftermath. 12. The only way our district plan relates to staff members is in an informal way of being available to counsel them. It really depends on individual crisis team members as to how extensive their outreach to staff is. 13. Time out of class was not scheduled for teachers to debrief. 14. More relief should be provided for administrators, teachers, and APPENDIX J. (Continued) school based counselors. 15. Outsiders need to step in and do the majority of the counseling work. I was asked to do too much grief counseling when I was grieving (I knew the victim since 1985). I took care of myself by doing more organizational work and less intense counseling. 16. I'm not sure if schools would want to prepare a faculty for this type of tragedy before hand. We did use it as a learning experience for the 15 interns who were there. 20. What were the most difficult aspects of returning the school's staff to normal functioning? 1. The emotions become very intense and self care needs to be held in abeyance in order to meet the needs of others. 2. Given the nature of the incident I'm not sure if normal functioning will ever occur again, however, within a week we tried hard to maintain business as usual. (Thank God for denial). 3. Some staff members did not realize that weeks after the incident counseling would still be necessary. 4. It took a lot of time to heal and the media was all over campus. This did not help a return to normalcy, until they left. 5. Getting the students back in class. 6. After 3 crises in the school, students were still grieving, afraid, and angry. 7. Our staff did a super job. They returned to normal on their own. 8. We did not really focus on the staff directly. Our main focus was the kids. 9. Constant news about the search. 10. Dealing with difficult cases. 11. Teachers needed time off. It was too stressful for many. 12. Wanting to do special things to remember the victim, but not wanting to trigger more emotions. 297 21. Please list any other suggestions to improve the school district's crisis plan as it relates specifically to staff members. 1. I feel we have an excellent plan, with good staff, support by administration, and good training. 2. I'm not real clear on why you want to know how the district's crisis plan relates to staff members. I'm not sure that the plan even specifically includes services to staff members although this did happen and APPENDIX J. (Continued) continues to happen. Perhaps the best thing our district can do is promote it's Employee Assistance Plan t meet mental health needs of its employees. 3. More discussion or in-services on the benefit of taking time to go through the process. One teacher, in particular, appeared quite insistent on isolating with her class and "carrying on as if nothing happened." She appeared disturbed by emotional responses of other staff members. Help needs to be provided for each teacher. Perhaps a crisis intervention team member who floats from class to class specifically tuning in to the reaction of teachers and its impact on students would be beneficial to provide support, relief, etc. where necessary. Many are religious-- more ministers from community should be brought in earlier. 4. Other than making ourselves available to listen, I have no suggestions. In my experience, most faculty members do not want to talk to someone they don't know. They instead want to reach out to people they know within their own school. Perhaps improved outreach to teachers could be accomplished through better training of administrators at school level re: adult grieving reactions and ways to alleviate that stress (ie floating substitutes, special food available, other TLC measures) With a school-wide crisis such as ours, we had literally hundreds of sobbing kids. I believe our efforts (district CIT) were best spent on the mobs of kids and their status and the faculty and staff's needs were to be best met by the school's administrative staff and school based guidance staff. I would recommend a similar plan in future crisis situations. DISTRICT 3 Written Responses to the Crisis Team Survey 298 8. Did you feel that the crisis intervention provided for the staff members of the school was effective? If you answered "No", what were your concerns? YES / WHY n/a NO / WHY APPENDIX J. (Continued) 1. not enough or over a long enough period of time. 9. Did you feel there was adequate follow-up for staff members in the weeks following the incident? If you answered "No", what were your concerns? YES / WHY n/a NO / WHY 1. not enough or over a long enough period of time. 10. Did you feel all crisis team members had adequate training to provide crisis intervention for staff members? If you answered "No", what were your concerns? YES / WHY n/a NO / WHY 1. I saw less than helpful behaviors by helpers 16. Understanding that mandatory attendance at debriefings does not mean mandatory participation, do you feel debriefings should have been mandatory for staff members? What is the basis of your opinion? YES / WHY 1. Those least likely to attend after, need it most for other unresolved crisis etc. 2. Many people might feel that they don't need debriefing when they could benefit from it. 3. Training and experience 4. Whether they participate or not they will be exposed to others having same problems. 5. Some teachers expressed a concern regarding what to do and said that they did what they thought was the right thing to do. 6. Willingness of staff in district to offer services. NO / WHY n/a 299 18. Please list any strengths you saw in the school district's crisis intervention plan as it related to staff members. 1. I think that the district did not have a crisis plan in place. During my APPENDIX J. (Continued) tenure we only had 2 major crises prior to the 1989 incident. 2. The school district responded immediately to the crisis. Professionals were disperse4d to the site and remained there until late that night. Although I was not involved in the following weeks, I know other professionals were. 3. Offered immediate relief so teachers could check on their own children. 4. There was no formal plan as far as I know - and still is not. 5. Again, most of what I saw was for parents and children. Also I worked for the principal who was eager that everyone be helped. 19. Please list any weaknesses you saw in the school district's crisis intervention plan as it related to staff members. 1. No standard plan for all schools. 2. All counselors that could be released were asked to help out. 3. Principals had no school based plans either. 4. They just yelled, "help". . 5. I feel that the total school community needs training in crisis intervention. There are frequent incidences of violence experienced around the district; whether student vs student or student vs staff. One needs to be prepared in all cases. This should be on-going and required. 6. Little coordination or preparation for such a crisis in advance. 7. Can't think of any. 8. There was no formal plan as far as I know - and still is not. 9. I think they tended to be the forgotten victims. 20. What were the most difficult aspects of returning the school's staff to normal functioning? 1. Dealing with students and parents fears. 2. Not only were the children affected but so was the entire community. The spouse of the slain man was employed at my school, thus affecting us as well. The most difficult aspect was providing on-going support and the assurance to the children that every effort would be made to provide a safe environment for them. 3. Wasn't involved. 4. I don't know - I'm not at that school. 5. I don't know? 21. Please list any other suggestions to improve the school district's crisis plan as it relates specifically to staff members. 1. A viable plan should be implemented 300 2. Workshops should be held in all schools to familiarize staff members with the plan. 3. A parent workshop should be held in all schools. 4. Counseling for groups of students (until the entire population has been seen), should be held several times per year. 5. Safety procedures should be discussed and implemented and known by all staff members. 6. Is there a plan? 7. Can't think of any off hand. The district is currently in the process of re-writing. 8. Need to debrief them as you would anyone who has witnessed an event of this magnitude. But a written plan in the handbook should be in place. Thank you for asking. I think if it happened now it would be handled better. All of us have more information. 301 APPENDIX K. PERSONAL INTERVIEWS District 1 Key Individual on the Crisis Team 1. What training in crisis planning or crisis intervention have you had? The interviewee was a licensed clinical social worker; Master's Degree in social work; graduate work at University of Chicago in short-term treatment. 2. What role did you have in the recovery process of the incident? The interviewee was on the committee to write the model for the county Crisis intervention Plan; was on the crisis team and coordinated all the counseling each day for two weeks. 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. A. The full crisis team was there for two weeks. B. Two district psychologists visited the school once a week for several months after the incident. C. The Social worker and psychologist assigned to the school were there on a regular basis. D. There was a staff meeting at the close of the day of the incident, to disseminate information about the shooting and inform the teachers of the plan to deal with students the following day. E. It was made clear the CIT would be available for teachers if they felt they needed assistance. One district school psychologist held 3-4 sessions with teachers on a voluntary basis. The sessions were held on planning periods. F. Some teachers may have asked another to take their class. G. CIT members went into some classes where the teachers couldn't handle student questions. Some years before the incident, the teacher's union asked for funds for student services to provide counseling for teachers. The union was aware of teachers who were experiencing job stress. Largely it tended to be the younger teachers. Some were going home and throwing up and didn't dare let anyone know because someone may think they were not a good teacher. It was abandon after a year, largely for the lack of funding a second year. The district started the process for developing an Employee Assistance APPENDIX K. (Continued) Program (EAP). They found it was very hard for employees to trust the system 302 to be confidential. The program never got off the ground and was abandon. When a tornado hit an elementary school and killed several children several years prior, the teachers were provided two days of counseling with significant results. Outside mental health professionals conducted large and small group counseling as well as one-on-one. There were lots of tears. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? Essentially, the teachers are key to helping the students and bring about normalcy, so if the teachers need help, the student services team should make themselves available to assist them. The interviewee felt it was important to get input from the teachers on how to proceed. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? A. It was felt that the Central Administrative staff should have relied more on the expertise of the crisis team members. Some decisions were made that were contrary to the crisis team's better judgment. 1. A parent meeting was held the evening after the incident. The crisis team didn't feel it was appropriate in an auditorium setting. If anything, parents should have been invited to meet in small groups, (e.g. home rooms). Outsiders and curiosity seekers could be disruptive in a large group setting. As it turned out, the principal had to be escorted out under police guard due to the volatile nature of the crowd. The media cameras seemed to provide fuel to the fire for those who insisted on grandstanding. 2. There was a great deal of pressure exerted by the Central Administration to back out of the school in an effort to "get things back to normal". They didn't understand there was a need for people to move through the grieving process in a therapeutic manner. It seemed they thought the team's presence would remind people of the incident and keep them from putting the incident behind them. The team had to really fight to continue to provide the intervention they knew was necessary. B. The push to hurry and "get things back to normal" made some feel as though their feelings were unimportant. It was like adding insult to injury and cause some bitter feelings. APPENDIX K. (Continued) C. There was insufficient follow-up for the staff. A survey was sent to the faculty after two weeks and the majority said they wanted no more intervention by the crisis team. By rights, a few months or even a year later, the staff should have been exposed to some follow-up. 303 D. The public relations department stressed repeatedly this was an "isolated incident". This offended some people. Some felt administration was trying to minimize the incident. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? A. Sessions with the faculty were valuable. B. Lists of outside agencies were made available and some agencies called and offered free services. It was hard not to be biased in making our recommendations for outside help. C. Materials were handed out listing symptoms of grief and stress and alerted them if certain symptoms persisted. D. Having some crisis team members available to relieve teachers in the classrooms was appreciated and necessary. E. The cafeteria staff was really traumatized and group counseling was set up for them. F. CISD was provided for school based administrative staff, although it should have been scheduled sooner. G. The team made a concerted effort to make the staff understand that people deal with death and grief in a variety of ways over different periods of time. It was important that everyone be sensitive and tolerant of one another as each worked to cope with the incident. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? There was not much if any collaborative efforts to plan for an incident. 9. Describe the communication between agencies and the school district before, during, and after the crisis? During the incident some agencies called and offered their assistance and provided free counseling sessions. Afterwards we discussed the agencies that were viewed as helpful. No attempt was made to contact them and utilize them in the future. The victim advocate for the police department was extremely APPENDIX K. (Continued) helpful and did a lot of follow-up in the months following the incident. She spent a great deal of time at the school when the case went to trial a year later. 10. Did you feel crisis team members had adequate training to be effective? Not a lot of folks were trained in crisis intervention at the time. There were 304 some very helpful individuals from outside the school district, for example the victim advocate from the police department. Many team members did general counseling and did a very good job. They were good listeners. Some team members just couldn't handle the situation and were sent home. It was no reflection on them as professionals, it was just that they were too close to the incident or weren't comfortable with the situation. The team members had a good deal of counseling experience. 11. Were there any changes made as a result of the experience gained from the incident? What were they? A. The key people on the team should be the counselors, school psychologist and school social worker assign to the affected school. It seemed that when the crisis team arrived, the school based counselors felt they were relieved of any further responsibilities. B. It was recommended that there be more follow-up for staff members. C. The staff should be more involved in the decision of how long the crisis team should stay. D. Key central administrative staff should be available at the school. The superintendent was out of town and it was felt he should have come back sooner. E. More student services staff should be trained in CISD. F. Crisis team members should be rotated. It was very stressful to be subjected to that level of intense emotion day after day. Exhaustion was a problem for the team members. 12. What were your data sources for creating the present plan? We used plans from other districts, Department of Education guidelines, staff expertise - quality circle techniques were used such that everyone had a lot of input, research of the literature, workshops. 13. What are the strengths of the present plan? APPENDIX K. (Continued) A. The plan was updated by members of the team. B. Additional training has since been made available. 14. Are there any weaknesses in the present plan? What are they? A. We don't rely as much as we could on school based employees. B. Providing communication is difficult. There are a limited number of phones in each school. They are not adequately handle the volume of calls. C. The news media could be used more effectively to disseminate 305 accurate information and give instructions to parents on what to do. D. The trauma was heightened by the news coverage of the custodian cleaning up the blood in the cafeteria. We need better assistance from the media. DISTRICT 1 Student Services Administrator Directly Involved with the Crisis Plan 1. What training in crisis planning or crisis intervention have you had? This individual earned a Ph.D. in counseling and psychology and attended approximately five workshops in recent years. Two of these workshops featured Rick Weinberg, mental health director from University of South Florida and Scott Polland, an author featured predominately in the literature on grief and death intervention for children. 2. What role did you have in the recovery process of the incident? The interviewee worked at the scene of the incident for approximately two weeks. The individual met daily with the principal to discuss the events of the day, progress made by the crisis team, and the course of action for the following days. The individual assisted with the organizational aspects of the recovery process; such as, an organized paper trail on students who received counseling for future follow-up, materials for the teachers (handouts for the awareness of stress reactions), and a classroom visitation schedule for team members to follow. The interviewee also counseled with students and teachers as needed. The development, evaluation, and modification of the district's crisis plan were APPENDIX K. (Continued) among this individual's responsibilities. 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. A. The teachers were briefed on the psychological and physiological reactions to be expected when a normal person is exposed to an abnormal life event. B. They were strongly encouraged to refer one another for counseling if they recognized a colleague having problems. C. They were made aware of the fact that even those who did not witness the incident could be affected and the notion that some may have reactions as prior unresolved problems surfaced. 306 D. The administration was advised to be flexible and provide latitude for staff members. E. An Employee Assistance Program was explored a few years before, but never got off the ground. F. CISD was conducted for the assistant principals and the cafeteria workers. It was led by a community mental health professional. G. The Board negotiated mental health coverage as part of a HMO health insurance option for school employees. It covers a specific number of visits per year. Even parents of students who are covered by the same HMO can receive mental health coverage. H. Substitutes were provided for those who needed to be relieved. I. All interventions were strictly on a voluntary basis. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? Sensitivity was needed for all individuals involved in the incident. If teachers are to be there for the kids, then the student services' crisis team needed to assist teachers too. The crisis team made sure everyone knew counseling was available and strongly encouraged participation. The intent was not to impose on staff, but encourage participation. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? A. Much was insufficient. The CISD came to late. CISD or counseling could have been made available after school and teachers could have been APPENDIX K. (Continued) given release time during school to seek assistance. This would have made it easier for staff to participate in group or individual counseling. B. If teachers had requested long term intervention, they would have been given it. We failed to encourage the idea. C. Central administration exerted a good deal of pressure to pull out of the school. The team recognized the need to stay and they prevailed, but the pressure was felt. There seemed to be a false idea that one's presence may continue to bring up bad feelings and continue the pain. In fact, people needed time to work through the pain and come to terms with it. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? A. We had an organized way to respond. B. The crisis team responded in a very caring way. C. The team gave people permission to grieve. 307 D. The team promoted tolerance of the variety of emotions that could be felt. We sensitized staff to the time and type of coping styles. We acknowledged that they had bad feelings and explained that was to be expected. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? We had meetings with several local mental health facilities to discuss crises and suicide. We reached an agreement to have them provide services on site, on a referral basis, and to wave parent permission in an attempt to respond in a timely manner to student crises. 9. Describe the communication between agencies and the school district before, during, and after the crisis? Prior communication occurred as stated before. During the crisis a local mental health professional conducted CISD with different groups. We provided referrals for anybody to outside agencies at no cost for a short period of time (approximately 4 to 6 weeks). We were concerned about the district's liability in case of a law suit. Should we offer counseling by school district personnel only, one could argue that our help may be biased. The addition of services from outside mental health agencies diluted that argument. The interviewee did not believe any suits were filed against the district as a result of the incident. APPENDIX K. (Continued) The victim advocate from the police department was effective and caring. She communicated with us regularly on victims' progress for 6 to 8 weeks. She worked with the school psychologist and school social worker for months after the incident. For the future, the incident gave us a handle on what agencies were helpful and which ones may place us in a libelous position or just weren't in the best interest of the recovery. It gave us a standard to screen volunteers in the case of a future crisis. 10. Did you feel crisis team members had adequate training to be effective? No one really felt they had enough training to deal with such a serious challenge, but that is a natural tendency for those who seek perfection in their field. The team members had a great deal of applied experience with students, but were probably less comfortable with adults. The interviewee felt the district should have an Employee Assistance Program (EAP) with highly trained individuals experienced with adults. If 308 employees felt an EAP team was a viable organization and not just a patsy to the central administration it could contribute to higher morale and more productivity. The team should be employed by the district, be familiar with school issues, and be experienced mental health professionals. If professionals were hired specifically to deal with adults, it may not carry the stigma associated with a mental health facility. This team could work with families of employees with a focus on the employees themselves. 11. Were there any changes made as a result of the experience gained from the incident? What were they? A. Rick Weinberg debriefed the crisis team, but that came too late. We would make provisions for team debriefing in a timely manner. B. Workshops outlining the steps of CISD were provided for student services personnel. Two of our people attended Jeffrey Mitchell's training and were certified in CISD. C. A plan was developed to screen volunteers in future crises. D. Time was devoted to receive input from hospitals, mental health hospitals and treatment centers to focus upon the educational, prevention and/or crisis intervention service which their agency is able to provide (or continue to provide) for district personnel and parents. APPENDIX K. (Continued) E. A good deal of planning took place to prepare for the ensuing trial. 1. Counselors were given a list of students and faculty members who had been subpoenaed. Counselors were asked to talk with students individually or in small groups and distribute packets of information of General Trial Information for their review. 2. The principal met with the faculty concerning trial and conferencing techniques. It was suggested that faculty talk to the police department's victim advocate and the team had some recommendations for outside sources. 3. The principal and district information officer contacted the press to lay ground rules. An attempt was made to keep press off campus to insure orderly school function. The faculty was informed that all press questions should be directed back to the principal or to the district's information officer. 4. The possibility of a change of venue was reviewed. 5. The following activities were suggested: a. Remind teachers to be cognizant of students who are having problems for any reason. b. Use Teacher Advisors to assist students. c. Gather information from resources on post-traumatic stress. d. Meet at least once a week for updates. 309 e. Increase meetings of crisis group working with the school psychologist and social worker. f. Provide information service for students to assist in squelching rumors. g. Extend information to students to meet with the police department's victim advocate. h. Be aware of circumstances that will develop after the verdict. i. Invite parents to come to school ore call school to have questions answered. j. Inform subpoenaed witnesses of the appeal process. F. We will not hold a large group meeting again. If meetings are warranted, they should be organized in numerous small groups. G. The crisis plan should provide for school based decisions. The district crisis team or outsiders should not supplant the school personnel. 12. What were your data sources for creating the present plan? APPENDIX K. (Continued) Other districts with mature plans, Scott Polland, Jeffrey Mitchell, Rick Weinberg, literature, staff expertise. 13. What are the strengths of the present plan? The district has had the experience of using the plan during a full scale (i.e. worst scenario) crisis situation. Experience has helped us refine expectations. 14. Are there any weaknesses in the present plan? What are they? The plan has not been reviewed recently. Schools may not have revised their in-house crisis plan. Sessions should be held with all administrative and student services personnel. DISTRICT 1 Assistant Principal 1. What training in crisis planning or crisis intervention have you had? No formal training other than college courses in behavior management and experience in student discipline intervention. 310 2. What role did you have in the recovery process of the incident? I witnessed the incident and made the immediate decisions about who should be notified, what announcements must be made. Since the principal was at a county meeting, I worked with another assistant principal to secure the building until police, paramedics, and county level administrators arrived. I then served as part of a team of people to organize the activities for the ensuing recovery process. We held a faculty meeting after the students were sent home to let people know what happened, dealt with police, arranged for a place for media to meet with school officials, organized parent volunteers, organized a telephone tree, organized a parent meeting the following evening, organized a method of referring students to counselors, and was part of most all the recovery activities. (Refer to Appendix K for a list of recovery activities) APPENDIX K. (Continued) 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. I am not aware of any provisions made for employees at the time of the incident. There was a program for alcohol or drug abuse, but it targeted those who had a problem and admitted it before they were caught. It was more of a plan to keep from getting fired. We had a crisis plan for the school which outlined things like; who should be notified, that teachers with classes should stay with their classes and those with planning periods should report to the office to assist, and counseling would be organized in the media center for affected students, but that's as far as it went. We were flustered and had a hard time finding the fool thing in the filing cabinet. I believe there is a management book in the Area Office that may have more information. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? I don't know what the District's philosophy was. I wasn't aware of any crisis plan that specifically addressed the employees. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? Most everything failed to meet the needs of employees. If it wasn't for the guidance counselor nagging district level administrators, I wonder if anything would have been provided. She kept saying, " Do you understand we've had a 311 major crisis? Teachers need support!" The district kept emphasizing that it was an "isolated incident", like it would never happen again. This made people feel like they were trying to sweep it under the carpet. They didn't ask the victims how they felt or ask for suggestions about what was needed. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? At the urging of the guidance counselor, we had debriefings as needed for the staff and a month after the incident, they finally debriefed the administrative team. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? I was not aware of any planning that took place between the schools and community agencies. 9. Describe the communication between agencies and the school district before, during, and after the crisis? Everything seemed to handled in house. The police department's victim advocate did a great deal to help the school- faculty and students alike. APPENDIX K. (Continued) 10. Did you feel crisis team members had adequate training to be effective? I'm sure the school social worker, school psychologist, and debriefing team had training in such things, but how well or to what extent I don't know. 11. Were there any changes made as a result of the experience gained from the incident? What were they? Well, we know to call the police first if there is a report of a gun. That's about all the change I am aware of. As an administrator, I haven't seen any plan beyond what is in the teacher handbook and part of the school's original plan. 12. What were your data sources for creating the present plan? I don't know. 13. What are the strengths of the present plan? 312 I don't see that we have anything more now than we did at the time of the incident. 14. Are there any weaknesses in the present plan? What are they? There is no in-depth plan that I know of. We should have a "how to" plan with suggestions on what to do. Everything we did was a result of decisions made at the scene, without knowing for sure if they were good decisions. I know what to do now because I went through it, but I've not seen anything that would guide an administrator through such an incident. DISTRICT 2 Key Individual on the Crisis Team 1. What training in crisis planning or crisis intervention have you had? The interviewee has taken USF college courses, in-service through student services, and certification in school psychology. She largely does testing and feels more reactionary when it come to crisis intervention. The graduate program she completed did not have a lot of counseling content. There were two incidents in the mid 80's, one where a teacher committed suicide and a second where a female student was killed (off campus) and the assailant was never found. The district gained some experience from that which lead to their current plan. She has in-serviced on self care/stress management, how to refer individuals to outside agencies, who should take charge of the media and when to enter the classroom. 2. What role did you have in the recovery process of the incident? The interviewee was the crisis team leader for the school in question. She managed the logistics of the recovery process, to include: requesting back-up, giving people breaks, meeting with the media, deciding where to hold counseling and who should get help, filing reports, and holding debriefing sessions with the crisis team daily. 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. It was deemed appropriate to give faculty support. They made referrals to outside mental health agencies, they met in small groups with the District Crisis Team (DCT), the Life Center did grief counseling free of charge. She knew of a 313 support staff member who was referred to an outside agency, but she indicated there was no way to know if individuals went or not. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? The district did not have the resources for large scale employee intervention. There is a notion that an adult should know when they need help. Largely it was assumed staff would know what to do to help themselves. Mostly the staff came to us instead of the crisis team approaching staff. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? The incident dragged out for such a long time. It was almost too much for the school based team, i.e. school social worker, school psychologist, and school counselors, to deal with. We were sapped out. The district level support dwindled as the media attention lessened. Her own children noticed the change in me and the stress she was under. The itinerant workers had other schools to deal with which gave them some intermittent relief, however, the school counselors were stuck there. She would like to see a fresh team pulled in to relieve the main team periodically. APPENDIX K. (Continued) 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? Counselors were on site to help and they provided resources for those who needed referrals to outside agencies. The crisis team was accessible and very supportive of the teachers. They had counselors designated to follow (the victims) class schedule. She saw (the victim's) teachers be real brave but over time need someone to talk to. Counselors were available for this purpose. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? She was not aware of what planning had taken place before the incident. 9. Describe the communication between agencies and the school district before, during, and after the crisis? She was not aware of any communication before, but during the incident a liaison from the University of South Florida worked with the team, and mental health agencies, grief counseling centers and clergy offered assistance. After 314 the incident, outside agencies were used on a referral basis. 10. Did you feel crisis team members had adequate training to be effective? She surmised most felt they needed more training. Most team members had a master's degree and a clinical background, but felt more reactionary than proactive. 11. Were there any changes made as a result of the experience gained from the incident? What were they? None that she was aware of. 12. What were your data sources for creating the present plan? Not sure. 13. What are the strengths of the present plan? There was a good plan for a quick organized response. 14. Are there any weaknesses in the present plan? What are they? Needed relief for crisis team workers. APPENDIX K. (Continued) DISTRICT 2 Student Services Administrator Directly Involved with the Crisis Plan 1. What training in crisis planning or crisis intervention have you had? The interviewee's training specific to crisis intervention included conferences in suicide intervention and postvention procedures, Scott Polland's workshop on copy cats and high risk suicidal students, Marty Cohen's workshop in grief and loss, Hospice workshops on grief, and Rick Weinberg's in-service on crisis intervention. 2. What role did you have in the recovery process of the incident? The interviewee played a key role in the organization of the district's crisis plan and the training provided for student services staff, administrators and school staff members. She helped on the scene of the incident and debriefed daily with the crisis team captain to assess services provided and to determine if additional service were needed. 315 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. The crisis team members are expected to help the staff as well as the students. The assistance provided for the students in effect helps the teacher. The heaviest burden of dealing with the student's grief rests on the crisis team not the teacher. The crisis team is available for staff and is expected to reinforce their availability for individual counseling regularly. The systematic delivery of training to staff members familiarizes staff with key issues related to crisis intervention and postvention. This is designed to make the staff members more comfortable with their knowledge and ability to handle crisis situations. Training sessions are developed just for principals and an administrative checklist is provided to take some of the guess work out of handling a crisis. Staff meetings are held to keep everyone well informed and to deal with rumor control. Staff are informed about the facts of the event, signs and symptoms of stress, how kids react in crisis situations, and what to expect of their own emotional response. Packaged information helps school based personnel and crisis team members from having to make signs and develop memos. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? Three years before this incident there was a brutal murder off campus that affected the school community. At that time we did not have a written crisis plan at all. We developed at plan after that but administrators did not use our services that much until recently. Now they are using it more and more. This was the first large intervention since the plan was developed. After the workshop with Scott Pollard we decided to mandate a systematic delivery of crisis intervention to staff members instead of the small orientations which were held before. Training packets were developed to train school staffs. It is understood that school based administers are key to a recovery process, so all administrators went through training. We recognize that teachers must care for the children and sometimes suppress their own feelings. We feel it is our responsibility to address the needs of the staff even though our focus in the past has been on the student. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? The incident went on for so long without closure, that crisis team members got burned out. We needed to have more formal and immediate debriefing of the crisis team members. Also they didn't have the capacity to relieve teachers from their classroom duties in order to receive services in a more timely manner. It was hard to manage this incident because nearly every child wanted services. 316 People got sick of the focus and wanted to be left alone, but it is hard to find the middle ground because you can't expect it to be business as usual either. In fact, people will react negatively if you try to minimize their anxiety. It is a difficult balance to keep. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? Counselors were available for teachers, helped with their classes when needed, communicated facts effectively, cared for the students, distributed literature on grief and stress management, brought in clergy to minister to nonsecular needs, debriefed crisis team members and made referrals to outside agencies. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? Due to the incident three years before, we had a better idea of those who were of substantive assistance and those who seemed to be ambulance APPENDIX K. (Continued) chasing. We determined internally those agencies we would ask for assistance if we needed it and those who may complicate the situation. 9. Describe the communication between agencies and the school district before, during, and after the crisis? Rick Weinberg, mental health director at the University of South Florida served as a consultant throughout the incident. We welcomed members of the clergy which seemed to provide a great deal comfort to many people. We referred a number of students and a couple of staff members to mental health agencies. 10. Did you feel crisis team members had adequate training to be effective? The crisis teams are made up of school psychologist, school social workers, school counselors, school nurses, and administrators. In some rural settings, the school personnel are more highly trained than community agencies. The district has provided training sessions with Scott Pollard, Rick Weinberg, Marty Cohen and Hospice. Death and dying, suicide intervention, grief and loss and postvention has been delivered to all student services personnel. Many staff members are licensed clinical psychologists as well. We have not been trained in a formal debriefing process although we feel we debrief effectively in an informal setting. 317 11. Were there any changes made as a result of the experience gained from the incident? What were they? The interviewee indicated that crisis team members feel that once they are involved in the recovery process, they need to stay with it and tough it out. The stress can be detrimental to crisis team member's emotional endurance. The district will make provisions to rotate team members and not wait until a member requests help. Also, even though the team leader did an outstanding job throughout the incident, the interviewee is considering assigning a psychologist not associated with the affected school as the team captain. Their psychologists are itinerant, but have no more than three schools, therefore, they become very close with the schools they serve. Someone who is not so emotionally close to the school family may have an advantage over time. 12. What were your data sources for creating the present plan? Dade and Hillsborough County crisis plans, Scott Polland, Rick Weinberg, Marty Cohen, Hospice, professional literature, and personal experience of district employees. 13. What are the strengths of the present plan? They have a "cook book" delivery system with manuals including sample letters, signs to post for counseling, and an administrative checklist for principals to use. Administrators have received training in crisis intervention and the plan is revised and reviewed each year. A training manual has been developed and there is a systematic approach to training all staff members in crisis intervention using the school psychologists, social workers and counselors. Duties are precisely defined and the team captain is clearly in charge of crisis team activities. Team members have received a good deal of training and have diverse skills. 14. Are there any weaknesses in the present plan? What are they? They do not follow a formal debriefing model for staff members. DISTRICT 2 Principal 1. What training in crisis planning or crisis intervention have you had? Training specific to crisis intervention was provided by student services. Scott Polland did an all day session with principals. 318 2. What role did you have in the recovery process of the incident? As principal of the school she was the center of all activity. She designated areas for counseling, scheduling, who should get help, evaluated each day and decided what needed to be done, helped the Sheriff all weekend, requested crisis team, called faculty meetings, and dealt with the media. She found the media generally speaking to be sensitive and cooperative. She made a point to be up front, set up the ground rules, included a representative from each group, and not stonewall. She felt that if she acted like she was hiding something or stumbled around a topic, they would get aggressive. The ground rules for the media at her school were: A. There would be one pooled camera B. They couldn't go past the corners of the administration building C. They couldn't interview students without parent permission D. What she did for one she did for all E. The Principal was the spokesperson 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. She was not sure any particular provisions specific for staff. The crisis team for students offered their services and made sure the staff knew they were available for them. One counselor and psychologist went to those most closely involved and checked with them periodically. There were two or three group session with teachers and two sessions with the assistant principals. There may be an employee assistance program but it is not real formalized. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? Individual counseling is available. If a teacher wanted it they'd seek assistance. It was reinforced at the school repeatedly, at the end of the year and the beginning of the next year. . 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? There is nothing is place for administrators. The principal had to be the toughest of all and had to plod on without time to grieve. Looking out for others was the way it had to be. She dealt with it to some degree, but essentially had to steel herself for each day's battle because she felt she couldn't fall apart during her school's needy period. Exhaustion was her primary memory. Each one of us broke down at different times in the year for something totally unrelated. It seemed to manifest itself in an over-reaction to something that may not have 319 phased them in the past or since. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? The interviewee was not really sure it was the district's place to provide individual counseling, although she would have liked to have been able to refer teachers to counseling. She saw what she felt was latent reactions to the incident or other issues caused a build up of emotions. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? There was none that she knew of. She was not sure there had been any move since to involve outside agencies. It is a rural school district and probably has the most expertise with its own employees. 9. Describe the communication between agencies and the school district before, during, and after the crisis? The SRO was helpful to coordinate and be a liaison between the Sheriff's office and the school. It was a very difficult time. Closure for the incident was a long way off and there were two other incidents that added to the grief. A boy was severely beaten up ten day before this incident and there was an accidental shooting death shortly after. Some were critical of some student's outward inappropriate behavior. We had to keep in mind that the behaviors may be their way of handling their anxiety. 10. Did you feel crisis team members had adequate training to be effective? Most adequate. Our own people were well prepared. The crisis team was well prepared too. 11. Were there any changes made as a result of the experience gained from the incident? What were they? We had a renewed commitment on supervision. Students must be supervised. The incident was used as an excuse for other problems. Parent's anger was also difficult to deal with. 12. What were your data sources for creating the present plan? Polland, student services department 320 13. What are the strengths of the present plan? The fact that there is a plan. They are prepared and have thought through the procedures. The response is immediate and the people are trained in what to do. It was easy-- one phone call got everything in motion. Everyone clearly understood their task and knew their role. Having someone in charge of the crisis team helped immensely. There was someone to coordinate the counseling and they were there at the faculty meetings to help teachers prepare for the next day's activities. Having help and advice with logistical arrangements was valuable. 14. Are there any weaknesses in the present plan? What are they? Long term concerns are a problem, but she was not sure what could be done. DISTRICT 3 Key Individual on the Crisis Team 1. What training in crisis planning or crisis intervention have you had? Jessica Gurvis served as a consultant in 1988. All student services workers three or four principals and three or four teachers, social workers, and occupational specialist attended the workshop. Students services had a conference on grief and dying, plus the interviewee had a bachelor's degree in elementary education and a master's degree in counseling. 2. What role did you have in the recovery process of the incident? The interviewee's job was to get counselors on the scene. She went to the school for three days, participated in the debriefing at the end of the first day (the principal conducted the debriefing), assisted with a faculty meeting in a large group the first day (all the teachers were not there), and assisted with sessions for parents. 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. At the time the plan was limited to students. Individuals who had some expertise worked with teachers, but identified need on an adhoc basis. The Employee Relations Department has since made some arrangements to assist 321 employees with a local community hospital, but this was not in the plan at the time. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? The district is in the process of updating the plan. It has not been updated since 1988. We are looking at what should be available for employees. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? An omission was not addressing the employees. Some may not have been knowledgeable of the need to respond to employees. Everything was adhoc in nature. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? The quick response to the scene was super. There was a ground swell of support from other administrators. The principal's knowledge and ability to work through problems was exemplary. She knew how to be a facilitator for parents, media, teachers and students. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? There was not a normal connection with school and community agencies. Any connection was done on an individual basis at the school level. She felt that was a missing link. Now there is better communication. 9. Describe the communication between agencies and the school district before, during, and after the crisis? There was no particular communication before the incident. During the incident many organizations and individuals from the community offered their services. After we determined we needed to develop an official document to facilitate cooperative relation with community agencies in case of an emergency. Some were concerned that a few private providers were just ambulance chasers. More discretion needed to 10. Did you feel crisis team members had adequate training to be effective? Some people were not as prepared as others. Every two years we have 322 Hospice provide an afternoon workshop on grief and dying. 11. Were there any changes made as a result of the experience gained from the incident? What were they? At the time of this incident there wasn't an official plan approved by the Board. Now it is an official document with and official link with agencies. The district is not equipped to provide long term crisis intervention, so the community agencies are needed. There are issues of the cost factor, insurance and level of expertise for long term intervention. The district has arranged so the employees don't have to worry about cost. We saw a need for more training. Not only crisis team members, but it is necessary to involve more teachers. In-service will be school based as a part of Blueprint 2000. There has been some activities offered in crisis intervention, but the teachers could choose whether or not to attend. With it being school based, it will be easier to schedule. 12. What were your data sources for creating the present plan? Professional literature, Paul Freeman (State Task Force for Crisis Intervention), internal expertise (one of the school psychologist is on a Crisis Coalition Committee). 13. What are the strengths of the present plan? The plan is more organized now, crisis team members have more training, the community is more involved in the plan, and the plan is Board approved. 14. Are there any weaknesses in the present plan? What are they? It is in the process of revision. Hopefully when we are finished, there will be no weaknesses. DISTRICT 3 Student Services Administrator Directly Involved with the Crisis Plan 1. What training in crisis planning or crisis intervention have you had? The interviewee taught at the University of Louisville, was a member of APA for many years, was the Supervisor of Guidance and has a Ph.D.. in counseling and guidance. 323 2. What role did you have in the recovery process of the incident? The interviewee responded to the scene, manned the phones, talked to parents and met with the faculty. All expulsions were processed through her office and prior to the incident she determined there was a need to develop a plan to deal with violence. She called the American Psychological Association Headquarters in Washington, D.C. and was referred to the Florida Psychological Association. 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. There is an employee assistance program but it is not part of the crisis plan. There is an orientation in the Fall for new teachers. They are given materials with names and numbers of agencies who will help with personal problems. We discourage school people going to school people for counseling. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? Student services initiates the crisis plan and the focus is on the student, however, the crisis team is available for the entire staff and provisions should be made for the families of the staff members. Counselors were expected to take the majority of the burden of diagnosing student needs. They were available to take over a teacher's class if the teacher needed a break. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? The student services plan did not have specifics about crisis intervention. The emphasis was on security not so much helping traumatized people. Nothing was in writing or Board approved. The local psychologists the principal asked to help were good, but other local practitioners that offered assistance seemed to be just ambulance chasers trying to bolster their business. The superintendent decided we should call in the Occupational Specialists to assist. They really didn't know what to do and did little to help the situation. The spouses of the teachers were affected and that one thing we should have made provisions for. We kept a record of the students who received help, but there was no record of the teachers who were referred for help. We had a problem with space to do individual counseling and forms had to be generated on the spot which was time consuming. The public relations person was not much help and the principal handled most of the press. 324 There were hard feelings about a Central Office Administrator who left for an out-of-town professional conference the day after the incident. There was a notion that it showed a profound lack of support in a difficult situation. The decision of who should report to a crisis scene should lie in the hands of those trained in crisis intervention. Central Office Administrators sometimes make decisions that are contrary to the recovery process because they fail to consult with those who are trained in field. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? They had enough trained, certified counselors available that if teachers wanted to talk to someone they could. Teachers didn't have to evaluate students with the counselors the to help. The interviewee had the ability to pull all the counselor and psychologists to the scene of a crisis. The meeting with parents alleviated a lot of fears. The phones were manned until late that evening which provided good communication between the school and the parents plus a letter went home with students giving parents the facts of the incident. The principal did an excellent job. She showed good common sense and intuitively knew what to do to pull the school together. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? We didn't need local people. 9. Describe the communication between agencies and the school district before, during, and after the crisis? There was little communication before the incident. During the incident many community agencies offered their help but we only effectively used a few. A nurse from the University came and a private practitioner worked with the school. After the incident we determined those agencies who were helpful and those who were just opportunists and made a note of those we would call on in the future. 10. Did you feel crisis team members had adequate training to be effective? The Occupational Specialists had no appropriate training and were of little help. The school psychologist and social workers on the other hand were excellent. 11. Were there any changes made as a result of the experience gained 325 from the incident? What were they? We determined we needed to finalize a plan and have it approved by the Board. The employees needed to feel safe so they erected a parameter fence around the property. Each school had to develop its own crisis plan in writing Community mental health resources were evaluated and contacted to coordinate services The National Safety Counsel evaluated the entire district and most of the recommendations of a physical nature (lighting, fences, etc.) were addressed. Created forms, sample letters and signs for use in the future. The plan calls for better record keeping regarding who was seen by each counselor. Those with special skills have been designated different responsibilities. More training was made available. 12. What were your data sources for creating the present plan? Professional journals, consulting firm, National Safety Counsel, other districts, and internal personnel. 13. What are the strengths of the present plan? There is a plan approved by the Board. It has specifics to guide a crisis team and a school through a crisis. Basically the changes mentioned previously are the strengths of the plan. We learned through our experience and changed procedures accordingly. 14. Are there any weaknesses in the present plan? What are they? Since the interviewee had retired since the incident, she did not have sufficient knowledge to evaluate the weaknesses. DISTRICT 3 Principal 1. What training in crisis planning or crisis intervention have you had? Much of her training she attributed to on-the-job experience. The 1968 teacher walk out was a particularly stressful experience. She attended a week long workshop on how to continue with an objective when all is falling apart around you. She also had in-service regarding out of control students. It was a 40 hour component which addressed restraining students, appropriate 326 communication techniques, and managing crises where students are out of control. 2. What role did you have in the recovery process of the incident? She lead the recovery of her school and community. She provided services to the teachers, planned activities, and was constantly analyzing the situation to decide what to do next. 4. Explain the provisions made for employees in the district crisis plan that existed at the time of the incident. She was aware of an employee assistance program where principals could refer people for emotional, drug, and alcohol problems. The district paid for the first trip if the employee's insurance didn't pick it up. She is retired now and is not sure if the program still exists. 5. What was the philosophy behind the components of the plan as it related specifically to the employees involved in a crisis? She was not sure there was any consideration for employees when it came to crisis intervention. 6. Can you cite any areas of district's crisis plan that failed to meet the needs of the district's employees? The interviewee felt school should have been closed the next day to give the staff time to recoup. Had they had more time together they would have had more time to plan. She wasn't aware of a crisis plan. In fact she had a lock down plan for her won school but wasn't aware of anyone else who had such a plan. There was no plan to avert a problem, no way for folks to talk and get it out, no way to share the experience, and no way to ventilate before people internalize their feelings. Something should be done to help everyone whether they think they need it or not. It is insufficient to ask, "Is everybody OK?" People inevitably respond, "Yes", whether they mean it or not. A plan should have some way to communicate between the district and employees. There should be a constant flow of information. There was a situation where the staff sent the wife of the victim flowers, cards, and messages from the children. They did not realize the wife held ill feelings toward the school because of the incident and called personnel to complain. Personnel called and chastised the principal and told her to quit harassing the wife. It came as quite a slap in the face to the staff members. The principal needed a hands on assistant. She shouldn't have had to do it all herself. Risk management gave her some information but she wasn't 327 prepared to advise the entire staff on what to do when the insurance company came and interviewed everyone. No one told her what was right or wrong to do. No provisions were made to coordinate the investigation. She asked the Board Attorney, an old friend of hers, to sit with each teacher through the depositions, as she felt the teachers should have someone on their side to advise them. Administrators should have been designated to respond and assist. There were three principals who came to the school, but only because they were close friends of mine. One brought his custodial staff to help clean up, one went out to several fast food restaurants and got enough food to feed the children who had not yet eaten, and one manned the office. There was no plan to assist the principal. The district public relations staff was supposed to be the only ones to talk to the press. The entire staff went to a Governors Club to have dinner the night of the incident, leaving the principal in charge of the media. The next day the Director of Elementary Education went to a state meeting for a week. The principal felt as though the district left her on her own which added to the stress. 7. Can you cite any areas of district's crisis plan that adequately met the needs of the district's employees? Guidance counselors were at the scene within thirty minutes to help teachers with classes. There was a counselor in every classroom and they stayed the rest of the day. They were back the next day to do individual counseling. For most of the next week a team remained for teachers and children. They reported to the principal if a teacher was having difficulties and they took over their class. A letter went home to every parent that afternoon. Parent volunteers took some children home and made sure that every child had someone at home. When the State CISD team worked with the staff, most felt it was time well spent. Teachers said they were so glad to know the whole story. A couple of teachers who are chronic complainers felt it was a waste of time. 8. Describe the planning that took place between outside agencies and the school district prior to the incident? There was no planning before the incident. In fact, the assailant had tried to commit suicide and went to a mental health clinic. The school had no knowledge of this. The interviewee had mixed feelings about the issue of a right to privacy and the safety of the children in public schools. It seems someone ought to know about such things. 9. Describe the communication between agencies and the school district before, during, and after the crisis? She was not aware of any communication that occurred before the 328 incident. During the incident some problems arose with the police department. The Sheriff wanted to dismiss the children immediately after the incident. The principal had to insist that the children remain at school. Many children would have no one at home for supervision. Then he wanted to talk to the whole school in the court yard. The principal felt the students would be better off addressed in small groups by classrooms. It reached the point where the Sheriff accused her of obstructing justice. She prevailed but felt strongly that prior communication would have made the difference between confrontation and cooperation. Numerous doctors in private practice called and offered their services. The principal used their services effectively but felt the district should have been aware of what she was doing. A couple of weeks after the incident the State CISD team called the principal and offered their services. They had one large meeting with teachers in the morning and broke into smaller groups the rest of the day. 10. Did you feel crisis team members had adequate training to be effective? The counselors seemed well trained in grief counseling. The State CISD team was excellent. 11. Were there any changes made as a result of the experience gained from the incident? What were they? The district adopted a policy that all threats have to be reported and every school had to have a crisis plan. Other than that she didn't recall any changes to help employees. 12. What were your data sources for creating the present plan? Professional journals, experience, other districts 13. What are the strengths of the present plan? The guidance counselors were great. They helped everyone. The principal retired before any real formal plan was adopted by the district. She could not comment on it's strengths at this time. 14. Are there any weaknesses in the present plan? What are they? Again, she retired before a new plan was adopted and could not comment on any weaknesses. APPENDIX L. (Continued) 329 SUGGESTED PRINCIPAL/TEACHER STATEMENTS TO STUDENTS ATTENDING A FUNERAL/ MEMORIAL SERVICE: I know that a number of you are planning to attend the funeral/memorial service for ________________________. A funeral/memorial service is a solemn occasion that provides an opportunity for friends and relatives to pay their respects and say "Good Bye" to _____________________. It is also a time to show the family the love and respect this school has for __________________. Some students have not attended such a service and we offer the following suggestions: 1. Arrange for transportation to and from the service. 2. Check with your classmates to make certain that they have transportation to and from the service. 3. If you wish, take a sympathy card to the service and leave it on the table in the hall. 4. If you take a floral tribute, make certain it is in a container with water. 5. If you get too upset, go to the back and talk to someone. Support each other in a quiet manner. 6. Take tissues to use/share 7. Avoid making angry statements to the press (if a crisis situation has occurred). DRESS Girls: 1. 2. 3. 4. 5. Plain dress, skirt & blouse or dress slacks. No mini-skirts (middle/high school). Tasteful jewelry; nothing that makes distracting noise. Limited make-up (middle/high school). No heavy perfumes (middle/high school). Boys: 1. Tie and jacket, or plain shirt and slacks 2. No heavy aftershaves (high school). APPENDIX L. (Continued) SUGGESTED TEACHER'S STATEMENT TO CLASSROOM STUDENTS 330 AFTER A SEVERE CRISIS SITUATION AT THE SCHOOL: Thank you for coming to school today. I appreciate your being here. We are all concerned about what happened and it is having an effect on all of us. There are still a lot of unanswered questions and you might hear all kings of rumors. We will keep you informed of the situation as it progresses and pass on new information as it comes to us. If you (students) need to talk to someone, we can talk in our room as a group or we have counselors in the school that can talk to you individually. If you (students) know of someone who has a special need, please let me know and I will contact one of the counselors. Now, how are we doing and what do we need? 1. Classroom discussion with teacher or Crisis Team Member as the leader/co-leader. 2. Student in special need taken to the Counseling Center. 3. Teacher requests classroom release to go to Counseling Center for their own needs. APPENDIX L. SUGGESTED PRINCIPAL/TEACHER STATEMENT TO FACULTY/STUDENTS AFTER A DEATH IN THE SCHOOL: 331 I have something to share with you that can be very distressing and difficult to understand. _____________________(name) died _________(time) from _________________(cause). _____________________(name) has been a student/teacher in this school since ____________. He/she has/has not been ill for ______________(time). Funeral arrangements have/have not been made at this time. (If not) We will notify you on any further developments. (If yes) _________________(name of Funeral Home) located at _______________________(address) is in charge of the arrangements and visitation hours are from _________ to ___________. The funeral will be held _____________(date) at _____________(time) and burial will be _________. Money may be donated for a floral tribute through the school office/classroom. The counseling center is open to any student/faculty member who are in need. APPENDIX L. (Continued) Stress and Trauma Your Day-to-Day Life Individuals exist in a normal state of equilibrium. That equilibrium involves everyday stress: being late to work, getting a promotion, having a flat tire, getting ready for a date, putting the children to bed. Occasional stress will be severe enough to move an individual out of the 332 state of equilibrium, but most people most of the time stay in a familiar range of equilibrium. When TRAUMA Occurs Trauma throws people so far out of their range of equilibrium that it is difficult for them to restore a sense of balance in life. Trauma may be precipitated by stress: "acute" or "chronic". 1. Acute stress is usually caused by a sudden, arbitrary, often random event. 2. Chronic stress is one that occurs over and over again-- each time pushing the individual toward the edge of his state of equilibrium, or beyond. Most trauma comes from acute, unexpected stress like crime, natural disasters, accidents and acts of war. 1. But some trauma is caused by quite predictable (but hated) stressors like chronic child, spouse or elder abuse. 2. "Developmental crises" come from transitions in life, like adolescence, marriage, parenthood and retirement. THE CRISIS REACTION The normal human response to trauma follows a similar pattern called the crisis reaction. It occurs in all of us. Physical Response The physical response to trauma is based on our animal instincts. It includes: 1. Physical shock, disorientation and numbness: "Frozen Fright". 2. "Fight-or-Flight" reaction: a. Adrenaline begins to pump through the body. b. The body may relieve itself of excess materials, like ingested food. c. Physical senses-- one or more may become very acute while others "shut down". d. Heart rate increases. e. Hyperventilation, sweating, etc. 3. Exhaustion: physical arousal associated with fight or flight cannot be prolonged indefinitely. Eventually, it will result in exhaustion. Emotional Reaction Our emotional reactions are heightened by physical responses. 1. Stage one: Shock, Disbelief, Denial 333 2. Stage two: Cataclysm of emotions -- anger/rage, fear/terror, grief/sorrow, confusion/frustration, guilt/self-blame. 3. Stage three: Reconstruction of equilibrium-- emotional roller- coaster that eventually becomes balanced. TRAUMA AND LOSS Trauma is accompanied by a multitude of losses: 1. Loss of control over one's life. 2. Loss of trust in God or other people. 3. Loss of a sense of fairness or justice. 4. Loss of personally significant property, self or loved ones. 5. Loss of a sense of immortality and invulnerability. 6. Loss of future. Because of the losses, trauma response involves grief and bereavement. TRAUMA AND REGRESSION Trauma is often accompanied by regression to childhood -- mentally and physically. 1. Individuals may do things that seem very childish later. a. Singing nursery rhymes. b. Assuming a fetal position. c. Calling authority figures mommy or daddy. 2. Individuals may feel very childish. a. Feeling very "little". b. Feeling very "weak". c. Feeling like you did when you were a child and something went terribly wrong. APPENDIX L. (Continued) RECOVERY FROM IMMEDIATE TRAUMA Many people live through a trauma and are able to reconstruct their lives without outside help. Most people find some type of benign outside intervention useful in dealing with trauma. Recovery from immediate trauma is often affected by: 1. Severity of crisis reaction. 2. Ability to understand in retrospect what happened. 3. Stability of victim/survivor equilibrium after the event. 4. Supportive environment. 5. Validation of the experience. Recovery issues for survivors include: 334 1. 2. 3. 4. 5. 6. Getting control of the event in the victim/survivor's mind. Working out an understanding of the event and, as needed, a redefinition of values. Re-establishing a new equilibrium/life. Re-establishing trust. Re-establishing a future. Re-establishing meaning. LONG-TERM TRAUMATIC STRESS REACTION When someone survives a catastrophe event, they often experience stress reactions for years. Long-term stress reactions are natural responses of people who have survived a traumatic event. Stress reactions may involve Posttraumatic Stress Disorder. The following is the description of that disorder in DSM-III-R: A. The individual has experienced an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone, e.g., serious threat to one's life or physical integrity; serious threat or harm to one's children, spouse, or other close relatives and friends; sudden destruction of one's home or community; or seeing another person who is being (or has recently been) seriously injured or killed as the result of an accident or physical violence. B. The distressing event is persistently re-experienced in at least one of the following ways: 1. recurrent and intrusive distressing recollections of the event (which may be associated with guilty thoughts about behavior before or during the event.) 2. recurrent distressing dreams of the event. 3. sudden acting or feeling as if the event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative [flashback] episodes, even those that occur upon awakening or when intoxicated). 4. intense psychological distress at exposure to events that symbolize or resemble an aspect of the event, including anniversaries of the event. C. Persistent avoidance of stimuli associated with the distressing event or numbing of general responsiveness (not present before the event), as indicated by at least three of the following: 1. deliberate efforts to avoid thoughts or feelings associated with the event. 2. deliberate efforts to avoid activities or situations that arouse recollections of the event. 3. inability to recall an important aspect of the event (psychogenic amnesia). 335 4. 5. 6. markedly diminished interest in significant activities. feelings of detachment or estrangement from others. restricted range of affect, e.g., unable to have loving feelings. 7. sense of a foreshortened future. D. Persistent symptoms of increased arousal (not present before the event) as indicated by at least two of the following: 1. difficulty falling or staying asleep. 2. irritability or outbursts of anger. 3. difficulty concentrating. 4. hypervigilance. 5. physiologic reactivity at exposure to events that symbolize or resemble an aspect of the event. E. Duration of the disturbance of at least one month. Specify delayed onset if the onset of symptoms was at least six months after the distressing event. LONG-TERM CRISIS REACTIONS Not all victim/survivors suffer from long-term stress reactions. Many victims may continue to re-experience crisis reactions over long periods of time. Such crisis reactions are normally in response to "trigger events" that remind the victim of the trauma. "Trigger events" will vary with different victims but may include: 1. Identification of the assailant. 2. Sensing (seeing, hearing, touching, smelling, tasting) something similar to something that one was acutely aware of during the trauma. 3. "Anniversaries" of the event. 4. The proximity of holidays or significant "life events". 5. Hearings, trials, appeals or other critical phases of the criminal justice proceedings. 6. Media articles about a similar event. Long-term stress or crisis reactions may be exacerbated or mitigated by the actions of others. When such reactions are exacerbated, the actions of others are called the "Second Assault" and the feelings are often described as a second injury. Sources of the second assault may include: 1. The criminal justice system. 2. The media. 3. Family, friends or acquaintances. 4. Clergy. 5. Hospital and emergency room personnel. 6. Health and mental-health professionals. 336 7. Social service workers. 8. Victim service workers. 9. Schools or educators. 10. Victim compensation system. The intensity of long-term stress reactions usually decreases over time, as does the frequency of the re-experienced crisis. HOWEVER, THE EFFECTS OF A CATASTROPHIC TRAUMA CANNOT BE "CURED". Even survivors of trauma who reconstruct new lives and who have achieved a degree of normalcy and happiness in their lives-- and who can honestly say they prefer the new, "sadderbut-wiser" person they have become-- will find that new life events will trigger the memories and reactions to the trauma in the future. (National Organization for Victim Assistance, 1987) APPENDIX L. (Continued) Victim's Rights Dealing with the Media Victims and family members of victims of violent crime have certain rights when approached by the news media: 1. You have the right to say no to an interview. 2. You have the right to select the time and place for an interview. 3. You have the right to ask for a specific reporter, although editors can rarely comply with this request because of conflicting assignments. 4. You have the right to release a written statement through a representative instead of giving an interview. 5. You have the right to keep your minor children from being interviewed. 6. You have the right to refrain from answering questions that make you uncomfortable. 337 7. You have the right to ask to check the story prior to publication. Editors almost never grant such requests, but asking may make sure they remind the reporter to double- and triple-check the facts. 8. You have the right to demand a retraction when inaccurate information is reported. 9. You have the right to ask that offensive photographs or visuals not be used. 10. You have the right to conduct a television interview behind a screen in order to conceal your identity. 11. You have the right to ask that your photograph not appear in the paper. 12. You have the right to file a formal complaint against a reporter. (San Diego County MADD, 1988) Suggested Guidelines for Firearms on Campus The information presented in this document may or may not apply to an incident you may encounter. There are no definite set of rules to cover each and every incident that may happen. Nothing can substitute for good "common sense", letting the subject escape or retreat. 1. Never take anything for granted, from the student's behavior to the weapon used. 2. Be totally aware of everything occurring around the suspected individual--what violence may have occurred in the community and any signs or symptoms of possible disturbed individuals. 3. Suspicion of a gun should be reported immediately to the administrator in charge. Staff should not take action of their own. 4. The administrator should find out as much as possible about the student, the weapon ;and the location of the weapon. Always assume the weapon is loaded. 5. The SRO, Campus Police, or the police department of your jurisdiction should be notified. The person designated to make the call to police should stay on the line and be aware, via tow-way radio if there are any changes or additional information, to better prepare law enforcement officers responding to the scene. 338 6. The person with the gun should be isolated, if possible, from other students and faculty. 7. A "code" should be developed to communicate the problem to the staff and holding the changes in classes is a possibility. 8. A group of staff members should be designated to assist in emergency situations. 9. Encourage good rapport with students and have channels for them to report a person with a weapon. 10. Encourage a school neighborhood watch program. 11. Those responsible for taking the gun should be prepared for the unexpected and should think about what to do if the student runs or goes for the weapon, or if a second gun appears. It is suggested, time permitting, to allow for the arrival of police. If not, allow room for the student to escape. If the student displays the weapon retreat. Do not meet aggression with aggression. If you can not isolate, observe to see if the student has a companion. 12. If immediate action is necessary, restrain the student's arms next to his body until the weapon is found. 13. Be aware, there are other weapons that can seriously injure you than just firearms, i.e. knives, pellet guns. Water guns, and firearm lookalikes, have to be treated as dangerous weapons. Do not take for granted it is a toy. 14. Suspected person (s) may have the weapon concealed in a book bag, locker, pocket book, inside a pants belt, or sock. These areas need to be addressed first. 15. Once the gun has been confiscated, isolate the weapon from the student. Treat the weapon cautiously by pointing the barrel upward, and secure it until police can take possession. This will insure the safety of all persons and prevent an accidental discharge of the weapon. DATA SOURCE: Chief Of Campus Police 339 APPENDIX L. (Continued) Guidelines for Bus Drivers-- Student Fights and Weapons The following information is designed to give the bus driver guidance when faced with situations involving fights or weapons. There is no way to anticipate every situation that might occur. When student's behavior becomes bizarre, no one set rule applies. We are assigned the responsibility to protect the students in our care, and there are situations that require us to use our best judgment and behave as a prudent person might behave. Each situation involves infinite combinations of unique circumstances, and there is no pat answer that accounts for everything that may occur. With this in mind, the school bus violence committee has developed the following guidelines: BUSES WITH RADIOS AND ATTENDANTS I. FIGHTS A. Radio a signal-38, and identify your route number and location. B. Look for a safe place to pull off the roadway. C. Stop the bus, shut down the engine and pull the keys. D. Verbally instruct the students to stop fighting. E. The attendant should isolate the fighters by instructing the other students to move away, while verbally instructing the fighters to stop fighting. F. Assist the attendant in isolating the fighters and verbally instruct them to stop fighting. G. If it appears that there is evidence that a student may be seriously injured, try to intervene, to restrain the fighters. H. If police arrive, step aside and allow them to proceed without interference. I. Complete a referral on any student involved in the fight and notify the administrator on duty. Comments may be made on the referral if you feel that one student provoked another. J. Complete an incident report when you return to the 340 compound and notify your supervisor. At any point in the process, the students may cease fighting and you should contact the office by radio with an update on the situation, and proceed as it is safe to do so. If medical attention is needed, you would stay at the location and radio a signal-49. The decision for filing charges is at the discretion of the law enforcement officer. Most administrators make a distinction between mutual combat and battery. Mutual combat occurs when students confront each other, neither one backs down, and fisticuffs develop. Battery occurs when one student is struck without notice, or has made every effort to indicate an unwillingness to fight and turns away. IT IS NOT THE DUTY OF THE BUS DRIVER TO MAKE THE DISTINCTION BETWEEN BATTERY OR MUTUAL COMBAT. Simply make every effort to report as accurate an account of the incident as possible. When you have an attendant, prior arrangements should be made in anticipation of each person's responsibility when a fight breaks out. If you are taking students home, contact the office by radio and request direction as to whether it is better to proceed on to the stop or return to the school. DO NOT place yourself in danger of injury, by blundering into a fight without first evaluating the situation. DO NOT instruct other students to assist in physical intervention. Many students will help voluntarily, but do not allow them to intervene if you feel their safely is jeopardized. DO NOT attempt to restrain a student from exiting the bus if they are intent in doing so. Radio the office with the information so that school officials and parents may be notified. DO NOT leave students on an unattended bus. II. CONCEALED WEAPONS A. Whether you know for a fact or merely suspect a student has a concealed weapon of any kind, radio a Signal - 0, your route number, location and destination. B. Mentally note pertinent information: i.e. student's name, informant's name, bus stop, school, etc. C. Proceed to the school. D. Shut down the engine, take out the key and exit the bus. E. Allow school personnel to handle the situation without interference. F. Submit a bus discipline referral to school officials, if a weapon is found. G. If you are enroute to the bus stop in the afternoon, follow steps "A" and "B", and allow the student to exit the bus without interference. H. The route coordinator will take steps to notify the appropriate personnel, but it is your responsibility to write a referral, 341 follow-up with the coordinator or supervisor, and communicate with school personnel the following day. DO NOT confront the student. DO NOT restrain the student from exiting the bus. DO NOT make overt actions that alert the student that there is a suspicion of the possession of a weapon. III. DISPLAYED WEAPONS A. COMPLY with the armed student. Do what ever he/she demands. B. If you are able, radio a signal 0, your route number, and location. C. Stop the bus in a safe place. D. Display all emergency lights and stop arms. E. PROVIDE A MEANS OF ESCAPE. F. Encourage the armed student to leave the bus. G. Instruct the other students to duck and cover. H. COMPLY with the armed student, until he leaves the scene. I. Radio the office with an update of your situation, and wait for instructions. J. Cooperate with police when they arrive on the scene. K. Write a referral and follow-up with the supervisor and the school officials. DO NOT try to disarm the student. DO NOT try to confine the student on the bus, even if you know the police are on the way. BUSES WITHOUT A MEANS OF COMMUNICATION All of the above instructions are applicable to buses with communications. For buses without radios, the driver should make note of public telephones or other schools along their route. Once you have found a safe place to pull over, you would send TWO students to the nearest telephone to call 911. It does not require a coin to use 911. The students should be given the emergency instruction card provided by Transportation, and communicate the problem. This procedure would be used if the dangerous situation persisted. In other words, if you brought the fight under control, and there were no injuries, you would not need to call 911. Once the danger has passed, and the bus and children are out of harm's way, gather as much information as you can, and proceed to your destination. ALWAYS notify the supervisor and school official. SUMMARY The following statement is an excerpt from the "Student Code of Conduct": 342 "ALL STUDENTS are expected to conduct themselves at all times in a manner that will contribute to the best interests of the school system. No student's conduct shall infringe on the rights of others. For purposes of the Code, school authorities shall have jurisdiction over any student misconduct which takes place on school property, on field trips, at school activities, on a school bus, while boarding or leaving a school bus, or off school grounds, if the misconduct is deemed to have a detrimental effect of the general atmosphere of a school. The following actions, or attempts to commit them, shall be considered SERIOUS MISCONDUCT and may warrant immediate suspension/expulsion without consideration of alternative punishment." Assault, battery, and possession of weapons or other dangerous objects are three offenses listed thereafter. The principal may chose to pass alternative steps on the bus discipline plan, and go straight to suspensions or expulsions. The principal may also suspend or expel students from school for infractions on the bus. The following is a excerpt from a memo written by the Associate Superintendent for Human Resources: "Board Policy and State law permit the use of reasonable force when employees are protecting themselves or the students for whom they are responsible. Reasonable is always subject to interpretation in each incident, but normally if the force used is not excessive under a standard of reasonableness, then employees are considered acting in good faith. The Board provides liability protection for employees under such circumstances when the employee's actions are consistent with the expectation of their jobs. Individual employees are typically not sued under these circumstances, the Board is. Consequently the Board provides legal counsel through the Board Attorney or the Associate Attorney when the Board is sued." 343 APPENDIX M DISTRICT #2 CRISIS INTERVENTION TEAM PROGRAM ADMINISTRATOR'S CHECKLIST FOR DEALING WITH A SCHOOLWIDE LOSS/CRISIS 344 APPENDIX N. DISTRICT 3 CRISIS INTERVENTION PLAN Position: Our 1st priority with regards to any unusual incident will be to protect the interests of children and staff and to return the school or other site involved to a state of normal, orderly operation as soon as possible. 1. Each school will have planned emergency intruder or incident procedures which may include a "lock down" procedure. a. This plan will be reviewed and approved by the appropriate executive director and a copy will be placed on file in the office of that executive director and assistant superintendent for instruction. b. The school's staff will receive in-service regarding the emergency procedures plan. c. The written plan will be kept in a readily accessible place known to the entire school. 2. Upon notification of a crisis at a school, the Superintendent dispatches a district crisis intervention team for the purpose of assisting at the school site. This team consists of either the Superintendent or the Deputy Superintendent, the Community Relations Officer, the Assistant Superintendent for Instruction or the Elementary or Secondary Executive Director and other personnel as appropriate. 3. Once at the site, the intervention team establishes a crisis headquarters for dispensing information and instructions and establishes locations for media, parents and support staff. 4. The Superintendent or Deputy Superintendent is responsible for assigning specific tasks and responsibilities to the crisis intervention team and providing support to the site administrator once the situation has been assessed. 5. The Community Relations Officer or other appropriate individual acts as spokesperson for the District to the news media and to district personnel. This will include immediate notification to all schools and departments, follow-up bulletins, rumor control efforts, etc. (Refer to the Crisis Communications section of the Press Relations Plan.) 6. The crisis intervention team arranges for necessary support personnel including, if appropriate, crisis-trained counselors and non-instructional help. 345 APPENDIX N. (Continued) 7. Once the immediate crisis has been contained, the crisis intervention team provides for necessary follow-up support and assistance at the site. 8. The Superintendent or the Deputy debriefs with the crisis intervention team and other involved staff. 9. The District Administration conducts and internal review to determine the following: a. the facts of the incident b. the success of the mode of crisis intervention c. the need to establish additional procedures or alter existing policy in any way. 10. The District Administration takes action on the findings of the investigation, including, if appropriate, any personnel actions, policy (School Board action) or practice revisions, Crisis Intervention Plan refining, employee in-service, etc.