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Stress First Aid for Wildland Firefighters
Student Manual
October, 2018
U.S. Forest Service
Department of Agriculture
National Fallen Firefighters Foundation
National Center for PTSD
Department of Veterans Affairs
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Table of Contents
1. Table of Contents
2. Acknowledgements
3. Introduction and Overview
4. Check
5. Coordinate
6. Cover
7. Calm
8. Connect
9. Competence
10. Confidence
11. Summary
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Acknowledgements
The principal authors of this Stress First Aid Manual for Wildland Firefighters are: Patricia
Watson, Ph.D., of the National Center for PTSD, Kimberly Lightley, Patty O’Brien, C.J.
Johnson, Jason Virtue, Jennifer Rabuck, Chris Tipton, Vickie Taylor of Prince William (VA)
Community Services/NFFF Behavioral Health Specialist, Richard Gist, Ph.D., of the Kansas
City (MO) Fire Department, Erika Elvander of the Defense Centers of Excellence for
Psychological Health and Traumatic Brain Injury, Captain Frank Leto of the FDNY
Counseling Unit, Captain Bob Martin of the Chicago Fire Department, Captain Jim Tanner
of Prince William (VA) Fire and Rescue, District Chief Don Vaught of the Eugene (OR) Fire &
EMS Department, William Nash, MD, Captain, MC, USN (Retired), Richard J. Westphal,
Ph.D., PMHCNS-BC, Captain, NC, USN (Retired), and Brett Litz, Ph.D., of the Mental Health
Core of the Massachusetts Veterans Epidemiological Research and Information Center at
the VA Boston Healthcare System. Photography acknowledgements to Kari Greer.
The Stress First Aid for Wildland Firefighters Student Manual is an adaptation of the Stress
First Aid for Firefighters and Emergency Medical Services Personnel Student Manual
developed by the National Fallen Firefighters Foundation. The principle authors of the The
Stress First Aid for Firefighters and Emergency Medical Services Personnel Student Manual
are Patricia Watson, Ph.D., of the National Center for PTSD, Vickie Taylor of Prince William
(VA) Community Services/NFFF Behavioral Health Specialist, Richard Gist, Ph.D., of the
Kansas City (MO) Fire Department, Erika Elvander of the Defense Centers of Excellence for
Psychological Health and Traumatic Brain Injury, Captain Frank Leto of the FDNY
Counseling Unit, Captain Bob Martin of the Chicago Fire Department, Captain Jim Tanner
of Prince William (VA) Fire and Rescue, District Chief Don Vaught of the Eugene (OR) Fire &
EMS Department, William Nash, MD, Captain, MC, USN (Retired), Richard J. Westphal,
Ph.D., PMHCNS-BC, Captain, NC, USN (Retired), and Brett Litz, Ph.D., of the Mental Health
Core of the Massachusetts Veterans Epidemiological Research and Information Center at
the VA Boston Healthcare System.
The Stress First Aid for Firefighters and Emergency Medical Services Personnel Student
Manual represents a civilian adaptation of the Combat and Operational Stress First Aid
(COSFA) Field Operations Manual, developed by the Bureau of Medicine and Surgery,
Department of the Navy, in cooperation with the Combat and Operational Stress
Control, Manpower & Reserve Affairs, Headquarters Marine Corps, the Navy
Operational Stress Control, Chief of Naval Personnel, Total Force N1, and the National
Center for PTSD, Department of Veterans Affairs. The principal authors of the COSFA
Field Operations Guide included William Nash, Richard Westphal, Patricia Watson and
Brett Litz. We are grateful to the military units and bureau listed above for allowing the
adaptation of their work to help our nation’s first responders.
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Introduction and Overview
The stress encountered by wildland fire
personnel is influenced by a number of
factors: the threats the job can present,
the tragic losses which they routinely
witness, the difficult decisions they have
to make, and the cumulative demands
that wildland firefighting places on them.
While these “big ticket” stressors often
draw the most attention, when surveyed,
issues like pay, supervision, interrupted
sleep patterns and relationships with coworkers get top billing for their effects on
work satisfaction. Added to
these factors, personal issues arising
deployment patterns and from home and
family stressors can result in fire
personnel juggling many competing
demands in a job where the stakes are
high if mistakes are made. Most
firefighters cope with these issues at
different times, but when any
combination of them weighs on the
individual, stress reactions can result.
Stress First Aid (SFA) has been developed
to help reduce the likelihood that these
stress reactions will develop into more
severe or long-term problems. SFA offers a
flexible set of tools for addressing stress
reactions in firefighters and Emergency
Medical Services (EMS) personnel. It can
be used for self-care, or to help coworkers, company officers, crew leaders
and others offer assistance as a way to
either prevent the progression of stress
reactions, or bridge affected individuals to
other resources.
In wildland fire settings, when SFA is being
used for others, the individuals best
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positioned to use SFA are co-workers, peer
support personnel, mentors, company
officers and others who have existing
relationships with the affected individual.
Friends and family members can also play
an important role in the identification of
firefighters who may be in need of stress
first aid.
SFA Aims to Reduce the Risk for Stress
Reactions
•
SFA is used to continuously
monitor self and co-workers
•
SFA is used to recognize
reactions to a wide range of
stressors in one’s work and / or
personal life, and identify who
might be in need of assistance.
•
SFA offers a spectrum of actions
to ensure safety, reduce the risk
for more severe stress reactions,
and promote recovery.
•
SFA monitors the progress of
recovery to ensure a return to
full function and well-being.
•
SFA bridges individuals to higher
levels of care, as needed.
SFA is Guided by a Set of Core
Principles
•
Strong leadership and unit cohesion
are potentially the most powerful
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•
•
•
•
•
forces for healing and recovery
available to fire and EMS personnel.
SFA promotes recovery from stress
reactions by augmenting, restoring
and leveraging leadership, peer
support and unit cohesion; it never
supplants or competes with them.
SFA occurs in natural work contexts,
wherever and whenever it is needed.
SFA is individualized to meet the
needs of each person in their
context; there are no one- size-fits-all
SFA solutions.
SFA is never a one-shot straegy. It is
an ongoing process of promoting
recovery from stress reactions,
monitoring progress and adjusting as
needed over time.
SFA requires a collaborative team
effort to be most effective.
Firefighters Speak:
“This isn’t about fixing someone, it’s not about
psychology, or, “how can I give someone the
tools to fix themselves?” There is nothing really
to fix; nothing’s broken. It’s more, “these are
things you need to be cognizant of so that you
can make changes in behavior and bet back
into a better track.”
“The traditional CISM model calls for folks
coming in from outside the group. That’s why
this model is different - it can be just us. CISM
is more clinical, more formal, and more
detached. The SFA model starts with
introspection, and it fits our culture. It’s like
the stereotypical advice from a grandfather to
grandson. It doesn’t take a PhD to make it
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work. Think about the times in your life when
you already have naturally done these things.”
“There are two philosophies about how to
prepare for a critical incident. One is to try to
anticipate everything that might happen, and
to have a plan in place for the most likely
possibilities. The other is to be competent at
what you do and be ready to help when called
upon. I favor latter. If someone comes to me
and I can help, I will help, or I will find someone
who can. I do not have to be someone who is
ready for every scenario. This model builds an
effective team, so I don’t have to try and be
someone I’m not, or fumble around and
perhaps do more harm than good. Rather, I
seek out and surround myself with the right
people for the job.”
“This model helps people understand that these
are all common reactions so they can be very
well aware. And the seven Cs are not so clinical
or diagnostic. They are more personal,
interpersonal, and tactical.”
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Taking Care of Each Other
In the Wildland culture, there is often a gap
between experiencing stress reactions and
seeking help. This culture appeals to “type A”
personalities and those who are problem
solvers and service-oriented. Therefore, it is a
culture that could benefit from learning the
basics of self-care, support for each other, and
good mentoring. SFA can only be as strong as
the determination of the culture to preserve
the health and well-being of each of its assets,
so that they can both serve others and get the
most out of the job for as long as they choose
to be a part of the culture.
Using SFA principles to improve your own selfcare, or with your inner circle of “go to” people
is the ideal use of SFA, but the core actions can
also be used with those you work with and
those who seek the guidance or leaders or
other mentors. The best mentor is one who is
chosen, rather than imposed. If firefighters
could be given a list of folks they can contact to
build their careers, know more, or seek
mentoring, some will be more likely to jump at
the chance to sit down and talk to somebody
who has years of experience. To build a list of
folks who are willing to do that, you could ask
at the district meetings or retirement meetings,
or set up monthly breakfasts to help
firefighters and retirees to connect. Most
seasoned firefighters are more than willing to
talk with a young firefighter wanting to
interact.
Firefighters Speak:
“Assigning people a mentor is not how
mentorships work. Mentors are people that
you trust. Respect is the important component
that makes it easier to trust; not just my
respect for them, it’s their respect for me.
People I consider mentors are people who
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were in way higher positions than I was, and
would come in sit down, have a casual
conversation with me, and say “hey if you ever
need anything, give me a shout.” It was a sign
of respect to me that they cared enough to
take the time out and sit down and talk with
me, and then offer their assistance.”
“We usually find a mentor on our own, whether
you call that person a mentor or not. I have
some of those folks who I’ve called for advice.
If I get in bind or I am struggling, I have a
number of folks I can call. I think it’s really
important. The guys I call have been in the
agency for 20-30 years. I’ll call them, ask what
they think, and that’s helped me big time.”
“For me, what made a good mentor was the
older, gruff, rough around edges, firedog.
They’re who I went to, looked up to. They had
gone through fire, and although not trained in
behavioral health, wellness, or self-care, they
got it. Even though they didn’t go through
exactly what I had went through, they knew
what it was like. To me it meant the world, it
meant so much to be in their presence, and to
this day I see my mentors and there’s
understanding. Those who have gone before,
they get it.”
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“After my wife told me she wanted a divorce,
my mentor told me to think about how many of
my peers were happily married. I saw that
many had trouble, and realized that it was part
of the job. I accepted the fact that if I stay as
operator on road 120 days / year, I will not be
married. That opened my eyes immediately.
Later, when we had a child, another mentor
said, you realize that if you stay in this job, you
will have known your son 9 years when he’s 18,
because you’re gone 6 months out of the year.
I got it. It was 4 months later that I had
another job.”
SFA is Based on a Stress Continuum
Model
Stress States clearly lie along a spectrum of
severity and type. They are neither all normal,
transient, and self-limiting, nor are they all
signs of chronic mental illness.
“In the 1990’s my team leader swatted the
canteen out of my hand and said you drink
when I tell you to drink. Now we've realized
that culturally we have to change with the
generational differences, and we also have to
allow people to be responsible for their own
safety, and encourage them to speak up.”
“If a rookie comes up and says something isn't
right to me, they're not going be told to shut
up. I tell them what we're about to do, and the
reasons for what we're going to do.”
“You build confidence and competence in
somebody by giving them the opportunity to
teach, be a mentor, or step up and help
others.”
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The Stress Continuum Model shown in
Figure 1 was adapted from the model
developed by the United States Marine
Corps leaders as a tool for conceptualizing
the spectrum of stress states. The Green
Zone is the goal of most training and
prevention activities. The Yellow Zone is
the one that most people are in when work
and life demands are challenging but
transient, and stress reactions are more
temporary. The Orange Zone is the stress
zone in which the risk for failure of role
performance and future mental disorders
becomes significant. Once an individual
goes beyond the normal daily stress
reactions into the more significant Orange
Zone responses, SFA actions may reduce
the likelihood of needing more intensive
intervention (which usually takes place
with Red Zone reactions).
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Figure 1. Stress Continuum Model
Ready (Green)
Definition
• Optimal
functioning
• Adaptive Growth
• Wellness
Features
• At one’s best
• Well trained and
prepared
• In control
• Physically, mentally,
and spiritually “fit”
• Mission-focused
• Motivated
• Calm and steady
• Having fun
• Behaving ethically /
legally
Reacting
(Yellow)
Definition
Ill (Red)
Definition
Definition
• Mild and
• More severe and persistent distress
transient distress
or impairment
or impairment
• Leaves an emotional / mental “scar”
• Always goes
• Higher risk
away
• LowFeatures
Risk
Features
• Feeling irritable,
anxious, or down
• Loss of motivation
• Loss of focus
• Difficulty sleeping
• Muscle tension,
heightened heart
rate, breathing, or
other physical
changes
• Not having fun
Causes
• Any stressor /
trigger
• Loss of control
• No longer feeling like normal self
• Stronger emotions like panic, rage,
depression
• Excessive guilt, shame, or blame
• Loss of memory or ability to think
rationally
• Being unable to enjoy previously
pleasurable activities.
• Increased or uncontrollable
physiological reactions, such as
sustained muscle tension and pain,
heightened heart rate, panicked
breathing, or other persistent physical
changes, particularly
Causeswhen reminded of
trauma or loss
• Life threat
• Loss
• Inner conflict/turmoil
• Excessive wear and tear
Unfortunately, as with physical injury or
illness, this is not always the best solution.
It is important here to note that 100% of
people will react when faced with stressful
stimuli.
However, the way in which they respond
will depend on how prepared they are for
the stressor event, how they interpret it,
and their resources.
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Injured (Orange)
• Persistent and disabling
distress or loss of
function
• Unhealed stress injuries
• Clinical mental disorders
Features
• Reactions persist or
worsen over time
• Severe distress or
social or occupational
impairment
• Hopelessness
Types
•
•
•
•
PTSD
Depression
Anxiety
Substance abuse
During the course of this response, a person’s
state can range relatively rapidly from Green
to Yellow to Orange to Red and back again.
In the wildland firefighting culture there is
often a stigma associated with reacting to
stress, and many will try to conceal stress
reactions.
Additionally, firefighters are often more
attuned to duty, honor, and helping others
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than they are to helping oneself. That
increases the likelihood that getting help
for oneself will be delayed or denied.
Yellow Zone Reactions Versus Orange
Zone Injuries
Firefighters are regularly exposed to
highly stressful situations. As a result,
many are experiencing elevated stress
levels much of the time. Because they
may more commonly be in the Yellow
Zone rather than the Green Zone, it is
important to clarify the difference
between stress reactions and stress
injuries.
Stress reactions are common and are a
part of developing competence and
confidence as a result of facing life’s
challenges. Most people have sufficient
resources and skills to recover from a
stress reaction with limited outside
assistance.
Stress injuries, on the other hand, can
result from more significant affects to
the mind and brain. These may result
in no longer feeling like your normal
self, feeling out of control, or being
impaired in your work or personal
roles. They typically require activation
of additional resources to facilitate
recovery and growth.
The concept of stress injuries is similar to a
strained versus a broken ankle. When an
ankle or tendon is strained, physical therapy
and use are often prescribed. However, when
there is an injury like a broken ankle, a cast
and rest are needed.
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Figure 2 shows four classes of
stressors that place individuals at risk
for enduring stress reactions:
•
•
•
•
Inner Conflict or Turmoil
Life Threat
Loss
Wear and Tear
The first three are usually discrete events
that can be experienced either singly or in
combination with each other. The last,
wear and tear, is the accumulation of
stressors from expected or normal life
challenges, both large and small, over a
long period of time. These four sources of
stress often operate simultaneously and
their effects are cumulative.
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Figure 2. Four Sources of Stress
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Signs of Stress Injuries
The experiences, behaviors, and
symptoms that characterize stress injuries
include:
•
•
•
•
•
•
•
•
•
•
Not feeling in control of one’s body,
behavior, mind, or thinking.
Being frequently unable to fall or stay
asleep.
Waking up from recurrent or vivid
nightmares.
Feeling persistent, intense guilt or shame.
Feeling unusually remorseless.
Being unable to enjoy usually
pleasurable activities.
Displaying a significant and persistent
negative change in behavior or
appearance.
Losing grounding in previously held
moral values.
Experiencing attacks of panic, anger or
rage.
Losing memory or the ability to think
rationally.
Where Stress First Aid Fits Into the
Continuum
SFA is a toolkit of actions intended to fill the
care gap between training, stress
management and prevention at the left end
of the Stress continuum, and clinical care to
the right of the continuum.
Figure 3. Where Stress First Aid Fits Into the Continuum
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Loss:
“This year someone will die. You probably
won’t know them and you’re going to say “that
sucks” If you stay in this career long enough the
next thing you are going to say is “I was just on
that fire.” Another few years you’ll say “I just
worked with that guy.” And another few years
and you’re going to say “ I was just having
dinner at his house with his family.”
going on between members. So now we’re
trying to build capacity to remedy that so we
can have more folks respond to for fatalities.”
“Those of us working with the firefighter we
lost are doing okay except for the visuals. We
have a really healthy group. But the intrusive
visual memories are what are really getting to
people. They quickly pull people from what
they think is a good place, to this turmoil.
People seem okay one day, and then they’re
“The fires that always hit hardest with me is
not okay the next day. It's like climbing an ice
when it’s someone’s home. In one fire I caught
wall. You make progress every day, you latch
myself saying “yep there’s another burned out
in, you make steps, and then the next day you
house.” It’s easier and safer to not think about
have a day where you lose 2000 feet of
the families. It’s also hard when incidents are in
elevation.”
your own back yard.”
“What pushes us into Orange is the incident
within an incident; people close to us who end
up hurt, either through things we do or don’t
do.”“After a pretty heavy year for the honor
guard, we had another incident and afterwards
sat to talk about what was going on. And there
was just a lot of shortness, a lot of snapping at
each other, and I could tell that they hadn't
recovered from the previous year, so that they
brought stuff from the prior year to this
incident. As were talking, we got another
fatality. All the sudden everybody was popping
Life Threat:
up saying, “we're ready. We're ready to go.” I
“I have had a couple triggers recently, and I feel
said, “no way I'm taking you guys. You guys are
the tightness in my chest so I know I’m reacting
all going home today to just be with your
to one of those past traumas. I know I need to
families because you're not right.” In
get help, and I don’t have to have big words.
retrospect, you could see the subtle stuff that
The stress continuum model helps me to
was coming up before, where not everybody
was together, the alcohol intake was increased
more than normal, and more anger that was
communicate how I’m doing without getting
into the emotional/feeling piece.
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Inner Conflict:
Wear and Tear:
“Inner conflict injuries can happen when our
“The job in and of itself can be very destructive
response wasn’t what it could have been and a
to home life, and we don’t do good job of
person is put in harm’s way.”
telling people that upfront. You take an 18
“We’re a learning agency, we learn from
incidents and accidents instead of putting
blame on people. We learn from an incident so
we can educate. Even though we don’t point
blame, people carry that.”
year old, tell them they’re saving the world, let
them see amazing things, develop a sense of
camaraderie. It’s like a drug. They get hooked
on it. I can’t tell you how many people I’ve
worked with who have multiple degrees in
anything but fire, and they are firefighters
“I carry a lot of personal responsibility for
because they’re hooked on it. And they’re not
checking in with other firefighters and then I
married. They’re all still single or divorced.
realize there are thousands we can check in on
They don’t understand the mitigations that
and there is no way to do a great job with all of
have to be put in play in order to counteract
them. We need to give people permission to be
the stress.”
easy on themselves.”
“The wildland fire community is tight. You can
“I place expectations on myself to be there for
go anywhere in the States and you are one
my daughter’s school events. I had to travel at
person away from knowing someone. I think of
the same time that she was performing on
it as a very large fire department. Every year
stage. To this day I have so much regret that I
we are losing firefighters to line of duty deaths
missed her singing.”
or serious injuries. We are going to memorials
and funerals and burying our brothers and
sisters. In a full career, many of those we know
will die. The cumulative effects and wear and
tear add up, and we also worry about retirees.
Cumulative stress goes hand in hand with
serious injuries and wear and tear.”
“There are familial and institutional stresses
compounding those in the workplace. You
bring with you the baggage related to what has
happened in your family, or related to a conflict
between your personal and professional ethics,
or related to a new policy or guidance from
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above. We’re all affected by these things, and
mechanism to cope with it. I have to be very
deal with them daily. Now, pile on a coworker
aware. So how I choose to react is not to take a
who gets seriously hurt, and you (as an incident
walk. That is not appropriate, even if it is an
responder and problem solver), are powerless
instinctive reaction.”
to affect a positive outcome. When your job is
all about wielding the power of control, when
you can effect massive change with a simple
order delivered on a radio, and, in this
situation, you can’t affect the change that’s
needed to fix things, it’s really challenging to
accept it.”
“A pretty clear indicator for me for people in
the orange zone would be going back to their
comfort zone. When stuff is going wrong and
they’re really stressed out, they pick the lint
balls off their sweater, as in: “This is something
I can do, it’s not helping whatsoever, in fact it’s
really causing things to snowball and continue
“Some of our crews go out back to back, and
to get worse around me, but at least it’s not
there is a different energy and resistance level
hurting anyone, at least it’s something.” It’s
from start to finish. There is cumulative
because we are “doers” in our profession. And
fatigue, less rest, more smoke in your lungs,
you might be throwing dirt over and over on
and your ability to cope goes down.”
the stump but the structure is burning down
Orange Zone Indicators:
around you. What you’re doing is not helping.
We need to have the presence of mind to say
“Substance use is a red flag, but it’s a tricky one
“sometimes doing nothing is a really good
because the baseline is so high to begin with.”
thing.” That is hard because it’s also admitting
“It’s hard to identify depression within this
system. The masculine expression of
depression is different, like anger, physical
aggression, drinking a lot of alcohol, working
out constantly, and not wanting fire season to
end.”
“No one in WF wants to be the guy who
freezes. My thing is that I can’t think unless I’m
moving. If I’m starting to feel stress
accumulating, I need to get on a treadmill, or
take a walk and let the stuff go out that way.
But if I’m sitting on the fire line with the world
falling down around me, I can’t use that
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defeat. It’s also like that when we have to
disengage from the fire, drop our shit and run.
That’s the hardest thing to do, because you are
admitting defeat. That’s probably why people
end up in the orange zone. They’re afraid of the
stigma, of admitting defeat, of needing help.”
“People sometimes wish fire season was year
round. They are with friends all year long,
clothed, banked, and can go to lay waste to
nature, or cut, smash, dig, and set things on
fire. And then all of sudden it starts raining or
snowing and they go back to boring, normal
lives, where they have been absent for 6
months, so relationships have become
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strained. If they are laid off they can collect
work situations, and are able to identify
unemployment, but it can be pretty boring and
triggers and figure out what to do.”
unproductive. They excel during fire season,
but get depressed or drink too much in the offseason. When something bad happens, like a
fatality, accident, or even a significant
social/work conflict, this can be even more
pronounced.”
“It seems like when folks are busy working with
a lot of fires, or people are doing their job, you
don’t notice issues, because they are active and
engaged. But when things slow down, and they
are not mentally or physically engaged, that is
when you start seeing issues. We especially
see irritability, if they are not busy working.”
“I have hired a number of Veterans who have
identified themselves as dealing with some
level of PTSD after having been through some
pretty bad situations. Some handle it really well
and with other folks, there are days or weeks
with no issues, then something triggers how
they operate, and then you see a totally
different person. They can’t get along with
their cohorts, or they start drinking heavily.
Many are already getting help through the VA.
Some have realized that this is probably not the
line of work they should be in and resigned.
Others were able to get treated, and had no
further issues whatsoever. I think it would help
even more if they were able to be supported by
some of our folks who weren’t in military but
who over time have been through stressful
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SFA Evidence Support
The Core Actions of SFA were derived
from an exhaustive literature review of
elements related to recovery from a
number of different types of adverse
circumstances (Hobfoll et al., 2007). The
five essential elements of immediate and
mid-term intervention that are related to
better recovery from stress are:
1. Promote a sense of safety.
Maintaining or re-establishing a
psychological sense of safety lowers
the risk of stress injury. Safety can be
relative and it is important to have a
balanced view about the levels of
danger in one’s environment.
2. Promote calming. Some anxiety is
normal and healthy. However,
extended arousal of heart rate, blood
pressure and respiration is associated
with disruption of sleep, lack of
hydration, poor decision-making and
long- term health problems.
3. Promote connectedness. Social
connected- ness is one of the
strongest protective factors against
stress injury and is linked to
emotional well-being and recovery
following trauma and adversity.
4. Promote sense of self and collective
efficacy. People who believe that they
have the skills to overcome threat can
handle stressful events, solve their
problems and show greater resilience
during and recovery after stressful
events.
5. Promote a sense of hope. Hope is
linked to optimism, faith, and/or the
belief that things will work out in the
best possible way.
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SFA strategies are designed to catch the
early warning signs of severe stress
reactions regardless of their cause. It
aims to evaluate needs, get assistance
and support when needed, and assist
firefighters during and after cumulative
stress, significant loss, adversity, inner
turmoil, or exposure to a potentially
traumatic event (PTE). It also promotes
emotionally supportive actions in the
workplace and provides follow-up over
time. For instance, you can help mentor
or coach the stressed individual to
problem-solve ways to repair and /or
prevent stress reactions from increasing.
It can also involve making a plan to
leverage resources that promote
healing, wellness, connection and a
return to fully effective functioning.
SFA has Seven Core Actions
SFA consists of seven Core Actions: Check,
Coordinate, Cover, Calm, Connect, Competence and
Confidence. Figure 4 gives an overview of the
seven actions and how they fit together. The
Core Actions will each be described in more
detail in following sections, and further
illustrated by quotes from wildland
firefighters about of how SFA might be
applied in a wildland firefighting setting.
*Hobfall, Watson, Bell, et al., (2007).
Psychiatry, 70 (4), 283.
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Figure 4. Overview of the Seven Core Actions of Stress First Aid
SFA FUNCTIONS
Check
Coordinate
POSSIBLE ACTIONS
▪
Assess foundational functioning and personality
▪
Assess current level of distress and functioning
▪
Assess immediate risks
▪
Assess need for SFA actions, resources, or higher levels of care
▪
Reassess progress
▪
Decide who else should be informed of the situation
▪
Refer to other resources, further evaluation, or higher care, if
necessary
▪
▪
Ensure immediate physical safety of stress-injured person and
others
▪
Foster a psychological sense of safety and comfort
▪
Protect from additional stress (ensure respite)
▪
Maintain calm presence
▪
Give information or direction that is calming
▪
Reduce physiological arousal (slow heart rate and breathing,
relax)
▪
Reduce intensity of negative emotions such as fear or anger
▪
Listen empathically to individual
Cover
Calm
Connect
Competence
Confidence
Facilitate access to other resources or care
▪
Encourage connection to primary support persons
▪
Help problem solve to remove obstacles to social support
▪
Foster positive crew and/or department social activities
▪
Help problem-solve strategies to manage stress reactions
▪
Help mentor back to full functioning
▪
Facilitate rewarding work roles and retraining, if necessary
▪
Encourage gradual re-exposure to stressful situations
▪
Mentor back to full confidence in self, leadership, mission and
core values
▪
Foster the trust of crew and family members in the individual
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Check
The first SFA Core Action, Check, involves
paying attention to your own stress levels
and reactions, or to the functioning of
fellow crewmembers. You make the time
to get to know foundational levels of
functioning and behavior, and keep track
of any persistent or significant changes in
behavior that might indicate that a
person is experiencing Orange Zone
stress. Check is essentially a screening
mechanism to determine if stressed
individuals are recovering from a stress
injury on their own, need other
preventive SFA actions, or should be
referred to other resources or higher
levels of care. It is also used to determine
the effectiveness of any SFA actions, and
to ensure continual progress toward
recovery. There is a psychological and
emotional “immune system” that gets
formed with a foundation like this.
Many departments already practice
some form of Check on an informal
basis. For instance, crew members
might text or call each other during the
off season, to see how each other is
doing during their “down time,” when
stress injuries are more likely to surface.
Or a senior crewmember may keep
someone who had experienced a critical
incident involved in tasks that allow
them to keep an eye on the
crewmember, or make sure he or she is
involved in activities that help them
regain their sense of purpose or
connection with others.
Within the context of SFA, Checking on
others is an on-going process
performed continuously. When Check is
fully integrated into the normal day-to-
day procedures of a department,
individuals value the function of getting
to know each other on good days, so
that they can know when a person may
be experiencing an Orange Zone stress
reaction. They are better able to
recognize each other’s red flags and
care for each other.
The goals of Check are to:
1. Identify baseline functioning.
2. Identify current level of stress.
3. Look for indicators of ability to
function.
4. Determine needs for:
• SFA actions.
• Other physical, emotional,
social or spiritual support.
• Others who need to know.
• Others who can help.
What is Check?
Figure 5 shows the major components of
Check. The first and most critical task is to
observe—to look and listen for baseline
functioning, as well as verbal and nonverbal clues that the individual may be
experiencing a stress reaction that might
benefit from assistance. While observing,
you can also identify current and recent
stressors, and note any distress or
changes in behavior.
If indications of a possible stress
reaction are present, make an effort
to examine the situation more closely,
through direct one-on-one
interactions, or through collateral
sources. This information can then be
used to determine what (if any) future
actions are required, based on the
person’s current Stress Zone and a
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better idea of the level of danger, if
any, to themselves and others.
It might be helpful to think of Check as
similar to the first step of Basic Life
Support (BLS). When learning to
perform CPR on manikin ResusciAnne,
students are instructed to first check to
determine whether or not she actually
needs emergency life support. They ask,
“Annie, Annie, are you okay?” before
beginning CPR. Check is looking and
listening for Orange Zone stress
reactions before deciding whether or
not to intervene in the situation, and
what to do next.
Why is Check Needed?
Wildland firefighters are regularly exposed to
high levels of intense and prolonged stress.
These stressors, either independently or
compounded by those experienced in their
personal life and family relationships, can
cause stress reactions. Fellow firefighters
should continually monitor crewmembers
for stress reactions because:
•
•
•
•
•
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Responders who are impacted by
stress are often the last to realize it.
Stigma can be an obstacle to asking
for help in some fire and EMS
departments.
Matching needs to available resources
with ongoing assessment.
Stress Zones and needs change over
time.
Risks from stress injuries may last a
long time and appear normal for an
individual.
Recognizing Who Needs Check
The first step of SFA is recognizing that a
crew member might be experiencing an
Orange Zone stress injury and may need
help. There are three Orange Zone
Indicators (signs that an individual is
experiencing Orange Zone stress), all of
which are important:
1.
Recent Stressor Events: A
department member was involved
in a situation that has a high
potential to cause stress injury.
Examples include life threat (a close
call or near miss), the loss of
someone or something cherished
(such as a divorce, a death,
retirement or being passed over for
promotion) or violations of the
individual’s moral code. Recent
exposure to a PTE, such as
responding to a multi-fatality fire, a
fire with a lot of loss of structures,
or experiencing a line-of-duty death
in the department, may be an
important Orange Zone Indicator.
2. Distress: An individual is
experiencing significant and
persistently troubling feelings, such
as fear, anger, anxiety, sadness, guilt
or shame.
3. Changes in Functioning: The person
is experiencing significant and
persistent changes in physical,
mental, social or spiritual functioning
at work or home, that seem to be
outside of his or her control.
Monitoring for Orange Zone Indicators is
an important skill to learn and practice. A
company officer or peer may become
aware of increased stress indicators in a
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crew member in different ways, such as
when:
•
•
•
A firefighter under severe stress
demonstrates an abrupt change in
behaviors.
A department member confides that he
she is experiencing a significant
increase in internal distress, or
alarming changes in his daily
functioning.
A co-worker or family member seeks
assistance for a firefighter who is
exhibiting stress reactions.
•
The crew (or part of it) has been
exposed to amultiple-fatality incident,
a LODD or other PTE.
•
Figure 6 gives examples of Orange
Zone indicators that might prompt the
Check function of SFA.
•
Note that the key indicator of possible
Orange Zone stress is the individual’s
response to events—in particular, a
recent significant change in level of
distress or personal functioning.
Figure 5: Components of the Check Function of SFA
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20
Figure 6: Examples of Indicators that Might Prompt the Check Function of SFA
Stress Indicators
Current Stressors
Level of Distress
•
Look
For:
A close brush with death while on an
call or during training
Listen
For:
• “I almost got killed in a motorcycle crash yesterday.”
• “My son has a serious illness.”
•
The loss of one or more friends, peers or
leaders by deathor serious injury
• “My mom just died.”
•
Events in which an individual’s actions or a
failure to act may violate deeply held beliefs
or moral values
• “I can’t believe my wife cheated on me!”
•
YellowZone stress reactions that continue
day after day for many months
• Pacing or persistent agitation
• Uncharacteristic outbursts of anger, anxiety, or
fear
• Uncharacteristic fighting, alcohol abuse or
misconduct
• Persistent sadness or absence of normal emotions
• Loss of interest in work, hobbies or socializing
• “My husband just lost his job.”
• “My husband left me, taking the kids and all our stuff.”
• “I just found out I have heart disease.”
• “The child who died in the fire reminded me of my
child.”
• “Ican’tstopseeingthesamescenereplayedoverand
over again in my mind.”
• “I keep waking up from the same nightmare.”
• “I don’t have any energy anymore.”
• “It was entirely my fault.”
• “I don’t trust anyone in this department.”
• Withdrawal from interactions with others
Changes in Functioning • Significant and persistent changes in personality • “I can’t slow down my heart rate.”
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• Uncharacteristic poor hygiene or grooming
• “I haven’t slept well in weeks.”
• Sudden drop in job performance
• “My appetite is gone, and I have lost a lot of weight.”
• Persistent forgetfulness
• “I am afraid I might lose it and hurt someone.”
• Uncharacteristic loss of control of emotion
• “I’m drinking more than usual.”
• Uncharacteristic problems in personal
relationships
• “My wife and I are arguing a lot more than usual.”
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Talking about Stress Reactions
In some cases, acquiring the information
needed to make an accurate assessment
will require discussing the situation with
the individual.
The OSCAR communication technique can
be a useful—and easy to remember—tool
for talking to someone about stress
reactions:
Observe: actively observe behaviors;
look for patterns that are different from
baseline.
State Observations: focus attention
on the behavior; state just the facts
without interpretations or
judgments.
Clarify Role: state why you are
concerned about the behavior, and
validate why you are addressing the
issue.
Ask Why: seek clarification; try to
understand the other person’s
perception of their own behavior.
Respond: clarify why you are concerned,
and discuss desired behaviors; state
options in behavioral terms.
The OSCAR technique can be used to
survey the individual for Orange Zone
Indicators, and to gather information to
answer the following questions:
•
Which Stress Zone is the individual
currently in and why?
• Would he or she benefit from any SFA
actions to restore calm; create social
connections; build personal
competence; or enhance selfconfidence?
• Is referral to any other resource
warranted?
Checking Collateral Sources of
Information
It may also be helpful or necessary to
discuss the situation with co- workers
and/or family members. Again, look and
listen for clues about the three Orange
Zone Indicators:
1. Current and recent stressors
2. Indications of internal distress
3. Evidence of loss of previous
functional capacity or changes
in functioning
Information received from these
collateral sources will either support
or conflict with the information that
was gathered from the individual.
Either way, it will probably be useful
in making more accurate and sound
decisions about next steps.
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Self-Awareness Stress Indicators
Here are some self-awareness stress indicators
common to Wildland firefighters:
but instead staying in and watching
television.”
Checking on Self
•
Fatigue
•
Having a hard time focusing
•
Being short on the fuse
are fatigue, having a hard time focusing, being
•
Not exercising
short on the fuse, not exercising, and not doing
•
Not doing the things you like
•
Watching more television
•
Nervous habits that others might point out,
like whistling
•
Calling home more often
Check Strategies: Others
“I have made a very conscious effort to keep
tabs on myself. The big stress indicators for me
the things I like, but instead staying in and
watching television.”
“One guy pointed out that I would whistle
Christmas carols. Finally my supervisor said,
“every time you do that bad things happen.” I
wasn’t paying attention to it. Sure enough,
that was one of my stress indicators.”
Here are a few Check strategies you can use
with others:
“It’s important for everyone to know ahead of
•
Offer basic resources like food water,
warmth, etc.
We’ve had fire leadership classes, where
•
Find the right way to check on someone
without annoying them (i.e.,
writing/texting versus calling).
•
Check in on anniversaries
•
Begin with a casual two way
communication to get someone talking.
Use active listening and look for words,
non-verbal signs, and cues as to how they
are doing.
•
I have made a very conscious effort to keep
tabs on myself. The big stress indicators
for me are fatigue, having a hard time
focusing, being short on the fuse, not
exercising, and not doing the things I like,
time what they do when they’re stressed.
everyone in half the class watches the rest of
the class and tries to identify stress reactions in
the person who is assigned to them. The
person watching you then says what they saw.
The fire keeps burning things down until you
just can’t take it anymore, and they see those
stress reactions. It’s all a simulated exercise,
but it’s very realistic. And the fact that
someone is staring at you whole time doesn’t
help either. It’s locked in a room so it feels like
you are at an incident command post. Then you
get together one on one with the individual
who was watching you. Before you talk, you
write down what you think was happening to
you and how it might look to observer. Then
the observer says what they saw. I became
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very aware that when I get stressed it feels like
I get two pinpricks of fire on my cheekbones
and I can feel like want to abbreviate
communications and get really direct. And
that's not helpful, so knowing that it is coming,
I can usually short circuit it by purposely
slowing down communications and adding
more words, then that hot sensation will back
off. I learned a lot because I never stopped to
see what I do when I’m under stress. Just to
know what that is going to feel like, and what
feels like inside my head, I am not so freaked
out by it now. To not have pre-loaded that, I
would have just have gone on thinking I’m
fine.”
“I usually don’t call home much, but when
stressed, I catch myself calling home. That is
the sign that I’m stressed. I need a touchstone,
to make sure everything is normal at home,
that the rest of the world is still spinning, which
means I’m okay.”
Checking on Others:
“It’s interesting to me who the wounded
firefighters go to when an incident occurs. A
tribal instinct happens in fire crews. They
circle wagons real tight, and it’s very hard to
get into the circle. They don’t allow anyone in
unless they are an alumni of the crew. The
support that comes from within the culture fits
our culture. For instance, one crew had a
barbeque when a crewmember was in the
hospital on life support, which was perfect –
they know what the family and crew needed,
and they did it right.”
“I use Check with employees regularly – they
don’t even know I’m doing it. If I’m looking at
someone in orange or red I will pursue a line of
questioning if there is two way communication,
and try and get down to what’s going on. Its
active listening. I would never come in to
someone after a stressful incident or event and
say “hey man, how’re you doing?” If I’m asking
a rhetorical question, why ask it? I will instead
start a line of communication, get them talking,
and look for words, non-verbal signs, and cues
as to how they are doing.”
“When folks are having issues after a critical
incident, it helps to take a few minutes and
wind down, take a walk, talk to someone, be
less entrenched, and take a break. People
would come to me, and we would go outside,
walk, and get fresh air. The whole support
network really helped me, and I haven’t had
any lingering issues. If we had that support
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network the first time, it really would have
time and we’ll put you right back in. If that
helped. If a team member was struggling more
works for you, we’ll talk again in 45 minutes
one day, they removed themselves for a while
and see if you need more time. I know you can,
and went and did what they had to do. I would
but I don't’ want to burn you out, so do this for
go back and check on them by saying, “are you
me and then we can keep fighting. I know you
okay,” or something simple. They mostly just
can do it but don’t want to burn you out.” It
needed a break from what they were doing,
saves face.”
rather than having anyone ask how they were. I
think they appreciated me asking though. If
you’re in a fairly connected team environment,
I think it’s okay to do that. If there is less
connection, you have to give it a little bit of
time. It’s situation dependent.”
“I try to be non-intrusive when I check on
someone. I took coffee and donuts over to a
shop and it worked. Sometimes basics are
important – food water, warmth, etc.“
Anniversaries of my incident get to me. There
are so many serious injury cases and line-ofduty deaths and I wonder who is checking in on
them. Not all fatalities receive the same
attention on anniversary dates.”
“Winter is a hard time especially. I haven’t lost
a close friend in fire operations but I have had a
“Most times I’ve been more successful at
couple who died off duty. Compared to a line-
getting an honest response by setting it up
of-duty death, it seemed like no one cared.
right. You don’t do it when you have six
There was no fanfare, there are no benefits, no
engines there. You go to that one engine that
memorials. If problems with alcohol or
you have doubts about. You might make a big
depression or “extreme living” outside work
speech with all of them there, but then you go
create you showing up and not functioning well
to that one separately, and provide them with
socially or otherwise, we should acknowledge
option. It’s about saving face. I provide them
that and ask leaders to think more about that.
with an option: “I’ve been relying on you for six
We often tend to write off the importance of
days now, we’re still in that same pickle, I need
personal problems until the person is really at
you to be fresh for me, so how about we just
high risk or at risk of professional
give you an hour off, you guys just take some
consequences.”
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25
“Situational awareness is big thing in fire. We
everything is fine right up until it’s clear that
are starting to talk more about human factors
things are not.”
and the importance of tuning into how we
react to stress and how we in interact with
people. We are starting to recognize these skills
as part of what it means to be a good leader.
But, that situational awareness also needs to
include off-duty time and off-season time. It is
time to acknowledge that the consequences of
firefighting and the lifestyle it requires extend
far beyond fire season.”
“It’s incumbent on me to get to know my
employees, to keep tabs on people. I start to
notice changes in behavior, when they act out
of character. If you spend enough time with
people you get to know them. Monitor your
crew, get to know their subtle cues and
behaviors. It’s a full time job to keep in touch
with how people are doing. Sometimes it’s not
possible on fires. People come together for
such a short time and go through
forming/storming/norming/performing, the
normal progression of bringing people together
and making a group out of them. But it is
important to get to know them professionally
and personally, to see how they act when
happy and when upset.”
“We often cover for people. We don’t want to
“By working side by side with a veteran with
get involved or overstep into what seems like
PTSD, I knew when he was doing well, and
someone’s private business. In every situation
when wasn’t going to be in the next day. I
in which I lost a friend off-duty the person had
could see it in his eyes, a distant stare, and he
some problems at work beforehand that no
was not paying attention. Normally he was
one addressed (e.g., calling in sick to work,
more attentive. He would have delayed
being AWOL, showing up hung over, reckless
responses, a lack of focus, little things that
behavior on duty, loss of control of emotions at
were a confirmation of a feeling I had. I would
work, social problems, more risk-taking at work
test him to see how he would respond. There
or sports, etc.) Many people were aware, but
was also body language; when he was starting
not many people knew how to ask or when to
to have problems, he looked like the weight of
say something. The behaviors they showed
the world was on his shoulders, even though
were notable, but not that out of the ordinary
his voice would be upbeat. I started telling him
in our culture. It’s hard to know what is a red
to take time off to visit family. When he would
flag because it can look very different for
come back, he would say thanks for letting me
different people. In many cases, we think that
do that. I really needed to see my dad.”
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26
“I could see a firefighter’s body language - it
“The groundwork or the foundation that you
was screaming anger, sadness, and frustration.
lay at the human level is going to make a
I started talking with him and after 5-10
difference when it's time to have a hard
minutes he said, “I just got back from the
discussion or conversation that's way below
hospital, my dad just had stroke, and they don’t
the surface. Having something else to engage
think he is going to survive. I’m not doing well.”
people on a personal level outside of the
I said, “Man that sucks. Is there anything we
profession is hugely important. Caring about
can do for you? Anything you need? Anything
your people beyond the task and duty is one of
we can do to help him?” I offered to listen if he
the key top rated leader characteristics in
needed to talk, and offered help if he needed a
research studies.”
hand, or someone to sit with his dad, or
someone to go mow his grass. Whatever the
problem is, I try to listen a lot. I try not to talk a
lot. I kept the conversation going by asking
questions like, “how old is he? Wow, what a
life,” and tried to spin something positive from
the discussion, just to keep him talking about it,
to continue our conversation. Several days
later, his dad did not die, and he came back and
said, “I appreciate you talking to me. No one
else would even talk with me. You didn’t ask
what was going on, but you were checking in
on me.”
“I talk to younger leaders who might have a
better connection to the younger generation
and empower them to work with those guys,
because I know there's definitely that gap
between generations. When my intention is to
provide some stress first aid action but it
crosses, I realize that the folks who are closer in
age and rank may do a better job. It doesn't
raise a threat flag because they're used to
having a normal conversation with them. When
it's with the supervisor they're used to having
you tell them things to do or having disciplinary
actions, so it races at that flag. If you've had
enough normal conversations with people, it's
less likely it is to raise threat that it's about
disciplinary action.”
“We all live in the same area between seasons,
so off-season, at least once a month we all
gather at a place that’s kind of like our own
little place. At other times we get together to
PT, and that's been really great. It's just small
groups of us but I think in my business were all
pretty physical of people, so to see the guys
and gals get together and train together, I feel
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27
as though, for us, it's actually putting us on
each one of them at some point. That's how
track to go back and engage the next season. I
the conversations going to start with me. It's
am keeping an eye on them and getting them
not going to be about their performance on
together, just to start feeling that togetherness,
that call. It'll be about whether they went fly
because we break apart, and then come
fishing that weekend. That's probably the most
together. We went from being together,
successful way to check. They don't feel like
coming from this incident, in this relationship
you're intruding on their life. But they also
together, and then it’s over. So coming
know that I start the season out with
together like this off-season is getting us in line
observation. They're all served notice. You
with where we're going. You sweat together
really have to pay attention to your people, and
and you work together as a team, because
I want them to pay attention to me. I'm at the
ultimately when the season starts, we're
top of the food chain so who's going to tell me
coming together as a hotshot group, and that's
that I'm not acting right. I want that oversight.”
how it’s going to work.”
“One of the key points of check is knowing
your people, and spending a lot of time with
them, both professionally and personally. Then
you can recognize those subtle changes. What
I've done is to start a conversation about
anything except what I think might be bugging
them, and then I actively listen. And once
again I'm talking the floodgates open, and it
goes well.”
“One of my team members was reported to be
acting out, not normal, and I've known him for
“The way we operate is that we're pretty close.
a long time. I couldn't believe that this report
We work together, we live in the same town in
was coming in and so when I went to talk to
the winter, and we see each other from time to
him about it, they were obviously some
time in the winter. If I'm not showing up for
underlying issues. It took a couple hours of
hockey, they know something’s going on,
talking about it, but his biggest fear was that if I
because I love hockey.”
were to let him go that the department would
“As a leader, I can tell you all the deaths that
have occurred on my engine. I have overall
responsibility for all firefighters in my district,
so I make sure I have face-to-face time with
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find out, because he knew he had overstepped
his boundaries. I think I just connected with
him, he trusted me, and I trusted him, because
I've known him for a number of years, so I
could be direct with him.”
28
One of the key points of check is knowing your
minute, but I knew it had affected him. And the
people, and spending a lot of time with them,
first question out of his mouth was, “what
both professionally and personally. Then you
could we have done differently?” You have to
can recognize those subtle changes. What I've
watch people for those subtle clues.”
done is to start a conversation about anything
except what I think might be bugging them,
and then I actively listen. And once again I'm
talking the floodgates open, and it goes well.”
“I usually start with, “how’s it going for you?” I
see if they can offer some information that will
give a lead-in. If that doesn’t work, I try to start
with something positive like, “hey you’re doing
well but it seems like you may be struggling
here, is there anything I can help you with?” It
kind of depends on if you know the person very
well or not. I might say, “I’ve heard what you’re
going through.” Having a specific example
helps.”
I think a lot of this as a use of force continuum.
You start off with more kind language and end
up with pretty dramatic force. Obviously, you
never want to get there if there’s any way to
avoid getting to that lethal force level. I can
“When we sit down to dinner I start just
think of a time when someone was on a self-
bringing up general things that happened
destructive path, and nothing I said or anyone
during the day and watching everybody. I know
else that would make a difference. They were
how they like to sit and where their comfort
going down a path where they had DUIs and all
spot us, and I notice somebody out of their
kinds of crazy stuff going on. This person did
adjustment. It gives me an ability to use a
not want to help, would not seek help, was
group setting to talk about how the day has
offered EAP, offered personal assistance, we
gone. It’s a continuous checking.”
brought in best friends to talk with him, and
“We had a critical incident, and as soon as the
the individual just wasn’t interested. Years
later, after they got life their life squared away,
helicopter lifted off the ground I saw the look in
they said they appreciated the persistence
a crewmember’s face that I had never seen
even though they weren’t ready for help, even
before. I’d work with him for two years and I’d
though they weren’t ready to accept that help.
never seen that look in his eye when that
They recognized that we didn’t give up. It’s a
helicopter lifted, and it only lasted and maybe a
20
hard thing being on the other side of that.
29
When you can help, all I can say is be
to revel in the accomplishments of the field
persistent. This was a good outcome. There are
season and to find the relaxation and recovery
bad outcomes, where you saw it coming and
that’s needed. There is a rhythm to that
couldn’t do anything about it.”
recovery. When faced with recuperation, your
Check Challenges:
rhythm is disrupted. Often, the injured are
forced to find a ‘new normal,’ that doesn’t
“Proximity is our issue. We could all come
coincide with the healthy rhythm being
together for one big fire and then we all go
enjoyed perpetually by their coworkers. This
home. So we don’t see each other anymore but
results in a sense of alienation that is
we know what we experienced on the fire.
destructive to relationships and healthy
Then we disperse and go home. On a recent
rhythm. It takes a dynamic, empathetic crew to
line-of-duty-death, the agency called in a peer
maintain relationships with the injured in the
support team for the week following the
off-season and efforts often fall short of the
firefighter’s death. Thirty days later we went
mark.”
back to the Forest with a clinician, a fire chief,
and a District Ranger. We talked about
checking in on folks, putting ownership on
leadership to notice when people are deviating
from normal behavior. One particular
firefighter was still struggling with the line-ofduty-death. I have been in touch with him
since, sending him texts, and asking about how
his kids and the holidays. I identify when he is
engaged with family, has health, and hope. He
may not be out of the orange or red zone but
he has hope and health. When engaging with
his kids, he’s fine, so I am hands off. I also got
him connected to a clinician.”
“Check” is a lot easier to do when it’s related to
operational stress. You can often recognize in
others that they are getting overwhelmed with
demands on a fire and can jump in to lighten
the load. We are trained to delegate
responsibilities and our ICS system is design up
so that each position is only in charge of 5-7
resources max. This doesn’t always work out,
but we excel at jumping in and helping others,
solving problems, and requesting more
expertise or additional resources when we
need it. But we don’t do so well with personal
stress and physical exertion. Requesting
physical or emotional help is often interpreted
“One of biggest challenges for our community
as a sign of weakness. A student in a class once
is the serious physical or mental injury of a
told me he would “rather be medivaced” than
seasonal employee. During the season, when
pass the chainsaw to his saw partner on a hard
we see each other every day, we can keep tabs
hike. While we encourage asking if another
on the injured. That changes when crews
person is okay or if they need help or a break,
disband for the season. The off-season is a time
20
30
the culturally encouraged response is “I’m
what’s normal. There are some people who
good” no matter what.”
will always resist being checked on, and some
“In the younger generation there's less
who would like to be checked on.”
interaction. You come in to do a morning
“We’re a bunch of judgers. When you go to a
briefing, and they're all sitting there looking at
fire, you have not met people, they are
their phones. It used to be that we would all sit
assigned to you for two weeks, and you literally
around and talk, but now that doesn't happen.
make snap decisions based on their shirt or
They sit right next to each other and there's no
gear. It’s hard to pin down why you’re
conversation. It's hard for me to try to get to
choosing to trust that person. It’s hard because
that level, because I can't relate at all. That's
it isn’t rational. When you drive down line and
been a problem. All of us leaders trying to
you see people who will not look you in the
figure out how to reach the younger
eye, or they’re constantly fiddling with
generation, because a typical question like,
something on their truck, there are things you
“hey how's everything going?” doesn't
can tell intuitively. There are certain
resonate. They can't answer it. It's just
mannerisms. You know when someone’s with
different. So when you ask hey how's
you and when they’re not. And also when they
everything going, it's just "fine." It's something
are able to handle stress and when it’s time to
I'm working on, and I'm trying to figure out
switch them out. I’ve been wrong, but I call it
how to bridge that gap.”
out to get more information: “you’re in great
“Check is a tough one. I wouldn’t want
someone checking on me. It’s hard to do offseason, since it’s almost normal for people to
feel bored or down during the off-season. It’s
almost the norm in your 20s that you go out to
bars or drink a lot by yourself in this culture.
Autonomy is such a high value, so people don’t
like feeling like they are being checked-up on or
that others are doing something that’s not
really sincere. There are also trust issues.
Reputation is everything in fire, and it can be a
competitive environment. There can be a lot of
mistrust in forest service. And many are not
even aware of when to be concerned, what it
looks like to be in the orange or red zone,
20
mood today.” “No I’m not.” I rely a lot on
people’s eyes when I talk to them. Just the
slightest shift in their eyes tells me if wrong, or
if they’re not agreeing with me, if they don’t
want to be open with me, or if they’re holding
something back. So I’ll follow that up with
questions: “Is there something I’m missing?”
“What would you do?” “Do you have any
suggestions?” “You guys feeling good with
this?” “Are you able to handle this
assignment?” “Do you need to step back for a
minute?” “Do you want me to have me rotate
someone in for an hour?””
31
“Our culture is not comfortable talking about
with it differently. In a similar situation, with
things. Check has to be really simple. I could
the lessons I had learned, I was able to tell the
see some folks being irritated by this and some
crew “the focus should be on helping the family
being totally okay with it. Especially after line of
or crew, this is totally for them,” and people
duty deaths, it’s important to realize what local
understood it, which made it totally different.
factors are. People are all wired differently, and
The family told us what they wanted within
outside influences want to direct how the
agency policy, we knew what we could do, and
response goes. I learned after one line of duty
it went a lot better. We also had experienced
death that the focus should be on checking in
mentors helping. They checked on us and
with what the family or crew wants. Then, any
advised us that it’s also important to make sure
response should be for them. Folks all deal
that we were taking care of ourselves. That
with it differently. In a similar situation, with
really helped.”
the lessons I had learned, I was able to tell the
crew “the focus should be on helping the family
or crew, this is totally for them,” and people
understood it, which made it totally different.
The family told us what they wanted within
agency policy, we knew what we could do, and
it went a lot better. We also had experienced
mentors helping. They checked on us and
advised us that it’s also important to make sure
that we were taking care of ourselves. That
really helped.”
“No matter how much you check on someone,
“Our culture is not comfortable talking about
there are some you can’t get through to. The
things. Check has to be really simple. I could
person has to want to work on it, or otherwise
see some folks being irritated by this and some
there is no point. A few I’ve worked with have
being totally okay with it. Especially after line of
left the job. I watched one individual go
duty deaths, it’s important to realize what local
headstrong into self-destructive behavior. I
factors are. People are all wired differently, and
don’t know what the trigger was, but in 5
outside influences want to direct how the
months he went from one of my top squad
response goes. I learned after one line of duty
leaders, to one who was showing up drunk. I
death that the focus should be on checking in
offered him time off, employee assistance,
with what the family or crew wants. Then, any
leave with pay, and leave without pay. Every
response should be for them. Folks all deal
olive branch in my capacity to extend to him
20
32
was swatted away, and he continued on with
that my friend who was injured is doing fine
self-destructive behavior. Despite trying
emotionally. He’s laughing and talking as he
everything in my power, I watched him spiral
always has despite his physical injuries. That’s
all the way down until he had to quit. He didn’t
a wonderful relief, and it helps me to see that
want help. He was too good, and too tough.
my own anxiety about being injured and
Three years later, he pulled himself up.”
isolated is unrealistic. It’s not about me, it’s
“Some people who are checking on me are
calling me and it annoys me. I’m not upset
about him, and about what can we do
together.”
about it, but I’ve never been one to take help
from others. When people are calling me, they
want me to talk and be emotional, and I don’t
like it. I have received handwritten cards or
notes, which are always welcome.”
“It can be difficult to accept help because I
don’t want someone helping me. A buddy of
mine just had a major, life-changing injury and
my inclination is to avoid him, because I’m
projecting what would I want were it me who
was injured; I wouldn’t want someone
inconvenienced by my plight. If I were
debilitated, I can’t imagine a tougher thing to
“It’s very difficult for people in my community
deal with and I wouldn’t want to have my
to understand when we can’t reach someone.
situation affect others. I would want a normal
We don’t understand what stop means, what
relationship with my friends, and would worry
quit means. When your legs hurt and you can’t
that because of the injury, that would not be
breathe, and your back is hurting, and your
possible. A more healthy reaction is to accept
eyes hurt, you don’t stop. That is something
that I would need help, not only because it’s
that is paramount in our culture. We take
helpful for me, but it also helps those who care
chaotic, broken, systems, apply will power,
for me and want to help. Because I know this
knowledge, and skill to repair them and
about myself, I will make myself connect
stabilize them. That’s what we do. To admit
because I understand that folks would want to
that I can’t help someone, somebody doesn’t
help me if I were injured. Ultimately, I know
want help, is a very tough pill to swallow.”
that by friend is still him, I’m still me, and we’re
still friends. I just heard from a mutual friend
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33
Coordinate
The second action of SFA is Coordinate,
which always flows from the Check
function. There are two broad goals for
Coordinate:
1. To inform those who need to know.
2. To obtain other sources of needed help
or care.
What is Coordinate?
Figure 7 shows the major components of
the Coordinate function of SFA. There are
three actions that may follow, depending
upon the information gathered during
Check:
1. Collaborate means forming a
partnership with the affected
individual, to expand resources and
options that may have been
depleted by the situation or their
reaction to it. This action is about
getting the person to the next level
of support, which could be a
mentor, trusted co-worker, trained
peer support member, EAP
provider, etc. The choice of who is
brought in to collaborate is
dependent upon the situation and
existing relationship with the
individual (such as
boss/subordinate, peer counselor/
or fellow crew members).
2. Inform implies actively engaging key
individuals who have a need to
know, have the ability to help within
the organization or are able to offer
emotional support. This action is
most effective when it is done in
collaboration with the affected
20
individual.
3. Refer is to bridge the individual to a
higher level of care when indicated. It
is important to remember boundaries
and the limits of your capabilities.
When department members are
suffering stress injuries beyond the
scope of trained peers, they need to
be connected with appropriate
organizational supports and
resources.
Coordinate with Other Sources of Care
and Support
SFA providers may need to refer a crew
member to a higher level of care and to
determine what source of care would be
the best fit. In making these decisions, the
following factors should be considered:
•
•
•
•
•
How confident are you in your
assessment?
How solid is your re the individual?
Would this individual benefit from a
form of care other than SFA?
Are there other resources available,
such as EAP providers or outside
counselors?
How has the individual’s level of stress
changed over time? Is it improving,
staying the same or getting worse?
When in doubt, getting another opinion is
often helpful. Although questions may still
remain unanswered, in most cases,
getting input from others is the right
thing to do.
Coordination with other sources of care
and support does not end with a referral or
request for help. In cases where an
34
individual is connected with other sources
of care, follow up (Re-Check) is important
to make sure he or she is getting the
needed support and appropriate
resources.
•
Give support and access to contact, but set
boundaries for your own health as well
•
Be aware of local and national resources,
such as:
Coordinate Strategies
•
The Wildand Firefighter Foundation
Here are a few Coordinate strategies you
can use:
•
Try to find the most acceptable way to
refer someone to EAP or other support,
rather than telling them to talk to someone
The “You Will Not Stand Alone” course,
a five-day course designed to prepare a
unit for a line-of-duty-death or serious
injury.
•
Peer support teams
Coordinate only if needed
•
Local counselors
•
•
Figure 7. Components of the Coordinate Function of Stress First Aid
20
35
Coordinate
resources, told us to watch out for each other
over the winter, to keep talking, that there’s
Characteristics that make you feel you can talk
nothing wrong with anyone, to call our
to someone:
brothers, and to check in on each other. It was
•
A person who is quiet, calm, okay with
silence, who asks questions, who doesn’t
always have to have an answer, and who is
fine with listening.
•
A person who can create a mutual
resolution to things as opposed to having
all the answers, fixing things. It’s hard
because we like to fix things, but just
knowing when to shut up and listen.
•
Someone who is experienced enough and
has been around enough that they don’t
•
very conversational and subtle. The way we
talk about that in wildland fire culture is using a
star wars analogy – “you have to have mad Jedi
skills.”
“Whether one-on-one or in a group is situationdependent. Some folks operate better one on
one, but it seems like the group seemed to be a
better fit for others. When folks are in a small
group and someone steps up and opens it up,
then people can feel okay to speak up because
of that connection and group cohesion. One on
one some folks might not be okay or be able to
have to tell you that they have been.
open up. One on one people sometimes feel
It doesn't matter if they’re
okay if the group facilitator is from the outside,
male/female/young/old. In fact, females
as long as they are not too overbearing, as long
tend to be a hair more competitive with
as there’s some kind of connection. If the
each other.”
outsider does not have a connection, or are
“The forest wanted to use critical incident
stress management after a really bad run of
luck one year – a dozer rollover, a couple of
traffic fatalities – nothing major, but enough
that the hotshot superintendent reached out to
the peer support group in region 3 and they got
someone to come up and talk to crew. They
came in and said, “you don’t need to be here
but we’re going to just give you some
information,” and they were doing it in a very
subtle manner, not singling anyone out
because that’s looked upon as weakness in this
culture. In a group setting the CISM facilitators
ran through a stress debriefing model, gave
their back is against the wall. With groups, it’s
overbearing, then it is tougher to have that
connection.”
36
“I have had luck coordinating with local mental
helpful to have the resources to be able to talk
health professionals in the community who are
to a local clinician, mentor, peer teams, or
willing to provide free services or low-cost
somebody else who provides stress first aid
services to firefighters.”
and ask them what they think.”
“I have worked with the Wildland Firefighter
“I have good outcomes and bad outcomes.
Foundation. Their bylaws in the past have not
Even after referring someone to EAP, they
allowed them to deal with mental health
report that they had a bad exchange with the
issues, but that is changing. They may be able
counselor, so they’re going to give up now. So,
to help expedite some of the help that is
you say go try a different counselor. But they
needed.”
are tired too, and don’t have a lot of energy to
“I would recommend testing the system prior
to a problem. Start dialing numbers, and find
out if everyone in the chain knows what to
do. We can test the strategy, and come up
with our work arounds and alternative plans
before there is the immediate need for help.”
get out of what their stuck in. I show empathy
and understanding that it’s a very hard time for
them and exercise a lot of patience. Often that
helps, but I’ve also had to let go, because you
can’t always help somebody that isn’t
interested in helping themselves. Sometimes
you just have to step back a little bit. It’s a
“We have a contact list with information, and
burden on everyone. You, the employee,
options, so you have names of people you
everyone that works with them, because they
could contact easily.”
can see the train going off the tracks. You have
“We have invited an EAP representative to
come to our “You Will Not Stand Alone”
class: The person will come with some options
for us. They will come armed with that. Invite
them in, and hopefully they will take a seat at
the table and give us an idea of what resources
we can bring to bear. Sometimes there's no
resolution, but there can be understanding.”
“The vast majority of people you going to run
into our going to be helped by you being a
human being and just having a listening ear just knowing somebody cares and has some
simple advice. However, when you run into
things where you don’t know what to say, it is
20
to sometimes step back and say, “you know
what, I tried everything I could, and I can’t do
more.” It’s healthy boundaries. It’s not easy,
because you do get invested. Just remember
that sometimes you can only go so far.”
37
“Once somebody came up to me and showed
b. The “You Will Not Stand Alone” course is a
me that they have been cutting themselves. He
five-day course designed to prepare a unit
said, “I think I need help, I called the suicide
for a line-of-duty-death or serious injury.
hotline 3 times this week.” I spent a good hour
Topics such as Incident Management,
with him, and we identified some pretty major
Hospital and Family Liaisons, Death and
life changing events that happened in the last
Serious Injury Handbook and Benefits are
few weeks and months, years. So, I called the
covered. It arms the agency responsible for
EAP for him, and the EAP counselor said it
an individual or their family with
would take time to get the counselor assigned
knowledge to better coordinate benefits
in the area. I asked if he should go to the
and resources.
hospital right now, and he said, “I’m out of
here if you do that to me.” I knew a trauma
therapist in the area, and we got him into that
trauma therapist right away. So, we kept him
alive for 24 hours, then we got him through the
EAP process, and got him signed up for three or
four sessions. I also kept texting him and gave
him permission to text me anytime for a week.
c. We are building a big pool of peer
supporters because it’s often hard to fill
the need. The peer support teams obtain
training from ICISF courses, which include
basic/advanced/suicide prevention, and
strategic response to crisis.
d. Building rapport with local counselors is
They have to be an active participant in their
pivotal. The local structural fire department
own rescue but sometimes they’re so blind
are often available to offer advice on local
they don’t know what that looks like. So, it
chaplains, social workers and clinicians who
helps if you can be available until they get on
are trained to work with first responders
their feet. We got him through that hard 48
and wildland firefighters.
hours, got him to counseling, and then he went
out on the fire line and had a great summer. I
had to set a boundary of one week of unlimited
texts, then give him the resources he needed,
and then let him get his life back.”
“We do have some great resources to
coordinate with:
a. The Wildland Firefighter Foundation assists
firefighters and their families. It is an
integral piece of our community.
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38
Coordinate Challenges
code, or otherwise we have to call
someone. Not sure how many seasonals
“In this culture, coordinating is a challenge, a
know whether they have access to EAP or
monumental challenge. Coordinate should be
how to use it, especially during the off-
one that is there if you need it, but you
season. It’s not commonly used by
probably aren’t going to need to use it a lot.
seasonals. Culturally, going to a therapist is
The moment you mandate something, we love
not something that’s accepted for a young,
our organizations and our hierarchies, but we
male firefighter.
hate authority. My boss walked into my office
once after a tough situation and said you need
•
In some areas it takes a month to get an
to go talk to someone about this, and I said, it’s
appointment for EAP. I want to get them
all good, people are born, people die, I have
the help they need quickly, without them
closure, I’m good to go, because he cued me
changing their mind a month later. There
off the wrong way, so I fought it every step of
needs to be something there that's
the way.”
accessible immediately. This may be the
one moment you have to make an impact.
“When you start shoving EAP as an example
down people’s throats, it doesn’t go so well.
•
It’s sometimes hard to find a therapist
The timing was the issue. Not all people are just
that’s a good fit for what you need. For
going to go right out and ask for help, or even
instance, if someone is interested in
need it. Just let folks know it’s available, but
couples counseling, they call EAP and get a
EAP might not be the answer. Because of the
name or list of names, if they go and it’s
culture of the wildland fire agency, folks are
not a good fit or the person doesn’t do
real leery to get that clinical help. Peer help
couples counseling, you are back at square
has seemed to help people more than clinical
one.
help. Being able to have that opportunity with
peer support has really seemed to make a
difference. It’s just being able to let folks have
that connection and being able to talk.”
•
Some problems are systemic, some regions
work better than others, often on forest
there is some local point of contact who is
the default gateway to a lot of these things,
“There are a many barriers to using EAP,
but for seasonals, who don’t work out of
including:
their supervisor’s office, or have to walk to
•
EAP information is often pretty hard to
find. It varies region by region, and we
have to be on forest service intranet
computer to find a FS password or access
20
the person’s desk in front of their boss, it
gets complicated. And seasonals may not
have insurance.
39
•
People have no idea how to get substance
abuse treatment, especially in a rural area.
•
How and when to find counselor is often
not easy information to find. Employees
often talk to their supervisors. That can be
great but also can be very thin ice
depending on who you talk to and how
they respond. There is a lot of stigma, and
•
We need more education about substance
use and peer support for substance use
moderation / treatment-seeking / recovery.
Alcohol especially is such a huge part of our
culture that sometimes we accept really
high risk use as normal. People who might
be predisposed toward addiction are sort
of set up for problems.”
there are a lot of “old school” people in the
FS who see mental health
difficulties/treatment-seeking as a signal of
weakness, emotional instability.
Supervisors don’t always maintain
confidentiality for many reasons, including
a concern that a person might become a
“watch out” situation on the fireline. In
some areas EAP only offers 3 sessions.
•
Each region has a different contract for
EAP, so if you go someplace different you
will get a different contract. It's a mystery
for most supervisors on the ground.
•
•
want to go right to EAP or an HR person in fire
camp and that’s the wrong approach. Those
are unknowns and we don't like unknowns. I
In some regions there are few inpatient
think we like to have that pre-existing network.
substance treatment facilities so it’s really
You don’t need to know the person you
hard to enter treatment anonymously.
gravitate towards. It’s the personification of a
Coworkers are generally caring but there is
person that matters. It is important to have
a lot of stigma.
people who can serve that role embedded in
One person who went to an inpatient
program was told by their boss that they
might try to fire them, which of course was
not permitted. People often view
substance problems and mental health
problems as simply misconduct or bad
behavior, not a health condition.
20
“When there is a critical incident, we tend to
the organization already. So to teach us to help
each other is really important. We don’t have
to run around with sticker on helmet saying
we’re the EAP PERSON. Just to be able to,
when you look at someone, to feel that thing
that you’re looking for, that’s important.
40
Cover
When is Cover Needed?
What is Cover?
Cover is needed when there is a threat
to the safety or perceived safety of
one or more people. These situations
fall into three categories:
During operations, every member of the
fire department is accountable for their
own safety, and for that of their fellow
crew members. The SFA action of Cover is
a natural extension of this concept, and
specifically refers to actions that reduce
any threats to safety that may result from
an individual’s reactions to stress. The
goals of Cover are to:
a. Ensure the immediate physical safety
of the stress injured person and
others.
b. Foster a sense of psychological safety
and comfort.
c. Protect from additional stress.
Cover is used only as needed, when an
individual’s stress reactions are either
impacting safety or the perception of
safety. Figure 8 shows the major
components of Cover. Its key components
are stand by ready to help as needed;
make safe the environment for the
individual and co-workers if in imminent
danger; and encourage the perception of
safety that results from both reduced
danger and greater quiet and order.
Cover and the following SFA action Calm
are analogous in some ways to BLS (CPR).
They are used rarely, can be life-saving
when needed, and can prevent further
harm from occurring until other forms of
help can be obtained.
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1. The stressed person is in danger
•
The person is in an immediate lifethreat situation; has reduced
situational aware- ness; is not
thinking clearly or is not making
good decisions because of stress.
The person has frozen or panicked in
a life-threat situation.
The person is impacted by a stressor
in a way that impairs current
functioning.
The individual has expressed
thoughts of suicide.*
•
•
•
2. Others are in danger from the person
Due to stress, the person is behaving in
a way that impacts the safety of others,
for example:
•
•
•
•
While working an accident scene, a
preoccupied crew member does
not remind co- workers of traffic
hazards.
A driver freezes or panics while
driving an apparatus with three
firefighters aboard.
A previously traumatized crew
member overreacts due to fear of
repeating a traumatic event, such
as a fire officer unnecessarily or
prematurely pulling crews out of a
burning building, reducing the
crew’s ability to save trapped
civilians.
A firefighter threatens others.
41
*A threat of suicide must always be taken
seriously. It is not your responsibility to decide
if the threat is real. Persons who are
threatening suicide must be taken to an
Emergency Room or to a behavioral health
professional for assessment.
3. The stressed person has a perception of
danger
•
A firefighter and/or family members
have a perception of danger after a
line-of-duty injury or death of a coworker.
How Does Cover Work?
way. Depending on the local culture, Cover
can also be needed when family of crew
members are feeling unsafe as a result of the
work experiences of crew members. This need
for cover can manifest in many ways, as
illustrated by these examples:
•
A fire with a lot of fatalities caused
firefighters to shift their sense of safety
towards a need to look out for themselves
because they felt the agency was not
looking out for them.”
•
In one fire with fatalities, to protect
firefighters from media or onlookers, a
supervisor attempted to limit
crewmembers from leaving the station
and from communicating with others. This
caused firefighters to feel mistrust and
resentment.
•
Even though his crew uses a learning
model, a firefighter still feels like every
incident is negatively evaluated, as in
“how did you screw up?”
•
A supervisor set the tone of an unsafe
social environment by cultivating a
judgmental attitude in crew members for
whoever didn’t fit with the unspoken
norms to be cool or tough.
•
After a large fire, someone posted a video
on the Internet with a few hours, and
spouses of crew members found out their
spouses were killed by seeing the video
online.
Within the Cover action, SFA providers
promote safety and perceptions of safety by:
•
•
•
•
•
Making decisions on behalf of
someone who is not thinking clearly.
Taking action on behalf of someone
who is not behaving in a safe
manner.
Providing authoritative presence to
remove the person from danger.
Warning and protecting others who
may not be aware of a danger.
Creating an environment of safety to
promote recovery from stress.
When is Cover Needed?
Cover is needed any time a person or crew
feel unsafe and experience stress reactions as
a result of that sense of threat, either in the
immediate environment or in a longer term
20
42
Figure 8. Components of the Cover Function of Stress First Aid
How is Cover Implemented?
Any action that quickly increases the safety of
those in danger can be considered a Cover
procedure.
There are an almost limitless number and
variety of non-verbal and verbal options. In
fact, most Cover procedures are intuitive and
are often what people would do instinctively
when faced with a dangerous situation.
When choosing a Cover action, the most
important priorities are to:
1. ensure safety quickly, and
2. take no more autonomy away from
others than is necessary for safety.
In other words, intrude on others as little
as possible and for as short a period of
time as possible.
Non-verbal Cover procedures for enforcing
immediate safety, from least to most
intrusive:
• Make eye contact.
• Hold up your own hands in a “stop”
gesture.
• Apply reassuring pressure on the
shoulder or arm with one hand.
• Shake or nudge the person
to get his or her attention.
• Pull or drag the person to safety.
• If necessary, take physical control of
the person’s body in any way
possible.
Verbal Cover procedures for ensuring
immediate safety, from least to most intrusive:
• Ask, “Are you okay?”
• Ask, “Do you need help?”
• Give directions, telling them what to
do.
• Suggest an alternate, safer course of
action.
• Yell a warning to the person about
possible danger.
• Forcefully command the person to
stop.
43
Ways to enforce an environment of safety and
perception of safety:
•
Find those people, places, or actions that
feels safe to you and call on them when
you need to feel more safe.
•
•
When you feel unsafe, distract yourself by
focusing on something near you or your
own breath or thought (i.e., counting).
•
Realize that no one is perfect, and
everyone is going to have strengths and
vulnerabilities – be aware of your own.
•
•
•
•
•
•
•
•
Perform an After Action Review (AAR),
highlighting lessons learned and
problem solving.
Give indicated time off for those
needing a break.
Mentor individuals who have
experienced negative impacts
regarding concerns about their own
safety or the safety of others due to
their stress reactions.
Train personnel on situational
awareness and decision-making
under stress.
Enhance both individual and
organizational accountability for
safety by empowering crew members
to monitor situational awareness and
stop unsafe behaviors.
Partner up crew members.
Directly address all department
members’ concerns for safety after
a line-of-duty injury or death.
Set policy about whether videos of
fires can be posted online prior to
spouses being informed about the
fire.
Support and educate families who
are concerned about their loved
ones after the line-of- duty injury or
death of a department member.
Cover Strategies: Self
Here are a few Cover strategies you can use to
make yourself feel more safe:
20
Cover Strategies: Others
Here are a few Cover strategies for use with
others:
•
Slowly implement SFA actions into any
organization so it is normal well in advance
of anything happening.
•
Make it a matter of policy to get people to
cover as soon as possible after a difficult
fire (i.e., a hotel, or out of the fire camp, or
back to family.
•
Depending on what a person is doing and
how they are responding, adjust
communication with that person to be
more abrupt or directive if it’s necessary to
keep them safe.
•
Let others know that no one is perfect and
let those around you know your strengths
as well as your own vulnerabilities.
•
Educate firefighters about the physiological
response to horror or life threat, to
minimize the shock of their own potential
stress responses.
•
After line of duty deaths, assign a trusted
family liaison who is also given support for
the work they do.
44
What are Potential Obstacles to Cover and How are they Overcome?
Because the Cover function of SFA is often used in difficult and stressful situations, it may be
useful to consider in advance obstacles to its use and ways to mobilize resources to overcome
them. (Figure 9)
Figure 9. Potential Obstacles to Cover and How to Overcome Them
Potential Obstacles to Cover
Mobilize Resources to Overcome Them
•
You are not thinking clearly or behaving safely
•
Get help
•
Youare occupied keeping yourself safe
•
Get yourself safe first, then attend to others
•
You cannot acquire or hold the person‘s attention and trust
•
Involve other leaders, trained peers or family members
•
Thepersonremainsanxiousevenafterbeingremovedto
safety and mentored about realistic ongoing and future
risk
•
Consider peer support or Employee Assistance Program
involvement
•
The person’sfamily is concerned about their safety after a
line-of-dutydeath
•
Find ways to involve peer support teams to reassure family
•
Include this topic in an After Action Review
•
Mentor the firefighter or EMT in ways to address their family’s
concerns
Cover: Self
procession from Phoenix to Prescott. I went
and stood amongst the Granite Mountain
“Cover is intangible. I don’t know how you
Hotshot alumni. As the news came that the
know how to make yourself safe, other than
nineteen hearses were in close proximity and
just knowing that a person or place seems like
approaching Prescott, I needed to find cover. It
they can offer it. The safe type of person on
was the most intense experience to witness
the job is someone who makes eye contact. I
and hear the family’s reactions as the fallen
feel something when I look at someone, that
firefighters passed by. With 19 hearses passing
connection. It’s either there or it’s not.”
in front of me, I needed something to keep
“Internally, I cover myself by focusing on
breathing, or focusing on an object. When the
Granite Mountain Hotshots died in 2013 in
Yarnell, Arizona, they brought the boys back to
Prescott. All nineteen hearses were coming
through town as there was an immense
myself from collapsing. There was an American
flag straight across the street, so I started
counting the stars. I made myself focus on the
stars with open focus/situational awareness of
what was going on around me. You can do it
with breath, but to me the American flag was
what saved me.”
45
safe to speak. Had I worked with all those
individuals prior to this, the FLA would have
taken 1-2 hours. Fortunately, at the end the
guys were high fiving and everyone was good.”
Cover: Others
“One way Cover is achieved is by showing
vulnerability yourself and by knowing your
employees. SFA needs to start well in advance
of anything going on. You slowly implement it
into any organization so it is normal. We talk,
drop our guards, and show our vulnerability. It
has to begin well in advance of anything
happening.”
“We find our safety with our family and friends
back home. When I was in a pickle, I don’t
usually call home much, but I caught myself
calling home. And now it’s easier with cell
phones and Facebook.”
“In a facilitated learning analysis (FLA) that was
very contentious, with 65 to 70 people in the
room, we wore our oldest muddy jeans (the
accepted uniform) and only one person took
notes for us, on sticky pads so everyone could
read them. We just wanted to know if there
was anything to learn from the situation, but it
took 7-8 hours, with yelling back and forth. We
had to go through and entire evolution of
communication in order for everyone to feel
20
“Cover is one thing we do, whether the crew
requires it or not, once the initial job of
someone who is injured or killed on the fireline
is handled logistically. We make it a matter of
policy to get them to cover. We may get them
to a hotel, or out of the fire camp, or back to
family, or get someone they trust to be liaison
for them so they don't have to deal with a
responding, distant bureaucracy. The agency
administrator provides a family liaison that acts
46
as an intermediary and can say to the agency,
yelling is “get mad!” So I found my mad, and I
“Despite what you want, the family isn’t ready
dove off the hillside and down into the
for that now, or they don’t want it. This is what
drainage and made it out. It was an extreme
they need.” The liaison becomes a barrier
account of cover, but it was very effective, and
against the chaos of diffuse assistance, and
very necessary.”
gives the individual cover from the chaos. He or
she provides clarity and efficient logistics
support, which provides cover immediately.
Over the long run they are the communications
intermediary. They provide the check, the
coordination, and they perform a lot of the
seven Cs on behalf of the individual. We also
have to provide cover for the liaison, because
sometimes they care so much that they put
their own needs aside to provide the best care,
which can create problems in their own
personal life.”
“After action reviews (AARs) are a good way to
check on people, and also a good way to make
my crew safe. We've all been through good
AARs and bad AARs. The good ones are where
there are more multiple hats in the room,
instead of the person who's always doing the
same job. If you're in a hotshot crew, maybe
bring the dispatcher in and have them be part
of the AAR or have a line officer come in and
say this is why I made the decision I did. That
gives people the opportunity to learn what is
going through the mind of the decision-maker,
“I think it’s really important for people to
and get a different perspective. You can bring
understand the physiological response to
that into a better education of AAR. Ultimately
horror or life threat, to minimize the shock of
it's execution and facilitation that determines
your own stress response. I was not a rookie
whether AARs have lasting benefits to the
firefighter, and I was strong and confident. But
unit.”
when the foreman said, “pull your shelter,” the
switch went off and I didn’t have any
movement in my body, and I lost bodily
functions. A crewmember handed me my
shelter and we started running down the hill. It
is the most tremendous gut wrenching guttural
sound you make when you’re about to die. And
then you totally freeze and don’t care at all
about the situation around you. I was totally
dissociated from the fire. The foreman saw that
and came back to me and used strong profanity
and hit me on the head. What I remember him
20
47
“I don't like to do AARs every day for
with active listening what is at the root of
everything, because it just becomes repetitive.
problems with the crew.”
After major events, I'll let a lot of the guys run
the AAR, let them talk, let them have a
discussion about what they think went right.
But I've been on the end of some pretty bad
stuff, we just sat down and it's just day after
day after day after day of AARs for everything,
and it's just horrible. It just turns negative. You
can do it on different scales. On those days
where you're mopping up, maybe you don't
need to bore all your commitment
crewmembers with it, but it's just that open
dialogue, “did anything happen today that we
need to talk about?” Maybe you don't need to
have the exact AAR questions, but you do have
quick questions. It's how you talk about it. I
asked every day, “How did things go today?
Anything we need to discuss? OK, let's go eat.”
The question needs to be asked. But it's all
about how you execute it. If you're not having
that open dialogue every shift, or every
transition period, whatever it is, something is
going to get missed. When something bad does
happen or something big does something, if
your structure already has that open dialogue
in place, then you plug in the crew members,
and it makes it a lot more feasible for them to
communicate comfortably back-and-forth.”
“There is a use of force continuum in
communications. So depending on a person’s
nonverbal behavior, on what they are actually
doing and how they are responding, you adjust
your communication with that person. One of
the examples is an audio clip from a flight
service station of a VFR pilot who can’t see
anything, and the plane starts rolling. This guy
working in the FSS gets a call for mayday and
starts off very low key tempo, not
understanding the severity, and by the end of
it, this guy is screaming into the radio, “Help
me help me help me!” There is a time and
place for me to be more abrupt and directive, if
“If a person has high-risk behavior, you will
there is danger, or if it is a re-occurring thing.
probably address that person individually to get
Also in terms of efficiency, sometimes you need
a pulse check of what's going on: “I'm hearing
to be abrupt.”
that you're driving like this are not doing thing
safely.” Hopefully you're going to draw out
20
48
Calm
What is Calm?
The SFA action of Calm works by slowing
down and reducing stress reactions in both
the body and mind. This promotes the
recovery of normal mental and physical
functioning, and suppresses excessive
physiological arousal. Actions that promote
Calm quiet the body by slowing down or
stopping major muscular activity and
reducing heart rate and level of alertness.
They soothe intense and distressing
emotions such as fear, anger, guilt or
shame. Calm actions help compose
scattered mental focus by redirecting
attention outwardly, away from anxiety
and internal states of distress. And finally,
Calm may be achieved by providing rest to
help promote recovery and healing.
Figure 10 shows the major components of
Calm
When is Calm Needed?
Calm is needed when intense stress has
interfered with an individual’s ability to
reduce his or her physiological activity
level or emotional intensity. Typically,
there are three categories of situations
that require Calm:
1. When physiological arousal level
remains too high, as demonstrated by:
• Loss of physical control.
• Excessive motor activity.
• Hyperactivity or hypervigilance.
20
2. When cognitive functioning is
disorganized, one or more of the
following is usually noted:
• Rapid, pressured speech (talking too fast).
• Reduced situational awareness and
decision-making capacity.
• Flight of ideas (thoughts flit from one
topic toanother).
• Not responding appropriately to
directions or questions.
• Freezing in place.
49
3. When negative emotions are out of
control, as characterized by:
• Poorly controlled fear, anxiety or panic.
• Poorly controlled depression or anger.
• Intense guilt or shame.
Situations where Calm is needed can vary
considerably. Some examples for need for
Cover are:
•
•
•
•
•
Alcohol is the only thing a crew member
feels he can turn to, to calm himself.
An experienced sawyer begins to make
careless mistakes and notices his
adrenaline increase when several others
gather to watch him cut a complex tree in
advance of the fire.
An experienced sawyer begins to make
careless mistakes and notices his
adrenaline increase when several others
gather to watch him cut a complex tree in
advance of the fire.
A firefighter who is tired after fighting a fire
for a week feels angry and irritable when
dealing with worried homeowners who
have difficult personalities.
A firefighter who is a veteran becomes
irritable and hostile when there is
downtime, and often yells at other
firefighters about standards and safety.
•
•
•
How is Calm Implemented?
Like Cover, Calm is performed as needed
through a wide range of non-verbal or
verbal procedures. Its application should
always be tailored for the specific situation
and person being assisted. Here are some
ways to immediately calm an individual
who is experiencing intense stress that is
interfering with functioning:
Non-verbal procedures for inducing
immediate Calm, from least to most
intrusive:
•
•
•
•
•
How Does Calm Work?
The Calm function of SFA depends on the
interconnectedness of the mind, brain and
body in order to work. It promotes
recovery and healing through by:
•
•
•
•
•
20
Reducing muscular activity.
Reducing mental and emotional effort.
Slowing heart rate.
Reducing levels of stress chemicals
in the blood and brain.
Decreasing the intensity of negative
emotions like fear and anger.
Increasing positive emotions like a
sense of safety and trust.
Increasing the capacity of the
individual for self-control.
Restoring mental clarity and focus.
Establish a confident, calm,
authoritative physical presence.
Make eye contact.
Stay with the person.
Do not show fear, anger,
impatience or disgust.
Provide reassuring physical touch, if
appropriate and not threatening.
Verbal procedures for inducing immediate
Calm, from least to most intrusive:
•
•
•
•
Use repetitive, soothing phrases, such
as “Easy now…” or “It’s okay…”
Reassure of current safety and
support, such as “I’m here with
you…” or “You’re safe now…”
Provide encouragement “You can
do it…” or “There you go…”
Give a calming directive, such as
50
•
“Slow down…” or “Try to relax.”
Get the individual’s attention by
saying “Look at me!” or “Listen to my
voice!”
Longer-term procedures for inducing Calm
•
•
•
•
•
•
•
Reduce chaos on the scene.
Get the individual to focus on your
directions by asking to be briefed on
what is happening.
Give clear information on what is
needed, and specific instructions on
what to do next.
Take charge, but elicit and accept
feedback from the stressed
individual.
Distract the person by having them
focus on your questions or
directions, or encouraging them to
think about something else.
Stay focused on yourself and your
own stress level, to avoid escalating a
sense of chaos and anxiety.
Coach the person in slow-breathing.
•
Calm procedures for those who are
bereaved
When a fellow crew member has
experienced a loss of any kind, either on
or off the job:
•
•
•
•
Calm procedures for use with angry
individuals
•
•
•
•
20
Distract: ask for help with a task or
suggest taking a break, such as
walking away to calm down, or doing
something else for a while.
State clearly that you or someone
else will be available when he or she
returns.
Defuse: ask the individual to look at
the situation in a different way, see it
from another’s viewpoint or suggest
that they talk to a friend or loved one
Distance: separate those who are
angry at each other, or keep them
otherwise engaged.
Deter: when feeling uncomfortable or
threatened, don’t be afraid to ask for
assistance.
It is often best to say nothing. It’s all
about providing a supportive presence.
Stay present, stay quiet and listen.
Don’t try to make a bereaved individual
feel better because there is no better
way to feel at the moment. Just be
there.
When a person does want to talk
with you about the loss, don’t feel
compelled to talk. There are no
“magic words.” Listen and be
supportive in the most appropriate
way.
Check in to connect and assess
progress periodically over the
following week and months.
Ways to influence longer-term Calm
•
•
•
•
Listen carefully to distressing
thoughts, feelings, and memories.
Ask what you can do in the moment
to help, or what he or she thinks
would help.
Provide information about mission,
skills strategies that serves to make
the individual feel more informed
and in control.
Conduct an AAR that focuses on
lessons learned and brainstorm
solutions to deal with similar
51
problems in the future.
Maintain a culture of learning from
all missions, rather than judging or
punishing for mistakes made.
Discourage and stop rumors.
Let crew members know that you
have or others have experienced
similar stress reactions in the past.
Engage others who have been
through similar situations to act as
mentors.
Make informal and formal peer
support accepted part of the
culture.
•
•
•
•
•
What are Potential Obstacles to Calm
and How Are They Overcome?
Like Cover, Calm actions are most often put
to use in already stressful situations. It can
be helpful to identify specific obstacles to
its implementation in advance and to
consider ways to mobilize resources to
overcome them. (Figure 11)
Figure 11. Potential Obstacles to Calm, and How to Overcome Them
Potential Obstacles to Calm
20
Mobilize Resources to Overcome Them
•
You are not yet calm yourself
•
Use calming techniques on yourself, which will allow
you to provide similar assistance to others
•
Youaretoodistractedorbusytoattendtothepersoninneed
•
Get help
•
You are surrounded by too much noise and chaos
•
Get to a safer, quieter place if possible
•
Another person is increasing the individual’s stress with
their loud and/or frantic behavior
•
Direct others away from the stressed person if they are not helping
•
You cannot acquire and hold the person’s trust or attention
•
Engage and involve others
•
Thepersonfailstocalmdownafterusingallavailablenon-verbal
andverbal techniques
•
Consider peer support and/or BHAP involvement
52
•
Make every effort not to call attention to
someone’s stress in a way that might
make them feel ashamed.
•
Acknowledge possible stressors and the
potential need for support in a matter of
fact way ahead of difficult events.
Calm Strategies: Self
Here are a few strategies for calming yourself:
•
Engage in regular physical activity.
•
Spend time with family and close friends
and let them know what is calming for you
ahead of time so they can better support
you when needed.
•
If a stressed person can’t make good
cognitive decisions, use the person’s
name and communicate exactly what is
needed in a calm, methodical voice.
•
Take a break from stressful situations for a
short time.
•
•
Realize that there are cycles of adrenaline
that may make you prone to depression at
times and build in rewarding activities to
get energized during down cycles.
After line of duty deaths, determine next
steps for each person on a case-by-case
basis.
•
Try to see things from a higher vantage
point and see a broader perspective,
literally and figuratively.
Disciplining yourself to take care of yourself
with small rewarding activities is called
behavioral activation. It will not make you feel
better the first time, but over time it will help
give balance out and you a buffer for other
stressful experiences. Like getting good
nutrition, it makes you stronger, similar to how
eating well and taking a good multivitamin can
give you more energy over time. Eventually, it
will start making you feel like there are some
things in the world that can get you activated it
or get you to smile.
Calm Strategies: Others
Here are a few strategies for calming others:
•
Make others aware of the importance of
self-calming strategies.
•
Ask for help to empower and distract the
other person.
•
If possible, get the stressed person to look
at you for a minute, then be very specific
and detailed about what you want them
to do.
•
Use light humor.
53
Calm: Self
“There are things you have to do in order to
She seems to know when I need to talk. Those
are the things you absolutely cherish.”
bring yourself back into this bar of normalcy.
“Self-awareness is good for Calm. We have
Like Jeff Gilmartin says in his book Emotional
these 14-day assignments, plus travel. On day 8
Survival for Law Enforcement Officers, you go
I am aware that there is always this funk that
on a giant swing from adrenaline to depression.
wants to set in. It’s not really complacency.
There are things that you have to do in order to
Maybe it’s a combination of exhaustion,
claw fight and drag yourself back to normalcy.
complacency, feelings of being overwhelmed,
Things like hobbies. “Use tas” “I use ta hunt,
and fatigue. That's when I have to be on guard,
fish, spend time with wife.” You have to turn
because I don’t want anything bad happening
them into “I’m going tos.” After I let everything
on day 8. So I try to mix up any routine that I
out, I started doing things again, like learning
have. I don’t stand in the same place at
how to fly fish. I started making an effort to
morning briefing. I wait until after the briefing
make work not get in the way of spending time
to have coffee. I put on fresh socks, any little
with my son and wife.”
thing I can do, just to get past it.”
“What works for me is to pull myself out of the
situation for a bit. I do something simple, like
driving down road, sleeping in an area where
no one else is. I have gone out on my own, not
very far, still sleeping with the same crew, but
not with all the crews sleeping together. We
went out on our own, and made some
separation. We didn’t have to go very far out,
just a little isolated, but it helped immensely. If
we’re out working on line and we go to spike
camps, it seems to make big difference, versus
driving all the way back to a big camp to sleep
and eat. Crews seem to do much better when
they don't’ have to drive all the way back to
camp on remote roads.”
“To calm myself, I like physical activity, exercise
motion, and having my family and close friends
is good. I have a good female friend up street.
20
54
Calm: Other
“We had a prescribed burn that was going
wrong, and it was the first time the line officer
who was in charge had been in charge. I
needed her to not be doing anything else so I
had her sit in the truck and write down
“Humor is a very safe to Calm down with
firefighters. Being self-deprecating always
works, because you’re the butt of it, not
anyone else, although you have to be careful
because you don't’ want to undermine your
own leadership.”
everything she heard on the radio. It was being
“Asking for help is a good way to calm people.
recorded at dispatch, but it made her feel
Saying, “in order to get through this, I’m really
purposeful. You could see in her writing - when
going to need you to “x, y, and z.” I can’t do it
she started, her writing was illegible, and as
by myself, if you could just help me out here
time went on, she was able to capture more of
that would be great.” It’s empowering. It
the facts and details. She was able to come
appeals to all the parts of us that are doers,
back and be more centered, make better
fixers, and movers.”
decisions, and help inform the system. That
simple movement to reduce anxiety was good
for her.”
“Helping people to rest and sleeping is a huge
issue. In the worst case we put 16 hours in, and
we don't’ do a good job letting folks rest and
“There was a guy who would start picking the
recuperate. We expect folks to get rest but we
lint off his sweater when he was anxious. I
don’t provide a good context for it. It will vary
would say, “just look at me for a second.” I
depending on where you are. Some
would get him to stop doing what he was doing
environments we work in, we go back to a
and focus just for that second, and say, “here’s
camp, which is the worst place to get rest, with
what I need you to do,” then be very specific
generators going, outside distractions, and
and detailed. It was great. He could get right
sleeping on the ground. We can’t sleep in bed
back there and focus. Something needed to jog
in every single place, but when we expect
him out of his funk.”
people to get good rest, they can’t. Some
camps have provided sleep trailers, we were
able to go in and get rest, because it was quiet.
When a person works the night shift, during
the day they are not good (providing quiet
sleeping areas) and folks are not able to sleep.
So we have to get better at providing a good
environment. One that is quiet, and not
distracting. Otherwise, folks will not be
mentally fit. The body is not wired for that.”
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55
“From an operational perspective, when
see that retention and people really start to get
someone is not doing well, whether their head
it. When I’m training people on the aviation
is not in the game, for whatever reason, I will
side and see the trainee get to the point where
find a less arduous, less hazardous task for that
I’m starting to see some serious stress
individual to accomplish. It’s not trying to be
indicators, beads of stress on forehead, saying
manipulative or deceptive. I know these
wrong thing, on the next mission I ask them to
people, if I tell them I know you’re tired, go sit
evaluate me. It’s giving them break. I bring
in crew hall, they will say, I’m good to go. But if
them right to tipping point, and then they get
I say “we’re in tight spot, I need someone I can
to decompress and evaluate me – from the
trust sitting with the rig, can you be my guy
aviation side it really fits in. We do that quite a
today. Catch some zz’s if you want, but keep
bit.”
the radio turned up and make sure you’re
ready to roll.”
“On the line, if a person is really having
problems, the thing that’s taught is to get the
person off the line and give them some water,
get them to sit in the shade, it is such a
common approach that it feels humiliating to
be that person, even thought that is probably
what needs to happen. Any time you’re singled
out it feels like you did something wrong and
everybody knows and is watching, it feels bad.
There are good leaders who are tuned in can
pull it off without humiliating the person. It’s
really situational. Some examples are being
able to sit without being in front of group,
being assigned a task, or having the whole
“People reach a freak out point. When they
group be given a break. Sometimes people will
do, my crew laughs at me and says, “Okay, here
be assigned to a job like being a lookout.
comes Mr. calm again.” The more chaotic
Depending on the leader, it can be risky to ask
things get, the calmer I become in my
for an easy job. Good leaders can read their
communication.”
employees and ask them to take a walk to
patrol the line or to do an easy but useful task
“Stress is a really good thing in some instances.
that can give them a break. They keep track of
There is optimized stress for optimized
how tired people are, and try to distribute
retention when you’re learning, so we apply
things that way.”
stress to the appropriate level, and then you
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56
“People who don’t have hobbies or identities
fainting when the brain perceives danger. The
outside of fire often struggle during the off-
more I talk about myself freezing and losing
season or if they get injured. It seems like
bodily functions, the more I hear stories from
people who thrive are those who are invested
others that it’s very common place. It should be
in their families, have side careers or creative
known before you go into life threat situations,
outlets like woodworking, hunting, home
so that you’re not shocked by our body’s
improvement, brewing, and physical activities
response to extreme threat.”
like ski-patrol.”
“Peer to peer, calming can be hard to do
because of the hotshot mentality. It’s easy to
shame people by implying you think they’re not
competent. Things can be really competitive.
Humor is a big calming influence. People’s
morale will go in tank sometimes, like when it's
raining and people don’t want to be there. It’s
helpful if people just acknowledge potential
stressors. It has it be on your radar instead of
expecting people to suck it up and deal with
their own stuff. Acknowledge that it could be
necessary to have some help.”
“Substance abuse masks wounds. I don’t drink
as much when I’m around fellow firefighters. I
“The nature of the job that we do is chaos
go home and I drink. It gives a momentary
punctuated with equilibrium. On a 14 day
feeling of relaxation and relief, but if I drink too
assignment, you know there are times when
much, it has a negative impact, and I don’t feel
it’s going to be chaos, you’re just trying to take
relief anymore. It’s not like I don’t know what
your next breath, but we desire the calm that’s
I’m doing, I’m very aware – and I see others in a
going to come when the incident stabilizes. It’s
similar way, drowning feelings or trying to
something we’re all quite used to, we’re
sleep. I really think total wellness has to start
accustomed to that rhythm. We force the
young, creating programs for younger
opportunity for calmness by mandating an end
firefighters to empower them at a young age.”
to the assignment before you return to duty in
the form of R&R.”
“In the Orange to Red Zone, those who have
really gone deeply into their stress reaction and
“It’s been helpful for me to learn about the way
can’t make good cognitive decisions are in a
the body goes into flight, fright, freeze or
danger zone. In one fire, the town was about
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57
to burn down if we lost the road. We had lost
you see them really struggling, know the
the road but we were still trying to pick it up.
person well enough to know that they need a
We were trying to pick up a spot in the
task or something to do away from the
firestorm. In my earpiece I heard the
situation or tell him or her to go home to get
superintendent say, “we’re leaving, it’s time to
well rested sure what's coming. For some
go.” One firefighter, who is usually calm,
people it may be the fifth thing that's
screamed into radio “we’ve got this – we’re
happened that year, as well as things that
going to pick it up.” That firefighter was in the
happened in their childhood. There may be a
Orange Zone. He was not making good
whole historical background contributing to
decisions. The superintendent, in a calm,
how they're reacting today.”
methodical voice, said the firefighter’s name
and then, “we have lost division, we’ve pulled
back to town, it is time to go.” At that
moment, the firefighter snapped out of it, spun
back around and went back.”
“After a really bad fire with a line of duty death,
we brought everyone home and let them rest
over the weekend. Then with the support of
our forest superintendent, forest FMO, and
district FMO, we decided we wanted to give
some control back to the crew. So we went to
each crew member individually and asked them
if they wanted sick leave, or to go back to work.
There were a few guys who went back to work
for 3 to 4 days. We sent them back to districts
they had already worked in, where they
were surrounded by their friends. Then we
“Our crew experienced a fatality, and the crew
was allowed to stay. Others were allowed to go
home. Sometimes it helps for people to stay
around and see what normal looks like, to see
someone who is coping well. For some people
it's very comforting to see other people who
were involved in the situation, and be able to
huddle and see how they are. For other people,
they can actually make them feel worse if they
were severely affected. I really think it is to be a
case-by-case. Usually the person has a sense if
they need to go home, but if they don't and
20
came back together and sat around a picnic
table and went through and said, “There are
about 10 different options for us right now.”
We talked with every person, gave each one
every option, and then gave them whatever
they needed, to support them. In the end, most
of them wanted to stay together on light duty.
There were some people who wanted to go out
and cut with a chainsaw with their friends. It
worked out pretty well, doing it on a case-bycase basis. We did it independently, rather than
bring it to the group. We didn't want
58
groupthink. They came out with what they
able to redirect and come back at it from a
wanted and we honored that. They are people,
different perspective. Strategically shifting from
not machines. They're human beings, so we
one way of looking at things to another.”
treat them like that and it goes along way.
They're all different. You can still meet the
needs of the organization and meet their needs
at the same time. Just treat them like your
brothers and sisters. They do extraordinary
things so we should act with extraordinary
compassion with them.”
”It used to be that you just work, and you
didn’t ask why. The culture has changed, and
now I have second and third year seasonals
who feel comfortable challenging why we’re
doing things. They’re paying more attention,
and it opens up a big can of words. They get
really stressed out about why we do things the
way we do, and question everything. That’s my
job. I tell them: “I’m not stressed about it I
don’t know why you’re stressed about it. This is
the area that you have control over, not the
30,000 foot view that I’m supposed to be in
charge of. Worry about what you’re doing, not
what everybody else is doing. Don’t be so
stressed about the big picture. It’s just wasted
time and energy.” So, I’m trying to squeeze the
role down to something they have control over,
which reduces that stress and angst. Attitude
stress is contagious - if people start to talk it’s
“Preparing people ahead of a very stressful
going to be all through the crew. You may be
experience can be very calming as well. Before
able to turn the titanic a degree or two, but you
a memorial we walk the new ones in the honor
are going to be able to turn it around. You just
guard through their role in the event. It calms
kind of squeeze things down and that can be
them because they felt they then have a sense
calming.”
of control over that one piece.”
”In Alaska there was a wind shift, and they had
“I spend a little bit of quiet time with them,
nowhere to go. We were listening to the radio
redirecting them with a question to get them
and talking to the person in charge on the
off of what just happened to talk about
ground. The entire scene on the ground fell
something unrelated. Explaining equipment,
apart. I got our stuff squared away because
reminding them about what they like to do.
things were going to start happening really
Just changing that frame for that person, being
quick. But the communication to the ground
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59
was very direct, acknowledging: “you’re cut off,
to more nurturing, caring, and humility,
and the options are the house and your fire
working with a 1200 pound animal and getting
shelters. It’s going to suck, it’s going to be
it to respect them. It would give them an
smoky, it’s going to be hot, it’s going to be
opportunity to come out and clear their
scary. you need to get folks rounded up. Make
minds. You can talk to the horses all day and
sure you can get into the structure. We are
they’re not going to share your secrets with
bringing two scoopers, some copters, and two
anyone. Horses will give you a reward if you’re
loads of retardant.” I kept giving them updates
kind to them. And it was a little change of
and told them to make sure they had this test
behavior where they went from drinking all
done when I came back. They saw that we
weekend to doing something productive. I
recognized the gravity of the situation. So, my
thought people would want to scatter and just
mind is going 6,000,000 miles an hour but what
get away from each other off duty, but there
was coming out of my mouth was completely
were a couple weekends where all 20 people
different. I had to be very slow, very calm,
on the crew showed up. Being able to see them
almost sarcastically calm: “wow that sucks but
in different positions other than a fire position
we’re moving on. Here’s what we’re going to
opened each other’s eyes and made them pay
do for you. Here’s what needs to happen.” We
a little more attention to each other as well. It’s
did bring levity to the situation after everybody
been a good coping mechanism for the crew
was okay, when we got back to the airport,
the last couple of years.”
After the plane was brought back and they
checked on whether we were okay, we jokingly
said “that was good, I was getting kind a rusty
on that.”
“I operate a horse ranch, so I opened up the
ranch to the crew on their days off to come out
and ride. The ones that I never thought would
come out, the city kids, the younger ones who I
knew were homesick, the ones who isolated
themselves, or the standoffish ones, were the
ones that showed up and wanted to see the
horses and just hang out with them. People
would come in super angry and really
depressed, and for whatever reason it helped a
lot of the crew. You could see their anger shift
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60
Connect
trust. The purpose of Connect is to identify
challenges to social support, and attempt
to correct them.
What is Connect?
After an intensely stressful event or time in
their lives, it can help people to connect
with those they trust, to talk about their
experiences and perceptions, affirm their
personal worth, and restore understanding
and predictability in their lives. Connect
works directly and indirectly to meet all of
those needs.
Connect facilitates three types of social
support:
• Instrumental support: providing
material aid, such as help with daily
tasks. Many fire and rescue personnel
prefer this type of sup- port to
emotional support during difficult
times.
• Informational support: providing
relevant advice or guidance to help the
individual cope with current difficulties.
• Emotional support: expressing
empathy, care, and reassurance, and
providing opportunities for venting and
expressing emotions.
If organizations, families, and social
networks always functioned perfectly,
there would never be a need for the SFA
Connect function. However, few people
and organizations are able to function at
optimal, or even adequate, levels during
difficult times. Stress can create friction at
work and within families, and can generate
persistent feelings of alienation and loss of
20
Figure 12 shows the three components of
Connect. Although all overlap to some
degree, each of these areas is a separate
domain of social support, and should be
considered in every case. The most basic
component of Connect is to be with the
person by maintaining a steady presence
and eye contact, and by listening and/ or
empathizing. When needed Connect also
entails providing comfort to the person, if
needed, by encouraging or soothing him
or her, or by accepting what he or she is
going through.
Connect also includes procedures to
reduce the alienation and isolation that
can result from severe stress. This might
be accomplished by working with other
department members to improve their
understanding of the individual’s
circumstances, correct misperceptions
and restore trust in the individual.
61
When is Connect Needed?
Connect is closely related to the state of mutual
trust, respect and communication that normally
exists within fire service organizations.
Severely stressed members usually withdraw
from those around them, and may lose some
of the trust and camaraderie they previously
enjoyed. Stressed leaders may also be less
effective at promoting trust and
communication within their team.
Connect should be used whenever there is
a relative loss of connectedness within an
organization or crew, or an individual
becomes socially isolated or alienated.
Examples of when to use Connect may be
when a crew member:
• No longer seems like his or her usual self, or
appears uncomfortable around others.
• Seems ashamed of his or her stress reaction.
• Fears others in the unit have lost trust in him
or her.
• Cannot stop thinking about the vivid details of a
recent experience, but is afraid to talk with
other crew members about it.
• Appears emotionally numb and detached, or
not interested in interacting with peers as in
the past.
• Fears that talking with others in the
department will trigger painful memories
about mutually experienced events.
• Can’t stop feeling angry, so avoids being
around others.
• Blames leaders or co-workers for a troubling
event.
62
• Is blamed by other members of the unit for a
troubling event.
• Feels exhausted and overwhelmed.
• Doesn’t have sufficient energy to interact
with others.
Here are a few examples of a need for Connect:
• A firefighter’s sense of connection with fellow
crew members falls off when he is not in close
proximity in off-season, and he gets depressed.
• A near miss makes crew members question the
judgment and skill of those involved.
• A firefighter gets ostracized because he yells
out in fear when he is hit with a falling
branch, which violates cultural norms about
toughness.
• A female firefighter married a firefighter who
was gone three months when their daughter
was born, and she didn’t have any family close
by. She worked full time and took care of the
home front. Hearing that he was in harm’s way
and knowing that she wouldn’t hear his voice
for another 4-5 days was very stressful.
20
You may have noted from these examples that
Connect can be needed at either an individual or
organizational level. For instance, an individual
firefighter might withdraw from his crewmates
after a fire due to factors such as shame,
exhaustion or loss. At the department level,
disruption of connectedness can be caused by
factors such as blame, lack of confidence in peers
or leadership, shame and stigma, overwhelming
exhaustion or loss.
When affected by stress, people can feel a sense
of being alienated from themselves, like they are
a different person. It is also very common for
them to feel disconnected from friends or family,
for a number of reasons:
• A common identity through shared
experiences and values.
• Trust may be an issue. An individual may have
lost trust in him or herself, or be experiencing
shame, a feeling that other were disappointed
or betrayed, or a loss of trust in his or her
peers.
• Stress reactions may cause individuals to lack
the confidence and/or competence to make
new relationships, or to rebuild existing
relationships.
• Stressed individuals may not want to share
negative experiences or feelings for fear that
they won’t be understood, or will be a burden
to others. Some may just be numb or
withdrawn, or don’t want to be triggered by
talking about events. Orange Zone stressors
and/or reactions may cause difficult emotions
to surface (such as increased anger or
frustration), which can push others away.
• Individuals may not be getting enough positive
feedback or support from their environment
due to Orange Zone stressors such as loss, or
lack of access to appropriate supports or
63
•
•
•
•
resources (e.g. separations, lost contact, new
living environment, etc.).
Other people might need Connect because
they feel exhausted and overwhelmed, or
are unable to talk about their feelings and
put their experiences into words.
Some may be unable to express an increased
need for support from others for their stress,
or don’t feel that their existing social support
networks can or will meet their needs.
Some may want to be available to provide
support to others, but are avoiding doing so
because they are overwhelmed, or don't
want to trigger their own stress reactions.
Finally, stigma is a big obstacle to asking for
support. Asking for help can make people
feel that they are weak, or that they are
unable to handle their life stress. It may also
raise concerns that their disclosure will affect
either their peers’ view of them, or their job
security.
How Does Connect Work?
Connect works by reducing an individual’s
isolation and alienation. Within the organization,
it promotes:
▪
▪
▪
▪
▪
▪
▪
▪
A common identity through shared
experiences and values.
Common experiences through sharing of
perceptions, thoughts and feelings
Common understanding and meaning of
events.
Shared responsibility.
Shared suffering.
Reduced feelings of guilt, shame or betrayal.
Greater forgiveness.
Shared hope about the future.
How is Connect Implemented?
As summarized in Figure 13, the Connect function
of SFA progresses through the three general steps
of:
1. Assessing resources for social support.
2. Assessing obstacles to social support.
3. Intervening to remove those obstacles.
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64
Figure 13. Steps to Perform the Connect Function of Stress First Aid
Steps
1. Assess social
resources
2. Assess obstacles
to social
support
3. Intervene to
remove
obstacles to
social
support
Why Do It?
To identify the best
possiblesourcesofsocial
supportforan individual
Tounderstandwhyan
individual is not using all
available social resources
To overcome obstacles in the
individual or in others in
order to foster better social
connectedness
How to Implement It
▪
Identify who in the department is most trusted by the individual
▪
Identify someone from inside or outside the department who has been through a similar
situation and could act as a mentor
▪
Identify most trusted family or friends outside the department
▪
Ask how he or she perceives current levels of social involvement and connectedness
▪
Ask if he or she is satisfied with current levels of social support
▪
Find out what has changed in the individual that has led to isolation or alienation
▪
Observe the individual interacting with others looking for patterns of poor communication,
respect, or trust
▪
Ask unit members for their perceptions of an isolating individual
▪
Consistently show concern and caring
▪
Build teamwork
▪
Beagoodmentororrolemodel
▪
Listen non-judgmentally, especially to experiences of loss, trauma or moral injury
▪
Encourage and/or lead formal or informal social activities
▪
Encourage the isolated individual to seek out greater social connectedness
▪
Provide a model for social connectedness
▪
Describe to the isolated individual the specific isolating behaviors you witnessed
▪
Look for and confront distorted perceptions and conceptions in the individual that might
interfere with two-way trust and respect
▪
Reassure the individual and confront and try to neutralize blame, guilt and shame
▪
If specific problems are identified that are interfering with social connectedness, encourage
active problem-solving
▪
Lead After Action Reviews in order to promote common perceptions and understanding
▪
Reduce conflict, blaming, scapegoating and rumors in the department
▪
Honor the fallen
orindividuals who lack sufficient trust or motivation to work on improving connectedness with
For
individual
others,
consider activating the peer support team or Employee Assistance Program, if available.
20 s who lack
sufficient
trust or
motivatio
65
Connect: Leader Actions
Company officers play a critical role in
developing and maintaining social
cohesion in most fire service organizations,
particularly after exposure to a PTE.
Leaders can support the SFA Connect
function through the following actions:
▪
▪
▪
▪
▪
▪
▪
▪
Lead AARs after all significant events.
Encourage discussion about the event.
Show caring and concern consistently.
Reassure and support individuals
experiencing stress reactions.
Be a good mentor or role model.
Reduce conflict, blaming and rumors.
Build teamwork.
Honor the fallen.
Shame and guilt can be difficult obstacles
to overcome in trying to connect with a
stress-injured person. The support of
mentors and leaders is especially
important in these situations because they
can tell the stress- injured person that he
or she did a good job and didn’t let anyone
down. Leaders can also increase
contributory, meaningful or interactive
activities for the stress-injured person or
unit, and reduce inter-organizational
conflict, blame and rumors. For example, a
company officer or a trusted peer can tell a
stress-injured firefighter “I saw you in
action and you did not fail.”
After a line-of-duty death or injury,
finding ways to honor those lost or
injured can also help other members of
20
the department to make sense of the loss
and to re-engage with each other.
Leaders also implement Connect by
identifying existing resources that can
facilitate healing and recovery, mobilizing
these resources
and assessing their effectiveness. It may
also mean mentoring or teaching others
to provide support. Leaders must also
realize that if the stressed individual
moves from the Orange Zone to the Red
Zone, a higher level of care is usually
indicated.
What are Potential Obstacles to
Connect and How are They Overcome?
The Connect action can be difficult to
implement in certain situations. Figure 14
lists a few possible obstacles and ways to
mobilize resources to overcome them.
66
Figure 14. Potential Obstacles to Connect and How to Overcome Them
Potential Obstacles to Connect
You are too distracted or busy to attend to the affected
person
Mobilize Resources to Overcome Them
▪
Engage crew members or peer support team members to help the affected
person
▪
Connect the person with supportive family, friends and others
You cannot gain the trust and confidence of the affected
person
A crew member has recently lost one or more of his/her close
friends
▪
Recruit peer support team members to assist
▪
Encourage the communalizing ofgrief
▪
Encourage peers to engage with the grieving person
The person in need has been ostracized by others in the unit
▪
Temporarily separate the person from negative influences
▪
Address possible scapegoating
▪
Talk to someone you trust about your feelings toward this person
▪
Ask someone else to provide SFA aid to that person
You have negative feelings toward the person in need
Connect Strategies: Self
Here are a few strategies for connecting with
others:
• Know the value of good mentors and
friends.
• Surround yourself with people who are
genuine, authentic, and honest.
• Make friends with people you can be
yourself with and talk with about what
bothers you.
• Discipline yourself to have conversations
people who know you well enough to know
when something is bothering you.
• Reprioritize your schedule to spend more
time with those who mean the most to
you.
•
•
•
•
Connect Strategies: Others
Here are a few strategies for helping others
connect:
• If someone has retreated because of an
incident, find ways to indirectly include
them in projects and create collaborative
•
opportunities with peers, to get them back
into doing something meaningful.
With introverts, bring them back being
connected after they recharge, whatever
that looks like for them.
If someone is in the orange/red zone and
resistant to getting support, and they trust
you, don’t be afraid to be more
authoritative in getting them help.
In the middle of intensive stress, keep
people moving get them engaged in
activities that facilitate talking while you do
things. For instance, while moving, have
people briefly report out on successes,
loose ends, and their plan for the next 24
hours.
Depending on your role, don’t be afraid to
sit and just listen and be comfortable
letting a stressed person talk. The fact that
you’re in the same culture carries a lot of
weight and can be more helpful than
talking to anyone else.
Keep calling, texting, and writing letters to
the families and co-workers of fallen
firefighters. Regardless if they pick up the
phone or not, the fact that someone
remembers them on an anniversary date,
or on any random day, is what is helpful.
67
Connect: Self
“After 28 days, my calm is coming home to
have, and it is heightened by the rubric I’ve
described.”
wife, or going out to see a friend who’s not in
“ I always believe that if there are two people
fire, so I can just be normal with him. Just
in the room with the same opinion, you’ve got
returning to getting outside the circle of things
one extra person. I have people I can talk to,
that are giving me stress. Or I like to walk in
call up, and in the conversation, whatever’s
the woods without smoke. I realize that I need
bothering either of us will come out. I force
to get there. I need to go seek that out.”
myself to have conversations with three or four
“The people I reach out to are honest. It’s
about calling spade a spade, not dancing
around it. They’re able to give their perspective
people who know that when I’m calling,
something has come up. We flesh it out by
talking.”
on my problem that it might pale in comparison
to another’s: “You need to pick up pieces of
your shattered life and move on.” It serves to
provide another’s perspective, and foster
honesty. They might say, “That’s not normal for
you.” I am skeptical of self-diagnosis. I think
you need to get a second opinion- a fresh
perspective. I know my guys will give it to me
straight, which is a bi-product of this line of
work. The people I’m surrounded by don’t have
a problem calling bullshit on something. It’s the
nature of incident command that commanders
can, within reason, create their own worlds of
“It has helped me to connect in the trainings
with folks who were in U.S. armed special
forces. They were brought in and were able to
share stories and experiences –from what he
dealt with in military that meant a lot to me.
Hearing how they did business, how they took
care of selves was a good fit, and connected
very well with me.”
incident response. It’s refreshing to be able to
“Being with my wife is the easiest thing I do all
jump into a conversation with someone you
day. She doesn’t have to do anything, she just
haven’t seen in three years, and you can pick it
has to be there- I got what I wanted when I got
up again, based on complete honesty. And
married. She is just the person who gives me
because it’s also a very small group of people,
what I need when I come home, by acting
we see the same people again and again; when
normally. The thing she likes to do most is go
you pull into fire camp you know them. This is a
camping, so I go from one tent to another. She
place to find your faults. You self-deprecate,
always asks me if I need a break from a tent,
learn from your mistakes, and improve. There
but it’s a completely different situation. So it’s
is a sense of competency that you have to
all right, I relish getting back into the tent.”
20
68
Connect: Others
“I’m an introvert, like many firefighters. I like to
fight, and then I flee. That is innate, so that is
what I do. I do tend to disappear. That’s just
how I cope. But for introverts, it’s important to
bring them back into the tribe, get them back
into that connectedness after they recharge,
whatever that looks like for them. That is the
key.”
person, they can say whatever they want and I
won’t freak out. You need to recognize when
it’s time to escalate to that approach – to say
“you need to get your shit in a kit – get your
stuff together. That’s the far end of the
continuum. “This is what’s going to happen and
here’s why.” The couple of times I had to use
that, the individuals recognized later that they
were in the orange/red zone, making very poor
“What makes people calming to be around is
genuineness. I tend to try to surround myself
with people who are genuine. I don’t seek out
those who party until 2am; that’s not what I
want, not what I need. I just need peace and
quiet away from incident response. As long as
there’s someone you have a good feel for, and
you know it’s what you need right now, you can
seek that person out because you know what
decisions, despondent, fighting it.”
you’re going to get. Rather than trying to put
“Some people block getting support. One of
pressure on someone to help me out who
the guys I work with had a different perspective
can’t, I’d rather go seek the person out who
than his supervisor. They were oil and water,
can provide what is advantageous for me, and
did not make good team. The firefighter was
hopefully for them at the same time.”
going through personal stuff and needed to
“If someone is resistant to getting support, one
way I’ve addressed it is going to a more
authoritative approach. I go in to the office and
close the door and have a “come to Jesus talk.”
It may not be the right approach but it has
worked every time. I have talked to that person
and said “look, here is some life coaching, here
is some advice. You’ve got a, b, c, and d. What
the hell are you doing? I’ve only done that with
people who trust me. They know I’m a safe
20
spend time with family. One of his
grandparents who he was very close with was
not doing well. He said, “my supervisor doesn’t
want me to leave, I don’t need to talk with
anyone, I don’t need to go home.” I became
the person to talk with. I told him “if you come
to work, you will sit and do nothing. You are
going home to see your family. I will buy ticket
for you to go back if you don't’ do it.” It took
that shock for him get it, but he was really glad
he went home.”
69
“There was a fatality and one of the crew felt
condition. But the definition of insanity is
overwhelmingly responsible for the incident.
doing the same thing over and over and
We rallied around him as much as he would let
expecting a different result. Isolation doesn’t
us. He was a solitary kind of guy before the
allow you another’s potentially healing
incident, so it would be normal for his reaction
perspective. Thankfully, isolation isn’t so
to be one of retreat. A year ago, I would have
common in our cohort. As we progress in our
let him retreat, but because I was introduced to
careers, foster a crew mentality. There are
the SFA model, I rallied an effort to help. Post-
very few opportunities to come up through the
accident, I included him in discussions and
agency by yourself; it’s not always what you
projects for which I would not have in the past.
know that counts- it’s who you know. And, it’s
They were positive projects that would benefit
who you know that’s going to be helpful when
from his expertise, and created collaborative
you’re hurt.”
opportunities with peers. It gave us the
opportunity to include him, take his
temperature from time to time. It redirected
his energy to get him back to a sense of
competence, confidence and connection, to get
him back into doing something that was in his
wheelhouse professionally. These actions have
all the appearances of being effective.”
“It’s amazing how fast the connections happen
in fire world. You look around any fire camp
and you know people – you have that sense of
support without even having to go say hi to
them. It’s amazing. Plus there is a familiarly of
operation. You know where you fit in the
process, and what is expected there.”
“Relationships created in fire often seem
intense and close- like a family. But, often
those relationships change when things stop
being fun and light-hearted. Sometimes when
people start having real problems and going
through hard times, friends from fire don’t
connect in the same way. We have a lot of
“A lot of people get into this job because they
values in the fire service, like duty, integrity,
like taking a 20 mile hike and spending two
and respect, but we need to put more on being
nights in woods, and they see that as character
good people to each other when things are
traits that everyone should have to be healthy.
hard, because the reality is that our jobs can
It can lead to isolation. The lone wolf might
create a lot of problems in peoples’ personal
embody an American ideal to some, but maybe
lives. You don’t have to be lifelong “brothers”
not such good thing when you’re broken. Some
to be a genuine friend to someone. Reaching
isolate themselves to get back to a simpler
out, supporting other people getting help, and
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70
keeping other people’s personal information
“Connecting means sitting and listening and
confidential go a long way. For instance, for
being comfortable letting the other person talk,
people who are really depressed in the winter,
and taking on some pain so they leave feeling
give them a phone call, a text, whatever is
better. But it doesn’t mean keeping that for
simple and how you normally communicate.
yourself, either. Recognize that you can listen
The genuineness piece is important. There can
and empathize without taking it on in a harmful
be a lot of mistrust, but we need to look out for
way. It involves learning to listen attentively,
each other.”
recognizing that it could hurt, and if it starts to,
“I would recommend that when there is a lot of
stress, leaders should keep people moving and
facilitate talking while you do things. I had one
leader who, instead of sitting down and having
lunch, would make people walk around camp.
He gets people engaged and laughing, and it’s
helpful for their stress levels. Or, have people
each report out on successes, loose ends, and
their plan for the next 24 hours. It only has to
take a half hour.”
figuring out what to do right after. For me, it
helps to know that no matter what I say or
what I do, there is no right way to do anything.
Don’t even bother with cliché words, just be
with them, nod, pay attention, and just feel it,
and it’s okay. I know that it’s okay to support
others, and there are plenty of people I can
reach out to after, if I need to, and I have. But I
would not walk away from someone. For me, if
it starts to hurt, I go off by myself and let it out,
away from the person who just talked to me. I
hit the pressure release valve, let my emotions
out, then look at it rationally and ask, “What do
I need to do? Do I need to go talk to someone,
is there something I can physically do, should I
do work to keep all this stuff moving towards
solution?” I have one person I can call up and
sit in a café with and have coffee, and we don’t
have to talk but I know that if want to, I can,
“My wife, and kid, and I have ways that we
and if I can’t say anything, that’s okay too. It’s
stay in touch when I’m on the road or when I’m
just not being alone while you’re thinking and
working long days. We’ve worked mitigations
feeling about it, because sometimes that’s just
into that sense of absence. It’s about re-
too much.”
prioritizing. I will choose not go to a fire. It’s not
my emergency. Instead, I will take my kid
camping, go fishing, and have some fun.”
20
“When a kid died on a crew, some crew
members wanted to split up the crew. They felt
that some were not ready to reengage fire, but
71
others on the crew were itching to do exactly
expecting to download it at 11 o’clock at night,
that. The ones who were ready to go back out
but no one would stop it. Why would you? The
were okay to leave their crewmembers behind
fact that they felt comfortable doing it, and we
because it would allow those who stayed
felt comfortable to listen, speaks to out culture.
behind the time to deal with the loss in their
If they want to talk, we’re going to be there to
own ways. I believe there is a value in staying
listen. And that is a really big asset for our
connected to those who aren’t ready to move
culture. But it’s also a huge responsibility
on even if you are. It gives the injured a chance
because you want to do it right. Right to me
to see what a return to normal looks like. I
means sharing a little hurt and reducing their
encourage people to get back with the crew
hurt. Overall it seemed like there was way too
and stay with the crew as long as they can. It’s
much pain on that side room at the beginning,
up to agencies to facilitate that time together
and it seemed like it was better at the end. I
when possible.”
understand that you can expose people
“We continue to have firefighters die in the line
of duty. The most important message I have
after all of these years is to keep calling. Please
keep calling, texting, and writing letters to the
families and co-workers of our fallen
unnecessarily to things, but I don’t think that
was unnecessary. That helps us. If I'm ever in a
situation like that, I’m going to be able to use
that to help me be stronger and get through it.
It’s mutually beneficial.”
firefighters. Regardless if they pick up the
“I read a great book, “Dealing with People you
phone or not due to the distress or pain it may
Can’t Stand.” In that book there is a very simple
cause them, the fact that someone remembers
diagram that shows that some people are task-
them on an anniversary date, or on any random
focused and some people are people-focused.
day, is what the phrase “we will never forget” is
So after reading that, I now start the
all about.”
conversation by asking simple questions to tell
“For the last honor guard assignment we were
on, we were in the gaming room playing video
games at the hotel and the hotshot crew who
had just lost one of their own walked by, and
they knew immediately just because of how we
were walking and who we were, that we were
someone they could talk to. They came in and
completely downloaded to us everything that
had happened, from the beginning to the end.
We weren’t expecting it, and they weren’t
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you what quadrant that person falls into. If an
engine captain walks into my office and says,
“How was your weekend?” and I respond, “It
was fine. Hey I need you to do this,” it should
tell them that I don’t want to talk about my
weekend. There is something of higher
priority. The inverse of that is if I walk into
someone’s office and say, “Hey how was your
weekend” and they say, “Oh it was great, we
went skiing, the kids had fun…” then I know
72
how to talk with them. If you have someone
people on for the summer, to create our own
who is task-focused and the other person is
world. You can take negative things about
people-focused, it’s hard to connect the dots.
yourself and change them. So bringing new
If you’ve got someone who wants to get it right
crewmembers on is a real opportunity to
versus just getting it done and not caring as
modify your world to make it fit for folks. I try
much, conflicts can arise.”
to push that “everyone's got something to
“Ganging up on one person on the crew can be
fixed in a number of ways. At the beginning of
the season I state the expectations. I say,
“These things are not going to happen. If they
bring to the table, let's optimize our
opportunities.” People are far less likely to
make someone a pariah if they get to know
them. I catch it as a positive opportunity, to
do, you and I are going to have a serious
conversation. Duty, respect and integrity, all
the things we preach all the time, it starts here
and now. So I'm not going to put up with this.” I
think if you lay it out at the beginning, and
address it early, and take it case-by-case
individually as it's going on, things seem to
work out. You give the crew expectations
about how we will conduct ourselves, so we all
hold ourselves accountable, and there are
consequences if we don't. It makes it really
keep it positive and engaging for everyone,
which seems to keep stuff from happening.”
easy to have that discussion later if you have
“A lot of veterans come from respective fields
that base and always go back to those
in the military, special operative special
values. Crews will do what you tell them to do
operations, rangers, seal team. What I've seen
largely. If someone is having a hard time, I
is that the younger firefighters have a higher
mention nine things that are going on to
level of respect, and gravitate toward veterans,
specifically hit on one thing that is going on, so
because of their experience: “Wow you have
I'm not singling someone out who has been
eight years of experience in the Ranger
having a hard time. I'll say “these are the kind
Battalion, what do I have to learn from you?””
of things I will not put up with: this, this, this,
this, and this.” That way no one is singled out,
and no one knows what I'm talking about.”
“We really have a unique opportunity when
we go to a fire assignment or when we bring
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73
Competence
What is Competence?
Stress can deplete an individual’s ability to
function and perform in all important life
roles including occupational, personal and
social domains. The SFA action of
Competence focuses on enhancing and
restoring these previous capabilities or
facilitating the cultivation of new skills.
Competence should be applied in
situations in which:
1. A specific lack of competence is
contributing to stress in the individual.
Firefighters and EMS personnel who
have less experience or lower levels
of training often experience higher
levels of stress.
Leaders can support less-experienced
personnel by fostering a culture where
ongoing mentoring and training
continuously improve competence and
reduce the stress that accompanies a
perceived skill deficit.
Shame and blame after difficult calls
and PTEs are reduced when fire
department leaders create an
environment in which all events are
learning opportunities.
2. Intense stress has contributed to the
loss of previous mental, emotional or
physical capabilities.
or loss injury may cause a brief
period of significant mental
confusion. This might also be
followed by a longer period of slightly
decreased ability to think clearly and
sharply, or to control intense
emotions.
3. Intense stress has created the
need to develop new skills.
Intense stress often presents new
and significant challenges to an
individual’s capacity to cope and
adapt, such as dealing with
reminders of experiences of life
threat or loss. The intensity of
Orange Zone experiences can also
require the development of new
communication skills
in order to maintain supportive
connections with others during hard
times.
Figure 15 depicts the three components
of Competence. Individuals suffering the
severe stress of life-threat trauma, loss,
inner conflict and fatigue also experience
a loss in their sources of resilience and
the good feelings that stem from
competence in their work and personal
roles. The Competence function
encourages and supports the
reestablishment of important social
skills, occupational skills and wellbeing skills, and to mentor individuals
to learn new ways to manage their
stress reactions.
A severe life threat (such as a near
miss, close call or exposure to a PTE)
Figure 15. Components of the Competence Function of Stress First Aid
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74
When is Competence Needed?
The need for Competence is signaled by:
1. Indications that an individual does not
have the experience or skill level to
address the demands of the position.
2. Temporary or persistent loss of
previous skills or abilities due to
Orange Zone stress.
3. An inability to cope with newly emerging
life challenges due to symptoms of
Orange Zone distress.
1. Lack of experience or training can
con- tribute to difficulty meeting job
demands when:
•
•
•
•
The following are examples of each
category of the need for Competence.
20
Specific operational challenges are
new to a crew member.
A crew member does not have the
experience or training to handle the
specific emotional aspects of the
position.
A crew member has not been trained
well in certain aspects of the position.
Exposure to a PTE leaves the entire
crew feeling unprepared to handle
their organizational duties.
75
•
2. Intense stress can cause the loss of
previous skills or abilities, as
demonstrated by:
•
•
•
•
•
•
•
Temporary loss of mental focus,
concentration, or clarity during an
Orange Zone crisis (e.g. foggy thinking,
freezing or going blank).
Temporary loss of emotional or
behavioral self-control (e.g. panic or
rage responses under stress).
Loss of ability to modulate
physiological arousal due to intense
stress (e.g. shaking, trembling,
pounding heart or rapid and shallow
breathing).
More persistent changes in cognitive
functioning due to wear and tear
stress (e.g. slowed memory recall,
difficulty making decisions or solving
problems).
Loss of enthusiasm and motivation
due toacute or chronic Orange Zone
stress.
Decrease in social aptitude due to
loss of sense of humor, changes in
fluency of speech or decreased
range of emotional responses.
Loss of ability to see the “big
picture” due to moral injuries.
3. Intense stress can create new
challenges to coping, such as:
•
•
•
20
Trauma or loss reminders that
cause feelings of dread, panic or
anger.
Disturbing memories of trauma,
loss or moral injury that intrude
into conscious awareness.
Difficulty relaxing, slowing down or
going to sleep.
•
•
Difficulty maintaining an “even keel”
emotionally when frustrated.
Dread and desire to avoid re-exposure
to situations that are reminiscent of
trauma or loss.
Stress-induced physical symptoms,
such aslow energy or changes in bowel
functioning (e.g. diarrhea).
Here are some examples of a need for
competence:
•
•
•
A firefighter makes a mistake cutting a
tree, and the tree falls the wrong
direction, causing his saw partner to run.
He is shaken and avoids sawing for fear
he’ll seriously hurt himself or someone
else.
A firefighter who narrowly escaped dying
experiences persistent anxiety which he
medicates with alcohol.
A firefighter veteran who had life threat
and wear-and-tear stress injuries loses
the ability to stay calm when dealing
with co-workers.
How Does Competence Work?
The Competence action lays the
foundation not only for recovery and
healing, but also for growth and
development. This can be a realistic
outcome when expectations are
managed from the start, so that every
call is considered a learning experience
and needed skills are obtained and
practiced.
Competence can reduce the stigma
associated with Orange or Red Zone
stress by minimizing its impact on an
individual’s firefighting or EMS career or
76
volunteer service. It also reduces the
potential social consequences of Orange
and Red Zone stress by identifying those
interpersonal skills that have been
diminished and facilitating their
restoration as quickly as possible.
How is Competence Implemented?
The core process for the Competence
function of SFA is to take one step
backward in order to move two steps
forward. In other words, like an obstacle
that suddenly appears on the road after
we drive around a bend, Orange Zone
stress can present a life challenge that
sometimes cannot be circumvented
without first stopping, backing up a bit
and then changing course. Figure 16
describes the elements of the three
Competence steps (1) Stop (2) Back up
and (3) Move forward again.
Figure 16. Steps to Perform the Competence Function of Stress First Aid
Competence
Step
1. Stop
Specific Intent
How to Implement it
• Rest, take time to recover
• If possible, take an operational pause
• Identifyskillsdecrementsor
challengestofunctional capabilities
• Assess functional capabilities and limitations in occupational,
social, and personal well-beingspheres
• Don’tkeepdoingwhatisn’tworking
1. Back up
• Retrain and refresh old skills
• Refresher training
• Learn newskills
• Leadership mentoring
• Explore new options
• Problem solving
• Training in new occupational, social or personal wellness skills
• Enhancewellnessthroughsleep,goodnutrition,
exercise, meditation, prayer, etc.
1. Move forward
again
• Practice refreshed skills
• Gradually increase responsibilities and duties
• Practice and perfect new skills
• Setachievablegoals
• Find new directions and goals
• Explore and trouble-shoot obstacles as they arise
• Reinforcesuccesses
• Reinforce motivation to overcome challenges
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77
In addition to training and mentoring in
occupational skills, leaders should
consider educating their crews in a
variety of stress coping skills that are
relevant to Orange Zone stress.
Examples of important well-being skill
sets that should be considered as part of
the Competence function of SFA include:
•
•
•
•
•
•
Goal setting
Problem-solving
Physical exercise and conditioning
Sleep hygiene
Relaxation and self-care
Anger management and conflict
resolution
• Attitude and belief adjustment
•
•
•
•
If the person feels shame about his or
her ability to perform in the position,
implement remedial steps to offer as
an alternative.
Reduce any sense of helplessness or
passivity.
Find ways to integrate the individual
back into their role within the
department.
Provide supportive, corrective
feedback and resources.
For example, if a firefighter is avoiding
some aspect of his or her duties,
resulting in a hesitancy to return to full
duty, a progressive program could be
devised to gradually help him or her to
get back to full functioning.
Competence: Leader Actions
Leaders are in a unique position to perform
the Competence function of SFA in
important ways, including:
•
•
•
Reduce the exposure to the particular
stressors confronting the individual.
Delegate meaningful activities to the
stressed person to increase sense of
competency.
Find a step-by-step strategy for the
individual to resume productive
contributions within the organization.
What are Potential Obstacles to
Competence and How are They
Overcome?
Restoring and enhancing Competence in all
important life spheres can be challenging.
Figure 17 lists a few possible obstacles to
Competence and ways to mobilize
resources to overcome them.
78
Figure 17. Potential Obstacles to Competence and How to Overcome Them
Potential Obstacles to Competence
Mobilize Resources to Overcome Them
You do not have the time, trust of the individual or motivation to
restore Competence
• Coordinate with others in the unit to support mentoring, retraining or skills building
The individual does not recognize their need for the Competence
action
• Refer the individual to the Peer Support Team or the EAP Provider
• Repeatedlybuttactfullydescribeyourobservationsabouthis/herfunctional
capabilities and performance to the affected individual
• Coordinate with others to trouble-shoot obstacles to restoring the individual’s
competence.
• Coordinate with others to do the same
The individual lacks motivation to retrain or develop new skills
• Appealtotheperson’sloyaltytopeers,familymembersandotherswhorelyonhim/her
• Coordinatewithotherinfluentialpeopleintheindividual’slifetoenhancemotivation
Resources are not available for retraining or training in new
skills
• Actively address the need for resources
You are not sure you have sufficient skills to implement
Competence
• Consult with others; seek mentoring
• Consult with other commands to brainstorm ways to address lack of resources
• Refer individual to other levels of care
Competence Strategies: Self
Competence Strategies: Others
Here are a few strategies for building your own
competence:
Here are a few strategies for building
competence in others:
•
If you’re under too much stress, do
something that is easy for you to give you a
sense of accomplishment.
•
•
Be more disciplined in taking whatever
healthy steps support you in dealing with
stress.
If someone is psyching him or herself out,
because they are overthinking give them
simple systematic ways to occupy their
thoughts, like counting random numbers,
or counting steps.
•
Mentor others by figuring out how the
person is going to best learn something,
and potentially teach the same strategy to
others.
•
If someone is struggling to learn something,
find someone who matches their
personality, somebody they can relate to
and communicate with, and assign that
person to them.
•
Regularly reflect on the balance between
the satisfaction of fulfilling work duties and
the personal sacrifices you are making. Be
prepared to adjust behaviors and
expectations if that balance changes over
time.
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•
Start with absolute basics and provide
stepped escalation of stress and
responsibility in a calculated manner.
Competence: Self
•
Give the stressed individual responsibility
little by little, so that they are more and
more in control, to build a past foundation
so that when they are in a situation where
serious mistakes could happen, they know
that there is a high likelihood that they will
be okay, and if they’re not, it’s not because
they didn’t try.
doing something that is easy for me. It gives me
•
•
•
After mistakes, help the person become
more competent, to help with shaken
confidence. Remind them that everyone is
human, that all reactions are acceptable in
the right context, and help them to figure
out what they might do differently in the
future.
As a leader, if your crew’s sense of duty
and commitment lead to overworking,
make sure that they're getting rest, and
advocate for them.
Before you have a conversation with
somebody who you think needs time off,
make sure taking time off is feasible for
that individual.
When I’m under too much stress, I revert to
a sense of accomplishment, like tidying the
garage, or shoveling snow for a widowed
neighbor. It doesn’t take much thought, but it
gives me a sense of accomplishment.”
“It's just my nature to work hard. I'll go to the
office for an hour, and I'll stay late, it's just how
it goes. It's hard. It's really difficult to put worklife balance into practice. It comes a time and
age and shifting priorities. It's definitely
difficult. But you do have a lot of stuff to do.
Sometimes I'll get our junior and senior
leadership to do things for us. That takes some
of the workload off. There's just so much to
do.”
“I probably take on way too much, because I
don't like the guys come in. So if the buggy
needs to go out, I'll take the buggy in. I'll make
sure the times are in. It's handling all that stuff
because I need them to rest. I get winters off,
I'm home pretty much every night in the
winter, so I've accepted that for the job that
I've taken for the rest of the year, I'm
committed. My wife commits to that, and the
family commits to that. Right or wrong, that's
the life I live. Those of the sacrifices, and those
of the things I accepted when I took this job. I
don't expect my people to do it, because I
expect them to get rest. The position that I'm
in, I've taken that position. Therefore, it's my
responsibility to make sure these things get
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80
done. That is what I've accepted with my life.
go,” and my infant was in tears because
That's how I've adapted. For each person it's
everybody else was upset. I could hear my wife
going to be different. They will be constantly
behind me grinding the dishes into the
assessing where they are, where their families,
countertop. For me that was a watershed
where their crew is.”
moment. I realized that I had my dream job,
“In terms of self-care, I went through several
iterations initially as a young superintendent.
First it was, “I know we're on R & R, but we've
got to get the stuff done, to you guys need to
rest, go home, I'm going to take care of the
stuff.” Looking back on that, everything was
fine, everything was in harmony, but as time
goes on, as your situation changes, as all that
stuff starts to change, so I would say to stay
attuned to those changes and where you are
and the seasonality of your life. A very key
moment in my life showed me where I knew
that I was done as a hotshot. As far as I was
concerned, superintendent was my dream job,
I was going to retire as that, and I could not see
anything beyond. Then in one particular
season it was just slamming, and it was
different because it wasn't 14 and two, which is
very nice for my wife and kids to be able to
depend on. But this season it was variable:
home for an hour, or for a few days, home for
half a day, gone for a week. I had just gotten off
a fire, and had come home, unlaced the boots,
and sat down at the dinner table and the
phone rings with a call for the crew and I said
okay. I looked up, and was re-lacing the boots
that I just taking off, and my oldest daughter
got up abruptly and left the dinner table, and
my son was barring the door saying, “you can't
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but now my family, the part of my life that was
my rock and anchor, was now in jeopardy.
We're in a culture where we're a team and the
crew and we are going to keep pushing on.
That value is kind of ingrained in us. But I knew
at that point that I was not willing to sacrifice
my family for that, so it was time for me to
move on.”
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Competence: Others
“I came into a fire program that was pretty old
school. I had people who had very little
exposure to anything. In the first week I sat
with each employee individually and asked for
the top three things we can work on. Then I
told them that for next 12-18 months you will
be busy, and you will hate it, but everyone will
have an achievable goal. Every person looked
at the list and said there is no way this can
happen. We don’t have the funding, capacity,
“I had a couple of guys that I sent to advanced
fire calculations course. It’s all boring
math/science equations and calculations. I
tried 3 different ways to describe the
meteorological section to them, prepping them
to go to the course. Finally I got through to
both of them when I drew a river. I think a lot
of the competencies like that can be tied back
to mentoring. You can mitigate a lot of issues
with the right mentoring. The platinum rule of
treat others the way they need to be treated,
the skills, the knowledge, or the training. I said,
all I’m asking for is a little bit of trust. At the
end of that time period, everything had been
done – we built competence and that was tied
to their confidence.”
“In first year of training, people don’t know
what they don’t know. There is so much
learning going on. I’ve had a very fit trainee fall
out of ridgeline. He could run a marathon by
himself, and do anything by himself or with me,
but in a crew setting, he would psyche himself
out, because he would start thinking about it.
So I started working with him individually, and
telling him, “all you have to do is put your boot
where the boot in front of you was, keep the
same cadence and tempo, and find some way
to occupy your brain.” I told him to try
counting random numbers, or counting steps to
occupy his mind so he could build more
confidence. That was one of those little tools
that helped.”
20
it’s the same thing with teaching. It’s not about
me, it’s about how are you going to learn this
and how are you going to get the then get
confidence to teach it as well. A lot of one on
one is the way to do it.”
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“In every shop there is a great amount of
give them a small task to do for me. Just to
flexibility with returning firefighters to light
give them a job to do that is easily
duty – we call it “other duties as assigned.” It’s
accomplishable, or at least give them an option
what allows me to tell someone to do just
to do it, keeps one foot in door. If it gave you
about whatever I want them to do. It can at
professional pleasure before, it can again. I will
times provide immediate cover. It allows the
tailor it depending on the circumstances. If
person who wants it to remain productive. I’ve
they are not responding to me, I will try to find
got a job where we can adapt to whatever the
someone who they’re more connected with
new normal might be; it lets you get a sense of
who might know what they need.”
productivity and competence. Most want to
press on – there is a benefit to the soul in
remaining productive. That option of light duty
takes advantage of the fact that everyone may
have skill no matter their condition.”
“Aerial training is intense, and every year
we’ve had 1 student who just can’t get it.
Every time we’ve done this, when the cadre is
getting ready to ship him home, we find
someone who matches their personality,
somebody they can relate to and communicate
with, and we assign that person to them. We
build their competence and confidence by
starting with absolute basics in a small one-onone setting, then by bringing more of the cadre
into the room on a sand table or a computer
simulation. Slowly the whole cadre is there to
observe, and then to say, “great job, you
passed the simulation.” It’s a sliding continuum
“If a person is resistant to go back out
where we provide an escalation of stress and
immediately after a tough call, it is acceptable
responsibility in a calculated manner.”
to take break for a few weeks. I’ve never heard
a supervisor force someone to go back out
immediately. If work gives someone great
pleasure, it might not be helpful to take them
out of work. But if they do want to go home,
they may be anxious about coming back. So I
will call them in a couple days, catch up, let
them know what’s going on, what options
they’d have if they did come back, and even
20
“Our training, and the structure of the fire
system, is set up to accommodate operational
competence. We know what to do on fires
when complexity increases, but outside of fire
operations, we don’t have a lot of training or
cultural knowledge. Socially, psychologically
the go-to strategy is suppression of stress and
emotions. It’s probably a pretty good strategy
for the short term, but then it turns into a long-
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term strategy. So why not offer some training
works. And to have a successful track record,
in being proficient in dealing with emotions and
that you can rely on, and recognize, and to
stress, since it’s such a big part of this job? It
applaud before you need it, is huge. It takes
may contribute to competence on the job just
time to build up that track record after
as much as all the training we receive to
mistakes. You may be confident that you will
become operationally competent.”
never make THAT same mistake again, but you
“I really see the benefit of teaching in order to
become proficient at your job. The anxiety of
having to teach drives them to learn more. In
turn, they function better at work, and even
though they didn’t want to teach at the start,
many take to teaching for a lifetime. I know
what makes people anxious, so I need to set
them up for success. They come in very
do know that there are a million other things
that we can trip over, so it pays to brush up on
your competence a little to help cover your
shaken confidence. It also helps to have
someone remind you that we’re all just human,
and all reactions are acceptable in the right
context, and then we can figure out what to do
after that.”
stressed the day of, but by the end of the day,
“Pretty much everyone I see is burdened by
the scaffolding I’ve provided has given them a
work. We are out taking on more duties as our
successful day. Without knowing that those
workforce shrinks and budgets shrink. I think a
three Cs of connectivity, competence, and
lot of people will offer “solutions” when they
competence were there, I just called it setting
really don't know if those solutions are
people up for success.”
possible. To say you should take a month off
“When you give people more responsibility,
and give up control to them, they are more and
more in control. Every little thing builds. As
things get a little more complicated and a little
more complicated, they have that past
may be really tough for someone to do. So
before you have a conversation with somebody
who you think needs time off you need to
make sure that the check can be cashed by that
individual.”
foundation to go off of, so that when serious
“I had to have conversations with people and
mistakes could happen, they know that there is
say, “don't come in to work on your day off.
a high likelihood that they will be okay, and if
Get some rest and relaxation. Don't come into
they’re not, it’s not because they didn’t try.
this office.” People’s sense of duty and
There will be enough successes to be able to
commitment to the crew sometimes lead to
point out that they did this many times before.
overworking. I have to make sure that they're
They will do it, and nothing bad is going to
getting rest and that I advocate for them.”
happen to them. So they can trust and to hope
that that it will be okay, that it’s really how life
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84
“I talked to the acting superintendent and he
in another position where he doesn’t
hadn't had a day off in two straight months. He
supervise.”
did reach a breaking point and started to say,
“this is the system we've got, and we've got to
take a break. The crew is not going to be
available.” When he got calls from the regional
office and they said, “hey we've got orders,
emergencies,” he said, “not mine, not theirs.”
It took me a long time to realize it. We felt like
we had to do things. It took me a long time to
play that back out to say, “you know what, we
won't be there, sorry.” The greater duty is for
the well-being and safety of the crew. So, I
began putting that first. You have to do it. Are
there going to be fires in 10 years? What's the
big deal? You didn't start it. You’ve got to take
care yourself.
“Fire seasons are getting longer fires are
burning longer. The one thing that is it
changing is the size of the workforce.
Supervisors have to then develop the skills to
support their crews. You can give them five
days off to mitigate the stress, but then
regional office starts calling. We have to be
careful. We have to develop the ability to
assess whether we should we be asking a crew
to go to a fire. It’s very subjective, and it’s a
cascading effect to work life balance. Stress
First Aid can be used as a mechanism which we
can monitor the crew’s stress levels and then
put our foot down and say, “this module is
unavailable.” Or not available today. I’ve told
“Someone I worked with was good at fire
dispatchers that will be somewhere tomorrow
management but built his whole identify on the
when they said we need to be there tonight. I
job so exploded with crew if they did anything
tell them, “I understand what’s going on but
he didn’t like. It took a toll on the crew, and he
I’m not going to change that event. I’ll
was finally required to get professional help
compromise – we will leave a little bit earlier
and anger management.”
but we’re not going to miss a whole night of
“We don’t always have the time to mentor
everyone. There’s a range within which you can
put your attention and effort, and outside of
sleep. It’s too much risk for not much game
gain. Every fire goes out. You have to have an
ability to say no and take care of your people.”
that range, you’re potentially risking the good
“PT is always an issue for some people on the
of the whole crew. You try as hard as you can
crew. A lot of times it’s the hiking. When they
to help somebody, but sometimes you have to
get tired and start to fall out, the top of the
move somebody to a different workspace. A
mountain seems so far away. The rapid
supervisor I worked with really struggled with
breathing starts. I’ve had people that it didn’t
conflict, even pretty basic, pretty simple
even matter whether it was a hard hike or an
conflict. He frequently lost control, and his
easy hike. 10 steps in and they’re a mess.
employees took it personally. So they put him
Sometimes it gets to be a full grown panic. I tell
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85
them to just look at the boots in front of them
good books about this. I read a very good book
and concentrate on those don’t look at how far
that breaks different layers down into very
the top is. Concentrate only on your breathing.
simple strategies for dealing with different
Sometimes you have to go back to basics and
types of people. It can give you some strategies
stop looking at the big unit and start thinking
for how to deal with somebody coming into
about the small steps to get you there. Focus
your office screaming at you, like setting
on what you need to do in the next couple of
boundaries. For instance, you stop them and
steps. You don’t want them to lose sight of the
say, “no one no one speaks to me that way” It
big picture but if you can break the inertia and
puts them on their heels. They don’t know
two small steps where they know they’re
what to do, short circuit, and leave. You keep it
competent then it can build their confidence.”
clean, don’t get angry yourself, but say no, not
“A lot of stuff we do is hands-on, it’s good to
in my world.”
get a good balance of people so that some can
“We were really close to signing off one of the
mentor and teach as you go along. We do a lot
sawyers on our crew. He had the skills, and he
of that. It’s just the way things get done.”
had a lot of advanced cutting techniques, but
“Work stress is compounded by life stress. You
can’t avoid the news anymore, and people’s
stress levels in general are high, where they’re
constantly getting bombarded with bad news,
and getting crushed by the news. At some point
you have to put the phone away turn off the
notifications and pick and choose what you
want to hear, in smaller doses. I tell my crew,
day by day, just keep doing what you can do,
try not to go beyond that.”
he was trying to implement them into his level
of cutting. He was developing the confidence
but wasn’t consistent with it. He would nail
several types of trees, but all the sudden be
completely baffled by one. Rather than keeping
it simple, he was trying to apply to much
knowledge to the situation. So through many
conversations, we actually knocked his
confidence down in some situations.
Sometimes confidence and competence
fluctuate with each other. Especially if it’s
“When you build up an individual, you’re
uneven, sometimes you have to knock some
building a team. People feel more confident in
down to get it back in alignment. It’s a good
what you’re doing, and more comfortable
thing to have ups and downs. It’s about
around you. There is less fear about messing
growing.”
up. It’s a whole group thing. When you build up
an individual you build up a whole team.”
“Sometimes our jobs require us to learn new
skills in conflict management. There are very
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Confidence
What is Confidence?
Confidence is the final SFA action. It
focuses on building realistic self-esteem
and restoring hope, both of which are
often diminished in the aftermath of
intense or prolonged stress.
Confidence is the capstone of the process
of recovering from stress, becoming
stronger, more resilient and more mature
as a result the experience.
Realistic self-confidence and self-esteem
are earned by overcoming obstacles and
hardships to master challenges and
achieve goals. After a PTE, fire service
leaders and peers play a pivotal role in this
process by supporting personnel as they
make sense of what has happened.
Through this growth process the stressed
individual will come to understand his or
her role in what happened and learn
from mistakes (if any) that were made. If
properly supported by department
culture, he or she will also develop a
personal philosophy of learning from,
rather than being crushed by, intensely
stressful events. Personnel will also learn
to set realistic goals, work to achieve
those goals and maintain a positive but
realistic self-image.
Figure 18 depicts the four components of
the Confidence function of SFA: Trust,
Hope, Self- worth, and Meaning. Each of
these is a key to living a constructive,
creative and fulfilling life— as an individual,
and in relation to important others,
institutions and values.
Figure 18. Components of the Confidence Function of Stress First Aid
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87
When is Confidence Needed?
Each of the SFA actions discussed up
to this point addresses a potential
need of an individual who is
currently experiencing intense
stress. It is important to note that
for a person in the Orange Zone,
these needs can be experienced as
deep insults to self-esteem. This can
be especially true within the fire
service culture, which prizes selfsufficiency and autonomy.
However, the strong connections
present in the fire service culture
can be an asset as Confidence
depends on a firm social base to be
effective.
Confidence addresses the need to restore
a positive and sustainable self-image
based on a realistic sense of one’s own
capabilities. The life challenges addressed
by Confidence are common to all human
beings throughout their lives. It can be
assumed that everyone who experiences
a reaction to stress will face a challenge in
restoring and maintaining a positive selfimage in relation to the world and can
benefit from Confidence actions.
Confidence is directly related to having a
sense of positive self-worth, meaning,
trust and hope. The urgency and
importance of the Confidence function of
SFA becomes apparent when one
considers the alternatives: the alternative
to hope is despair, the alternative to trust
is alienation, the alternative to meaning is
emptiness, and the alternative to positive
self- worth may be suicide.
Here are some examples of a need for
Confidence:
•
•
•
•
A fire with a lot of fatalities makes a
crewmember see that bad things happen
to great firefighters even when they do
everything right. He starts to question
whether fire suppression is worth the risk.
After a critical incident, a leader
repeatedly questions the events and
decisions leading up to the event. He
questions whether he is capable of leading
others in high-risk situations in the future.
He no longer trusts himself.
A young firefighter has a question about
risks on the job and the way things are
being done. He becomes unsure whether
what they are doing is serving the land or
the people. While his crew is really good
at putting fires out quickly and efficiently,
he often disagrees with effects of fire
suppression on the land and wonders
about the long-term ecological
consequences.
You see a change in nonverbal cues
indicating that a crewmember has low selfconfidence, such as slouched posture, the
way he is wearing his hat, not standing at
attention with shoulders back, not squared
away like he normally would be, no eye
contact, or a change in healthy routines,
such as skipping PT.
How Does Confidence Work?
Confidence builds positive self-esteem and
self- image by:
• Helping to restore confidence in self,
leadership, organizational mission or
core values and beliefs.
• Helping the individual to make sense of
what has happened, and mourn losses
and limitations so that self-worth is
restored.
• Exploring possible obstacles to
confidence, and problem-solving
solutions.
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Building confidence often involves
helping people to change their
perspective or reframe the way they
think about themselves, their life
and the world. It also usually entails
helping them make sense of what
happened so that it doesn’t bleed
over into the next event or
experience. Often, too, it means
helping them find forgiveness and
trust in themselves, the people
around them, their values and their
spiritual beliefs.
Restoring Confidence requires strong
communication and/or leadership skills.
It is only through the empathic but
honest support and feedback provided
by a trusted individual over time that
people recovering from intense stress
can find sustainable self-worth, meaning,
purpose, trust and hope for the future.
20
It is important to meet people where
they are, without preconceptions or predetermined solutions. During the course
of recovery, individuals must perform
hard work—grieving losses, giving up
immature ways of viewing themselves
and their relationship to the world and
forgiving themselves and others for their
failings.
How Do You Implement Confidence?
Confidence requires an empathic, honest
relationship between the SFA provider
and the affected individual. There are no
shortcuts.
The SFA provider must be respected so
that distortions of thought and
perception, once confronted, will be
genuinely reconsidered. Tapping into
respected symbols and ceremonies may
also prove helpful. Figure 19 lists some
possible procedures to develop
Confidence.
89
Figure 19. Steps to Perform the Confidence Function of Stress First Aid
Confidence Step
Assess needs
Connect with
resources
Specific Intent
How to Implement It
• Assess self-image, understanding of
meaning of life events, level of trust
in self and others, and hope for the
future
• Listen empathically
• Restore depleted physical,
psychological, social, and
spiritual resources
• Coordinate with all possible sources of needed resources
• Develop a trusting relationship
• Ask questions and offer tentative observations and understandings
• Address financial problems, family problems, occupational problems, health
problems, etc.
• Identify obstacles and find solutions to overcome them
Encourage growth
• Remove excessive guilt or shame
• Listen for and confront distorted concepts or perceptions of self or others
• Promote forgiveness of self and others
• Encourage the individual to see events through the eyes of others, to walk in
the shoes of others
• Establish new meaning and purpose
• Set new directions and goals
• Appeal to trusted authority or spiritual figures
• Encourage making amends, or giving to others the same things that he or she has
lost
• Encourage learning and education
Confidence: Leader Actions
Leaders play an important role in building
trust and self-worth by developing clear
lines of communication; reducing stigma;
offering encouragement and praise;
fostering and supporting efforts that will
alleviate and mitigate stress; and helping
to re-establish confidence in colleagues
who are experiencing stress reactions.
For example, if a firefighter has been
temporarily removed from duty due
to Orange Zone stress injuries,
supervisors can convey a realistic
timetable for recovery and return to
work. Company officers can also
work with crew members to support
the affected firefighter by:
•
Gradually increasing duties and
responsibilities.
•
•
•
•
Being willing to cover, check and
compensate for his or her work for a
period of time.
Being patient and open to the
possibility that the affected individual
can return to duty.
Looking for positive changes in the
firefighter’s behavior.
Helping to clear up the
difference between making
assumptions based on no past
breach, and establishing trust
after a break.
What are Potential Obstacles to
Confidence and How are They
Overcome?
Restoring and enhancing Confidence is one
of the greatest challenges of SFA. Figure 20
lists a few possible obstacles and ways to
overcome them by mobilizing resources.
90
Figure 20. Potential Obstacles to Confidence and How They are Overcome
Potential Obstacles to Confidence
The individual is unable to grieve the death of a
friend or co-worker
Mobilize Resources to Overcome Them
• Search for and confront excessive self-blame or blame of others
• Relentlessly point out the self-destructive nature of stalled grief
• Encourage the individual to imagine how the deceased person would want
him/her to feel, or how they would want the other person to feel if the
situation were reversed.
• Encourage the individual to talk to trusted friends or family members
• Encouragephysicalmemorialsandceremonies
The individual has lost portions of himself or
herself that are viewed as essential
• Encourage supportive relationships with others who have sustained similar losses and
foundnew hope
• Identify and confront excessive self-blame or blame of others
• Encourage the learning and mastery of new skills and abilities
The individual feels unforgiveable
• Encourage the making of amends, even if that will be a life-long endeavor
• Invoke an authoritative social or spiritual image to promote forgiveness
• Consistently point out the self-destructive nature of self-blame
The individual cannot forgive others
• Consistently point out the self-destructive nature of blame and revenge motives
• Encourage the individual to learn more about and empathize with those who are blamed
• Appeal to core values
Even under the best of circumstances, it
takes concerted effort over a long period
of time to restore Confidence. Both the
stressed individual and the SFA provider(s)
must try to be patient and accepting that
today’s efforts will bear fruit in the future.
SFA providers must understand
boundaries, and be careful not
overstep either training or
relationship with the affected
individual. If the provider is unable to
provide the appropriate assistance, it
is important to know what resources
are available, and to be creative in
finding an appropriate person to
connect with the affected individual,
such as a friend, counselor or a
trusted mentor.
Finally, in promoting Confidence, it is
essential to continuously monitor (ReCheck) affected individuals for possibly
dangerous thoughts or impulses. If
necessary, actions should be taken to
ensure the safety of the affected individual
and of others by making a referral for a
behavioral health evaluation and possible
treatment.
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Confidence Strategies: Self
Here are a few strategies for building your
own confidence:
•
Use small triumphs to build confidence.
If you have self-doubt, read more selfhelp books or tactical reports.
•
After particularly traumatic situations
or losses, don’t push yourself to
“process” the situation in any particular
time frame, but if something triggers
you, give yourself time and space to
think it through, integrate it, talk to
someone, have emotions, find ways to
makes sure it doesn’t cause you to get
stuck in suffering, and / or make sense
of it.
•
•
20
Use the wisdom gained from hard
experiences to reconfirm your values,
make changes in your life, appreciate
what you value, or help others.
If you have tried to mentor someone
and cannot get them up to speed,
realize that not all personalities fit this
job, and sometimes you have to walk
away.
Confidence Strategies: Others
Here are a few strategies for building
confidence in others:
•
If young firefighters are struggling with
confidence, give them tasks that they
can be successful at, solicit their
opinions, set them up for success, or
find some way they can contribute to
the crew.
•
If firefighters show severe stress, talk
with them, work with them, give them
relevant reading materials, and
connect them to people who have
dealt with similar things. If they
continue to get triggered, mentor them
to consider their options, including
leaving the fire service.
•
If a firefighter is feeling bad about
some reaction he/she had, help them
counter their guilt by normalizing their
reactions, and letting them know they
are not alone in experiencing stress
reactions.
•
Consider involving other disciplines or
mentors/peers who can implement
Confidence either more effectively or
in a complementary way to you.
•
Improve communication, mentoring
and information about mission and
acknowledgement of person’s value.
•
Make efforts to confront stigma about
stress reactions
•
Foster and support doing things that
will alleviate and mitigate harmful
effects of stress.
•
Help to re-establish belief in colleagues
who have stress reactions.
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Confidence: Self
“I had to come to the realization that if I had
been with the guys who died, that I would have
been one of them. I trusted those guys, worked
with them countless times, spent time with
them both on and off the clock. To come to
that realization took a long time. First started
working 14 – 16 hour days, working on my
house, staying totally busy. Then it started
snowing. I put a log on the fire and burned my
hand, and I lost it. I thought, “I just got a small
burn on my hand. Imagine what my friends
went through.” So I had a good cry, let it out,
and then I made it a personal mission to start
informing young firefighters about the dangers
“I heard a speaker give an analogy about life
and moving forward after trauma. He spoke of
a vehicle cruising down the highway, with the
driver paying full attention to the road ahead.
Every now and then, the driver will look into
their rearview mirror, reflecting on the road
behind them. The glance to the past doesn’t
capture their gaze for long, because the driver
is heading into uncharted territory and needs
to be in the moment, paying attention to the
road ahead. In similar fashion, I’ve found I
must look to the horizon, keeping my eyes,
heart and mind fixed forward. I can glance back
for a bit, but mindfully keeping my focus on the
life before me.”
and risks of this job, so they can come to accept
them.”
“You can be the most skillful person in the
entire world but if you don’t have faith in self
you are doomed. You’re never going to get
through it. And vice versa, you can be
overconfident but not able to learn from
mistakes or be more effective. You’re just going
to keep circling the drain. There is a fine line
between the two. The better you are at one,
the better you will be on the other one. Even
small triumphs can help with confidence. Trust
is hard to rebuild. Confidence is that way too. If
you have had a bad outcome, will always selfdoubt. You end up going to read more self-help
books, or tactical reports. Then you realize that
you were already good at your job. It was a
lightening bolt that came out of the sky, it had
nothing to do with your skills.”
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Confidence: Others
“When something seems out of place, I will act
on it. Maybe one day a person just needs a
pick me up. I try to be mindful and observant
as a leader in order to be there for that person
at times like that.”
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“If someone has bad attitude, their confidence
He froze, locked up. He had a really tough time
is low, and he feels like he has no sense of
coming back into the system. He just needed
purpose, or is not contributing to the team, I
some time off. Maybe he was too close and too
direct them to the team, and point out how the
inexperienced. About half way into the season,
team is all pushing forward to a good outcome.
he went back to spend time with his family. He
I try to help them look for something specific
ended up getting back into the crew. He
that they’re good at, some skill they have that
recognized he needed it, the crew wasn’t mad,
really does contribute to the team, and point
upset, or disappointed, and they gave him what
out their strengths, even if it’s just that they’re
he needed and supported him. He was still in
helpful and nice to crewmates. Something
town and still hung out with us. After his time
tangible. If you notice stress reactions, maybe
off, he got back into the system and is doing
you can point out one of the person’s other
well.”
strengths.”
“I’ve had a couple people who were super fit
but couldn’t hike up the hill with the crew. We
worked with them and tried and tried but they
quit in the middle of shift. We tried to boost
their confidence and give them that power that
I know they had, but they couldn’t figure out
how to turn it on when they needed it. They
“Sometimes it’s simple, if they don’t feel
were playing head games with themselves.”
comfortable doing something at that time for
some reason, but they’ve done it before and
“As a leader, I saw that a young firefighter was
know how to do it, so you just relate the
struggling to find a way to contribute to the
person back to their skills: “you do this all the
crew, which was affecting his confidence. I
time, you’ve done it before, you know how to
made an effort to give him tasks that I knew he
do it, just take a deep breath, take a step back,
would be successful at, asked his opinions, set
let’s look at what we’re doing here and move
him up for success, gave him some advice, and
forward.” Just have them reassess what they’re
when he said “every time I open my mouth I
doing, take a step back for a second, and try to
say something that confirms how dumb I am,” I
re-engage. But let them know you have the
joked with him, “you can always return to not
confidence in them to be successful: “Look I
saying anything.”
trust you or I wouldn’t have you doing this in
“We had a guy who was on an entrapment, and
he was still in the shelter after everyone got up.
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the first place, so I know you can do it, I know
you’re capable, just get back in there and do
it.”
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“Sometimes crewmembers have to realize that
input, it’s hard to get my trust and buy in. If
you need them to be successful for the whole
folks start with “this is what I want and what I
operation to be successful, and for the crew to
expect,” but don’t ask for my input or
be successful. If you are casting folks off, your
knowledge, I will probably not share a lot.”
program will not be successful. Figure out ways
to do it so that they are not going to feel guilty.
We had a burn boss who lost a burn, and
nothing bad happened, but his next two burns
were a no go decision. On the third burn, all
seemed to be going fine, but there was a big
hesitation in him with no reason. So rather
than asking him why he didn’t do it, I just
started asking him questions that I knew he
already knew the answers to, that were in
support of the decision: “So what’s the high
temperature going to be today? And the
prescription said what?” Pretty soon you could
see his posture start to relax and he lit the
match. We reassured him that the winds were
good. If it hadn’t gone well with him, we
couldn’t have completed our job.”
“We had one trainee who found out that her
spouse died while she was in training. The
trainee left but came back into the training
program within a year. When the trainee got
into a similar situation to when she got the call,
she started to show severe stress. We talked to
“It all boils down to trust, and depends on
her, worked with her, and gave resources of
what level you’re at. In the agency there are so
people who dealt with similar things and she
many layers of bureaucracy, a lot of trust is lost
passed the training. Later she encountered
in that, In the wildland fire environment, you
more difficulties because of getting triggered
work with a lot of people you’ve never worked
and left the fire service. I consider that a
with before, especially in large incidents. You
success story because she recognized that this
have to gain trust really quickly with someone
not for me, so I will take myself out of situation
you’ve never worked with. We do that all the
and do something else with my time.”
time. It’s just that openness. You have to
come up with some type of connection. I’m
pretty reserved so it takes time. If they’re open
and take my input, then I’ll open up, but if they
are really stern, arrogant, or don't want to take
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“ When I was trying to help a severely insecure
firefighter be less stressed, gain factual
competence, and develop interpersonal
connections with fellow firefighters, and
nothing worked, I felt like I should have been
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able to do something better, and the feeling
self-worth have suffered. He sees negativity in
lingered for five years. I mentioned it to one of
everything. Sometimes it doesn’t take long for
my colleagues, who sent me articles about
me to get overwhelmed. What I find is that
challenging personalities on the job, and it
because he has had the experiences he’s had,
made me feel like I didn’t fail. Sometimes you
he is in a position to teach others, to let them
have to walk away.”
know what is giving him relief. So I give him a
“People who are very firm believers in God
seem completely validated by God’s choices.
I’m not so religious. I don’t find comfort there. I
have seen people like me with more moderate
beliefs ask “what are we doing this for? This
chance to talk to others about what has given
him the most stress, to give him hope that he’s
helping the next guy. Giving someone any
relief in any one of these things is very
personal.”
just doesn’t make sense.” We end up coming
“Twenty years after my event, the survivors
back to our personal values overall. That’s all
went back for the anniversary and we
we have to use. As long as it makes sense to
recounted, retraced and told our stories to
each of us in some way, that it's the right thing
each other. We took off on the escape route,
to do for the family, for me as a person, for my
and I was telling someone about freezing and
career, that brings us back to center like a
losing bodily functions, and he turned around
rudder.”
and said, “You think you’re so special that you
“If we deal with someone with a long term
physical injury, it is difficult enough for that
person because whatever boost they get from
the sporadic connectedness they get, they’re at
home, not at work, and they are watching me
do same thing year after year, coming home
smelling like smoke. The relief I give is probably
a little less every time. If they’re dealing with it
fine, over time they will recover. If they are not
dealing with it well, the negative reaction I get
from them might intensify over time. An
individual I know is getting older, and sustained
very significant injuries twice. And now it’s
getting to the point where he can’t play with
kids, and there is no solace anymore in the
things that used to give solace. His hope and
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froze? We were just as bad. Our legs were
spaghetti, we were falling into trees, and
picking each other up and pushing each other
down.” All these years, I punished myself for
being weak, and he totally validated that I
wasn’t the only one who experienced what I
did. After being so hard on myself, healing can
occur, even years later.”
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“In the wildland fire environment, if you come
location of the wilderness fire, it was decided
up with a plan or objective and fail, you have to
not to transport him out of the forest on that
start over. How we do business is that success
day. Since he had to spend the night, we
breeds success. We set people up to keep
posted folks at the location. We also lowered
trying so they are not as apt to lose
our flag at the District Office and took it to the
confidence.”
accident site that night. His body was covered
“Confidence can be gained or lost quickly, but if
you know the individual’s strengths and have
some options for them, that’s what’s needed.
You have to have that coupled with flexibility at
work. Don’t write a check that someone else
with the American Flag where he laid on the
forest floor. This act was a meaningful way for
the crew to honor the faller, and to this day,
the family of the fallen firefighter is thankful for
how their husband/father was cared for.”
can’t cash. In a conversation, I can be
supportive, but everyone needs to know
precisely what I can deliver on. The SFA model
falls on its face when you can’t deliver what
you just offered.”
“I’ve seen young firefighters who have had a
couple of seasons and start working on
leadership qualifications. They work great in a
crew setting and then have to lead their peers.
We as leaders often criticize everyone but at
this time we have to build the young leaders’
confidence and set them up for success. It’s a
lot of one on one mentoring to build their
confidence to lead others.”
“When stress starts to build up in the crew, we
“Trainees sometimes don’t want to get signed
have to work harder to break it down to the
off, and you fully know they are capable. So
crew why we’re doing what we’re doing, so
you have to have that conversation with them.
they don't lose confidence in the mission or
They get overwhelmed. You have to go there
leadership.”
and let them know that they are plenty
“The top section of a burning Hemlock fell on
top of a faller on our Forest. He died at the
scene. Due to the time of day, terrain and
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competent, and to relax and get out there. And
once they get over that, it’s very rewarding to
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look back and see the development in their
made a great contribution, so don’t feel that
confidence.”
it’s a letdown.”
“After Yarnell Hill, I was leading a hotshot crew
“I had a guy who worked really well, and then
and was close with other hotshot crews, and a
his personal life fell apart and he had a divorce
guy came into my offices, closed the door, and
and child issues, and he walked in and handed
started sobbing. He said, what the hell are we
me a letter of resignation. I knew that his
doing, we just killed a whole hotshot crew. He
sense of identity was in the job, so I told him,
did one more year and got out of fire
“I’m going to sit on the letter for 30 days, and
permanently. It shook him. Nothing could re-
then after that, if you still want to quit, I’ll turn
build his confidence in the system. But for me,
it in, because right now you have a lot going
what I got out of that several months later was
on.” At 30 days, he came back in and said, “Can
a re-invigoration of my passion for setting a
I have that letter back?” Last year he walked up
forest on fire in a controlled manner, so that
to me and thanked me for that, after he had
every acre I burn this year, is one less acre that
gone out west and had been doing a great job
young firefighters are going to have to go out
out there. We text every six months or so, and
and burn next year. I made it my personal goal
he always tells me that he was so glad that I
to help change the culture in my little sphere of
didn’t let him quit. And I always say, “I'm so
influence, so people are more excited about
glad you’re here now helping out.” For me, it
prescribed burns and managing fires than we
would have been adding insult to injury to
are about putting things out. We want to
allow him to quit at that particular time.”
manage fire, and we talk a good game, but
when the smoke is in the air, everything
changes. We need to re-align our value system
to help keep our confidence.”
“I try to return people to a fundamental notion
of why they got into the job in the first place. I
always remind them, “If you’re ever in conflict
with someone or yourself, remember that one
“If someone makes a decision that it’s time to
of the greatest ideas the country ever had was
leave, what to say to them so they question
to have public spaces, and we are the stewards
their identity, self-esteem, and to prepare
of public spaces. So if you ever wonder if we’re
them for the transition? We had an honor
deviating from something small, remember
guard member who had had too much. I told
what we’re doing on a large scale, and you’re
him, “There is no shame in leaving honor
part of that. If you’re questioning that,
guard. It’s not a permanent thing, it shouldn’t
remember that once you leave here, you may
be, and you’ve really enriched the program and
look back on that with regret. So try a cooling
the team, so hold your head up high. You’ve
of period.” I also tell them, “You’re a valuable
part of the mission of wildland firefighting, and
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98
if your personal ethic is stomping on your
was hurting. You spend your life and career
professional ethic, let’s try to negotiate that, or
building up this reputation and skill set and
take some time to think about if it’s a deal
you’re respected and you’re a top performer
breaker. Maybe we can find something else for
and then all the sudden people are turning up
you so that you can really believe in what
their noses at you because you were at a fire
you’re doing.”
like that. I think that individual really needed
“I tell people who want to get out after tough
times, I need your story for our training
that direct form or more aggressive
communication.”
courses, and you can tell it however you want.
“We had a crash that killed 4 and the
You’re on safe ground here. People have taken
dispatcher took that blame, because the tanker
me up on it. It’s cathartic for them, and the
got re-routed to the fire. She took it upon
trainees never forget it. They will never forget
herself and said, “I should have never diverted
that story.”
it.” I kept it short, “You don’t know what you
“You may have to be very assertive and direct
with someone to restore his confidence. One of
the flight crews involved in the Yarnell Hill fire
told me that he had just been at the airport
don’t know, you made the best decision you
could have made given what you knew at the
time.” I tried to snap her out of it. She took a
break after that, but is still a dispatcher.”
and people started looking at his nametag and
“After we got back from a fire with deaths, we
call sign and knew he was involved in the fire.
got flooded by calls, so I reached out to an old
He told me that he walked out and tore the call
superintendent who had come through in a
sign off and put it in his pocket.” I could tell
similar situation. When tough things happen, I
that he was feeling bad for being identified as
establish new relationships: “What does this
part of the efforts, and needed to get his
look like, help me map this out.” We’ve
confidence back. So I said, “You know man, you
become semi-close considering he was a
fly that flag proud. I don’t care what other
complete stranger prior to the fire. He is going
people are judging you on. The people that
to come talk to the crew about what the
know, know. You put that damned thing back
transition was like for his crew, how to get back
on your jacket right now, because that call sign
in into the game. Before I kicked the gang lose
and you have saved so many of the hotshots
for the year, I talked with this person for about
asses more than you will ever know.” I went
an hour, and he said, “I want you to say these
back and gave him many specific examples, “Do
things to the crew, because these are the
you remember this fire, do you remember this
things I didn’t do. These are things you should
fire, do you remember this fire….” It was a time
be keeping an eye out for across the winter,
to be kind of aggressive, because I could tell he
and hiring people next year.” He gave me tips
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99
that have been very helpful. A ton of people
“It doesn’t have to take five years of therapy, it
reach out, there are a lot of resources out
could just be the right place, the right time, the
there, so I would recommend that you just call
right person, to give a seasoned perspective,
them. My guy has been a good mentor in some
like a verbal slap, and if the person trusts you,
hard times.”
it doesn’t have to take a long time to make a
“We have some important potential SFA
procedures for building confidence, such as
listening, being person-centered and being
aware of how a person can respond, and when
they are ready to respond. You have to start
with assessment, give them time, get a sense of
where they are and what is going on. It may not
shift in their perspective. Every single time a
person gets to know you and knows who you
are, it’s money in the bank for the time that
you can make an influence on a person. A
psychologist or family member does not have
that foundational relationship to make a shift in
just a few moments. It’s a big deal.”
be a direct approach, but if you restore
“We had some pretty rough days, pretty active
depleted resources, and help them with what
behavior with fires, a couple of tight spots. And
they need, and realize that each person will do
it was still fun. And then Yarnell happened. The
it their own way, they usually can regain their
crew felt that things weren’t as fun anymore.
footing and confidence.”
That rippled through the whole fire service. I’m
“The people who can especially be helpful are
the ones who have been through similar
situations, but being a guide has to come in the
not sure we’ve really fully recovered from that
as an agency. There was definitely some
confidence shaken.
person’s own time. If they are ready to be that
“After a line of duty death or traumatic event,
mentor to someone else, it’s especially potent,
it sometimes takes a time to get back into your
because they have clout because they also
comfort zone. Getting back on fire with people
went through a trial by fire. Sometimes a
you know helps. Just getting back on a fire
person in need of Confidence won’t listen to
assignment helps. As soon as were back on the
anyone else, but they will listen to the person
line, you still think about it, but just getting
who has been through the hardest of times. It
back to it and not dwelling on it helps.”
gives you a role model to show you how to
potentially go through things. And it also will
shape how you can mentor others at some
point.”
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Summary: Stress First Aid
Stress First Aid actions are to be used as needed with personnel who are experiencing
either significant distress or impairments in functioning caused by stress reactions. SFA
should be incorporated into departmental operations in a natural, seamless way, and
implemented when needed. In most cases, it is not necessary to provide all the SFA
actions. A summary of SFA is provided below.
SFA FUNCTIONS
Check
Coordinate
Cover
Calm
Connect
Competence
Confidence
POSSIBLE ACTIONS
▪
Assess current level of distress and functioning
▪
Assess immediate risks
▪
Assess need for additional SFA interventions or higher levels of care
▪
Reassess progress (Re-Check)
▪
Decide who else should be informed of situation
▪
Refer for further evaluation or higher levels of care, if indicated
▪
Facilitate access to other needed care
▪
Ensure immediate physical safety of stress-injured person and others
▪
Foster a psychological sense of safety and comfort
▪
Protect from additional stress (ensure respite)
▪
Reduce physiological arousal (slow heart rate and breathing, relax)
▪
Reduce intensity of negative emotions such as fear or anger
▪
Listen empathically to the individual talk about experiences
▪
Provide information that calms
▪
Encourage connection to primary support persons
▪
Help problem-solve to remove obstacles to social support
▪
Foster positive social activities within crew
▪
Helpmentorbacktofullfunctioning
▪
Facilitate rewarding work roles and retraining, if necessary
▪
Encourage gradual re-exposure to potentially stressful situations
▪
Mentor back to full confidence in self, leadership, mission and core values
▪
Fosterthetrustofunitmembersandfamilymembersintheindividual