3 Steps to Support Critical Incident Stress

Depending on the nature and severity of a critical incident, you may want to bring EAP counselors onsite to assist employees. It may be tempting to think of this as a process that can be handled internally, but research indicates that outcomes are better when trained professionals are called in.

The primary goal of Critical Incident Stress Management (CISM) is to speed the recovery processes of normal people who are having normal reactions to abnormal events.

"One of the benefits of calling in trained professionals is that we are knowledgeable about stress and trauma," notes Sarah Prom, senior consultant for VITAL WorkLife. "What seems like abnormal behavior to a manager dealing with a one-of-a-kind incident may actually look quite normal to a counselor who's helped other organizations recover from similar events."

Critical Incident Stress Management is not "group therapy" or psychotherapy of any sort. Instead, CISM provides a way for employees to:

• Talk about what's happened in a mutually supportive, non-critical environment
• Learn about stress reactions and how stress related to the incident may be affecting them individually and as a group
• Practice coping strategies that would help minimize stress and speed recovery
• Develop realistic expectations about the length of time it may take for those symptoms to lessen or go away entirely
• Gain confidence that an EAP counselor could assist them if they took longer to recover or had more difficulty recovering than their coworkers

The case history that follows shows how one organization made use of CISM to assist struggling employees.

Critical Incident Stress Management: A Case History

CISM services were recently employed by an organization where a tight-knit team had lost a co-worker to suicide. An EAP counselor came onsite to meet with the team—including some who had been aware that their co-worker was stressed about his home life and financial situation—but who were all surprised by the suicide.

In addition to meeting with the workers in a group setting, individuals were made aware that the EAP counselor was also available for one-to-one meetings with anyone who wanted to further discuss their thoughts and feelings on the loss.

Step 1. A Meeting With the Team as a Whole

Before the group began sharing their individual reactions and concerns about the event, the counselor established ground rules that included:

• A request that participants keep information they heard in the group confidential
• That speaking was not mandatory and participants could just listen if desired
• No criticism of other's feelings or reactions would be allowed

The counselor then facilitated a discussion of their thoughts, feelings and behaviors at the time they became aware of the death and since then. During this process, the counselor was actively assessing the participants to see if any of them should be referred to counseling or other services.

The counselor encouraged group members to give themselves "permission" to have some difficulties and acknowledge that they may not operate at their usual level right now. If symptoms were interfering significantly with tasks of daily life or did not dissipate, they were encouraged to reach out to professional help, like their EAP.

The session concluded with a discussion of healthy coping strategies to help the recovery process. This included basic care like being sure to rest enough, eat healthy, stay hydrated and get a good amount of physical exercise.

Participants received handouts that reinforced and expanded on what they learned for later review, along with contact information for the EAP.

Step 2. Individual Counseling Sessions

After the group meeting (which lasted one hour), the counselor met with each of the individuals who wanted additional support.

• One individual said the death brought up memories of a brother who also died by suicide
• Another struggled with feelings of guilt; that she "should have known that something was wrong" or that she "missed a sign" prior to the death (feelings of guilt; that we should have been or done more or treated the person better, are common)
• Another felt "numb," like he was just going through the motions of daily life
• Another didn't really feel anything at all (sometimes individuals feel bad about this, that they "should" be struggling in some way)
• Another individual had had several stressful things going on and this latest event felt like the "straw" breaking the camel's back (stress at home, with extended family, health and work; "and now this")

Step 3. Follow Up and Reporting

Further counseling was offered to all of the team members who stepped forward for individual counseling. Some of those individuals were strongly encouraged to seek additional help.

The team leader reported the group felt significant relief following the group and individual sessions. Most members of the team were back to business as usual within the normal time frame. One continued in individual counseling to address issues with roots in the past that had been brought to the forefront by the suicide.

Pathways to Well Being Call VITAL WorkLife at 800.383.1908