How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 133
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Defusing
Defusing is the front-line response to a critical incident or potential critical incident. It is provided within a few
hours of a crisis event to minimize the effect of acute critical incident stress. Its goal is to reduce intense
reactions to the event; to normalize the experience; to provide practical/useful information (stress education); to
develop expectancies about recovery, and to assess the need for follow up with a Critical Incident Stress
Debriefing (CISD). This process is used primarily to assist small groups of individuals who were directly
exposed to and most seriously affected by a critical event. A Defusing is led by a trained peer team member
without the aid of a mental health professional. It is less structured and less time consuming (approximately 30
to 60 minutes) than a Debriefing. A Defusing may eliminate the need for, but should NOT substitute for a
formal Debriefing if one is obviously required. After a Defusing, follow up is essential. Defusings are highly
flexible in how they are delivered and are of low visibility. This combines to make them one of the most
effective CISM tools.
Critical Incident Stress Debriefing (CISD)
CISD is a structured seven-phase group process utilized in the normalization of critical incident stress or
traumatic stress and integrates crisis intervention strategies with educational techniques. It is best conducted in
the short-term aftermath of a critical incident, approximately 24 hours post-incident, but usually within the first
72 hours (later if circumstances require). A CISD is called for after obvious, deeply disturbing events that may
overwhelm the coping skills of those involved. Typically a 2-3 hour confidential group intervention led by a
specially trained mental health professional and assisted by trained employee peers, after delivery, follow up is
essential.
Two main goals of a Critical Incident Stress Debriefing
1. Mitigate the impact of the Critical Incident on those who were victims of the event. Victims are defined as:
a) Primary victims i.e. those directly traumatized by the event.
b) Secondary victims i.e. those individuals who are in some way observers of the immediate traumatic effects
that have been experienced by the primary victims. Co-workers peripheral to the scene would be an example.
c) Tertiary victims i.e. those affected indirectly by the trauma via later exposure to the scene of the
disaster/trauma or by a later exposure to primary or secondary victims. Typically tertiary victims are those not
exposed to the immediate “first-hand” aspects of the traumatization, thus not impacted by the “shocking
immediacy”. Staff from other departments, family members & co-worker friends of victims or rescuers might
be examples of tertiary victims.
2. Accelerate recovery process in people who are experiencing stress reactions to abnormal traumatic events.
Individual Intervention (One-On-One)
This is an individual intervention provided by a Peer Team Member after a critical incident or potential critical
incident. Individual Intervention is used to support, stabilize and provide stress education and to help assess the
need for a formal Debriefing, in a group setting, if other individuals were involved. It is best provided within
24 to 72 hours of an incident (later if circumstances require) and may be conducted by specially trained peers,
in person or by telephone. An Individual Intervention should NOT substitute for a formal Debriefing if one is
obviously required for a group of individuals. After delivery, follow up is essential and a referral(s) may be
required.
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