Crisis Intervention:  Critical Incident Management

Critical incidents--those that are disruptive beyond our typical coping abilities-- occur as a result of our being directly traumatized (as in assaults, accidents, etc.), but also constitute a serious risk to emergency personnel due to secondary trauma or caretaker/compassion fatigue-- just being constantly exposed to people in pain. There are effective methods for helping both survivors and personnel in resolving these experiences. This page describes the symptoms of PTSD, some of the approaches used for resolution, and presents some critiques of some of these methods as well.

Study Questions

• How is it that responders may have stress reaction or PTSD as a result of dealing with survivors?
• What are the indications of PTSD in both survivors and responders?
• What do survivors and responders need following a crisis?
• What is the current status and criticism of current critical incident debriefing and treatment practices?

Post-Traumatic Stress Disorder (PTSD)

• Canadian Traumatic Stress Network (Network information, committees, links)
• Critical Incident Stress (Search & Rescue Society of British Columbia--several articles, self assessments, links)
• Critical Incident Stress Reaction (symptom list)
• David Baldwin's Trauma Information Pages (Excellent collection of info on PTSD, trauma resources, support, disaster links, and handouts).
• Disaster Finder (Search index for Internet disaster sites)
• Eye Movement Desensitization and Reprocessing (EMDR) (Description, training, discussion group, studies supporting the approach)
• National Hazard Center (Info clearinghouse, e-newsletter, disaster research, training, networking)
• Primary Care Treatment of PTSD-- Am. Academy of Family Physicians article
• Trauma Treatment Manual-- online manual

Critical Incident Stress Management & Debriefing

• Work-related psychological trauma (application study of CISD)
• Origins and natural history of debriefing (article)
• Individual differences & briefing effectiveness--
• Things to do to mitigate crisis effects--
• Visual/Kinesthetic Dissociation technique-- thorough review

Critiques of Debriefing Approaches-- Just a few comments on this section: Crises create desperate survivors and probably just as many interveners who would like to find the "magic bullet" for curing PTSD and related conditions. This gives rise to innovative practices and competent practitioners as well as outrageous claims and charlatans. This is a controversial area that is currently being researched and challenged extensively. Enjoy the debate!

• A critical view on debriefing  (short article)
• CISD values and limitations--
• Mechanisms of healing in critical incident & PTSD and the "power therapies" (Swenson's power point presentation, 11 slides)
• Critique of Thought Field-Therapy-- TFT is an increasingly popular technique for resolving trauma based on unconventional assumptions that have not been established.
• Critique of EMDR and TFT-related techniques--