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  • Rachelle Zemlok, PsyD

A FIRST RESPONDER SPOUSE’S GUIDE TO POST CRITICAL INCIDENT SUPPORT

As a first responder spouse you can often feel left out of what’s going on at the department. What services are available to my first responder? How does our department actually plan on supporting my spouse following a traumatic event or critical incident? What can I do?


I am here to clarify one thing many departments out there have taken to using. Something to be familiar with is CISD (Critical Incident Stress Debriefing) and CISM (Critical Incident Stress Management). If your department has a team of individuals trained to assist with the aftermath of critical incidents it’s helpful to know what that looks like.

CISD is one component from CISM (Critical Incident Stress Management) which is a multi-component approach to supporting individuals following critical incidents. The cool thing about this approach is that the psychologist responsible for its development, Jeffrey T. Mitchell, Ph.D., got the idea to create something for emergency responders while being a volunteer firefighter! He rose to lieutenant at his department and served for 9 ½ years. At the time he was also studying to become a child psychologist. He completed his dissertation research on paramedic stress, and this led to the development of CISM, something many departments have adopted for emergency personnel.


Dr. Mitchell developed CISD, or Critical Incident Stress Debriefing, in 1974, specifically for emergency responders following a critical incident. Therefore, this approach specifically takes the emergency responder culture into account.

WHAT IT IS:


  1. A very specific group intervention that is initiated following a potentially traumatizing on-duty event, a.k.a. critical incident.

  2. A supportive group discussion of the incident that involves as many personnel as possible, from the same occupation (e.g., all firefighters or all police officers), who were present at the scene of the event.

  3. It’s usually held sometime between 24 and 72 hours following the incident.

  4. Often conducted with at least one mental health professional trained in CISM and CISD and one trained first responder. Basically, first responders are more likely to trust other first responders than they are to trust mental health professionals. These are usually voluntary positions on top of regular duties, since these individuals will only be utilized occasionally.

  5. The Goal: Facilitate the prevention of post-traumatic stress among high-risk populations (emergency responders). The hope is to also enhance group cohesion and performance following the critical incident.

  6. CISM suggests that often many other interventions with mental health professionals are available as needed along with this group intervention such as individual crisis intervention, follow-up support, referrals to professional care, and post-incident education programs.

  7. This intervention has been proven effective at reducing depressive symptoms, stress symptoms, anxiety and anger in first responders that have participated following a critical incident versus those who did not.


A SPOUSES ROLE:


If at some point your spouse is involved in a critical incident and invited to participate in the discussion, or talked to by a trained peer-support personnel here are 4 things you can do to support them.

  1. ENCOURAGE PARTICIPATION (in a kind supportive way) if they are hesitant knowing how beneficial it can be to emergency personnel. Often your first responder's participation can support the firefighter or police officer sitting next to them (their colleague) even if they don't fin it helpful.

  2. BE GENTLE WITH QUESTIONING AFTERWARD Convey interest and support regarding your spouse’s thoughts and reactions. But understand that groups are often encouraged to hold the information shared by others confidentially to create a safe space for everyone.

  3. ALLOW SOME SPACE. Immediately following critical incidents people process very differently and at different paces. Let your spouse know you are there, but try not to demand play by play details as this is often what CISD groups have just done with them. As a therapist I support people all the time without knowing ALL the details. Stick to how they are doing now or any impacts it may have had on them (sometimes positive and sometimes negative).

  4. FIND YOUR OWN SUPPORT Spouses and children can also have a difficult time making sense of a situation his or her spouse was involved in. You can ask a union representative what is offered to family members. If they do not have anything formally set up in the department, you can contact your main insurance provider, EAP program, or find a licensed therapist in private practice (like myself) for individual, couples, or family services.

Dr. Zemlok is a licensed clinical psychologist located in California that specializes in supporting and treating first responder families

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Location: 2222 Second Street, Suite 16, Livermore, California, 94550

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