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Oct

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Managing the fallout from a critical incident

A critical incident is an unexpected event that causes a period of acute stress in a workplace environment or group. It can range from the unexpected death of a colleague through to a workplace accident, loss of a patient in a long-term care scenario, or a large-scale violent event such as a mass shooting, bombing or fire. It can affect those directly involved, those involved in the aftermath, for example the emergency service providers, and those in the wider region or community who feel the shockwaves of the event.

Critical incidents can create strong emotional reactions and responses which disrupt group cohesion, productivity, and/or morale. They usually produce acute stress i.e. an immediate and high stress response, as opposed to cumulative stress i.e. an ongoing period of stress from consistent factors. Read our blog for more details on the impacts of a critical incident…

How to manage the fallout: preparation

The very best managers of critical incident effects are those who are prepared. Appointing debrief and peer supporters is a must, as is Critical Incident Stress Debrief Training (CISD) and Psychological First Aid. Read more about adding CISD to your framework.

Note: if you have just experienced a critical incident or trigger for acute stress, and you don’t have a trained CISD supporter, then look to appoint an external provider of debrief services. Time is of the essence, but it is essential to use a trained individual rather than seeking to complete the steps yourself without training.

Preparation and training will help to enable your team to carry out the following steps:

Demobilise:

Dealing with the immediate physical and psychological symptoms, demobilisation offers a period of rest, information and time out as soon as possible after the event. It helps to calm individuals and ensure their immediate needs are met. It should be conducted by someone not directly involved in the original incident. A good demobilisation process will:

  • convene a meeting for those involved as soon as possible
  • summarise the incident and clarify the situation
  • invite questions and discuss concerns
  • show care and support, including the use of Psychological First Aid
  • create a plan to move forward, accounting for the needs of the individual
  • make short term, practical arrangements for anything that needs to be covered, giving individuals the reassurance that they can take time away
  • offer information on the availability of further support.

Defuse:

Scheduled within approximately 12 hours of the critical incident, defusing is designed to bring feelings of closure or completeness to the incident. It should be conducted by a trained facilitator and allows the group to:

  • review the event
  • further clarify questions and concerns
  • discuss the incident and share emotions and needs
  • offer advice and identify additional support needs and referrals.

Debriefing:

Scheduled three to seven days after the event, debrief is designed to support the group after the initial shock has worn off. It should be conducted by a trained facilitator and provides a structured discussion for the group. It is not and does not replace counselling, but helps offer clarity and devise a process for recovery. It should cover:

  • what actually happened. The event sequence, causes and consequences
  • the individual experience. Considering the incident from the point of the people that were there
  • memories and personal experiences that have been triggered by the incident
  • normal psychological reactions so people know what they can expect to experience and that it will be completely normal
  • management strategies for the emotional responses.

Follow-up support:

CISD is not supposed to replace psychotherapy or counselling, and it is designed to be delivered as a group outlet rather than an individual one. It should deal with the immediate aftermath, but in doing so encourage and direct individuals to further one-on-one support if they need it, and provide a framework to identify and refer delayed emotional responses for further support. Tidal Training is a leading provider of Post Critical Incident Stress Debrief and Psychological First Aid Training in the UK at the moment, supporting teams and groups to plan for unexpected traumatic events. Our training is in use in NHS Trusts, Emergency Services, Care Homes, Churches, and Community Groups across the UK, as part of event preparedness and risk management. Speak to our team on 01242 371 999 for more information.

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