What is CISM?

Critical Incident Stress Management (CISM) is a systematic and multi-component crisis intervention system. Initially, CISM was designed to help first responders talk about a critical event. The program was expanded for the prevention of PTSD. It helps to identify responders who should be referred for further care, normalize reactions to critical events, and simply improve peer group support.

A critical incident is, “an event out of the range of normal experience – one which is sudden and unexpected, makes you lose control, involves the perception of a threat to life and can include elements of physical or emotional loss.” These events cause extraordinary and debilitating reactions that may be cognitive, emotional, physical, behavioral, and spiritual. Some examples of critical incidents include: injury/death of children, mass causality incidents, prolonged events, disasters, suicides, LODDs, high media interest events, or any event the provider has an intense, personal connection with.

The CISM team is trained to provide a series of interventions that have proved to be effective in stopping the escalation of symptoms, reducing acute stress reactions, restoring adaptive functioning, and facilitating access for more care as necessary. The team provides individuals and group interventions either on scene or after the incident when deemed necessary. The team also responds to stress caused by effects over time. CISM attempts to help responders understand that normal people experience these common reactions to very abnormal events.

What CISM is NOT:

The CISM team is trained to alleviate the reactions to acute traumatic experiences. The team may have multiple elements in place before, during and after a traumatic event. CISM is not a stand-alone process. It is part of a multi-component system in which individual referral and follow up is needed. It is important to understand that—CISM is not a long-term support service. The team is designed to lower emotional tension and normalize their reactions to promote normal recovery processes, in normal individuals who are experiencing normal reactions to abnormal events. The CISM team is trained to identify individuals who are in need of further professional care and ensure appropriate resources and referral are provided long term.