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CISM Debriefs: Mental Health First Aid

Critical Incident Stress Management is a comprehensive, integrative, multicomponent crisis intervention system. CISM is considered comprehensive because it consists of multiple crisis intervention components, which functionally span the entire temporal spectrum of a crisis. CISM interventions range from the pre-crisis phase through the acute crisis phase, and into the post-crisis phase. Crisis intervention is a short-term helping process. It is an acute intervention designed to stabilize and mitigate the crisis response (Evenrly & Mitchelle, 2008). It is not psychotherapy. The goals are to foster natural resiliency through stabilization, symptom reduction, return to adaptive functioning and / or facilitation of access to continued care (adapted from Caplan, 1961).

To request CISM debrief for your organization please contact us.


Post-Traumatic Stress Disorder has been an accepted diagnosis since 1980. We believe it is time to adopt a new name – Post-Traumatic Stress Injury. PTSI is more accurate, hopeful and honorable.

PTSI is a biological injury that develops after a person has experienced or witnessed a terrifying event. While many people have difficulty adjusting and coping for a while after a traumatic event, they normally get better with time and don’t develop PTSI. Yet, some people show symptoms of PTSI like flashbacks, nightmares, anxiety and frightening thoughts that get worse and/or last for months or even years, severely interfering with their daily lives.

For a full article please refer to:

What is PTSI in emergency responders?

As first responders, we put others first during emergency situations, which is a technique we automatically do to get through a critical incident and ensure that everyone is cared for and safe. A traumatic event, or critical incident, is any type of disaster such a hurricane, flood, car crash, fire, or caring for a severely injured individual. The individuals we help during these incidents can easily develop Post Traumatic Stress Disorder (PTSD)/Post Traumatic Stress Incident (PTSI), as well as the first responders who help those individuals.

PTSD/PTSI is a medical condition that affects one’s mental health after being triggered by a traumatic event. This can occur by either experiencing or witnessing an event or by an accumulation of multiple events. Sometimes this they may lead to difficulty dealing with certain aspects of this event. These difficulties subside with time. However, if the symptoms interfere with daily activities or last for multiples weeks or months, this may indicate PTSD/PTSI.

The symptoms of PTSD/PTSI are extensive and vary from person to person. They are generally categorized into physical, behavioral, and emotional symptoms.

Symptoms of PTSI can be extensive and vary from person to person. Based on my personal experience, when these symptoms interfere with your life on a daily basis and you find yourself consumed by thoughts or feelings that you cannot control, it is a good idea to seek professional help for PTSI. Many First Responder organizations have established peer support groups, which can be a good place to find local information and assistance. Many agencies also have Employee Assistance Programs (EAP) that can help find a psychologist or counselor who specialize in PTSI. In addition, there are several national programs that specialize in PTSD for first responders. Please contact us for more information or to talk more about PTSD.

Signs and Symptoms of Stress
Common Stress Reactions from Critical Incidents

Physical symptoms may include:

  • Fatigue
  • Twitches
  • Grinding of teeth
  • Intestinal upsets
  • Vomiting
  • Insomnia
  • Headaches
  • Excessive sweating
  • Nausea
  • Nightmares
  • Pounding Heart
  • Chest Pain
  • Difficulty breathing
  • Diarrhea

Behavioral symptoms may include:

  • Withdrawal from friends and family
  • Restlessness
  • Substance abuse
  • Increased alcohol consumption
  • Suspicion
  • Difficulty remembering
  • Anti-social behaviors
  • Paranoia
  • Difficulty concentrating
  • Emotional outbursts
  • Pacing
  • Excessive worry

Emotional symptoms may include:

  • Anxiety
  • Denial
  • Agitation
  • Panic
  • Irritability
  • Apprehension
  • Guilt Depression
  • Suicidal thoughts or actions
  • Fear
  • Anger