FWFD Peer Support & CISM Program: S1120 R2

• Standard Operating Procedure S1120 R2 details the administration of the Peer Support and Critical Incident Stress Management (CISM) Program.
• This program is for the Fort Worth Fire Department
• The purpose is to provide procedures for Peer Support and CISM team members and support firefighters and their families.
• The FWFD has a CISM program to give FWFD employees peer support and crisis intervention for personal or professional crises.
• A trained Peer Support and CISM team, guided by a mental health professional, provides support to employees.

Definitions

• CISM Team: Peer support and licensed mental health professionals, meeting minimum training and screening standards.
• CISM Team Coordinator: Appointed by the Fire Chief; responsible for coordinating CISM services and networking to improve service quality.
• Clinical Director: A licensed mental health professional who provides oversight to intervention activities, ensuring appropriate service and that team members work within their scope of training.
• Critical Incident: An event with stressful impact that overwhelms coping skills; powerful, emotional events outside ordinary experiences.
• Critical Incident Stress: The reaction to a critical incident, with physical, cognitive, emotional, and behavioral signs and symptoms.
• Critical Incident Stress Debriefing (CISD): A peer-driven, clinician-guided group discussion to mitigate trauma and accelerate recovery after a traumatic event, normally within 48-72 hours post-incident.
• Objectives include prevention and mitigation of traumatic stress, assistance in recovery, acceleration of recovery, restoration to function, and maintenance of worker health.
• Defusing: A shortened CISD within 8-12 hours of an incident, managed by two uninvolved peers or a peer and a licensed mental health professional, typically lasting 30-45 minutes.
• Objectives involve the rapid reduction of intense reactions, normalization of the experience, re-establishment of social networks, and assessment for full CISD if needed.
• Demobilization: A brief intervention after a disaster to transition back to routine operations.
• Individual Consultations: Informal discussions with a trained peer and/or mental health professional, more casual than formal group processes.
• Mental Health Professional (MHP): Licensed in Texas with a Master's in a mental health field, specialized in critical incident and post-traumatic stress management.
• On-Scene Support: Crisis interventions and counsel provided at the scene by emergency personnel or the Incident Commander.
• Peer: A trained, trusted colleague who can empathize and assist co-workers in recovery.
• Peer Support Intervention: One-on-one conversations with a trained Peer focusing on crisis identification and support.
• Peer Support Personnel: FWFD representatives of any rank who have completed CISM Team training.

General Information

• Program objectives: provide support network; promote trust and confidentiality; develop awareness of self-help alternatives; maintain an effective stress management team; provide referrals.
• Two levels of crisis intervention: Peer Support (trained personnel following guidelines) and Critical Incident Stress Management (for harmful effects of stress).
• FWFD program uses trained individuals to minimize harmful effects before, during, and after critical incidents.

Peer Support

• Aims to provide emotional and tangible support and address potential employee difficulties, augmenting existing programs.
• Peer Support Member: A trained colleague (not a counselor) trained in crisis intervention, peer support, CISM, and related topics.
• Should refer cases needing professional mental health intervention.
• Peer Support intervention should not replace disciplinary action or interfere with investigations.
• Members are selected from respected officers/employees in good standing, with recommendations from superiors and peers.
• Critical Incident Stress Debriefing (CISD) is a stress debriefing and not an operational critique or evaluation.

CISD Rules

• Confidentiality is maintained.
• All involved personnel may attend is.
• Participation of all FWFD personnel is required in cases of line-of-duty death or suicide of a firefighter.
• No notes, cameras or recordings.
• CISD is not psychotherapy or an investigation.
• Participants are off duty during debriefing.
• No reports to supervisors, no media, and no breaks.
• Silence from participants is permitted.
• CISD takes place away from the incident.
• After CISM intervention, team members offer follow-up and referrals for those with ongoing distress.
• Referral sources include: Behavioral Health Services, EAP, Clergy, Medical Services, and Family support services
• FWFD may use regional CISM Teams or other resources after a line-of-duty death.
• Peer Support Members assist with training presentations. They also interact during joint training/disaster drills.
• Under State and Federal Laws, confidentiality has protection and limitations.
• Disclosure is required for threats to self/others and child/elder abuse; failure to report may result in criminal charges.

CISM Team Activation

• Personnel contact the Fire Alarm Office (FAO) to initiate activation.
• IC, Chief Officer, or Station Officer may initiate activation.
• All firefighters can request through the Station/Chief Officer, or request individual CISM support by calling the FAO.
• FAO's responsibilities: contact the on-call CISM member, and, in certain events, contact the Chaplain.
• Events include: line-of-duty incidents, multiple casualty incidents, fire fatality, disasters, and more
• The CISM Team/Peer Support will determine and coordinate the suitable intervention and provide appropriate support.
• Strict confidentiality should be maintained.
• General Considerations: CISD is not for critique, but for stress debriefing.
• After a CISM intervention, referral sources include Behavioral Health Services, EAP, Clergy, Medical services, Family support services, and other services.
• The FWFD can call on regional CISM teams or other resources after a line-of-duty death of personnel.