Hurricane Katrina Updates

September 30, 2005

Dear CISM Practitioner,

In today's update, we provide several articles. Links are provided to:

an article written by George S. Everly, Jr., PhD, F.A.P.M., Chairman of the Board Emeritus of ICISF on the role of Pastoral Crisis Intervention in disasters and other crises
an article by Jeffrey T. Mitchell, PhD, CTS, ICISF President Emeritus, about when Emergency Personnel also suffer losses in a disaster, and
an article by guest contributor Dennis Potter, LMSW, FAAETS of Kantu Consultants, about taking care of your team after they return from deployment.

Additionally, this message includes the text of a second article written by Dr. Mitchell on "The Dangers of Overused, Inaccurate Terminology."

The information in these articles is both timely and appropriate for those anticipating or considering deployment to the areas impacted by Hurricane Katrina. I urge you to read all four of these articles and to share them with others whom you feel could benefit from the information.

The following article by George S. Everly, Jr., PhD, F.A.P.M., is being distributed with the permission of Chevron Publishing.

The Role of Pastoral Crisis Intervention in Disasters, Terrorism, Violence, and Other Community Crises

Click on the link below for the text of an article by Jeffrey T. Mitchell, PhD, CTS

When Emergency Personnel Have Losses Too

Guest contributor Dennis Potter, LMSW, FAAETS, has provided an article entitled Bringing Your Crisis Team Home After A Disaster: Post Action Staff Support (PASS). This article is distributed with the permission of Kantu Consultants.

The Dangers of Overused, Inaccurate Terminology
Jeffrey T. Mitchell, PhD, CTS
President Emeritus, International Critical Incident Stress Foundation, Inc.

Some terms are overused or used inaccurately so often that they lose their primary meaning. In fact, overused terms can become confusing, misleading or meaningless. One overused and frequently inaccurately used term is "debriefing." For some time now, and especially in the last few weeks since the beginning of the Gulf Coast disaster, the term "debriefing" has been used so frequently and in so many different ways that many of us are unsure what is really being talked about. Everybody seems to be saying that they are "debriefing" this individual or that single victim or that they used a "debriefing" in church or with a huge group of people in a school auditorium. Some employee assistance programs claim to be "debriefing" people when what they are actually doing is providing employees with information alone. Some therapists have even used the term "debriefing" as if it were a synonym for the word "psychotherapy."

Very rarely are people using the term "debriefing" in its true meaning. In other words they are not referring to the Critical Incident Stress Debriefing (CISD) but to something else entirely. Yet people immediately jump to the false conclusion that "debriefing" of any kind equals "Critical Incident Stress Debriefing." The term "Critical Incident Stress Debriefing" should only be used when referring to a structured, seven-phase, small group crisis intervention tactic. It is provided by a trained team of crisis interventionists and it includes a mental health professional. Furthermore, the CISD should only be used with groups that are homogeneous and have completed their work at the scene of a traumatic event or their exposure has moved past the acute phases. Finally, a CISD is only provided when a homogeneous group has had about the same level of exposure to a traumatic event.

The terms "Critical Incident Stress Debriefing" or "CISD" should only be used as described in the paragraph above. Any other use of the term "debriefing" (if one is referring to any type of emotional support process) should be abandoned entirely.

Misuse of "debriefing" terminology is confusing, destructive and dangerous. People think they are receiving one type of service when they are actually getting something quite different. It is unfair to the people we serve and it is counterproductive to the entire field of crisis intervention. Thank you for reading my comments.

Further updates will follow as more information is obtained.

Donald Howell, Executive Director
International Critical Incident Stress Foundation, In.
Ellicott City MD 21042-2272
http://www.icisf.org
410/750-9600
Fax: 410/750-9601

KAT-05-06

October 7, 2005

Dear CISM Practitioner,

In today's update, I wish to share with you a synopsis of an article to be published in the Fall 2005 issue of LifeNet, ICISF's member newsletter. The article, written by Deb Boehme, PhD, EMT-I, LPC, DOM, of New Mexico, discusses her involvement with the recent disaster response to Hurricanes Katrina and Rita.

"Our New Mexico Disaster Medical Assistance Team (NM - DMAT) was deployed to both Hurricane Katrina and Rita. I had the opportunity to fill the roster on both as a mental health specialist and as an EMT. The experiences and challenges that our team faced will never be forgotten and the wonderful people that we connected with will stay in our hearts and minds forever. The full article to be published in LifeNet will describe how we utilized CISM for responders and civilians and their families affected by these two natural disasters. It was the experience of a life time! The article will be titled "Hurricane Blues Provide Valuable Lessons." -- Deb Boehme, PhD, EMT-I, LPC, DOM

(Note from the Executive Director: This article will provide factual information about Early Psychological Intervention services which should prove enlightening given the misinformation provided in some recent publications on this topic. An advance copy of Dr. Boehme's article may be obtained by contacting This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

In addition, today we provide links to two articles. Topics include: reducing the risk of premature crisis intervention; and enhancing the CMB. The information in these articles is both timely and appropriate for those anticipating or considering deployment to the areas impacted by Hurricane Katrina. I urge you to read these articles and to share them with others whom you feel could benefit from the information.

The articles in today's update are being distributed with the permission of Chevron Publishing.

The following article is written by George S. Everly, Jr., PhD, FAPM, CTS, ICISF Chairman of the Board Emeritus.
Five Principles of Crisis Intervention: Reducing the Risk of Premature Crisis Intervention

Click on the link below for the text of an article by Daniel W. Clark, PhD, Washington State Patrol, and Peter Volkmann, LMSW, Town of Ossining, NY Police Department.
Enhancing the Crisis Management Briefing

Coming Soon: We are in the process of setting up a web-based archive of previously sent Hurricane Katrina email updates. A link to the archive will be provided in a future email update as soon as it is available.

Further updates will follow as more information is obtained.

Donald Howell, Executive Director
International Critical Incident Stress Foundation, In.
Ellicott City MD 21042-2272
http://www.icisf.org
410/750-9600
Fax: 410/750-9601

KAT-05-07

October 14, 2005

Dear CISM Practitioner,

ICISF has been assisting, directly and indirectly, the Emergency Operations Centers in the Gulf Coast region since Hurricanes Katrina and Rita struck, in providing early psychological intervention and crisis management services in the affected areas. Recently, ICISF has received two specific requests for assistance in the Gulf Coast region:

1. To provide early psychological intervention/crisis management services for Emergency Services personnel. Any interested teams that would like further information may contact the ICISF office at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

2. To locate licensed Mental Health Professionals able to provide early psychological intervention/crisis management services. Interested individuals may contact the ICISF office at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Please indicate which of the two requests you are interested in potentially fulfilling when sending your email. Thank you.

In today's update, we provide a link to an article about a research study conducted on the effectiveness of employer-sponsored crisis interventions after a major disaster. The results include implications applicable to post-Katrina crisis interventions. The information in this article is both timely and appropriate for those anticipating or considering deployment to the areas impacted by Hurricane Katrina. I urge you to read this article and to share it with others whom you feel could benefit from the information.

The article in today's update is being distributed with the permission of Chevron Publishing and is written by Joseph A. Boscarino, PhD, MPH, Richard E. Adams, PhD, and Charles R. Figley, PhD.
A Prospective Cohort Study of the Effectiveness of Employer-Sponsored Crisis Interventions after a Major Disaster

Additionally, please see the announcement, below, about an important new research project. This is an opportunity for you and/or your team to participate and have an impact on the future of CISM.

ICISF is very supportive of research examining the effectiveness of the Critical Incident Stress Management (CISM) Model. In line with that, the following exciting opportunity to participate in research is being offered to ICISF members and other interested practitioners of early psychological intervention. The preliminary materials have been presented at the ICISF 8th World Congress on Stress, Trauma & Coping and are very promising. However, more teams are needed to expand the research.

If you or your team has the time to participate with this exciting project, please review the materials via the link below. Contact J. De Gaglia, PhD, LMHC, EMT-B, ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ), lead investigator, who will provide all materials and consultation. You and your team simply supply the venue and the techniques. Research done today will improve the health and welfare of the people we serve for tomorrow.

Handbook for the Collection of Research on the Critical Incident Stress Management (CISM) Model.

Further updates will follow as more information is obtained.

Donald Howell, Executive Director
International Critical Incident Stress Foundation, In.
Ellicott City MD 21042-2272
http://www.icisf.org
410/750-9600
Fax: 410/750-9601

KAT-05-08

October 21, 2005

Dear CISM Practitioner,

In today's update, we provide an article written by Dr. Jeffrey T. Mitchell, ICISF President Emeritus, about the value of thorough strategic planning before responding to a crisis.

A Good Strategy Serves Everyone Best
By Jeffrey T. Mitchell, PhD, CTS
ICISF President Emeritus
Clinical Association Professor of Emergency Health Services, University of Maryland

"Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat." --Sun Tzu, author of the The Art of War, an ancient Chinese military treatise.

It is extremeley hard for human beings to do something new rather than something they are already familiar with. This is especially so when they are caught up in an extraordinary event. The known path is the path that is usually perceived to be the path of least resistance, that is, the easier path. But the easier path is not necessarily the best path when we are considering emotional first aid. In fact, the usual things we might try under other less complex circumstances may not work if they are badly timed or poorly thought out while intervening during or after a disaster.

Some who have been trained to do the small group crisis intervention process known as "Critical Incident Stress Debriefing" (CISD) mistakenly apply the CISD process to all populations under all circumstances and at all times. The pressures of a large scale event may cause them to forget that the CISD is merely one technique from a wide range of techniques. All of these techniques can be useful when applied by properly trained people at the appropriate time and under the right circumstances.

When crisis intervention techniques are used under the wrong circumstances, these techniques tend to be counterproductive, often leading to anger and frustration among those receiving the services. In those instances, had interventions been carefully utilized via a strategic plan, those individuals could potentially have benefited from the support services.

The strategy, of course, is the "big picture." It is characterized by an assessment of the circumstances, the development of clear goals and objectives, the selection of the most skillful people to provide the services and the development of a plan of action. Once all of that has been put together, crisis interventionists must then carefully select a specific set of crisis tactics that are most likely to successfully carry out the strategic plan. A comprehensive, multi-tactic approach that integrates or blends the tactics in a systematic manner typically has the best chance of assisting people through the crisis experience.

There is a simple formula that can be used to develop the strategic plan when intervening in any emotionally charged event. It goes like this:

1. Target. Figure out which individuals or possibly groups might need psychological first aid.

2. Type. Determine which types of interventions are going to be most appropriate for this particular crisis.

3. Timing. Next decide when the various interventions are most likely to be helpful.

4. Themes. Make sure you have a full understanding of the issues, concerns, facts about the incident itself and the services that may have already been provided. Then review the Target, Type, Timing aspects of the strategic plan before instituting the slate of interventions.

5. Resources. Carefully choose the best resources available to provide the services you worked out while looking at the Target, Type, Timing and Themes of the situation as you developed your strategic plan.

The CISD should not be used in relief efforts for Hurricane Katrina, or any other crisis event, unless the three primary criteria for small group crisis intervention can be verified by the support team before the intervention is utilized. The first of the three essential criteria for a small group intervention is that the small group must be clearly a homogeneous group (they know each other, work closely together, have very similar job responsibilities, and the same leadership). The second criterion is that the mission is complete or has moved beyond the acute phases of the crisis event. The third criterion is that the level of traumatic exposure should be about equal.

The development of carefully designed crisis intervention strategies is so important that the International Critical Incident Stress Foundation has incorporated elements of strategic planning into most of its current courses. Starting in January of 2006, however, a specialized courses entitled "Strategic Response to Crisis" will be presented at most ICISF conferences. More information about the new course will be provided in the Fall issue of LifeNet, ICISF's quarterly member newsletter. We hope to see you at the new course. In the meantime, we encourage strategic planning before responding to any crisis. A well organized plan can make a big difference in how effective your response to crisis is.

Additionally, please see the announcement, below, about an important research project from Debra A. Pender. This is an opportunity for you and/or your team to participate and have an impact on the future of CISM.

Dear CISM Provider and Peers,

I would like to extend an invitation for you to participate in a comprehensive study into the critical incident stress debriefing process. I have developed a research plan to attempt to study the quality of the CISD group work, what therapeutic factors emerge (or do not emerge), the kinds of leader behaviors that characterize effective facilitation, as well as the individual differences that may influence the individual experience of the CISD as an effective source of support. I am seeking responses from emergency responders that attend CISD services, as well as the mental health and peer providers that conduct the programs.

If you would like to participate in the study, please see the links below:

If you were a CISD participant
http://www.advtech.biz/pender/deb/esr.asp

If you led a CISD as a Peer
http://www.advtech.biz/pender/deb/cism.asp

If you led a CISD as a mental health provider
http://www.advtech.biz/pender/deb/cism_mp.asp

Questions about this study can be directed to
Debra A. Pender, (815) 753-4906 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it

or to professor, Dr. Karen K. Prichard, This e-mail address is being protected from spambots. You need JavaScript enabled to view it Department of Educational Psychology and Special Education, SIUC, Carbondale, IL 62901-4618

This project has been reviewed and approved by the SIUC Human Subjects Committee. Questions concerning your rights as a participant in this research may be addressed to the Committee Chairperson, Office of Research Development and Administration, SIUC, Carbondale, IL 62901-4709. Phone (618) 453-4533. E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Further updates will follow as more information is obtained.

Donald Howell, Executive Director
International Critical Incident Stress Foundation, In.
Ellicott City MD 21042-2272
http://www.icisf.org
410/750-9600
Fax: 410/750-9601