Chapter 13

Providing Emotional Support

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Introduction

• An organization is defined by the people who make it up

• Recent push for improving our health and wellness

• The Fire and Life Safety Initiatives have devoted an initiative to address responders’ physical health (Initiative 6) and a separate initiative to their emotional health (Initiative 13)

• Note the ties between the physical and psychological sides of human beings

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Life Safety Initiative 13

Firefighters and their families must have access to counseling and psychological support

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Life Safety Initiative 13

STRESS

• Overview• Physical strains

• Emotional strains

• Adrenaline

• Long term effects

• Short term effects

Cont. 13-4Photo courtesy of Bob Gahr

Life Safety Initiative 13

STRESS

• Coping with stress• Must be able to accept the facts

• Must be prepared

• Impossible to not be affected

• Alcohol abuse

• Drug abuse

Cont.13-5

Life Safety Initiative 13

STRESS

• Failure to cope with stress• Likely to bring on severe depression

• Police officer study in 2008

• Must expose causes, signs and symptoms of stress

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Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Overview• Only officially labeled in last 30 years

• Early human stresses

• Webster’s 1913 dictionary

• Railway spine

Cont. 13-7

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Overview• Acute stress disorder (ASD)

• Precursor to PTSD

• Generally lasts less than a week

• Some proceed with no intervention

Cont.13-8

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Overview• PTSD could include

• Avoidance

• Seclusion

• Flashbacks

• Change in eating and sleeping habits

Cont.13-9

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Signs and symptoms• Categorization

• Re-experiencing

• Avoidance

• Hyperarousal

Cont.13-10

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Treatment• Psychotherapy

• Counseling as an avenue for healing

• Traditional psychotherapy

• Group therapy

• Individual therapy

Cont.13-11

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Group therapy• Overview

• Brief group therapy

• Bottling it up proven to be ineffective

• Discussion encourages healing

• Handbook of Psychotherapy and Behavior Change

Cont.13-12

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Group therapy• Alcoholics Anonymous (AA)

• Meetings• Similarities to fire departments• Single share• Cross-talk• Closing

Cont.13-13

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Group therapy• Critical incident stress management (CISM)

• Pre-incident CISM

• Incident response

• Post-incident response

• AA and CISM differences

Cont.13-14Courtesy of Scott Beveridge, Observer-Reporter

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Group therapy• Psychological first aid (PFA)

• Effectiveness of CISM

• Effectiveness of PFA

• Primary psychological victims

• Secondary psychological victims

Cont.13-15

Life Safety Initiative 13

POST TRAUMATIC STRESS DISORDER (PTSD)

• Individual therapy• Mental health support

• Employee assistance programs (EAP)

• Chaplains

• Available

• Approachable

• Adaptable

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Life Safety Initiative 13

THE FUTURE

• Overview

• Relative anonymity• Texting

• Complete anonymity• Web based program

• Support system• Include family members

13-17Courtesy of Erica Ziegler

Summary

• Psychological stress of emergency scenes can be as severe as the physical stresses

• CISM has evolved into a successful form of group therapy

• We need to research, obtain, and implement instruments such as CISM, EAP, and chaplaincy programs

• Improve the tools we have, and invent the ones that don’t yet exist

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