CRITICAL INCIDENT GROUP DEBRIEFING

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CRITICAL INCIDENT GROUP DEBRIEFINGTRAINER: JOHN KOOP HARDER, MSW, RSW

AGENDA

• Understanding critical incidents and common

responses

• CIGD considerations

• Preparation

• CIGD model

DEFINITION

Critical incidents are situations outside our normal frame

of reference that instantly challenge us to understand and

cope with what has happened.

Factors:

• Loss: real or perceived

• Sense of being out of control

TYPES OF CRITICAL INCIDENTS

• Natural disasters

• Accidents

• Sudden death(s)

or injury

• Violence

• Other

TRAUMA CONSIDERATIONS

• The event itself

• The meaning given

CORE ASSUMPTIONS

• Good things happen to good people

• If we are good, good things will happen to us

• Everything happens for a reason

• The world around us is largely predictable,

and we can know how to keep ourselves safe in it

COMMON REACTIONS

• Emotional: Numbness, anger, sadness, fear, guilt, etc.

• Cognitive: Scattered, preoccupation with the event,

blaming or intrusive thoughts, etc.

• Physical: Sleep, aches, feeling “on edge”, exhausted, etc.

• Behavioural: Seeking closeness, withdrawing, numbing,

changes in appetite, return to previous coping patterns,

etc.

• Spiritual: Seeking meaning – the “why’s”, seeking

closeness, or anger towards a higher power, etc.

REMEMBER…

• After a critical incident…

“Normal People having Normal Reactions to Abnormal

Events”

• Our systems are trying to accommodate the

shock and reset their balance.

• Reestablishing a sense of safety is key.

• Event variables

• Personal variables

• Social variables

TRAUMA RESPONSE VARIABLES


•Connection to the crisis situation

•Relationship to people impacted

•Physical injury sustained

E V E N T C H A R A C T E R I S T I C S

© C R I S I S & T R A U M A R E S O U R C E I N S T I T U T E

• Shock factor

• Probability of reoccurrence

• Expected or unexpected

• Duration of the incident

• Cause of trauma

E V E N T C H A R A C T E R I S T I C S


• Personality

• Prior ability to cope

• Past history of mental health issues

• Spirituality

• Age

• Self-assessment regarding their crisis response

P E R S O N A L C H A R A C T E R I S T I C S


• Supports

• Media

S O C I A L V A R I A B L E S



TRAUMA SUMMARY

• Not everyone will be traumatized (do not assume)

• The event may take weeks, years, or a lifetime to process

• Educate and normalize around stress and trauma reactions

• Meanings attached to events are often “fixed”

• Grief response is an individual reaction

CIGD IS ONE OPTION

• CIGD is an option that a Crisis Response Team

may utilize after a critical incident, but there are

others:

• Individual Debriefing

• Individual Counselling

• Family Counselling

• Safe Room/Grief Room

• Large Group/Town Hall Info Session

• Other?

SETTINGS

Where CIGD may be more appropriate:

• Community based

• School

• Emergency service personal

B E NE F I TS & C HA L L E NG ES O F C I G D

• Reduces rumor mill

• Is an acknowledgment

• Creates stability

• Can create new meanings

• Group support, not alone

• Assessment and resources

• Normalizing can occur

• Support those who do not seek individual help

P O T E N T I A L B E N E F I T S


BENEFITS & CHALLENGES OF C IGD

• “Safety” can be difficult to achieve

• Re-traumatizing/vicarious trauma

• Oversharing, regrets

• Not enough time to share

• People leave feeling worse

• Becomes something it is not intended to be (blaming session)

P O T E N T I A L C H A L L E N G E S


C.T.R . I GROUP DEBRIEF ING

• Preparation

• Response: 3 days – 1 to 2 weeks after the incident

• Natural groups preferred

• Co-facilitation model

• Voluntary involvement

• Process is fluid – not rigid

K E Y E L E M E N T S


THE SEVEN P ’S OF CIGD

1. Proper

2. Prior

3. Preparation

4. Prevents

5. Piss

6. Poor

7. Performance

INTAKE

• Contact information

• What happened

• Impacts

• Preexisting issues

• Hopes

• Suggestions

PREPARING

• Is this a safe environment?

• Who ought to lead?

• How large a group will this be?

• Should there be separate groupings?

• How long should the session last?

• What if people want to leave?

F O R A G R O U P D E B R I E F I N G


PREPARING

• Will people be called by name to share?

• How will you manage intense emotions?

• Should individuals be met with ahead of time?

F O R A G R O U P D E B R I E F I N G


CO-FACILITATION

• Co-facilitators

• A lead facilitator and a second facilitator

• A lead facilitator and helpers/watchers

THE GROUP DEBRIEF ING PROCESS

1. Introduction

2. Reactions and Experiences

3. Education/teaching

4. Follow-up and Closure

O U T L I N E


PHASE 1

• Introduce self

• Purpose

• Role

• What to expect

• Guidelines (confidentiality, nonjudgemental, etc.)

• Seek acknowledgement

• Questions?

I N T R O D U C T I O N


PHASE 2

Questions related to:

• Reactions and experiences

• Perspective taking

• Interpretation and meaning

• Remembering

• Coping

E X P L O R AT I O N O F T H O U G H T S


QUESTIONS

• What happened…?

• Where were you when…?

• What stood out ...?

• When did you know it was over?

• When did you know you were safe?

R E A C T I O N S & E X P E R I E N C E


PERSPECTIVE TAKING

• From your point of view, tell me about…

• From your experience…

• What was the worst part of…?

MEANING QUESTIONS

• What has changed in the way you go about life?

• How will things be different for you?

• What are your feelings/thoughts right now?

REMEMBERING QUESTIONS

• What kind of person was _________?

• Tell me a story about ____________?

• What are the things you remember about _________?

• What will you miss the most about ___________?

COPING QUESTIONS

• How are you managing life now?

• What do you normally do when you feel

sad/scared/worried, etc.?

• Do you have someone to talk to about this?

PHASE 3

• Review normal symptoms of grief/trauma/stress

• Review coping and stress management skills

• Review who may need more individual help

T E A C H I N G


PHASE 4

• Summarize the discussion

• Message that one-on-one help is available

• Give information regarding upcoming activities

• Loitering with intent

F O L L O W U P A N D C L O S U R E


GENERAL CONSIDERATIONS

• Be okay with silence

• Be perceptive to the unspoken things going on

• Be empathic without being dramatic

• Stay away from probing

• Don’t take notes

DEBRIEFING THE DEBRIEFING

• What was that like?

• What was the hardest part?

• What was the most rewarding?

• What do you need now?

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CRITICAL INCIDENT GROUP DEBRIEFING