For 9 1 1 Dispatchers Managing Cumulative and

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For 9 -1 -1 Dispatchers Managing Cumulative and Critical Incident Stress Tools for Survival

For 9 -1 -1 Dispatchers Managing Cumulative and Critical Incident Stress Tools for Survival Janet Childs Bay Area CISM Team Training for Safety

Perspectives on Stress & Change

Perspectives on Stress & Change

Joy vs. Stress, They are just emotions ¬ Joy: Upbeat Emotions Easy to share

Joy vs. Stress, They are just emotions ¬ Joy: Upbeat Emotions Easy to share with others People are willing to hear stories Laughter = Good/positive ¬ Stress & Loss: Difficult Emotions Can be isolating People may be uncomfortable or unwilling to hear stories Depressed, sad = Bad/negative ¬ Public Safety/ Emergency Response Culture

Change creates trauma/stress ¬Stress is the natural response to any change or loss ¬Emotional

Change creates trauma/stress ¬Stress is the natural response to any change or loss ¬Emotional trauma is similar to physical injury *Stress creates an Emotional Imprint & a Physical Imprint: sight, sound, touch, smell, taste

Stress ¬ The stress response is individual and unique ¬ A normal universal human

Stress ¬ The stress response is individual and unique ¬ A normal universal human experience ¬ Natural response to any loss or change Even positive change can cause stress ¬ Unpredictable waves of emotions ¬ The body remembers in ways we may not expect ¬ There is no timetable for stress management

Stress: CISM Team ¬ Proactive response to critical incident stress: Any incident that impacts

Stress: CISM Team ¬ Proactive response to critical incident stress: Any incident that impacts you. ¬ Team is present to listen and support, we don’t make it better or take away the pain. ¬ Empower affected personnel to support themselves and each other in a positive way. ¬ Everything is confidential – a safe environment is created to address the difficult issues of stress. ¬ All emergency personnel are vulnerable to stress: Its an occupational hazard.

Types of Stress/Grief Acute: Immediate reactions, laced with disbelief & numbness. First responders do

Types of Stress/Grief Acute: Immediate reactions, laced with disbelief & numbness. First responders do not have the luxury of having a stress response. Delayed: Feelings/Reactions can surface weeks or months later. Responders will have a delayed response. Cumulative: Multiple incidents can build over time, creating a backpack of stressors that can get triggered. Occupational: Especially for responders, needs not validated or responded to in a positive fashion.

Organizational Betrayal ¬Dealing with the workplace: Supervisors, co-workers, second guessing. ¬Coping with external influences

Organizational Betrayal ¬Dealing with the workplace: Supervisors, co-workers, second guessing. ¬Coping with external influences that create secondary trauma: such as the media, family members & loved ones ¬Internal self talk.

Dispatchers: What’s stress ¬Work the incident the longest. ¬Are often the first responder to

Dispatchers: What’s stress ¬Work the incident the longest. ¬Are often the first responder to know about incident. ¬Have the least opportunity to know outcome of incident or to respond with action step. ¬Are the hub of the wheel of response.

Stress and Change ¬Magnitude of change

Stress and Change ¬Magnitude of change

Stress Dynamic Crash Wall Tired/Wired Stress Baseline for Responders

Stress Dynamic Crash Wall Tired/Wired Stress Baseline for Responders

Stress and Change ¬Spiral of Reactions

Stress and Change ¬Spiral of Reactions

Backpack Present Stress

Backpack Present Stress

Stress and Change ¬ 3 types of landmines Triggered by Senses, Time or Memory

Stress and Change ¬ 3 types of landmines Triggered by Senses, Time or Memory

Stress and Change ¬Loss of Life’s Meaning/Purpose Rebuild a new normal

Stress and Change ¬Loss of Life’s Meaning/Purpose Rebuild a new normal

Stress, Change and Loss ¬Heart Hotel

Stress, Change and Loss ¬Heart Hotel

Dynamics of Stress

Dynamics of Stress

Signs of Stress ¬ Out of control (OOC) ¬ Anger, fear, guilt, loneliness, sadness,

Signs of Stress ¬ Out of control (OOC) ¬ Anger, fear, guilt, loneliness, sadness, depression ¬ Physical symptoms ¬ Relationship issues ¬ Loss of life purpose ¬ Suicidal feelings/thoughts ¬ Substance abuse ¬ Sleep disturbance ¬ Eating changes/disorders ¬ Loss of belief

Family Dynamics ¬Expectations for behaviors vs. feelings behind the behavior ¬Each person has a

Family Dynamics ¬Expectations for behaviors vs. feelings behind the behavior ¬Each person has a specific role Can be overwhelming or isolating depending on the stereotype (Feminine/Macho, Cultural) ¬Conflict because each person reacts differently to loss ¬Focus on individual experience and needs

Social/Work Dynamics ¬ Support can be difficult to find Stress is not talked about

Social/Work Dynamics ¬ Support can be difficult to find Stress is not talked about ¬ Isolation People are uncomfortable with Stress responses ¬ Expectations of society and public safety environment Depending on the loss or stress, social rules change: spouse, child, parents… work roles change

What’s difficult about dealing with change and stress ¬Might make it worse by talking

What’s difficult about dealing with change and stress ¬Might make it worse by talking about it ¬What do I do? ¬Might be painful for me ¬Might bring up past incidents ¬And. . .

Offering Support

Offering Support

How to support others Need Don’t Need ¬ Honesty ¬ Acknowledgement ¬ Listen ¬

How to support others Need Don’t Need ¬ Honesty ¬ Acknowledgement ¬ Listen ¬ Presence ¬ Choice ¬ Space ¬ Validation ¬ Empowerment ¬ Pity ¬ Advise ¬ Judgment/critique ¬ War stories ¬ Platitudes/cliches ¬ Ignored ¬ Fix-it ¬ Personal Power taken away

Support Tips ¬Stay in the present moment ¬Reassure stress response is normal ¬Focus on

Support Tips ¬Stay in the present moment ¬Reassure stress response is normal ¬Focus on most difficult issue RIGHT NOW ¬Assess what is needed RIGHT NOW ¬No easy way over stress, but moment by moment, we get through and build the NEW NORMAL

Ways to Respond to Occupational Stress ¬Control vs. Out of control ¬Where your mind

Ways to Respond to Occupational Stress ¬Control vs. Out of control ¬Where your mind goes, your emotions will follow. ¬Develop and maintain friends, activities and support systems outside of your occupation ¬Do an action step.

Personal Perspectives

Personal Perspectives

Circle of Meaning

Circle of Meaning

Loss Affects Everything Are you spending quality time with people you care about? Are

Loss Affects Everything Are you spending quality time with people you care about? Are you participating in activities that are meaningful for you? Is there anybody that you have unfinished business with?

Building the New Normal ¬What gives me joy? ¬Who and what are my support

Building the New Normal ¬What gives me joy? ¬Who and what are my support systems? ¬With whom and what do I have unfinished business? ¬What action steps do I need to do? ¬Are there any unspoken appreciations, or ‘I love you’s?

Adapted Maslow’s Needs Hierarchy ¬Survival ¬Safety ¬Emotional Needs/ Relationships ¬Building the New Normal ¬Creating

Adapted Maslow’s Needs Hierarchy ¬Survival ¬Safety ¬Emotional Needs/ Relationships ¬Building the New Normal ¬Creating Meaning from the Trauma/ Life Transformation

Tools for Survival ¬Acknowledge the loss & the impact of the grief process ¬Express

Tools for Survival ¬Acknowledge the loss & the impact of the grief process ¬Express your feelings & issues ¬Act – take steps to create as much meaning as you can to bring completion to the stressful event ¬Acknowledge your progress Reconnect to what’s good in your life

CISM Interventions ¬Demobilization ¬Defusing ¬Debriefing ¬Follow up ¬Landmine ¬Debriefers

CISM Interventions ¬Demobilization ¬Defusing ¬Debriefing ¬Follow up ¬Landmine ¬Debriefers

CISM Groundrules ¬ Confidentiality ¬ No critique of operations or personnel ¬ Automatic attendance/

CISM Groundrules ¬ Confidentiality ¬ No critique of operations or personnel ¬ Automatic attendance/ No mandatory participation ¬ No rank or hierarchy ¬ Only involved personnel* ¬ Puts puzzle pieces of the incident together ¬ Normalizes stress reactions and gives tools for coping

Phases of a Debriefing ¬Introduction ¬Fact ¬Thought ¬Reaction ¬Signs ¬Landmine ¬Education ¬Meaningful Aspects ¬Closure

Phases of a Debriefing ¬Introduction ¬Fact ¬Thought ¬Reaction ¬Signs ¬Landmine ¬Education ¬Meaningful Aspects ¬Closure ¬Re-entry

CISM for Dispatchers ¬Validate impact of incident. This sucks! ¬Get food, comfort items to

CISM for Dispatchers ¬Validate impact of incident. This sucks! ¬Get food, comfort items to Comm center. ¬Do NOT interrupt dispatcher who is actively working. ¬Have brief CIS Defusing before shift ends. ¬Include dispatcher in CIS Response. ¬Ask dispatcher what is needed and give choice when possible.

Info… What’s the 411? ¬International Critical Incident Stress Foundation – ICISF. org ¬Bay Area

Info… What’s the 411? ¬International Critical Incident Stress Foundation – ICISF. org ¬Bay Area CISM Team website – criticalincident. net ¬Training for Safety – trainingforsafety. com – Great trainings on a variety of subjects ¬California Peer Support Network – A network of peer support teams ¬WCPR: West Coast Post Trauma Retreat

What is the Bay Area CISM Team/ Centre for Living with Dying? ¬ Provides

What is the Bay Area CISM Team/ Centre for Living with Dying? ¬ Provides support, intervention and education for the life issues of grief, loss, serious illness, trauma and change ¬ Bay Area CISM Team ¬ Non profit program of Bill Wilson Center for Silicon Valley and surrounding areas ¬ Group, individual, children, family and community support and intervention ¬ For over 30 years, over one million people served

Triage : what’s important ¬Breathe ¬Drink plenty of water ¬Move ¬Give yourself a break

Triage : what’s important ¬Breathe ¬Drink plenty of water ¬Move ¬Give yourself a break ¬Ground: Get in the present moment ¬Identify: what is the most difficult and what do I need to get through it right now.

How to work with loss. . . Take care of you…You are not responsible

How to work with loss. . . Take care of you…You are not responsible for any one else’s experience…

Stress and the Holidays If it takes more energy than it gives, Let it

Stress and the Holidays If it takes more energy than it gives, Let it go…. .

Tools for Responders/Caregivers ¬Critical Incident Stress Management ¬Education of Family and Loved ones ¬Comfort

Tools for Responders/Caregivers ¬Critical Incident Stress Management ¬Education of Family and Loved ones ¬Comfort Anchors, Comfort tasks ¬Grounding tools ¬Daily Log ¬Positive Imprinting

Positive Imprinting • Imagine. . .

Positive Imprinting • Imagine. . .

Locking it in. . .

Locking it in. . .

Remember ¬Be easy with your own process. ¬We have today. Savor what’s good in

Remember ¬Be easy with your own process. ¬We have today. Savor what’s good in your life now. ¬What you do does make a difference in people’s lives and their ability to survive the loss. ¬Do something decadent to spoil yourself in the next 24 hours.