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US Coast Guard Command Instructions
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CISM Activity Measures
On-Scene Support Services
Critical Incident Stress Management (CISM) - index
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Enclosure
(1)
to
COMDTINST
1754.3
CISM
SERVICES
These
are
some
of
the
CISM
interventions
the
Coast
Guard
commonly
uses.
The
EAPC
has
the
proper
training
and
knowledge
to
determine
whether
these
services
are
needed
and
which
one is
appropriate.
1.
CRITICAL
INCIDENT
STRESS
DEFUSING.
This
is a
small
group
process
ideally
done
within
8
hours
after
a
critical
incident.
Post
traumatic
stress
disorder
(PTSD)
frequently
results
from
not
talking
about
and
being
able to
put
into
perspective
a
critical
incident.
Once
PTSD
develops,
the
impairment
the
long-term
emotional
response
to
the
trauma
causes
is
harder
to
heal.
Prevention
is
preferred.
Any
CISM
team
member
can defuse.
The
process's
objectives
are:
a.
Rapid
reduction
in
the
intense
reactions
to a
traumatic
event.
b.
"Normalizing"
the
experience
so people can
return
to
their
routine
duties
as
quickly
as
possible.
c.
Re-establishing
the
group's
social
network
so people do
not
isolate
themselves
from
each
other.
In
recognizing
similarities
to
others,
people
often
are
more
willing
to
help
each
other
in
troubled
times.
d.
Assessing
personnel
to
determine
if a full
debriefing
is necessary.
2.
CRITICAL
INCIDENT
STRESS
DEBRIEFING
(CISD).
This
is a
group
meeting
or
process
using
both
intervention
and
education
to
mitigate
or
resolve
the
psychological
distress
associated
with
a
critical
incident.
To
maximize
effectiveness,
a
debriefing
should
occur
24 to
72
hours
after
an
event.
CISD
usually
uses
all
team
members:
a
mental
health
professional
as
leader or
co-leader,
chaplain,
and
peers.
It is
not
therapy
even
though
mental
health
professional(s)
are
part
of
the
team.
The
process's
objectives
are:
a.
Mitigate
the
critical
incident's
impact
on:
(1)
Primary
victims,
those
directly
traumatized
by
the
incident;
(2)
Secondary
victims,
emergency
services
personnel
who
witnessed
or
managed
the
critical
incident;
and
(3)
Tertiary
victims,
dependent
family
members
b.
Accelerate
recovery
processes
in people
experiencing
normal
stress
reactions
to
the
critical
incident.
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