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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