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Peer support for public safety
By William Hogewood,
Provided by ETGI |
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Today’s police officers, sheriff’s deputies, firemen, medical technicians and correctional officers enjoy the availability of a multitude of psychological services to provide support in a variety of ways. This support takes many forms, such as mental health professionals who may work for a particular agency, employee assistance programs that may be available contractually, peer support teams sometimes known as CISM or CISD teams, and chaplains.
While public safety personnel take pride in being courageous and tough, most know full well that performing in today’s society is full of emotional speed bumps. Critical incident stress symptoms may occur after shootings, chases, barricades, hostage takings, accidents, multiple body counts, grotesque scenes, incidents involving children, fire deaths and the list goes on and on. Add to this the burdens of life; finances, relationships, children, part-time jobs, illness and all that the general populace faces each day, one can easily understand the potential of emotionality overcoming normal coping resources.
Stress reactions belong to the beholder. Having them is not necessarily a sign of weakness, just something that happens to some folks some time. “Sucking it up,” may not be the most advantageous way of dealing with issues. Instead a courageous person comes forth to seek the assistance of others when times get tough. Those that can “Get over it,” are fortunate, unless they are hiding from their own feelings and behaviors.
We have all heard of Acute Stress Disorder and Post Traumatic Stress Disorder. The Diagnostic Statistical Manual IV, defines PTSD as:
Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Several distressing symptoms are common in the person with PTSD, including Psychic numbing, emotion anesthesia, increased arousal, or unwanted re-experiencing of the trauma. These symptoms can affect any sex or age group. Anxiety, irritability, and depression are also common in people who have PTSD. People with PTSD have a diminished ability to experience emotion, including tenderness or intimacy. There may be problems falling or staying asleep. A person with PTSD will avoid any reminders of the trauma but re-experiencing the event in dreams, nightmares, or painful memories are common. Some people will turn to drugs or alcohol to escape the pain of PTSD. while others may become suicidal or self-defeating
Acute Stress Disorder develops within one month after a severe traumatic incident with similar but less severe symptoms.
It is not uncommon for public safety personnel to experience these negative reactions after critical incidents. Many don't. Or, think they don’t. Remember, how we handle stress is subjective. Each person may react differently. What puts some folks at risk is not acknowledging that something is happening and not using the resources that are available. Worse, continuing to ignore the symptoms may allow the accumulation of stress to change the makeup of who you are. This may negatively impact on one’s daily life and career, and may cause issues well into retirement.
Peer Support is one effective method for assisting personnel who are impacted in the aftermath of a critical incident. Peer Support may also assist those struggling with burdens of life that sometimes overpower us.
Peer Support teams are made up of personnel working in a specific agency. Members volunteer and are selected through an application and interview process. They can be sworn and non-sworn members of the agency. They must display maturity, compassion, a willingness to be available and they have to be emotional risk takers. They also should be honest, credible, patient, trustworthy and not presently under investigation. Finally, and most importantly, they should be able to understand and utilize the concept of empathy. Empathy is sometimes defined as:
One’s ability to recognize, perceive and directly feel the emotion of another. It is the ability to relate to the common denominator of mankind, which are feelings.
The use of empathy and other skills can be taught and utilized by those willing to learn. These skills are essential to assisting the affected person in the process of ventilating or sharing, thoughts and feelings. This ventilation process is found to be emotionally cathartic.
The International Association of Chiefs of Police recommends peer support and has published guidelines for such teams. Most importantly, the program has to be structured, with published duties, selection, mechanisms for removal and operational procedures.
One recommendation is assignment of a full time coordinator who is given the requisite time for program development, logistics, roster maintenance, and training. Joe Panico of the Chicago Police Department, Frank McAtee of the Montgomery County, Maryland Police Department and Bob Martin of the Chicago Fire Department are individuals who manage highly successful programs. These programs follow IACP guidelines and have assisted countless individuals involved in a variety of incidents.
The program cannot operate alone. Instead, most successful programs work within the structure of a Stress Management Division alongside the mental health professionals who provide clinical oversight. Not everyone supports the premise of peer support. I have met mental health folks who feel that personnel don’t want to share innermost feelings with peers, only professionals. Others would agree that many in public safety are not willing to trust professionals and relish the opportunity to share with a trained peer. Still others would prefer talking to a Chaplain. That is why I recommend that all three components be included in a comprehensive stress management program. This is an accepted practice in the world of Critical Incident Stress Management. After all, having a choice of services available may encourage the affected individual to seek the help they feel would be beneficial.
Peer Support Programs are recognized as a useful resource by most major public safety organizations. In Chicago alone, team members interact with thousands each year and those that come into contact with the team, applaud and commend their work. Hopefully, more and more agencies will sense the wisdom of the type of programs designed to help the men and women that represent them.
It is important for the program to enjoy administrative privilege, giving protection against questions about clients or sessions with clients. Confidentiality is the cornerstone of the success of a program. Peer Support Team members are bound by state law in terms of a duty to warn when there are threats of danger to self, others, children, elders and violations of the law. A Peer Support Standard Operating Procedure should state this and it should be available to the entire agency.
Training consists of subjects such as, but is not limited to:
• Active listening
• Confidentiality
• Limits and liability
• Ethical issues
• Assessment
• Crisis intervention
• Suicide intervention
• Alcohol and substance abuse
• Death and dying
• Grief management
• Stress management
• Mental disorder
Ongoing training is a must. There is no end to the learning curve in dealing with human behavior. Administrators must support the ongoing training effort.
Peer Support Team members are not and do not pretend to be therapist. They offer psychological first aid through consoling, providing comfort, providing safety, immediate care for physical necessities, reunion with significant others, goal orientation and support for reentering the real world. Through the use of listening skills, compassion and empathy, Peer Support Team members help the affected personnel retell the event through the ventilation of thoughts and feelings. Through education prior to events, immediate response to events and competent debriefs after events, Peer Support Team members can assist the members of an agency in mitigating the emotional impact and continuing to perform their duties after an incident.
Peer support has been around for many years. In fact, all of you provide support to each other daily. Formal teams, evolved out of efforts to make that support more formal, more organized, more available and staffed by well-trained individuals. Not only are they well trained, but they have an understanding of the culture of the respective agency. Peer Support programs are more than just debriefings of critical incidents. The programs offer 24 hour availability to support the employee in any situational or evolving crisis. Many times much peer support work is accomplished in daily informal interventions, as well as, during response to those incidents in law enforcement that we all dread.
About the author
William Hogewood is a veteran of 38 yrs. in law enforcement with Prince George’s County, Md. and ATF. His company, Crisis Associates, LLC presents peer support and other behavioral sciences programs tailored to the needs of the clients. He is also involved in Crisis Negotiation Training through Hammer Consulting. Mr. Hogewood has been involved in training others since 1980 with his department, the local Community Crisis Center, private corporations and the US State Dept. Anti-Terrorism Assistance Program. He has a Master of Human Services degree from Lincoln University, Oxford, PA.
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