International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Timothy Neal, MS, AT, ATC, CCISM
As the head athletic trainer at Syracuse University, I was driving into work listening to the “Imus in the Morning” program when I heard that the north tower of the World Trade Center had been struck by an airplane. Thinking it was pilot error, I mentioned the accident to the Syracuse University athletic director, Jake Crouthamel at the start of our weekly athletic department administrative staff meeting, which started at 9:00am on September 11, 2001. Within minutes, we saw several staff members running past the windowed door. Mr. Crouthamel, sensing something was up, abruptly ended the meeting, and the entire group quickly walked down the hall to the academic wing where dozens of coaches and clerical staff were huddled around a big-screen TV watching in horror the replay of the south tower of the World Trade Center being struck by a jet airliner. Shortly thereafter, the news reported that the Pentagon had been struck by another jet airliner taken over by terrorists. Right then, everyone knew the world was immediately changed. The angst and anger that followed in the aftermath of this terrible day lasted for months.
When I waked back to my office in the sports medicine facility at Manley Field House, I passed no one; everyone had either left the building or was glued to the TV or radio. When I entered my office, my phone rang. Surprised to receive a call, I answered, and was asked by a regional leader of ICISF if I was available to go to NYC, Washington DC, or to the Syracuse University health service to provide Critical Incident Stress Management (CISM) interventions for individuals. I told them I would be available. I then spoke to Mr. Crouthamel and he granted me permission to leave if needed to help others during this time of need.
Back in July 2001, I was selected by Syracuse University administration, along with a dozen other university administrators and leaders, to receive training by the International Critical Incident Stress Foundation (ICISF) on providing CISM to individuals following a critical incident. I found the training very informative and useful. Little did I guess that in only two short months I would be called to possibly be deployed to assist first responders or students at the health center. While I was not deployed to NYC or Washington, nor asked to provide interventions at the Syracuse University health services, I was fully committed to CISM and the very valuable intervention skills following critical incidents. This initial training in CISM has led to my involvement in the National Athletic Trainers’ Association (NATA) ATs Care program, which assists athletic trainers in the aftermath of critical incidents.
As I retrained in CISM after 2001, and by 2013, I was interested in becoming an approved instructor of CISM. I retired from Syracuse University in 2014 and was looking to become a full-time professor, which has been a life-long desire of mine. I started at Concordia University Ann Arbor as an assistant professor and clinical education coordinator for their athletic training program in January 2016. In June 2016, I was fortunate to attend private instruction by both Dr. Everly and Dr. Mitchell at the ICISF headquarters in Maryland prior to the 2016 annual NATA meeting in Baltimore. I was trained in individual and group interventions by these brilliant professionals that developed these interventions, as well as CISM instructor training over an intense and rewarding four-day process. Later that summer, I completed my advanced group training in Chicago, and passed the CISM on-line certification test in December 2016 in order to obtain my opportunity to become an approved instructor of CISM.
Near the end of his term as NATA president, Jim Thornton, MS, ATC, called me for ideas on supporting athletic trainers following a critical incident (death or catastrophic injury to an athlete). Often times, following a critical incident in athletics, athletes and coaches receive counseling, and the athletic trainer simply goes back to work without any psychological interventions to manage their psychological response to their participation in the event. Unlike the fireman, EMT, or police officer who is involved in a critical incident where they have never met the person or persons involved, the athletic trainer knows the athlete, coach, or staff member they are working on very well, perhaps for years. What was being reported to the NATA was that athletic trainers and athletic training students, following caring for a person who died or experienced a catastrophic injury, were suffering psychologically for weeks and months following the incident. Some athletic trainers were so distraught that they left the profession. President Thornton asked what the NATA could do to address this. I offered a peer-to-peer support program that I learned from ICISF, CISM interventions. It was at that time that I searched for a name for the program, and thought using the professional credentials of certified athletic trainers, ATC, was appropriate. I suggested the program be named Athletic Trainers Care, or ATs Care for short. I felt that the CISM concept by ICISF was the intervention strategy that should be used in the peer-to-peer program. This was based on the evidence of the program’s effectiveness, the numerous professions that utilize CISM in peer-to-peer programs world-wide, and the testimony immunity that officially trained CISM professionals receive when providing interventions to people during that person’s worst day.
Jim Thornton, as immediate past president of the NATA, made the case to the NATA Board of Directors in approving this program, and untold numbers of athletic trainers owe Jim a debt of gratitude for advocating this program. Dave Middlemas, Ed.D, ATC, has been the chair of the NATA Commission since the inception of the program back in 2017. Dr. Middlemas has been instrumental in launching this program and working closely with ICISF in developing the training and shepherding the program into one of the best benefits a NATA member can access after a potential career-altering moment. The members of the ATs Care Commission are all individual, group, and advanced group trained, and several of us, including commission chair Dr. Middlemas, are approved instructors.
As a member of the NATA ATs Care Commission, I have been able to provide CISM assistance to NATA members following their critical incidents, and instruct athletic trainers on CISM interventions in both individual and group training. Both of these experiences have been profoundly rewarding. I have been able to get to work with Dr. Everly on several endeavors related to ATs Care, as well as with Dr. Welzant; both have been helpful in my assimilation of content into action in assisting my fellow athletic trainers during their time of need.
I would like to share some of the items that I have learned or gained an appreciation for through my journey in CISM:
My journey through CISM has come a long way since September 11, 2001. I have been able to learn, apply, and now instruct the principles of CISM interventions to assist athletic trainers during critical incidents and apply these skills in my personal life. I am grateful to ICISF, Dr. Everly, Dr. Mitchell, Dr. Welzant, and the ICISF staff for the opportunity to learn from them to help others during their time of need following a critical incident.
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