International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Kathy Hoppe
The comedy routine of Abbot and Costello is known to many as the two discuss the players on the field. It’s a comical routine that keeps the audience laughing as the confusion about the team members and the action in the game grows. However, it describes an experience I faced during the past year when stepping in to help with a critical incidence stress debriefing event. Subsequently, I learned some important lessons about getting the player straight in the game and who played which base.
A tragic incidence occurred in a small town in the area resulting in the killing of six innocent people, of which five were children. Three children in the home were not injured. As the emergency response team descended on the scene, they were overcome by the horror of the situation and the ensuing trauma. Several children were transported to two different hospitals whereupon the staff were also witness to grueling injuries to small children which were not survivable. This left the EMSA workers and the hospital staff with posttraumatic stress symptoms.
Due to the number of respondents involved in the scene, and the different locales, I was asked to do a debriefing at one hospital in one town, while my co-worker did two debriefings at the hospital in the other town, and with the emergency responders. In trying to gather more information about the setting I was walking into, I was told to “play it by ear,” and that I needed to follow the lead of the religious workers. That left me in a quandary as I had little information on which to plan my intervention.
Entering the small conference room, amid the COVID-19 pandemic, the scene was already tense due to the lack of available distancing space needed at this time. I introduced myself and awaited the arrival of the religious workers. Shortly, two nuns entered the room and were introduced to the group which was comprised of about ten people. Then I noticed several people were included in a conference call. This was not my idea of an ideal set-up for a CISD, and certainly not the standard protocol.
The lead nun requested the other nun begin by offering a prayer. After reading a lengthy prayer aloud, the lead nun mentioned the horrific act, and then proceeded to discuss how to overcome the trauma of the situation by visualizing the children up in heaven. As my jaw dropped, I was aghast at how this debriefing was already proceeding. There was no CISD protocol followed, and I certainly was not invited to lead or participate. A few people shared their dismay at the scene, but most sat silently. I tried to intervene by inviting people to share their initial thoughts and what they saw, but that was followed by the nun telling the group to focus on what good might come from this. Again, I was horrified by the suggestion, and dismayed at the lack of knowledge and understanding of what was needed at this moment.
I decided to try a different tactic and offered some psychoeducation on trauma symptoms to normalize the physical and emotional experiences. Again, the conversation drifted back to the religious overtones and only a few people responded by nodding heads in agreement with the nun who passed out crosses at that time. The anger boiled within me, and I had to practice some self-regulation during this time. The entire process lasted about thirty minutes whereupon everyone was dismissed. As a final act, I mentioned I would remain for the next half hour should anyone need to visit further. The group scattered and I was left alone to ponder in that awful silence.
It was one of the most concerning group events I’d attended in my career as a counseling profession. Certainly, it reminded me of the need to obtain more information and enter in discussion with those in charge prior to the event. The opportunity to provide hope and healing was lost in that moment. As I reflect on it now, it seems like a comedic act, with no one really in charge, and everyone confused about the whole process. I still think about those people in that room and hope they found their way to healing.
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