The Misuse of the CISM Model and How it Affects Advocacy  

The Misuse of the CISM Model and How it Affects Advocacy   

By: Braxton A. Morrison, PhD, FAAETS, CCISM, & ICISF Approved Instructor

The International Critical Incident Stress Foundation (ICISF) has recently undertaken an effort to compile and maintain, to the best of their abilities, a list of state laws regarding confidentiality around peer support and/or Critical Incident Stress Management (CISM). I commend their efforts as they are in response to high demand from the CISM community. It would be who of the interventionists providing CISM interventions to support them by using the correct terminology and disseminating proper information around the model, given that their efforts are again in response to user demand.

Attending CISM meetings for Approved Instructor Friday’s, Team Coordinator meetings, a variety of CISM courses from ICISF, state-level meetings, and reviewing research articles, I continue to see CISM inappropriately and inaccurately referred to on many different levels. This appears to date back to the inception of CISM and Critical Incident Stress Debriefings (CISDs) (Sommer, 2013). While initially the same comprehensive model we see today, Dr. Jeffrey Mitchel appears to have begun referring to the program as CISDs and many people saw that as the primary focus. However, this was quickly rectified, and the name we know today, CISM, was developed. Unfortunately, CISD stuck and has been further generalized to the term “debriefing,” which can encompass a whole host of scenarios from after-action reviews, field debriefings of law enforcement or military operations, or simply the cathartic ventilation of emergency services personnel after a traumatic call or intense shift. This has led to poorly conducted research, misuse of the model (CISM) and tactic (CISD), and, to this day, inaccurate and inappropriate dissemination and use of the program.

From day one of CISM training, students are taught that CISM also stands for Comprehensive, Integrated, Systematic, and Multi-component (Mitchell, 2015). No one intervention tactic or support under the CISM umbrella should be used in isolation; each tactic should be integrated with others, and each tactic has its own systematic process. This creates a comprehensive, multi-component model providing group, individual, family, clergy, pre-incident education, and other supports. However, this continues to be misused, specifically with CISDs being used in isolation. This is two-fold in that CISM teams/interventionists are doing a poor job of pre-incident education and dissemination of accurate information on how the model works. Secondly, it is due to emergency services personnel (ESP) waiting too long post-event to seek CISM services, limiting the interventions that can be provided. Furthermore, emergency services personnel often reach out requesting “debriefings” and team coordinators do not do a thorough assessment to analyze if that is the most appropriate intervention.

Advocacy and support for legislation requires a thorough and comprehensive understanding of what is being advocated for. The way CISM is referred to on a broad basis makes clear that coordinators, instructors, and interventionists certainly do not understand the model or terminology. ICISF is a training organization and CISM courses are just that, trainings. Yet, “seasoned” coordinators, instructors, and interventionists inaccurately refer to being “CISM certified,” or worse, “Certified Debriefer” or something along those lines when they do not hold the CISM certification (CCISM) of knowledge that is not required to provide intervention. Coordinators and interventionists seem to ignore the package of interventions offered in the CISM model and only provide “debriefings,” further promoting the misuse of the model. It seems unreasonable and uneducated to expect so much from ICISF when the interventionists they serve are not following the model being taught by the organization. Moving forward, if we want to continue advancing the field of crisis intervention, the CISM model, and promoting new initiatives, we need to go back to the foundational courses, Group Crisis Intervention and Assisting Individuals in Crisis, and reground ourselves in the appropriate terminology and use of the model. Language matters.

References

Mitchell, J. T. (2015). Group crisis intervention – core course – fifth edition (5th ed.). International Critical Incident Stress Foundation, Inc. (ICISF).

Sommer, H. (2013). A Review of The History, Theory, and Effectiveness of Critical Incident Stress Debriefing (CISD).