Flashcards in CISM Deck (57)
What are the 6 stages in the Defusing process?
1) Make contact - acknowledge and contract
2) Get the story - the facts, just the facts
3) Find the impact - emotions
4) How are they doing - safety
5) Educate - handout
6) Ending - follow up
What are 6 key helpful things to mention to someone post-critical incident stress?
1) CIS does not mean you are mentally ill.
2) You are having normal / expected reactions to abnormal situation
3) Your family is involved - let them be a part of your recovery
4) Get help if your symptoms persist
5) Counselling will lessen your CIS
6) Find someone you trust and talk about it
What are 8 things to suggest people DON'T do following critical incident stress?
1) Drink excessive alcohol
2) Use substances to numb post-trauma consequences
3) Withdraw from family and friends
4) Don't stay away from work necessarily (normal routine will help you feel normal)
5) Don't fall back on easy answers, blame for incident
6) Don't think that you are crazy
7) Don't think you alone were affected
8) Don't be unrealistic in your expectations for recovery
What are 8 things to suggest people DO do following critical incident stress?
1) Expect the incident will bother you
2) Maintain diet and cut down on sugar, caffeine, stimulants
4) Take time for leisure
5) Remind yourself that post-trauma consequences are expected / normal
6) Learn as much as you can about stress response
7) Spend time with family, friends, and co-workers
8) Get extra help if you need it
What is stress?
The body’s response to demanding situations.
What are the terms for positive and negative stress?
Eustress and Distress
What consequenses lie at the ends of the stress continuum?
Burnout and boredom
What is an analogy for a healthy level of stress in life?
Violin string. If it’s too tight, it will break, if it’s not tight enough, it won’t sing.
What are the three major components to a critical incident?
1) The distressed state resulting from memories of trauma (experience which shatters sense of invulnerability to harm)
2) Any situation where one is overwealmed by sense of vulnerability or lack of control
3) Any situation faced by emerg services resulting in strong emotional reactions which may interfere with ability to function
What is traumatic stress? How is it different from a critical incident.
Any stress resulting from trauma. Traumatic stress is not necessarily critical incident stress. Death of a sibling may be traumatic, but may not be critical incident, for eg., if death were expected.
What are the four general typical responses to stress?
Acute (in the moment)
Delated (comes back to bite you)
Secondary (compassion fatigue, vicarious trauma)
Cumulative (burnout, several acute situations)
What are the 7 stages of a critical incident?
Alarm (e.g., a pager, phone call, there’s been an accident)
Impact (Rote training kicks in; feel overwealmed)
Inventory (confusion, frustration, disorientation)
Rescue (elated, purposefulness, euphoria, fearfulness, sadness)
Stress management (demobilizations, defusings, debriefing)
Empowerment (achieving mastery)
Loss accommodation (resolution, continuance)
What are the five main categories of critical incident reactions, and an example for each?
Physical (shaking, autonomic nervous system)
Emotional (fear, anger)
Behavioural (aggression, blaming)
Spiritual (look for meaning, question beliefs)
Where does critical incident stress sit in relation to PTSD in terms of normal/abnormal reactions?
CIS is involves normal reactions, that will either resolve or possibly develop into abnormal reactions like Acute Stress Disorder or PTSD.
What are the 8 categories of diagnostic criteria for PTSD?
Traumatic event (s) Exposure to actual or threatened death, serious injury, or sexual violence
Intrusion symptoms associated with traumatic event
Persistent avoidance of stimuli associated with traumatic event(s)
Negative alterations in cognitions and mood associated with traumatic event
Arousal and reactivity, marked alterations of.
Duration is more than 1 month
Impairment or Distress is clinically significant
Not attributable to substance or another condition
What are the PTSD diagnostic specifications?
1) With dissociate symptoms (depersonalization, derealization
2) Delayed expression (full criteria are not met until at least 6mo following traumatic event.
PTSD diagnosis: What are the 4 different ways one could be exposed to traumatic event?
1) Direct experience
2) Witnessing it happen to someone else
3) Learning that it happened to family or friend
4) Repeated or extreme exposure to aversive details of traumatic event
PTSD diagnosis: What are the 5 categories of intrusion symptoms and how many are required for PTSD diagnosis?
One or more of following required:
Distressing dreams related to trauma
Dissociative reactions (flashbacks)
Intense or prolonged psychological distress at exposure to cues (triggers, reminders)
Marked physiological reactions to cues (triggers, reminders)
PTSD diagnosis: What are the 2 categories of avoidance stimuli and how many required for diagnosis?
At least one:
Effort to avoid thoughts memories or feelings related to trauma
Effort to avoid external reminders, like people, places, things, closely associated to trauma
PTSD diagnosis: What are the 7 categories of negative alterations of mood/cognitions, and how many required for diagnosis?
At least 2 of following:
Inability to remember important aspect of traumatic event
Negative beliefs about oneself (I am bad, I can’t trust anyone)
Distorted cognitions of blame or consequences related to trauma
Persistent neg emotions like fear, horror, anger, guilt, shame)
Marked diminished interest in significant activities
Feeling detached, estranged from others
Unable to experience positive emotions like happiness, satisfaction, love)
PTSD diagnosis: What are the 6 categories of arousal and reactivity and how many are required for diagnosis?
At least two of following req’d
Irritable and angry outbursts with little provocation
Reckless, self-destructive behaviour
Exaggerated startle response
Problems with concentration
What is the main difference between acute stress disorder and PTSD?
Duration. ASD is 3 days to 1 month following trauma exposure. Symptoms begin very soon after trauma and persist for at least 3 days.
What is compassion fatigue?
A state of tension and preoccupation with trauma of clients manifested in one or more of 1) re-experiencing traumatic event; 2) avoidance or reminders of trauma; persistent arousal
What is the difference between compassion requirement and compassion trap?
The requirement is for feeling for another’s suffering; the trap is a lack of balance between therapeutic alliance and emotional over-involvement
What are 3 major ares of the brain that are affected by acute stress and trauma, and how are they affected?
Hippocampus (suppressed in acute stress; decreases in volume with PTSD)
Amygdala (activated during acute stress)
Reticular activating system (in face of danger, shuts down energy to cerebral cortex, leading to drop in creativity and logic, and reliance on training and instinct)
What is the main function of the hippocampus?
Seat of spatial and temporal experience, and has role in sorting and categorizing stimuli in short term memory
What is main function of amygdala?
Linked to emotions, reaction to danger, evaluates emotional meaning of stimuli, stores emotional memory, leads to hormonal fight or flight signals
What is the main function of reticular activating system?
Switching device between hippocampus, amygdala, and ceberal cortex
What is the filing analogy for the brain?
The brain is like a filing cabinet. There is an executive assistant filing experiences. Clerks come out at night and file. For unpleasant experience there can be delayed reaction, and no one wants to deal with it. It sits in the inbox, on top.