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9/13/2013 Understanding Critical Incident Mental Health Issues Trudy Gilbert-Eliot, Ph.D., LMFT, LADC Wisdom sdom is s no noth thing ing more th than n healed led pain in. Robert Gary Lee 1 9/13/2013 Understanding Critical

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9/13/2013 1

Understanding Critical Incident Mental Health Issues

Trudy Gilbert-Eliot, Ph.D., LMFT, LADC

Wisdom sdom is s no noth thing ing more th than n healed led pain in.

–Robert Gary Lee

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9/13/2013 2

Understanding Critical Incident Mental Health Issues

 Public

 Coping with a Critical Incident

 First Responders

 Debriefing  Compassion Fatigue  Vicarious Traumatization

 Mental Health Practitioner

 Compassion Fatigue  Vicarious Traumatization

Methods of Intervention

 Critical Incident Stress

Debriefing

 Used for First

Responders and those impacted by a critical incident

 Emphasis is on sharing

the impact of the event

 Research is unclear

 Psychological First Aid

 Used for First

Responders and those impacted by a critical incident

 Emphasis is on moving

the person forward in a positive way

 Research supports

efficacy

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Compassion Fatigue

 Progressive exhaustion  Dysfunction

 Biological  Psychological  Social

 Results from prolonged exposure to clients

stories of trauma

 Not burnout  Report high job satisfaction

Vicarious or Secondary Traumatization

 Controversial: research new  Caused by indirect exposure  DSM V allows for dx of PTSD  PTSD rates therapist vs. patient  Assessing  Empathy

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Responses to Trauma

 Resilience  Decline  Post-traumatic Growth (PTG)

Posttraumatic Growth (PTG)

 Coping takes the form of ‘meaning-making’: low

discrepancy between global meaning and appraised meaning= little distress

 The memories are stressful rather than traumatic  Social support greatly decreases likelihood of

developing PTSD

 Posttraumatic growth can take place when the

trauma is based on meaning and the person can attest to the personal growth they achieved as a result of the trauma

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Critical Incidents

 6 Sep 2011: Carson City Shootings  16 Sep 2011: Air Races Mass Casualty  23 Sep 2011: Casino Shooting

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What I Learned

 Boundaries  In group/out group  Voyeurs  Vicarious Traumatization

Planning Ahead

 Self-Care  Countertransference  Support  Talk, talk, talk

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Contact Information

 Trudy Gilbert-Eliot, M.S., LMFT, LADC  Nevada Marriage and Family Therapist #0828  Nevada Licensed Alcohol and Drug

Counselor #0127L

 458 Court Street  Reno, NV 89501  775-772-9017  nvpsych@sbcglobal.net

Back up Slides

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Operational Effectiveness

 Initial notification  Arrival, Observation, Assessment  Escalation

 No back up  Privacy vs. doing our best  What to Say

 Post-observational period: Aftercare

 Getting a list of names/Keeping in touch  Talking with Commanders  Rotation/self-care