Cisd Model

CISD My opinion of critical incident stress management (CISD) has been impacted by my reading of Everly and Mitchell's article. Prior to reading the article, I was skeptical about the efficacy of CISD because of anecdotal information that I had heard which suggested that CISD not only was not helpful, but may actually exacerbate symptoms in first responders who have experienced traumas. I viewed it as a way for employers to cover their legal responsibility towards first responders and limit future liability for healthcare services, particularly mental health care services.

Furthermore, I did not believe that I had ever experienced any type of CISD intervention, because I had not ever encountered it in an employment scenario. However, after reviewing the article, I came away with a different understanding of CISD. I even came to the realization that, when I was a child, I received a form of modified CISD. Taken together, my knew knowledge and my enhanced understanding of my own past have led me to change my opinion about CISD.

When I was in middle school, one of my classmates committed suicide. The school pulled in all available counselors from all of the other schools in the district and engaged in an intervention, beginning with the students identified by teachers and staff as being in the child's immediate peer group and radiating outwards. I was in the second-level of friends; while the girl who committed suicide and I were not very close friends, we shared many close friends.

In addition, the school had all of the students gather for a group discussion of the event, which, from my reading of the article is a significant part of the CISD (Everly & Mitchell, 2000). In fact, I was not aware of how important the group component was to the CISD process, as I had oftentimes equated CISD with generic crisis intervention services. What I learned through the article is that CISD is a group-intervention post-crises. Moreover, it refers to a specific crises intervention.

"CISD represents a highly structured form of group crises intervention and represents a discussion of the traumatic, or critical incident" (Everly & Mitchell, 2000). This discussion is not a free-form discussion, but a structured discussion with the goal of providing closure (Everly & Mitchell, 2000). Furthermore, when closure is not possible, then the thought is that the CISD can provide triage for those who are ailing and also serve as a gateway to further treatment by introducing people to intervention services in a broad setting.

There has been some criticism of CISD because of allegations that CISD can cause harm to people. Reading the article, I think those claims are suspect. After all, the only people who receive CISD services are those who have experienced a traumatic incident. How is it possible to suggest that those who receive CISD and then later experience negative consequences are suffering because of the CISD instead of the original trauma? It is impossible to set up a true experiment to test the efficacy of the results.

Furthermore, because of the nature of the type of large-scale trauma that dictates a CISD response, it would be difficult to compare incident to incident, and, even if they were compared, difficult to draw conclusions from the results. Therefore, researchers are stuck in a paradoxical situation; it is impossible to completely endorse CISD without getting proof of the efficacy of the intervention, but also impossible to bolster evidence that the intervention is helpful without using CISD in response to mass traumas.

As a result, I have to look back on my own experience. I do not think that the CISD-type intervention was particularly helpful to me. However, another acquaintance told a mutual friend about a shotgun that she had hidden under her bed and her own plans to commit suicide due to a parent who was molesting her after the CISD-type intervention. The other student then informed a counselor, who called the child's mother, who discovered the shotgun, and sought treatment for the child.

Would this revelation have occurred after the other suicide in the school, or was it prompted by the CISD-type.