NCJ Number
191694
Journal
International Journal of Emergency Mental Health Volume: 1 Issue: 4 Dated: 1999 Pages: 243-250
Date Published
1999
Length
8 pages
Annotation
This paper presents an approach to the needs of family survivors of mass casualty events. The methods can be applied by emergency responders in the field.
Abstract
Critical Incident Stress Management (CISM) is a comprehensive crisis intervention approach to critical incidents. New methods of family therapy have emerged in the past decade. But relatively few papers were written between 1967 and 1998 that focused primarily on family crisis intervention by the police, by health care providers for families affected by serious mental illness, or on interventions with children by child care specialists. Family crisis intervention knowledge may be helpful to emergency responders. If victims of psychological trauma do not recover within 30 days, they may develop posttraumatic stress disorder (PTSD). If family survivors of mass casualty events do not have clear information that will help them cope, they can become anxious, fearful, or possibly go into shock. Once information is obtained about the extent of loss of life and/or property, survivors may experience various stages of grief: denial, anger, bargaining and depression. Complications include witnessing the event, torture, rape, and a past history of violence. If victims develop PTSD, it is in their interests to try to reengage in family life, career, recreation and community. Without help, their lives will become unduly restricted. Intervention methods include interviewing the survivors to mitigate negative consequences, gathering facts so the family can know what happened, fostering the expression of feelings, empowering the survivors to accept what has happened, restoring a network of attachments, and assisting with making some sense of what has befallen the victim. A feeling of mastery of day-to-day activities can be restored to the victims when emergency responders help with ensuring there is food, clothing, and shelter. Responders also can help put the victims back in touch with their normal network of support. Restoration of meaning can be aided by allowing the victims to discuss the question of "why me?" or express their feelings or engage in religious activities. Emergency health providers need to be aware of the range of reactions to mass casualty events, such as a loss of speech or a need to keep busy. The model presented here has been supported by anecdotal clinical evidence. Further studies will need to specify what type of critical incident was addressed, what categories of families received services, and what services were provided. Later, findings could provide researchers with a list of common effective interventions that may be effective. References