Onsite EAP Services- Core Efficiencies


Stress an Overview- 2
Physiology of Stress
Relaxation Response
International Critical Incident Stress Foundation
Safe R Model
CISM Language
CISM Core Principles
CISM On Scene Support
CISM Demobilization
CISM Defusing
CISM CISD Introduction Phase
CISM CISD Fact Phase
CISM CISD Thought Phase
CISM CISD Reaction Phase
CISM CISD Impact Phase
CISM CISD Teaching Phase
CISM CISD Re-entry Phase
CISM CISD Post Action Report
PFA Intro
EAP Dual Relationships
Onsite services
Pre- incident Training
Corporate Debriefing
Individual Debriefing
Bereavement Noncomplex
Bereavement Complex
Follow up
Complex Incidents
EAP-Other Considerations
Taking Care of Yourself



If you've never had the CISM Basic Training which highlights the Mitchell Model, this section will provide it. It is not the model for onsite services, but you will see the overlap and the attention to areas that need modification (Red).

International Critical Incident Stress Foundation

In 1989, the International Critical Incident Stress Foundation was formed. Its two pioneers, Jeffrey T. Mitchell and George S. Everett Jr. came together during Mitchell's Ph.D. dissertation on Paramedic Stress. He came upon the work of Everly and the use of scales to assess individual stress. Through early collaboration and consultation on cases, Mitchell, with a focus on prevention, and Everly with a focus on treatment, seemed like a perfect match to work together. They began disseminating information, doing conferences and seeing the void in services for high risk occupations like firemen and emergency personnel.

With the emergence of the foundation, the two worked offering interventions to emergency workers and training in this new found field. Today the foundation has over 5000 members and provides an array of services, training and consultation.

"Historically, what we were doing is crisis intervention. We were doing training, consultation and intervention under the overall heading of crisis intervention. So it's not like we invented a new field. We applied crisis intervention principles to a group of professionals who had been, to some degree, neglected as recipients of these types of services. Along the way, we knew we had to make some adjustments to the way crisis intervention would be practiced when compared to a civilian population. Techniques such as critical incident stress debriefing and the whole genre which we now call Critical Incident Stress Management (CISM) emerged. In effect, what the foundation really is, is a crisis intervention foundation. However, we apply crisis intervention in a way that, historically, it has never been applied before. This is in a very comprehensive way. We have a comprehensive, total, multi-component approach to crisis intervention and it has proven successful to the point that the models are now being used with populations other than emergency service personnel. It's being used by the airline industry, by industries, school systems, psychiatric hospitals, and general medical hospitals."

George S. Everly JR., Trauma Response

The primary focus in the field of CISM is to support staff members of organizations or members of communities which have experienced a traumatic event. What CISM does not share with the field of crisis intervention is the range of the populations served. For example, CISM does not focus on primary victims such as auto accident victims, dog bite victims, women suffering post-partum depression, women who have lost a child in a
miscarriage, child abuse victims, substance abusers, victims of elder abuse or sexual assault victims all of whom are typically served through various other crisis intervention programs. Should primary victims with those concerns come into contact with CISM trained personnel, the best course of action is a referral to appropriate crisis intervention or psychotherapy resources which are beyond the central focus and capabilities of most CISM teams.

Jeffrey Mitchell Ph.D., Crisis Intervention and Critical Incident Stress
Management: A defense of the field; 2004



Primary to the success of this intervention is the application of it on the appropriate population. The ICISF/Mitchell Model intervention is designed for first responders- police, fire, rescue, military, etc. Nonetheless it has been tried on the general population in didn't settings by a variety of professionals with different training experiences. Anecdotally the response has been positive, but since greater exposure of the model to scientific communities after Oklahoma City and 9/11, it has been challenged.

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