What Is Critical Incident Stress Management?

Table of ContentsView AllTable of ContentsWhat Are Critical Incidents?What Is Critical Incident Stress?What Does CISM Involve?Impact

Table of ContentsView All

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Table of Contents

What Are Critical Incidents?

What Is Critical Incident Stress?

What Does CISM Involve?

Impact

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Critical incident stress management (CISM) is a type of structured crisis intervention used to support people who have experiencedtraumatic events. Interventions include education, prevention, and mitigation techniques implemented to reduce stress and prevent longer-lasting mental health issues, such as PTSD.

What Is Trauma?

To better understand what CISM is, it can be helpful to be aware of the types of incidents that may trigger the use of an intervention like CISM. Critical incidents are events that may quickly overwhelm a person or a group of people. The events are usually unexpected and may be traumatic.

Some examples of critical incidents include:

12 Ways to Deal With Trauma

People who experience a critical incident usually have an intense emotional reaction, and one of the primary purposes of CISM is to help people work through the feelings they may be experiencing in the early aftermath of the event. Most types of critical incident stress occur for an average of 2-4 weeks.

Critical incident stress can include physical, mental, and emotional components. Some of the signs and symptoms of critical incident stress include:

It’s important to understand that not everyone reacts the same way to a traumatic event. Some people don’t react right away, and different people may have completely different reactions to the same event. That’s normal and to be expected.

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What Does Critical Incident Stress Management Involve?

Critical stress management involves various different programs, interventions, and protocols designed to help people recover from traumatic events at work, school, and elsewhere. These may include education, support groups, disaster relief, and preparedness, and community outreach events.

Some of the protocols used in critical stress management may include the following.

Crisis Management Briefings

Crisis management briefings are informational events that take place within a community or organization. They provide details regarding the traumatic incident, such as what is being done to address stress, and what resources are available to help people.

Any falsehoods or rumors about the event may be addressed at this time, and questions may be fielded. Crisis management briefings may take place at workplaces, schools, religious organizations, and within neighborhoods and communities.

Critical Incident Stress Debriefing

Critical incident stress debriefing (CISD)is a tool used to help people process the traumatic event. CISD consists of seven sequential steps focused on managing stress and trauma.CISD usually occurs within the first 72 hours after the event, and the crisis team identify people who might need further support, such as psychotherapy.

Rest Information Transition Services (RITS)

RITS refers to support services that may be set up near where the traumatic incident took place. Support centers are likely to offer food, shelter, counseling, necessary supplies, and resting/sleeping accommodations for people who need it.

Individual Support

Many people need one-on-one support after a traumatic event. This may include peer support, support from religious clergy, or basic counseling services from crisis experts. Referrals may be made for people who need extramental health support, such as psychotherapy or psychiatric help.

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Impact of Critical Incident Stress Management

The effectiveness of critical incident stress management is something that’s been debated on an ongoing basis. Although some experts believe it can be helpful, it has a fair number of critics, especially those who feel CISM doesn’t do enough to help people deal with potential psychological conditions that can occur after trauma, such as post-traumatic stress disorder (PSTD).

A 2021-review of the data published in theInternational Review of Psychiatryfound that crisis intervention that occurs in the acute phase of a disaster orcatastrophic eventcan be helpful and effective. The most effective type of crisis interventions are ones that offer assistance that’s “simple, brief, immediate, practical, and innovative,” according to the study authors. Additionally, any mental health services must include varied, integrated, and robust care and support.

Efficacy of CISM

Some studies have found issues with CISM. For example, a 2019 study published in theInternational Journal of Nursing Student Scholarshipfound that although medical staff usually view CISM as helpful, there isn’t enough evidence to show that it works successfully. This may be because of insufficient adherence to CISM protocols and lack of training.

An older review from 2003 published inPrehospital Emergency Carefound that CISM is not effective enough at preventing the future development of PTSD among CISM participants. In fact, there may be evidence that CISM exacerbates stress in people who participate in it, according to the study.

How to Heal From Trauma

A Word From Verywell

Critical incident stress management can be helpful in the initial management of crises and traumatic events. But some people need more support or ongoing support. If you are experiencingcontinual stress, anxiety, agitation, or depression in the weeks and months following a difficult event, please reach out to your healthcare provider or a licensed therapist for support.

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9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.U.S. Department of Labor.Critical Incident Stress Guide.Monterey County Health Department.Critical Incident Stress Management.Monterey County Health Department.Critical Incident Stress Management.New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.National Interagency Fire Center.Critical Incident Stress Management.Bledsoe BE.Critical incident stress management (CISM): benefit or risk for emergency services?Prehospital Emergency Care. 2003;7(2):272-279. doi:10.1080/10903120390936941Mitchell JT.Continuum of care for disasters and catastrophes. International Review of Psychiatry. 2021;33(8):728-739. doi:10.1080/09540261.2022.2030678Elhart MA, Dotson J, Smart D.Psychological Debriefing of Hospital Emergency Personnel: Review of Critical Incident Stress Debriefing. International Journal of Nursing Student Scholarship. 2019;6:1-17.

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.U.S. Department of Labor.Critical Incident Stress Guide.Monterey County Health Department.Critical Incident Stress Management.Monterey County Health Department.Critical Incident Stress Management.New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.National Interagency Fire Center.Critical Incident Stress Management.Bledsoe BE.Critical incident stress management (CISM): benefit or risk for emergency services?Prehospital Emergency Care. 2003;7(2):272-279. doi:10.1080/10903120390936941Mitchell JT.Continuum of care for disasters and catastrophes. International Review of Psychiatry. 2021;33(8):728-739. doi:10.1080/09540261.2022.2030678Elhart MA, Dotson J, Smart D.Psychological Debriefing of Hospital Emergency Personnel: Review of Critical Incident Stress Debriefing. International Journal of Nursing Student Scholarship. 2019;6:1-17.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.U.S. Department of Labor.Critical Incident Stress Guide.Monterey County Health Department.Critical Incident Stress Management.Monterey County Health Department.Critical Incident Stress Management.New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.National Interagency Fire Center.Critical Incident Stress Management.Bledsoe BE.Critical incident stress management (CISM): benefit or risk for emergency services?Prehospital Emergency Care. 2003;7(2):272-279. doi:10.1080/10903120390936941Mitchell JT.Continuum of care for disasters and catastrophes. International Review of Psychiatry. 2021;33(8):728-739. doi:10.1080/09540261.2022.2030678Elhart MA, Dotson J, Smart D.Psychological Debriefing of Hospital Emergency Personnel: Review of Critical Incident Stress Debriefing. International Journal of Nursing Student Scholarship. 2019;6:1-17.

New Mexico Department of Health.Emergency Medical Services Critical Incident Stress Management.

U.S. Department of Labor.Critical Incident Stress Guide.

Monterey County Health Department.Critical Incident Stress Management.

National Interagency Fire Center.Critical Incident Stress Management.

Bledsoe BE.Critical incident stress management (CISM): benefit or risk for emergency services?Prehospital Emergency Care. 2003;7(2):272-279. doi:10.1080/10903120390936941

Mitchell JT.Continuum of care for disasters and catastrophes. International Review of Psychiatry. 2021;33(8):728-739. doi:10.1080/09540261.2022.2030678

Elhart MA, Dotson J, Smart D.Psychological Debriefing of Hospital Emergency Personnel: Review of Critical Incident Stress Debriefing. International Journal of Nursing Student Scholarship. 2019;6:1-17.

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