Critical Incident Stress Management User Implementation

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Summary of Critical Incident Stress Management User Implementation

EUROPEAN ORGANISATION FOR THE SAFETY OF AIR NAVIGATION EUROCONTROL EUROPEAN AIR TRAFFIC MANAGEMENT Critical Incident Stress Management User Implementation Guidelines Edition Number : 1.0 Edition Date : 06.12.2005 Status : Released Issue Intended for : EATM Stakeholders Critical Incident Stress Management User Implementation Guidelines Page ii Released Issue Edition Number: 1.0 DOCUMENT CHARACTERISTICS TITLE Critical Incident Stress Management User Implementation Guidelines EATM Infocentre Reference: 050913-01 Document Identifier Edition Number: 1.0 HUM.ET1.13.3000-GUI-01 Edition Date: 06.12.2005 Abstract This guideline document facilitates and supports the implementation of a Critical Incident Stress Management (CISM) programme. It proposes the steps to be followed during the whole process through the phases of definition, planning, implementation and supervision of the programme. Keywords Critical Incident Stress (CIS) Critical Incident Stress Management (CISM) Crisis intervention post-incident support service Post-Traumatic Stress Disorder (PTSD) Contact Person Tel Division M. BARBARINO +32 2 729 3951 Human Factors Management Business Division (DAS/HUM) STATUS, AUDIENCE AND ACCESSIBILITY Status Intended for Accessible via Working Draft � General Public � Intranet � Draft � EATM Stakeholders � Extranet � Proposed Issue � Restricted Audience � Internet (www.eurocontrol.int) � Released Issue � Printed & electronic copies of the document can be obtained from the EATM Infocentre (see page iii) ELECTRONIC SOURCE Path: DAS/HUM Deliverable Library Host System Software Size Windows XP Microsoft Word 10.0 Critical Incident Stress Management User Implementation Guidelines Page iv Released Issue Edition Number: 1.0 DOCUMENT CHANGE RECORD The following table records the complete history of the successive editions of the present document. EDITION NUMBER EDITION DATE INFOCENTRE REFERENCE REASON FOR CHANGE PAGES AFFECTED 0.1 05.11.2004 First working draft All 0.2 19.11.2004 Second working draft All 0.3 25.11.2004 Third working draft 78 to 85 0.4 01.12.2004 Fourth working draft, Mid-project meeting All 0.5 17.12.2004 Fifth working draft All 0.6 22.12.2004 Sixth working draft All 0.7 07.03.2005 Seventh working draft All 0.8 18.05.2005 Eighth working draft All 0.9 17.06.2005 First draft for HPFG discussion and agreement All 0.10 11.10.2005 Proposed Issue for HRT24 All 1.0 06.12.2005 050913-01 Released Issue All Critical Incident Stress Management User Implementation Guidelines Edition Number: 1.0 Released Issue Page v CONTENTS DOCUMENT CHARACTERISTICS.............................................................................. ii DOCUMENT APPROVAL ........................................................................................... iii DOCUMENT CHANGE RECORD............................................................................... iv EXECUTIVE SUMMARY.............................................................................................. 1 1. INTRODUCTION .................................................................................................... 3 1.1 Purpose..................................................................................................................................... 3 1.2 Scope ........................................................................................................................................ 3 1.3 Background ............................................................................................................................... 4 1.4 Structure.................................................................................................................................... 4 2. CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM)......................................................................................... 7 2.1 Background to the Development of Critical Incident Stress Management (CISM) .................. 7 2.2 Critical incidents and Post Critical Incident Stress (CIS).......................................................... 7 2.3 Critical Incident Stress Management (CISM).......................................................................... 11 3. PLANNING AND IMPLEMENTING A CISM PROGRAMME.............................. 15 3.1 Introduction.............................................................................................................................. 15 3.2 Checklist for the CISM Implementation Project Organisation ................................................ 15 3.3 Checklist Directory .................................................................................................................. 16 4. THE CISM PROMOTION AND INFORMATION PROGRAMME........................ 37 4.1 Introduction.............................................................................................................................. 37 4.2 Promotion Phase of the CISM Programme including Project Setup...................................... 37 4.3 Information Phase on the CISM Implementation Project ....................................................... 38 4.4 Post-implementation Phase.................................................................................................... 39 4.5 Checklist for CISM Programme Promotion and Information .................................................. 40 5. ROLES OF THE PEOPLE INVOLVED IN A CISM PROGRAMME.................... 41 5.1 Roles and Responsibilities...................................................................................................... 41 5.2 Recruitment and Selection or Election of Peers..................................................................... 43 5.3 Application of CISM to Other Groups of Employees within the Organisation ........................ 44 6. TRAINING COURSE FOR CISM PROGRAMMES............................................. 45 6.1 General Description ................................................................................................................ 45 6.2 Generic Elements in a CISM Peer Training Course............................................................... 45 Critical Incident Stress Management User Implementation Guidelines Page vi Released Issue Edition Number: 1.0 7. QUALITY MANAGEMENT AND EVALUATION OF A CISM PROGRAMME.... 47 7.1 Quality Management (QM)...................................................................................................... 47 7.2 Evaluation................................................................................................................................ 51 8. HANDLING OF SENSITIVE DATA...................................................................... 55 8.1 National Regulations............................................................................................................... 55 8.2 General Rules ......................................................................................................................... 55 9. CHECKLIST AND SUMMARY FOR CISM IMPLEMENTATION........................ 59 BIBLIOGRAPHY AND REFERENCES...................................................................... 61 GLOSSARY ................................................................................................................ 63 ABBREVIATIONS AND ACRONYMS ....................................................................... 67 CONTRIBUTORS ....................................................................................................... 69 APPENDICES APPENDIX A - CISM INTERVENTION METHODS AND THEIR APPLICATION ..................................................................................................... 73 A1. Introduction.............................................................................................................................. 73 A2. Description of the Intervention Methods and their Application ............................................... 73 APPENDIX B - CHECKLIST OF CRISIS INTERVENTION METHODS USED WITHIN CISM PROGRAMMES........................................................................... 79 APPENDIX C - EXAMPLE OF A COURSE FOR THE TRAINING OF CISM PEERS.................................................................................................................. 81 C1. Introduction.............................................................................................................................. 81 C2. Course Modules for the Training of CISM Peers and Supervisors ........................................ 81 C3. Prerequisite ............................................................................................................................. 81 C4. General Course Objectives..................................................................................................... 81 C6. Basic 1: Individual Crisis Intervention and Peer Support ....................................................... 82 C7. Basic 2: Group Crisis Intervention .......................................................................................... 85 C8. Advanced Group Crisis Intervention....................................................................................... 86 C9. Supervisor Training Module.................................................................................................... 88 APPENDIX D - SAMPLE TEMPLATES FOR INFORMATION AND SELECTION OF CISM PEERS............................................................................ 91 Critical Incident Stress Management User Implementation Guidelines Edition Number: 1.0 Released Issue Page vii APPENDIX E - USER EVALUATION OF CISM ..................................................... 93 APPENDIX F - INSTRUCTIONS FOR CISM PEER SUPPORTERS ON THE USE OF THE USER EVALUATION QUESTIONNAIRE..................................... 99 APPENDIX G - PEER NOMINATION FORM........................................................ 101 APPENDIX H - CHIEF EXECUTIVE’S STATEMENT............................................ 103 Critical Incident Stress Management User Implementation Guidelines Page viii Released Issue Edition Number: 1.0 Page intentionally left blank Critical Incident Stress Management User Implementation Guidelines Edition Number: 1.0 Released Issue Page 1 EXECUTIVE SUMMARY Critical incidents can lead to stress reactions - so-called post-traumatic stress reactions - for the staff involved. Crisis intervention methods, being part of a Critical Incident Stress Management (CISM) programme, are designed to help people negatively affected by such events, to recover from these affects and return to normal functioning and behaviour. Such interventions create advantages for the staff in Air Navigation Services and their employers, because employees can return to their normal duties more quickly following an incident. These guidelines describe the process for the implementation of critical incident stress management in Air Navigation Services Organisations. They provide advice for the promotion of a CISM programme, the selection and nomination of CISM peers, the appropriate training activities, and the evaluation of benefits and other consequences of the programme. This document is a complement to an earlier EUROCONTROL publication, ‘Human Factors Module: Critical Incident Stress Management’ (1997), that was developed within the former ‘European Air Traffic Control Harmonisation and Integration Programme (EATCHIP)’, later known as ‘European Air Traffic Management Programme (EATMP)’ and today simply referred to as ‘European Air Traffic Management (EATM)’. It is intended to support the implementation of CISM in the European Civil Aviation Conference (ECAC) States and provide some consistency in the approaches used. The detailed structure of the document is provided in Section 1.4 of this document. Critical Incident Stress Management User Implementation Guidelines Page 2 Released Issue Edition Number: 1.0 Page intentionally left blank Critical Incident Stress Management User Implementation Guidelines Edition Number: 1.0 Released Issue Page 3 1. INTRODUCTION 1.1 Purpose The purpose of the CISM User Implementation Guidelines is to provide support to Air Navigation Services Providers (ANSPs) in implementing a CISM programme. They provide guidance for the initial introduction of CISM into an organisation through to the maintenance of such a programme. 1.2 Scope The application of a CISM programme for ANSP staff is described in a previous document, ‘Human Factors Module: Critical Incident Stress Management’ (EUROCONTROL, 1997). Some Air Navigations Service Providers (ANSPs) in European ATM have adopted and adapted the recommendations in this document, and used them as a basis for their CISM programmes, whilst other providers have chosen different approaches in terms of the models of intervention used, the types of support they provide and the process by which this is achieved. The purpose and scope of this document is to provide a generic approach to the implementation of CISM type programmes, whatever the specificities of the approaches chosen. However, caution needs to be exercised as even the term CISM is open to some misinterpretation. For some the term CISM represents specific approaches using the techniques described in the 1997 publication described above. For others the term has come to mean something more generic, loosely describing a range of post critical incident management procedures. EUROCONTROL takes no position on the appropriateness or otherwise of approaches that might be used and accepts that cultural diversity, local needs and considerations may dictate different requirements for such programmes. The present document has been strongly influenced by the approach, terminology and intervention models described in the previous referenced EUROCONTROL document which is based on the seminal work of the International Critical Incident Stress Foundation, that first used the term ‘CISM’, and some of the methods described borrow heavily from this. However, these implementation guidelines can be used for programmes that may have different approaches. The European Convergence and Implementation Plan (ECIP) requires Member States of EUROCONTROL to introduce CISM programmes into their ANSP organisations by the end of 2007. Some ANSP organisations have already implemented CISM and have noted positive benefits for their staff. Based on the experience of some of these ANSPs this guideline document is aimed at organisations which intend to introduce a CISM programme. Critical Incident Stress Management User Implementation Guidelines Page 4 Released Issue Edition Number: 1.0 1.3 Background The development of CISM User Implementation Guidelines was initiated by EUROCONTROL (Directorate ATM Strategies, Human Factors Management Business Division [DAS/HUM]) to support the implementation of CISM within ANSP organisations. They were developed in cooperation with the following experts, who became the members of the newly-formed ‘CISM User Group’, sponsored and chaired by EUROCONTROL: � Deutsche Flugsicherung GmbH (DFS): Gerhard Diener, Wolfgang Merz and Jörg Leonhardt; � Irish Aviation Authority (IAA): Kevin Mc Grath; � Navegaçao Aerea de Portugal (NAV Portugal): Isabel Cambraia; � Latvian Air Navigation Service (LGS): Mara Romele; � University of Copenhagen: Joachim Vogt; � EUROCONTROL Agency: Roger Bartlett and Ian Patterson. The CISM User Group was used as an editing panel and the final draft was produced by EUROCONTROL DAS/HUM. 1.4 Structure The document starts with an Executive Summary. The actual guidelines are developed in nine chapters, summarized below. Then follow a glossary, a list of the abbreviations and acronyms used in the publication, and a bibliography. At the end of the document the reader will find eight useful technical appendices (A to H). Chapter 1, ‘Introduction’, outlines the purpose, the scope and the background to the document. Chapter 2, ’Critical Incidents and Critical Incident Stress Management (CISM)’, defines the relevant terms and presents information on the principles and objectives of a CISM programme. Chapter 3, ‘Planning and Implementing a CISM Programme’, outlines the steps to be taken to implement a CISM programme. It discusses how a CISM program project can be established. At the beginning of the chapter a checklist is provided highlighting the important ‘high-level’ elements that should be considered. This checklist has hyperlinks to more detailed checklist elements. Chapter 4, ‘The CISM Promotion and Information Programme’, contains checklists for the promotion and information activities to be considered for the implementation of a CISM programme. Chapter 5, ‘Roles of the People Involved in a CISM Programme’, discusses the different roles that have to be considered in a CISM programme and provides some guidance how to inform management and staff about the CISM Critical Incident Stress Management User Implementation Guidelines Edition Number: 1.0 Released Issue Page 5 principles, how to select CISM peers and how the CISM methods can be also applied to other categories of staff. Chapter 6, ‘Training Course for CISM Programmes’, addresses the general description of the requirements for CISM training for peer counsellors. Chapter 7, ‘Quality Management and Evaluation of a CISM Programme’, provides information on the application of quality management methods to a CISM programme and advice on approaches for the evaluation of benefits of such a programme. Chapter 8, ‘Handling of Sensitive Data’, discusses the legal requirements for the handling of personnel data and documents relating to the CISM programme. Chapter 9 ‘Checklist and Summary for CISM Implementation’, summarises the important points of the previous chapters. It might serve as a checklist that might be used to check you have covered the main issues for a CISM implementation. Critical Incident Stress Management User Implementation Guidelines Page 6 Released Issue Edition Number: 1.0 Page intentionally left blank Critical Incident Stress Management User Implementation Guidelines Edition Number: 1.0 Released Issue Page 7 2. CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM) 2.1 Background to the Development of Critical Incident Stress Management (CISM) Disasters and occurrences which cause devastating damage always result in intensive media coverage and extended public interest. The Sioux City DC 10 crash, the high-speed train accident in Eschede, Germany, the avalanche incident in Galthür, Austria, the Concorde aircraft crash in Paris, the midair collision over the Lake of Constance, Germany, and above all, the recent terrorist attacks in the United States and Madrid are examples of incidents that are etched firmly in the psyche of many individuals. Of course, for the people directly involved in such incidents and in the subsequent aftermath, the effects are generally much more devastating and can be debilitating for some. Increasingly there has been a focus on the effects of such incidents on the support services that assist following an incident, and in discussing the consequences of such involvement on the personal emotions of members of these individuals and the teams to which they belong. This led to the conclusion that it was necessary to implement a special approach to assist the members of these groups. One of the approaches is called ‘Critical Incident Stress Management (CISM)’. Subsequently, approaches of this type have been adopted by the aviation industry to assist personnel following an incident. ATM is no exception and increasingly formal programmes to manage stress following an incident are being implemented. 2.2 Critical incidents and Post Critical Incident Stress (CIS) 2.2.1 Introduction In general, we might assume that members of certain professional groups such as rescue services, fire fighters, members of the police and the armed forces, pilots and Air Traffic Controllers (ATCOs) are, due to their training, better prepared to cope with unusual situations than others who do not belong to these professional groups. However, there are events which reach beyond the scope of experience of members of these professional groups. Such events may have considerable traumatising potential and are referred to as critical incidents. In some cases the individual coping strategies do not suffice to fully cope with these critical incidents. The person affected may not be able to cope with the emotional, cognitive and physical reactions which they are experiencing and may be unable to appraise the situation in a manner that allows them to cope with the incident. Their professional experience is not sufficient to allow

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