Fire

Psychological resilience through peer-support: does it work? The 'Critical Incident Stress Management: Psychological resilience through peer-support' seminar was held in Ely, Cambridgeshire, providing plenty of debate on the controversial issue of peer support in providing 'psychological first-aid'.(Seminar Report)

THE SEMINAR WAS RUN TO INFORM fire and rescue services in the region or the existence of, and the opportunity to invest in, the standard of crisis-intervention that has been adopted by fire, rescue and emergency services around the world.

In keeping with health and safety principles, a foreseeable hazard is an avoidable hazard, or at least one that can be prepared for. Critical-incidents are those incidents that carry the potential to overwhelm a firefighter's or fire officer's coping abilities; where coping is not restored, exaggerated fears and a sense of dread can follow as self-confidence becomes eroded.

Where these feelings are left unaddressed, the prospect of a diagnosis of mental-illness increases. Talk to anyone who has gained a diagnosis of Post-traumatic Stress Disorder (PTSD) and they could probably tell you about 'the moment everything changed', their inability to do anything about it and how badly they felt about life since then. Few if any of us were trained to deal with the emotional threats of the job (despite health and safety legislation that says we should be) but regardless of the culture and its attendant mental-health risks, a critical-incident is one for which an effective system of preventative training does exist, and with a strong evidence-base.

With several fire services employing a standardised approach to managing the aftermath of critical incidents, mutual assistance becomes a realistic and practical option. The basis of crisis intervention is peer-support; the honest and intelligent use of colleagues trained to recognise and intervene in the early stages of seemingly catastrophic stress-reactions.

Objections

While the aim of the seminar was an educational one, attendees witnessed an interesting debate as a trauma counsellor raised strong objections to the use of crisis-intervention in any circumstances. Additionally, the counsellor went on, anything perceived as 'debriefing' was also likely to find its advocates in legal hot-water on the basis of published research. …

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