Critical Incident Stress Management in ATM
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Critical Incident - A critical incident is any situation that causes a person to experience unusually strong stress reactions that the person perceives as disturbing or disabling. (EUROCONTROL - Critical Incident Stress Management: User Implementation Guidelines)
It has often been a general assuption, in the past, 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, as a result of their training, better prepared to cope with unusual situations than others who do not belong to these professional groups. However, more recently, it has been recognised that 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.
When a critical incident occurs, no one can be sure how they will react and to what extent such an incident will affect them. What is known is that individual reactions to incidents vary considerably and are personal to the individual concerned.
Following a major incident, accident or trauma, individuals and the institution in which they work are likely to experience a deviation from what might be termed ‘normal functioning’. This may manifest itself in a variety of ways but is likely to include depressed or negative mood, institutional and individual anxiety, impaired thought process and less efficient work behaviour. The result is a significant impairement of both individuals and the organisation.
Critical Incident Stress Management (CISM) is an increasingly important element of the Human Resources Policies and personnel training at Air Navigation Service Providers.
What is Critical Incident Stress Management?
CISM is the structured assistance for a normal reaction to an abnormal event. It describes the human reaction to critical incidents - any situation faced for example by a controller, which causes him or her to experience unusual strong emotional reactions. All CISM activity aims to moderate the impact of Critical Incident Stress and to speed up the return to the pre-incident phase. A CISM programme consists of three phases:
CISM addresses different people and services in and outside the organisation. Its several steps help the persons affected cope with their critical incident Stress (CIS) reactions thanks to direct and immediate intervention. In this way, it may be possible to decrease the probability of consequential disorders. CISM is a comprehensive, systematic and multi-component approach to the management of CIS.
History of CISM
The history of CISM lies in military operations. The first mention of it was during the American Civil War. Soldiers suffering so-called combat stress were considered to be in league with the enemy and were ridiculed, imprisoned or even shot. Only in later years was combat stress recognised as a human reaction to the horrors of war and intervention techniques were developed to overcome the phenomenon.
Nowadays we speak of Critical Incident Stress when we describe our reaction to a shocking event. Incidents and accidents in aviation often have enormous impact on every human and every organisation involved.
What is CISM?
CISM is the structured assistance for a normal reaction to an abnormal event. In ATS it describes the human reaction to critical incidents: “any situation faced by an air traffic controller, which causes him or her to experience unusual strong emotional reactions”.
All CISM activity aims to moderate the impact of Critical Incident Stress and to speed up the return to the pre-incident phase. CISM exists to mitigate the normal, usually negative, emotions and thoughts, which result from critical events occurring in the work environment. In doing so CISM facilitates a more rapid return to the ‘normal’ functioning and thus has benefits for the individual and for the organisation in which they work.
CISM methods are secondary preventive measures which consist of discussions about the incidents in the form of structured individual and group discussions and help the persons affected regain their ability to apply coping strategies. Most of the time these discussions are performed by colleagues who have qualified in CISM programmes (the so-called CISM peer diffusers or CISM peers) or by Mental Health Professionals (MHPs) who are qualified CISM experts. None of the CISM techniques can, or should be, regarded as psycho-therapeutic measures.
CISM comprises the following measures:
Preventive teaching and training measures
- Training courses for managers, members of staff, colleagues and relatives of the above-mentioned professional groups or organisations;
- Different modules, depending on the individual target groups.
Individual crisis intervention
- Structured (individual) discussions with qualified CISM peers or MHPs on site or immediately after the incident or mission;
- Safer model as a one-to-one intervention method.
- Structured discussions in groups performed by CISM peers or MHPs up to 24 hours after the incident or mission
- Structured discussions in groups performed by MHPs and CISM peers between 72 hours and four weeks after the incident/mission
- Quick informational and rest sessions applied when a group of professionals have been released from service after a major incident. Among other purposes it serves as a screening opportunity to assure that Individuals who need assistance are identified after the traumatic event.
Crisis Management Briefing (CMB)
- Briefings in large groups performed immediately after the incident/mission; these briefings serve the purpose of providing information about CIS reactions and their consequences and about available support.
Support by the family/organisation
- Counselling and/or training for relatives and organisations of particularly affected professional groups. Counselling for relatives/organisations after a critical incident has occurred.
Follow-up / referral
- Follow-up following CISM peer counselling is recommended. Typically this may be one to one and for two to three sessions.
- If required, the persons affected may be referred to experts, doctors or therapists for further measures (therapy).
- Teamwork in Air Traffic Control
- Team Resource Management (TRM)
- Improving Safety Culture in Air Traffic Control
- Post Traumatic Stress Disorder (PTSD)
- Critical Incident Stress Management: User Implementation Guidelines.
- "Human Performance in Air Traffic Management Safety -A White Paper": EUROCONTROL/FAA Action Plan 15 Safety, September 2010.
- Human Factors Module: Critical Incident Stress Management
- CISM Case Studies