Effects of suicidal behavior on a psychiatric unit nursing team

1. Suicide of a psychiatric inpatient can have significant, although diverse, effects on the emotions and behavior of both individual nurses and team functioning. 2. The majority of participants in this study felt there was a need for formal debriefing or counseling for themselves and their colleagues after a critical incident, although there was less consensus about the timing and structure of such an intervention. 3. This research highlights the need for advanced training of critical incident stress management team members and for flexibility in the application of critical incident stress management techniques.     

Using Critical Incident Stress Debriefing to Mediate Organizational Crisis,Change and Loss

This article provides an overview of the development of critical incident stress debriefing and suggests its utility for both traditional and nontraditional purposes, by employee assistance practitioners. Both crises and traumas are defined and a brief history of the development of CISD is offered. The critical incident stress debriefing process is explicated and examples of how CISD's has been used by EAPs is shared. Case studies are then offered of both traditional and nontraditional situations where a CISD process was used by an internal EM, including a homicide, an operating room fire, an organizational change and multiple losses of employees by a work unit.     

The Role of Managers in Critical Incident Stress Management Programmes: A Qualitative Study of New Zealand Social Workers

This paper reports part of a larger exploratory research study of social workers' preferred models of critical incident stress management and experiences of critical incident stress debriefing. Social workers were invited to contribute to the research through an advertisement in the national association's newsletter for Aotearoa New Zealand Association of Social Workers. Using a qualitative methodology involving in-depth interviews with 13 social workers, participants were asked about their experiences of critical events encountered within their workplaces over the last five years. Interviews were recorded by audiotape with consent and analysed using thematic analysis. Four main themes emerged: the importance of preparation for critical incidents, the role of relationship between line managers and social workers, specifically the line manager's support immediately after the critical incident, and the availability of peer/colleague networks. An unexpected finding was that social workers interviewed noted that the pre-existing relationship with the line manager influenced their experience of the debriefing process itself. The more engaged and emotionally aware the manager was seen, the more the social worker claimed the debriefing process had been successful from their perspectives. The implications for social workers and their employing agencies are discussed.     

Part II. Work hardening for warriors: Training military Occupational Therapy professionals in the management of combat stress casualties

The purpose of this article is to describe the training of military occupational therapy personnel in a unique application of their professional skills. Ergonomic principles of training for stressful environments were implemented to ensure training effectiveness and transfer of skills to combat situations. Training schedules, casualty role-play scenarios, critical incident stress debriefing principles and scenarios, unit survey guidelines, and premises for training persons to function under stressful conditions are provided. Comparisons with civilian applications are drawn, and suggestions for future roles and training for Occupational Therapy professionals are given.     

Trauma Related Critical Incident Debriefing for Adolescents

Events like the tragedy at Columbine High School and the terrorists attacks on New York City in 2001 have highlighted the need for mental health practitioners to become familiar with interventions that are designed to assist young people who have survived extremely stressful events. Mental health professionals often see people who have experienced car accidents, severe abuse, rape, or other victimization, as well as survivors of natural and man-made disasters during the first critical stages of the recovery period. This article describes the process of critical incident de-briefing and provides a step-by-step primer for its application. The process is short-term (four sessions or less) and provides an intervention designed to reduce the frequency and severity of post-traumatic stress symptoms. Adolescents are particularly at risk because of issues surrounding identity formation, self- esteem, and developmental differences in coping mechanisms. Therefore, those who work with an adolescent cohort should be familiar with debriefing methods and how to apply them to the teenager.     

Responding in Times of Crisis— An Exploratory Study of Employer Requests for Critical Incident Response Services

Summary

Increasingly, employers play an active role in assisting their employees in dealing with crisis. This exploratory study conducted analyses using a large national database to examine how companies representing various industry types differed in the frequency of requests for critical incident response services, the types of incidents that evoked the requests, the types of interventions utilized, and the delay time between the request and provision of services. Results demonstrated substantial variability in the types of incidents and frequency of service utilization. However, some consistent patterns were noted. For example, over half of all critical incident response services across industry types were delivered in response to a death impacting the workforce. A different pattern was evident for the Finance/Insurance/Real Estate industry, where robberies were most prevalent and the delay time between the incident and the critical incident response delivery date was shortest. There appeared to be an inverse relationship between the size of the company and the use of critical incident response services. This study has implications for further research regarding the training of practitioners administering critical incident response services and determining themost effective crisis interventions for the situation and recipient population.     

Research as Clinical Practice: Creating a Positive Research Experience for Survivors of Sexual Abuse by Professionals

A team of practitioners created a research process that we hoped would be educational and healing for survivors of sexual abuse by professionals. In order to look at the impact of the study, we included a follow-up debriefing questionnaire designed to gather data about respondents' experiences. Nearly all respondents found the study both helpful and difficult. The potential for research to be educational or healing is demonstrated by these findings. The fact that research on trauma is likely to be painful or upsetting even when it is helpful to respondents underscores the importance of making potential risks of participation very clear.     

The professional's psychological response in disaster: implications for practice.

1. Victims typically experience recurring and distressing thoughts about a disaster and attempt to avoid thoughts and behavior associated with the event. As one works through the stressful event, the victim vacillates between intrusion and avoidance, with the magnitude of those oscillations being much stronger at first. 2. Although health-care workers may respond effectively following a disaster, they are not immune to its stresses. They must attend to the victims, regardless of their own needs, taxing even the toughest of the tough. 3. A crisis team should be established to work with the staff before disaster strikes, to be highly visible during a disaster to maintain staff support and emotional stability. They should take an active role in organizing and conducting mandatory debriefing sessions after a disaster to ward off traumatic effects.     

Case Studies of Federal Occupational Health's EAP Responses to Natural Disasters

Summary

Employee assistance professionals have increasingly been called upon to address the emotional and mental health needs of customer organizations and their employees in response to large-scale natural or man-made disasters. In doing so, employee assistance program (EAP) professionals must use a repertoire of responses that encompasses a broad range of interventions, generally anchored in an understanding of and focus on the organization and its culture, mission, management and labor concerns, and other critical characteristics. The EAP's fallback response to a crisis affecting the workplace is often a critical incident stress debriefing or close variant of it. However, EAPs can best serve their customers at all levels with interventions attuned to an understanding of the workplace culture gained through a consultative relationship with management, while factoring in the nature of the disaster, the length of time and characteristics of the disaster's aftermath, and the nuances of the employees' physical and emotional needs throughout the entire disaster response and recovery process.

This article highlights these issues through the presentation of two case studies, gained from the hurricane response activities of the Federal Occupational Health (FOH) EAP. FOH, a service unit within the U.S. Department of Health and Human Services' Program Support Center, has 60 years of experience working in partnership with its federal agency customers to deliver comprehensive occupational health services to improve the health, safety, and productivity of the federal workforce. FOH's EAP contracts with vendor organizations to provide direct employee assistance, work/life, and related services to more than 1.3 million federal employees. The first case study describes (from the first person perspective) an on-site, multi-focused EAP intervention at a federal facility. The second case study describes management consultation with the U.S. Postal Service in response to major hurricane activity.     

Issue Information

While engaged in research and teaching regarding racism in US organizations, members of the writing team have frequently found that conscientious humour and the meaningful lessons it can encode provide needed releases from the stress associated with social justice work as well as serve as an effective pedagogical tool. Taking inspiration from contemporary satirical humourists, including Robin Thede, Issa Rae, Dave Chappelle and Jordan Peele, who have used comedy to expose serious aspects of racism, as well as leading critical race theorists’ use of fictional chronicles about race we present a comedic chronicle centred around an African American protagonist who demonstrates a variety of coping and resistance strategies in conversations with a well‐intentioned yet culturally insensitive white male co‐worker who regularly engages her about her hair.     

More Than Help? Volunteerism in US Latino Culture

Volunteerism makes critical contributions to individual lives and society as a whole. However, to date, few studies have investigated volunteerism within Latino communities, a large and growing US population. The aim of this study was to understand how non-metropolitan US Latinos perceive volunteerism, as well as to determine what motivates and what deters their participation in volunteer programs. Our research team conducted six focus groups with 36 Latina women living in the State of Illinois. The focus groups covered topics such as the definition of volunteerism, participation motives and barriers, personal volunteer experience, and Latino culture, community, and organizations. We also assessed demographic information. Results from this study indicate that Latinas have a unique understanding of the concept of volunteerism. Participants associated everyday “helping” with volunteerism, establishing commonplace forms of aid as perhaps a “Latino way of volunteering.” We found time-consuming activities such as family responsibilities and work to be deterrents to Latinas participating in more formal volunteer activities.     

Effects of critical incident tasks on the intercultural competence of English non-majors

ABSTRACT

In this internationalised world, graduate employability in terms of intercultural communication skills needs to be taken into account in higher education. The present study aims to explore the effects of critical incident task instruction on English non-majored undergraduates’ intercultural competence. One group of students received ten weeks of instruction with one critical incident task per week and another group received standard English classes. Data were collected from the students’ pre- and post-test. The results showed a significant and strong effect of the intervention with critical incident tasks. Implications for educational practice are presented for further teaching with critical incident tasks.     

Community-Based M-Team Roles:

Recently, the elder abuse professional community has developed various models of multi-disciplinary team (M-teams) to handle difficult cases of elder abuse and neglect: hospital-based, family-practice, consortium, and community-based. Some professional literature is available about the hospital and family-practice models but none exists to date about consortium or community M-teams. This paper uses job analysis to describe one community-based M-team affiliated with four elder abuse agencies in Illinois. From the results, a picture of M-teams emerges in terms of the responsibilities, knowledge, and resources needed by teams to do their "jobs."     

The family educator: a professional resource for families.

The family educator works with the client's family members to help in their understanding of their ill relative and to assist with managing the stress of the caregiver role. Families come to understand that they can join forces with the clinical team in helping their relative engage in a trial of treatment. Each treatment recommendation is explained to the family and decisions are arrived at by consensus through partnership meetings. Role modeling effective interaction approaches and providing assistance in generating alternative solutions to problematic situations are important functions of the family educator.     

Work stress and musculoskeletal disorder etiology: The relative roles of psychosocial and physical risk factors

The intense battles preceding the recent promulgation of OSHA's Ergonomics Program Standard serve as a case study demonstrating the growing understanding that MSD causation, development, and exacerbation are the result of the combined contribution of (and possibly interaction between) a wide range of biomechanical and psychosocial stressors. The best designed studies, those that adequately measure both biomechanical and psychosocial exposures, strongly support this hypothesis. Work stress is one of the results of this stressor combination and is part of the physiological pathway to MSDs and a wide range of other occupational diseases. Prevention efforts geared to a single or single class of exposure may be only partly effective, ineffective, or even counter productive. The most effective control strategies are rooted in on-going, participatory ergonomics programs, incorporating a joint labor/management ergonomic team; this blueprint for intervention necessarily addresses the roots of both physical and psychosocial work stress experienced by workers.     

Enhancing the safety of children in foster care and family support programs: automated critical incident reporting

The Adoption and Safe Families Act of 1997 has made child safety an explicit focus in child welfare. The authors describe an automated critical incident reporting program designed for use in foster care and family-support programs. The program, which is based in Lotus Notes and uses e-mail to route incident reports from direct service staff to supervisors and administrators, facilitates timely clinical oversight and risk management and ensures the security of clients' protected health information. The authors present data collected using the program to illustrate how it can be used to monitor abuse and neglect allegations in a foster care program. A survey of users found that the program saved time, was easy to use, and helped manage critical incident reports.     

Sexual identity: Conflict and confusion in a male adolescent

This paper presents a conceptual formulation, derived from developmental object relations theory and ego psychology, of the passage in male adolescence that culminates with the achievement of a masculine heterosexual identity. Themes of psychosexuality, male gender attributes, masculinity and object preference, and sexual orientation are discussed with reference to the adolescent stage. Finally, the critical tasks, core conflicts, and internalizations of prior developmental stages, as well as the integration that is required of adolescence proper relative to a sexual identity as heterosexual and masculine, are highlighted through an extensive case illustration of an adolescent male with sexual identity confusion.a clinical social worker in private practive in Palatine, Illinois. The author gratefully acknowledges that the writing of this paper was supported by a research leave granted him by Loyola University Chicago.     

The readiness is all. Planning and training for post-disaster support work

Having acknowledged the world-wide impact of the terrorist attacks in New York on 11 September 2001 attention is drawn to the number of recent peace-time disasters that have happened in Great Britain. Local authority social services departments have been suggested as being best placed to be the lead agency in co-ordinating responses to such disasters. This paper describes how Buckinghamshire social services is working in partnership with its local voluntary counselling agencies to establish and maintain a trained team able to respond to disasters if needed. Contemporary theory relating to post-traumatic stress disorder, the imprint of death, psychic numbing and survivor guilt is cited and illustrated. The team has not yet been involved in a major disaster but examples are given showing its responses to various smaller scale, local disasters. It is acknowledged that counselling and de-briefing after disasters are not necessarily beneficial and therefore some critics of its provision are quoted. Lessons distilled from practice wisdom are provided. Responses to disasters are more likely to be effective, and least damaging to those involved, if potential helpers are trained as a team and are fully aware of the likely impact of such events.     

In and Out of Enactments: A Relational Perspective on the Short- and Long-term Treatment of Substance Abuse

This paper examines the contribution of a psychodynamic relational perspective to the treatment of substance abuse. Two cases of different lengths are presented to illustrate the therapeutic factors that contributed to successful recovery and long-term abstinence. Follow-up information on the successful outcome of both cases was available 7 years after the initiation of treatment. We discuss the critical role that the experience and processing of enactments played in both cases. Carol Ganzer, PhD, MSW, LCSW is on the faculty of the Institute for Clinical Social Work. She is a past president of the Chicago Association for Psychoanalytic Psychology and serves on the editorial boards of Clinical Social Work Journal and Beyond the Couch. She maintains an independent practice of psychotherapy and consultation in Chicago. Eric D. Ornstein, MA, LCSW, is a Clinical Associate Professor at Jane Addams College of Social Work, University of Illinois at Chicago. He is a field liaison in the College’s Field Division and currently teaches crisis intervention and field instruction workshops. He is on the Board of the Illinois Society for Clinical Social Work and Chair of their Education Committee.     

Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes

This study describes the implementation of three evidence-based treatments addressing traumatic stress symptoms within a wraparound foster care program in Illinois. Child–Parent Psychotherapy (CPP), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) were implemented with a racially diverse sample of youth ages 3–18 at six agencies. Culturally sensitive adaptations were made to treatment approaches to improve client retention and outcomes. Data analyses revealed no racial differences in retention in the program and no differences in outcomes between minority youth exposed to the intervention and other participants. All three evidence-based treatments were effective in reducing symptoms and improving functioning among minority youth. Implementation issues, including challenges and culturally competent accommodations, are discussed.