Critical Incident Stress Management

Handouts

Table of Contents

Table of Contents............................................................................................................. 2

Information Sheet.............................................................................................................. 3

Common signs and signals of a stress reaction:....................................................................................................................... 3

Practical Guide To Feeling Better......................................................................... 4

Find someone you trust............................................................................................................................................................. 4

Give yourself permission to feel what you are feeling........................................................................................................... 4

Take care of yourself.................................................................................................................................................................. 4

Do make as many daily decisions as possible........................................................................................................................ 4

Practice relaxation and meditation............................................................................................................................................ 4

Create a quiet scene.................................................................................................................................................................... 4

Play soft, background music..................................................................................................................................................... 4

Maintain as normal a schedule as possible............................................................................................................................. 4

Take one thing at a time............................................................................................................................................................. 5

Allow time for a task................................................................................................................................................................... 5

Spruce up your surroundings................................................................................................................................................... 5

Escape for awhile......................................................................................................................................................................... 5

Post-Trauma Do’s And Don’ts....................................................................................... 6

Critical Incidents: Coping With Children’s Reactions............................... 7

How to Deal With Fear and Anxiety............................................................................................................................................. 7

Advice to Parents............................................................................................................................................................................. 7

Settling Down................................................................................................................................................................................... 8

How Can Parents Recognize When To Seek Professional Help?.......................................................................................... 8

Information Sheet

You have experienced a traumatic event. Even though the event may be over, you may now be experiencing or may experience later, some strong emotional or physical reactions. It is very common and quite normal for people to experience aftershocks when they have passed through a horrible event.

Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Sometimes they may appear a few hours or a few days later. In some cases, weeks or months may pass before the stress reactions appear. The signs and symptoms of a stress reaction may last days, weeks, months and occasionally longer, depending on the severity of the traumatic event. With understanding and support from your co-workers, family and friends, the stress reactions usually pass more quickly. Occasionally the traumatic event is so painful that professional assistance from a counselor may be helpful. This does not imply craziness or weakness but it simply indicates that this particular event was just too powerful to manage alone.

Common signs and signals of a stress reaction:

PHYSICAL	MENTAL	EMOTIONAL	BEHAVIORAL
Fatigue	Tendency to blame others	Anxiety	Changes in normal activities
Insomnia	Confusion	Severe panic (rare)	Change in speech
Muscle tremors	Poor attention	Grief	Withdrawal from others
Twitches	Inability to make decisions	Denial	Emotional outbursts
Difficulty breathing	Heightened or lowered alertness	Survivor guilt/Self blame	Change in communication
Rapid breathing	Poor concentration	Emotional numbness	Suspiciousness
Elevated BP	Forgetfulness	Uncertainty	Inability to rest
Rapid heartbeat	Trouble identifying known objects or people	Loss of emotional control	Substance Abuse
Chest Pain	Increase or decreased awareness of surrounding	Fear of loss/of going crazy	Intensified startle reflex
Headaches	poor problem solving	Depression	Antisocial Acts
Visual difficulties	Loss of a sense of time, place or person	Lack of capacity for enjoyment	Pacing
Nausea/Vomiting	Disturbed thinking	Apprehension	Erratic movements
Thirst	Nightmares	Intense anger	Decreased personal hygiene
Hunger	Inescapable images	Irritability	Diminished Sexual Drive
Dizziness	Flashbacks	Agitation	Appetite Disturbance
Excessive sweating	Suicidal ideas	Helplessness	Prolonged Silences
Chills	Disbelief	Mistrust	Accident Proneness
Weakness	Change in Values	Feelings of worthlessness
Fainting	Search for Meaning	Apathy/Boredom

This information is not intended to serve as medical advice
If you experience physical symptoms which cause you concern, please consult your physician.

Practical Guide To Feeling Better

Find someone you trust

Find a family of close friend, and talk with them about your experience. Don’t carry this burden alone; share it with those who care about you. Contact a friend and have someone stay with you for a few hours or a day or so.

Give yourself permission to feel what you are feeling

Express your feelings as they arise. Take time to cry as you need to.

Take care of yourself

Get enough rest and eat regularly. If you are irritable or tense from lack of sleep or if you are not eating correctly, you will have less ability to deal with a stressful situation.

Do make as many daily decisions as possible

This will give you a feeling of control over your life. Know your limits. If the problem is beyond control and cannot be changed at the moment, don’t fight the situation. Learn to accept what is – for now – until a time when you can change it.

Practice relaxation and meditation

Create a quiet scene

You can’t always run away, but you can hold a vision in your mind – a quiet country scene or you walking along the beach can temporarily take you out of the turmoil of a stressful situation.

Play soft, background music

At your home and in your office or car, provide a soothing backdrop to the hustle and bustle of office personnel, noisy telephones, traffic or cranky children.

Maintain as normal a schedule as possible

Take one thing at a time

For people under tension, an ordinary workload can sometimes seem unbearable. The load looks so great that it becomes painful to tackle any part of it. When this happens, remember that it is a temporary condition and that you can work your way out of it … one step at a time.

Allow time for a task

This will help reduce some of your self-imposed time pressure. If you normally plan a half hour to get a job done by rushing through it, schedule forty-five minutes or an hour so you can do the job more deliberately and thoughtfully. This can only improve the quality of your work. Corner the urge to be everything to everyone.

Spruce up your surroundings

Keep a beautiful bouquet of fresh flowers at home or in the office. Surround yourself with plants or selected art pieces that you especially like. Make your environment one you enjoy.

Escape for awhile

Sometimes it helps to temporarily get away from whatever is causing tension. Whether it is a brief trip or a change of scene, or losing yourself in a book or movie, escaping for a while may give you the chance to put things in perspective so that you can return more composed to better deal with the situation.

If these coping strategies don’t seem to be successful in reducing your stress reactions,

please contact your EAP for additional assistance.

Post-Trauma Do’s And Don’ts

People who have experienced a traumatic event often demonstrate changes in behavior. These suggestions reduce the probability of long-term stress reactions.

DON’T…	DO….
…drink alcohol excessively	…get enough rest
…use drugs or alcohol to numb consequences	…maintain a good diet and exercise program
…withdraw from significant others	…find time and talk to supportive peers and family about the incident
…reduce leisure activities	…take time for leisure activities
…stay away from work	…follow a familiar routine
…increase caffeine intake	…spend time with family and friends
…have unrealistic expectations for recovery	…attend meetings regarding this traumatic event
…look for easy answers	…create a serene scene to escape to either visually or literally
…take on new major projects	…take one thing at a time
…pretend everything is ok	…expect the experience to bother you
…make major changes if you don’t need to	…seek professional help if your symptoms persist
	…seek medical assistance if your physical symptoms concern you

This information is not intended to serve as medical advice
If you experience physical symptoms which cause you concern, please consult your physician.

Critical Incidents: Coping With Children’s Reactions

How to Deal With Fear and Anxiety

Ø Fear is a normal reaction to any danger that threatens life or well being.

Ø After a disaster, a child may be afraid of recurrence of injury or death, being separated from family, or being left alone.

Ø Parents tend to ignore the emotional needs of the child once they are relieved that nothing “serious” has happened to the family.

Ø You must recognize that a child who is afraid is very frightened!

Ø A first step for parents is to understand the kinds of fear and anxiety a child experiences.

Advice to Parents

Ø It is very important for the family to remain together.

Ø The child needs reassurance from your words as well as actions.

Ø Listen to what the child tells you about any fears.

Ø Listen when he tells you how he feels, what he thinks of what has happened.

Ø Explain to the child, as well as you can, about the disaster and about the known facts; again, listen carefully to her.

Ø Fears do not need to completely disrupt a child’s and family’s activities.

Settling Down

Ø Parents should indicate to the child that they are maintaining control; they should be understanding but firm and supportive, and should make decisions for the child.

Ø It is natural for a child to want to be close to the parents and for the parents to want to have the child near them.

Ø Parents should also be aware of their own fears and uncertainties and the effect these will have upon the child.

Ø Children respond to praise and parents should make a deliberate effort not to focus upon the child’s immature behavior.

How Can Parents Recognize When To Seek Professional Help?

It is time to seek help if:

Ø a sleeping problem continues for more than a few weeks

Ø the clinging behavior does not diminish

Ø the fears become worse

Mental health professionals are specially trained to help people in distress. They can help parents cope with and understand the unusual reactions of the child. By talking to the parents and child, either individually or in groups, a child’s fears can be overcome easily.

For confidential help, contact your Employee Assistance Program.