Grief & Trauma Support
Grief is a natural response to loss, particularly to the loss of someone who has died. People also grieve when a pet dies. Grief can emerge following a variety of situations: health changes, death, job loss, relationship changes and more. The pain of loss can be overwhelming. Grief is complex and there is no exact time table for dealing with the variety of emotions that emerge after loss.
What is Traumatic Grief?
Current literature recognizes traumatic grief as: the death of a baby or child, violent death, suicide, homicide, untimely deaths.
Arizona State University professor, author and researcher, Dr. Joanne Cacciatore, developed a grief framework model called ATTEND (attunement, trust, therapeutic touch, egalitarianism, nuance, and death education). It is a mindful and evidence-based, culturally sensitive paradigm for compassionate care to the traumatically bereaved which does not pathologize grief. (1) This model has been shown to reduce depressive, anxious, and trauma symptomatology in both clients and clinicians.
(1) (Thieleman & Cacciatore, 2013; Cacciatore, 2010; Cacciatore & Flint, 2011; Cacciatore & Thieleman, 2012; Thieleman & Cacciatore, 2014).
Common Reactions to Trauma & When to Seek Support
- Flashbacks of the trauma/disturbing memories and/or dreams
- Feelings of disconnection or numbness
- Anger, guilt, shame and/or blame
- Changes in self-worth
- Inability to carry out daily activities
- Difficulty trusting
- Overwhelming fear
- Difficulty sleeping
What Is CISM?
Critical Incident Stress Management (CISM) is an intervention protocol developed specifically for dealing with traumatic events. It is a formal, highly structured and professionally recognized process for helping those involved in a critical incident to share their experiences, vent emotions, learn about stress reactions and symptoms. It is not psychotherapy. It is a confidential, voluntary and educative process, sometimes called 'psychological first aid'.
First developed for use with military combat veterans and then civilian first responders (police, fire, ambulance, emergency workers and disaster rescuers), it has now been adapted and used virtually everywhere there is a need to address traumatic impact in peoples lives.
There are several types of CISM interventions that can be used, based on the individual situation. Variations of these interventions can be used for groups, individuals, families and in the workplace.
Debriefing is a proactive intervention involving a group meeting or discussion about a particularly distressing critical incident. Based on core principles of crisis intervention, CISD (Critical Incident Stress Debriefing) is designed to mitigate the impact of a critical incident and to assist the persons in recovery from the stress associated with the event. CISD is facilitated by a specially trained team which includes professional and peer support personnel. Ideally it is conducted between 24 and 72 hours after the incident, but may be held later under exceptional circumstances.
Defusing is an intervention that is a shorter, less formal version of a debriefing. It generally lasts from 30 to 60 minutes, but may go longer and is best conducted within one to four hours after a critical incident. It is not usually conducted more than 12 hours after the incident. Like a debriefing, it is a confidential and is a voluntary opportunity to learn about stress, share reactions to an incident and vent emotions. The main purpose is to stabilize people affected by the incident so that they can return to their normal routines without unusual stress. Where appropriate, a formal debriefing may also be required.
Grief and Loss Session is a structured group or individual session following a death and assists people in understanding their own grief reactions as well as creating a healthy atmosphere of openness and dialogue around the circumstances of the death.
Crisis Management Briefing is a large, homogeneous group intervention used before, during and after crisis to present facts, facilitate a brief, controlled discussion, Q & A and info on stress survival skills and/or other available support services. May be repeated as situation changes.
Critical Incident Adjustment Support provides multi-faceted humanitarian assistance to individual, families or groups for coping with the aftermath of an incident and overcoming the ongoing impact of a death or injury.
Pre-Crisis Education provides a foundation for CISM services. It includes incident awareness, crisis response strategies and develops stress management coping skills that can prevent major problems should an incident occur. It takes the form of an employee handbook, e-book and/or workshops and training seminars.
*CISM International 2019