Airline Incident Response LLC

Airline Incident Response LLCAirline Incident Response LLCAirline Incident Response LLC

Airline Incident Response LLC

Airline Incident Response LLCAirline Incident Response LLCAirline Incident Response LLC
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What is Critical Incident Stress Management (CISM)?

The stealthy stressors

Written by Louise Cullinan (FO) and Gideon Ewers

Besides  these more obvious stress inducing scenarios, a number of less obvious  events common to the lives of pilots have been demonstrated as factors  that can elevate stress including a simulator check failure, a crew  member injured on the way to, from or during a layover as well as less  obvious factors like a disturbance such as a fire in the layover hotel.  Sadly, we live in times where there are additional risks to crews, a  prime and tragic example being when terrorists attacked the Oberoi  Trident and the Taj Palace hotels in Mumbai in 2008. As you may know,  these hotels are used by a number of airlines as layover hotels. While  this was a horrific event, it also revealedthe capabilities of the  global CIRP network with teams from KLM and Lufthansa’s CIRP programmes  working with those from the Mayday Foundation and ALPA, International.  


What is a stress reaction?


In  the context of critical incident stress management, stress reactions  are psychological and physiological changes that occur in a person who  has been exposed to a stressful event. Often we may not recognise our  stress reactions and may even believe that because of our training and  experience we are immune to them. Almost all people exposed to a  critical incident will suffer some form of critical incident stress.  Each person’s stress reactions will be different (see Fig 1). However,   CIRP has found that crewmembers experiencing stress reactions from an  accident or incident most often complain about sleep problems, anger at  the company, or the loss of “flying as fun.” The ALPA Aeromedical Office  has also found that of the pilots with post-traumatic stress disorder  or long-term severe stress, approximately 70 percent of those who  received proper assistance continued their aviation careers. Of those  pilots not receiving any critical incident stress support, 60 to 70  percent left their aviation careers within two years of the critical  incident or accident. Stress reactions may appear within days or they  may take months or years to surface. If stress reactions do not diminish  in frequency and intensity within a few weeks of the event it may be a  sign that PTSD is developing. PTSD is a psychiatric diagnosis described  as the development of characteristic symptoms following a  psychologically distressing event that exposes a person to an intensity  and/or duration of emotions outside the range of usual human experience.  

Major characteristics may include:

1. The traumatic event is persistently re-experienced, often as flashbacks or  

intrusive memories,  


2. There is persistent avoidance of things associated with the trauma and   

numbing of general responsiveness, such as the inability to enjoy aspects   

of life previously important, e.g. sex, hobbies, children, etc., and 

 

3. There are persistent symptoms of increased arousal such as hyper-vigilance   

(always being on the alert for something to happen), sleep problems, irritability   

and outbursts of anger, difficulty concentrating, and exaggerated startle response.   


PTSD has long-term debilitating effects but it can be treated. The diagnosis is not   

made if the disturbance lasts less than one month. A less severe form of PTSD is  

Acute Stress Disorder.These stress disorders seriously threaten your health,   

career, and family. Early intervention has proven effective in preventing or   

mitigating the development of long-term stress disorders. 

"CIRP is the Program, CISM is what we do"

What is the Critical Incident Response Programme?

The  Critical Incident Response Programme was implemented by ALPA in 1994 as  a flight safety initiative aimed at assisting crew members, accident  investigators and their families following a serious incident or  accident. The programme, which provides pre incident education and post  incident/accident intervention services is aimed at aiding normal  recovery before the effects of harmful stress reactions can begin to  affect job performance, careers, families and health. It works through a  system of peer support volunteers (PSV) who have been specifically  trained and certificated under the International Critical Incident  Stress Foundation, using peer support and CIRP protocols that assist  crew members, accident investigators, or their families with a critical  incident. This support consists of phone calls and person-to-person  contact.  


The  first step is referred to as a One on One and is designed to provide  education on stress reactions. One on Ones usually take place as soon as  possible after an event and may be done by telephone. The next step is a  defusing and it is a three-step process that lasts about 20 minutes and  may involve follow-up calls. In most cases the process will do much to  relive the symptoms however, this may not always be the case which is  where a Critical Incident Stress Debriefing (CISD) process can be  instigated. The CISD is a seven-step managed venting of  thoughts and  reactions to a critical incident by those involved. This debriefing  usually occurs within a week after an accident or incident; however, it  can be done weeks, months, or even years later. The CISD is conducted by  Peer Support Volunteers and always includes a mental health  professional. Debriefings are confidential and do not involve management  personnel. CISDs are not operational debriefings. They are conducted to  provide support to the individuals involved and to mitigate the  long-term effects of stress reactions. No records or notes are kept  during debriefings. A typical CISD lasts from 1 ½ to 3 hours depending  on the size of the group  


Remember,  it’s normal for individuals to suffer the effects of critical incident  stress - it’s a normal reaction to an abnormal situation. It is normal  for individuals to be unable to recognise their own stress reactions.  But you can mitigate the effects of stress reactions; stress management  information is available in the ALPA-Int CIRP Guide which is available  in the member’s area of the IFALPA website. If you want to find out more  about the CIRP or how you can develop a CIRP at your association,  contact me through IFALPA’s Human Performance Committee.  

*  *  *  *  *

Formally the National Chair for CIRP (Critical Incident Response) with the Air  Line Pilots Association (ALPA) 2007-2019, Louise continues to consult with  IFALPA and assists airlines around the world in developing their own CISM programs. Currently a First Officer with Frontier Airlines flying the  A320/321, Louise was a captain with Mesa Airlines flying the ERJ 175 along with the CRJ 200/700/900 and Be1900.  With over 30 years of grief  experience, she continues to volunteer her time in her hometown of  Steamboat Springs, Colorado.

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