What is CISM?

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The mission of the International Critical Incident Stress Foundation is to  provide leadership, education, training, consultation and support  services in comprehensive crisis intervention and disaster behavioral  health services to the emergency response professions, other organizations, and communities worldwide.

Louise is certified by the International Critical Incident Stress Foundation,  Inc. to facilitate education and training as an individual and Group Instructor with an Airline emphasis. Instructor Certification #2253.

George S. Everly, Jr., PhD., C.T.S. and Jeffrey T. Mitchell, PhD, C.T.

The International Critical Incident Stress Foundation

As Crises and disasters become epidemic, the need for effective crisis response capabilities becomes obvious. Crisis intervention programs are  recommended and even mandated in a wide variety of community and occupational settings (Everly and Mitchell, 1997). Critical Incident Stress Management (CISM) represents a powerful, yet cost-effective approach to crisis response (Everly, Flannery, & Mitchell, in press Flannery, 1998; Everly & Mitchell, 1997) which unfortunately is often misrepresented and misunderstood.

CISM represents an integrated multi-component crisis intervention system. This systems approach underscores the importance of using multiple interventions combined in such a manner as to yield maximum impact to achieve the  goal of crisis stabilization and symptom  mitigation. Although in evidence since 1983 (Mitchell, 1983), who argues that the CISD group intervention should not be stand alone intervention. This point has, frankly, never been in contention. The CISD intervention has always been conceived of as one component within a larger functional intervention framework.  

Admittedly, some of the  confusion surrounding this point was engendered by virtue of the fact that in the earlier expositions, the term CISD was used to denote the generic and overarching umbrella program system, while the term "formal  CISD" was used to denote the specific 7-phase group discussion process.  The term CISM was later used to replace the generic CISD and serve as the overarching umbrella program/system as denoted in Table 1 (see Everly and Mitchell, 1997).
 

The effectiveness of CISM programs has been empirically validated through thoughtful qualitative analyses, as well as through controlled investigations, and even meta-analysis (Everly, Boyle & Lating, in press Flannery, 1998; Everly & Mitchell, 1997; Everly & Boyle 1997; Mitchell & Everly in press; Everly, Flannery & Mitchell, in press; Dyregrov, 1997). Unfortunately, this is a fact often overlooked (e.g. see Snelgrove, 1998).
 

There is a misconception (that evidence exists denouncing) CISD/CISM, and has proven harmful to its recipients (Snelgrove 1998). This is a misrepresentation of the extant data. There is not extant evidence to argue that the "Mitchell Model", CISD or the CISM system has proven harmful! The investigations that are frequently cited to suggest such as an adverse effect simply did not use the CISD or CISM system as prescribed, a fact that is too often ignored (e.g. see Snelgrove, 1998).
 

In  sum, no one CISM intervention is designed to stand alone, not even the widely used CISD. Efforts to implement and evaluate CISM must be programmatic, not uni-dimensional. While the CISM approach to crisis intervention is continuing to evolve, (as should any worthwhile endeavor), current investigations have clearly demonstrated its value as a tool to reduce human suffering. Future research should focus upon ways in which the CISM process can be made  even more effective to those in crisis.
 

While  the roots of CISM can be found in the emergency services professions dating back to the late  1970's, CISM is now becoming the "standard of care" in many schools, communities and organizations well outside the field of emergency services (Everly & Mitchell, 1997).