Healthy Family Liaisons

Healthy Family Liaisons

Jeffrey T. Mitchell, Ph.D.

Clinical Professor Emergency Health Services University of Maryland

President Emeritus,

International Critical Incident Stress Foundation

Recent media reports about family liaison officers who abandoned their own families and moved in with the family of the deceased firefighter or other emergency services worker that they were helping have caused many departments to re-evaluate this important emergency services tradition. Some are on the verge of abandoning any official endorsement of the family liaison officer role. That would be a serious mistake. The programs are just too important to consider dropping. When properly run, a family liaison program can reduce some aspects of the pain and chaos associated with the loss of the loved one. Others departments, instead of dropping a potentially helpful program, are appropriately adding new guidelines and procedures to prevent similar problems in the future.

The problems encountered by family liaison officers in assisting bereaved family members are:

1. not new or unique
2. predictable
3. largely preventable

Family liaison officers have provided services in most departments for many decades and in some cases for hundreds of years. It is difficult and emotionally charged work. Unfortunately, outside of the funeral services, there are virtually no written guidelines for family liaison officers. Some are told to do everything they can for the grieving family for as long as it takes. Non-specific guidelines such as that open the door to a wide range of complicated, painful and overwhelming emotions for the liaison officer. The well meaning but poorly prepared liaison officer is frequently adrift with no training, no guidelines and no one to turn to for guidance. End results usually include such intense emotional involvement in the deceased colleague’s family affairs that appropriate decisions are too difficult or impossible to make. Dropping one’s own family for the family of the dead friend has happened now and again over the history of the liaison tradition. The phenomenon is predictable. It is based on the psychological concepts of transference and counter-transference. When a person helps another who is in pain the person receiving the assistance feels generally warm and positive feelings of admiration, gratitude and appreciation. That, simply put, is transference and it is natural. The helper, on the other hand, may interpret the positive feelings from the one they are helping as an invitation to get closer. That is counter-transference. It can be quite disruptive to the person who needs help because it complicates the entire emotional picture and it clouds clear thinking and good decision making. Predicting potential emotional involvement with the family one is helping is not a very difficult thing to do. Preventing the phenomenon is a little more challenging. With the right guidelines and procedures in place, however, the family liaison problem is largely preventable. Here are some important guidelines that can help to head off complicated emotional involvements with the families a liaison is attempting to help through a difficult time.

1. Develop specific teams of family liaison personnel. A specific departmental team with a specific purpose can do much to limit the powerful transference and counter-transference emotions associated with family liaison work.
2. Screen potential team members. Family liaison team members should be carefully selected. The work of family liaison is so important and so difficult that the task should not fall to just anybody. Just because someone is the best friend of the deceased does not necessarily mean that they should serve on the liaison team.
3. Train the liaison team members. They will be engaged in crisis intervention work and they will need training. A course of training should include crisis intervention theory and practice, death issues, family theory, human communications, transference and counter-transference and assisting individuals in crisis. Please note that many CISM team members may already have a good deal of the required training.
4. Monitor the teams. Teams need to be observed and supported by the department’s administration. The team leadership should meet with team members frequently while they are engaged in family support. Their needs and concerns should be managed. Team members who are getting a little too involved should be guided away from intense emotionally oriented thinking and into more objective thinking.
5. Assign a mental health professional. A mental health specialist should be assigned to meet with the team and guide them. A mental health CISM trained team member is usually the best choice.
6. Assign a clergy person. A department chaplain can be helpful in defusing intense emotions and guiding the team through its important work.
7. Always work in a team format. Family liaison personnel should never work alone. Each approach should be with at least two team members. Individual contacts with family members should be infrequent and of short duration.
8. Limit the time commitments of team members. There should be enough team members that no one person has to be responsible for all the needs of the bereaved family for very long. Taking turns to support a family is more helpful than being there for hours each day.
9. Coordinate efforts with many other resources. Liaison teams should be able to identify a wide range of resources that a family might need. A good deal of the work of a liaison team is to be able to connect the family with many resources, not to become those resources for the family.
10. Develop exit strategies. The work of family liaison personnel is temporary. It may take months to complete the work, but it is temporary. From the first day the team needs to be looking into the not too distant future when the family will need them less and will be able to make decisions and accomplish tasks without the liaisons. There must be flexibility in working with families. Not all families are the same. Some will need more support than others. But ultimately, the team is moving toward enhanced independence not dependence for the family.

A few simple guidelines and thoughtfully developed protocols can create a very positive effect on a family liaison program. The program will run more effectively and there will be less chance of intense emotional involvement for the liaison officers.