Think Before Doing
Think Before Doing
Jeffrey T. Mitchell, Ph.D.,
Clinical Professor of Emergency Health Services,
University of Maryland
President Emeritus
International Critical Incident Stress Foundation
"Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat" Sun Tzu, author of The Art of War, an ancient Chinese military treatise.
It is extremely hard for human beings to do something new rather than something they are already familiar with. This is especially so when they are caught up in an extraordinary event. The known path is the path that is usually perceived to be the path of least resistance, that is, the easier path. But the easier path is not necessarily the best path when we are considering emotional first aid. In fact the usual things we might try under other less complex circumstances may not work if they are badly timed or poorly thought out while intervening during or after a disaster.
Some people who have been trained to do the small group crisis intervention process know as “Critical Incident Stress Debriefing (CISD)” jump right to the illogical conclusion that the CISD process is equally applicable to all people, under all circumstances and at all times. The pressures of a large scale event may cause them to forget that the CISD is merely one technique from a wide range of techniques that can be useful when applied by properly trained people at the appropriate time and under the right circumstances.
Haphazard applications of inappropriate crisis intervention techniques have occasionally occurred in the past. They tend to be counterproductive and cause considerable anger and frustration among those who could potentially have benefited from the support services if only the interventions had been carefully developed with a strategic plan in mind.
The strategy, of course, is the “big picture”. It is characterized by an assessment of the circumstances, the development of clear goals and objectives, the selection of the most skillful people to provide the services and the development of a plan of action. Once all of that has been put together, crisis interventionists must then carefully select a specific set of crisis tactics that are most likely to successfully carry out the strategic plan. A comprehensive, multi-tactic approach that integrates or blends the tactics in a systematic manner typically has the best chance of assisting people through the crisis experience.
There is a simple formula that can be used to develop the strategic plan when intervening in any emotionally charged event. It goes like this:
- Target. Figure out which individuals or possibly groups might need psychological first aid.
- Type. Determine which types of interventions are going to be most appropriate for this particular crisis.
- Timing. Next decide when the various interventions are most likely to be helpful.
- Themes. Make sure you have a full understanding of the issues, concerns, facts about the incident itself and the services that may have already been provided. Then review the Target, Type, Timing aspects of the strategic plan before instituting the slate of interventions.
- Team. Decide who should be providing the support services. Carefully choose the best resources available to provide the services you worked out while looking at the target, type, timing and themes of the situation as you developed your strategic plan.
The CISD should not be used unless the three primary criteria for small group crisis intervention can be verified by the support team before the intervention is utilized. The first of the three essential criteria for a small group intervention is that the small group must be clearly a homogeneous group (they know each other, work closely together, have very similar job responsibilities, and the same leadership). The second criterion is that the mission is complete or has moved beyond the acute phases of the crisis event. The third criterion is that the level of traumatic exposure should be about equal.
The development of carefully designed crisis intervention strategies is
so important that the International Critical Incident Stress Foundation has incorporated elements of strategic planning into most of its current courses. Since January of 2006, a specialized course entitled, Strategic Response to Crisis has been presented at most of its main conferences. The course is one of the core ICISF courses. I hope to see you at the Strategic Response To Crisis course. In the mean time, think before you do things in crisis support. It a can make a big difference in how well organized and effective your response to crisis is.
