Can you find any organizations that have critical incident stress debriefing 
programs for LAY rescuers? NOT the counseling and debriefing programs offered to 
firefighters or other lifesaving professionals as part of their jobs but any 
kind of organized counseling program that follows up with a bystander, for 
instance, who performs first aid or CPR on someone in an emergency. The after 
effects for such a person, even when the victim lives, can be extraordinary, and 
as far as I know, there are no programs in place to help the responsive 
bystander. The American Heart Association, for example, trains thousands of 
people per year in responding to emergencies, but nothing seems to be in place 
to deal with the after effects if someone does what they're trained to do in an 
emergency!

Dear Kathleenjun,

Thank you for your inquiry.  I have found some information that I hope will 
help you find the information you requested.

In researching this topic, it seems that many psychologists may be able to 
provide the type of personalized training you are requesting.  Critical 
Incident Stress Management (CISM) is very closely related to Post Traumatic 
Stress Disorder (PTSD) and a local psychologist may be able to assist you in 
what you seek.  To find a psychologist in your area you can try:

4therapy.com
 http://www.4therapy.com/locator/
Will let you filter for specialists in PTSD in your area.

Athealth.com
http://www.athealth.com/Consumer/directory/directory.html

LocateADoc.com
http://www.locateadoc.com

MHI Professional Directory
http://www.mhsource.com/referral/

American Medical Association
http://www.ama-assn.org/aps/amahg.htm

Find-a-therapist.com
http://www.find-a-therapist.com/onlinecounseling/etherapy.htm
Online counseling.

Find-a-psychologist.com
http://www.find-a-psychologist.com/
Online counseling.



How to select a therapist
It not easy to wade through a professional's credentials to know if they fit 
your needs.  Here are some links to help you weed through some of the jargon 
and hopefully get to a therapist that fits who you are.

Metanoia
http://www.metanoia.org/choose/
“How to choose a competent counselor”

Healingwell.com
http://www.healingwell.com/library/health/grold1.asp
“How to Find a Good Therapist:  Finding & Evaluating a Private Therapist”

Self Help Magazine
 http://www.shpm.com/articles/psychotherapy/chooseth.html
“How to choose a therapist” - A 2 part article on choosing a therapist

SoYouWanna.com
http://www.soyouwanna.com/site/syws/therapist/therapist2.html
“So you wanna choose a therapist?”


Noted Authors on CISM

Critical Incident Stress Management (CISM): A New Era and Standard of Care in 
Crisis Intervention
by George S., Jr Everly, Jeffrey T. Mitchell, Published 1999 
Price: $27.00  Used Price: $12.00
http://www.amazon.com/exec/obidos/ASIN/1883581168/ref=ase_seaoxairmedicalA/102-
1181225-0668165
These 2 authors have collaborated on several books on CISM.



Additional Info
I thought the following information might also be of interest you.

David Baldwin
http://www.trauma-pages.com/
David V. Baldwin PhD is a licensed Psychologist in Eugene, Oregon.  “My main 
interest is in understanding trauma responses and their resolution; this 
includes treating, speaking, consulting, writing, and researching emotional 
trauma issues. My clinical specialty is in the treatment of emotional trauma 
and Posttraumatic Stress Disorder (PTSD), following a wide variety of stressful 
or traumatic events (including natural or man-made disasters). In my practice, 
I work primarily with adults and adolescents or older children -- using 
solution-focused or other brief therapy approaches as appropriate -- concerning 
a broad range of issues. I've been licensed as a psychologist in Oregon since 
1989. Aside from my practice and speaking engagements, I offer consultation for 
other therapists, clinical researchers, or corporations. Please contact my 
office if you would like to arrange a presentation, training, or consultation 
in your area.

Online Course
CyberU
http://www.cyberu.com/catalog/class_detail.asp?class_id=1115&partner=116
Taught through the University of California, Berkeley by David Wee.  David Wee 
is the program supervisor for the Berkeley Mental Health Mobile Crisis Team and 
also the Disaster Mental Health Coordinator for City of Berkeley Mental Health. 
He is the adjunct faculty at the Governor’s Office of Emergency Services and at 
the California Specialized Training Institute. This course provides students 
with an overview of Critical Incident 
Stress Management interventions with community and emergency service workers 
following distressing events. It is targeted toward mental health professions 
such as emergency service workers, school personnel, child welfare workers, 
employee assistance workers, health care providers, and emergency managers. 
Access to a VCR is necessary to view the 3 videotapes required in this course.


Location Specific Offerings
The University of Sydney Counseling Service
http://www.usyd.edu.au/su/counsel/textversions/critical

Sherry Cardinal, LMSW-ACP
http://www.criticalincidentstress.com/
Licensed Therapist & Personal Coach, Richmond, TX 77406

Richard Cross
http://hometown.aol.com/Growth7028/CISM.html
Hypno-Psychotherapist & Stress Management Trainer (DHP., Adv Dip SMT., MISMA., 
BHA.., UKHR.., ......) from the UK.

Vaughn Donaldson
http://www.cism1.com/
Vaughn Donaldson's CISM Page ( Dallas, TX) offers Basic Critical Incident 
Stress Management, Peer Support / Individual Crisis Intervention, Advanced 
Critical Incident Stress Management


Search Strategies

Google – Critical Incident Stress bystander
Google – Critical Incident Stress management
Google – critical incident stress
Google – how to find a good therapist
About.com – finding psychologist

I hope this information has enabled you to find the information you were 
looking for.

---

Request for Answer Clarification by kathleenjun-ga on 22 Apr 2002 07:22 PDT

Hi, I appreciate all the information you gathered, but it does not answer the question I asked. Certainly anyone who experiences a stressful event such as 
being involved in an emergency situation can take it upon themselves to go find a therapist of some sort. What I am seeking are programs in place who 
track and follow up with ordinary lay people who render aid. This kind of program intervenes from the beginning, does not wait until the person starts 
having nightmares and goes looking for help. At least one CPR instructor I know urges his students to get in touch with him if they should be called upon to 
use their skills--but, again, this is the wrong end--he has to wait for them to contact him. 

It may be that such a program does not exist. It would require professional emergency workers who follow up on such a situation to make note of the 
bystanders who were involved and get those names to some kind of professional who would then get in touch with the lay rescuer and offer support. This 
is probably too difficult to have individual community programs in place, but it would certainly be good. Your answer, however, was helpful in that it 
suggested to me that I go to a number of individuals I know who run an international site called the Citizen CPR Foundation, which would be a logical 
place for help to be found. If there were a link to counseling help there, the challenge would be making the Foundation's existence so well known that 
people would be quick to go there.

I publish a newsletter that reaches thousands of CPR instructors worldwide and we've run articles on this with an invitation to readers to let us know of 
any programs that exist. We haven't heard of any through what you would think is the most direct source! That's why I thought I'd ask you.

---

Clarification of Answer by roguedog-ga on 24 Apr 2002 08:10 PDT

Dear Kathleenjun,

I have been checking the aaets.org discussion board 
(http://www.aaets.org/cgi/ultimatebb.cgi?ubb=forum;f=14)and have not seen an 
answer posted.

Just letting you know status.

RD

The first answer, although thorough, ignored the criterion mentioned
in the FIRST sentence that this needed to be a program designed to
help a lay rescuer, i.e., someone who does NOT have a professional
duty to respond, with the emotional upheaval often occurring even
after a successfull save--not to mention the emotional mess if the
victim dies. The material was valuable but did not answer my question.

Follow-up comment, after I pointed out the missed criterion,  were
more helpful and I appreciate them. The main website mentioned by the
researcher, however, fails to come up even when I try to reach it via
Google.

I think the basic answer to my question is that very few, if any,
programs address this at all. It did bother me that I was promptly
charged for the wrong answer.

Dear Kathleenjun,

My apologies.  I had misinterpreted your intent and to some extent, 
miscommunicated my intent.

While I was aware that perhaps it was not you yourself looking for a program, 
in my research it seemed many programs were in the geographically specific 
areas and given by small, local groups.  Not knowing where you were located, I 
thought that perhaps you or your group could contact a therapist to lecture or 
teach a class on this topic.

Now I understand that you are looking for a group or program that proactively 
seeks out citizens who were personally involved in a rescue or emergency 
incident.  Apologies for the misunderstanding.


==Capital Area Crisis Response Team
In my, now, more clarified, hunt, I found a program called the Capital Area 
Crisis Response Team (CACRT) which works out of D.C.  

CACRT will train other communities to develop similar programs in their 
community.
http://www.cacrt.org/overview.htm

From reading their website, they will proactively respond to various local 
level critical incidents:

Critical Incidents:

Homicides/Serial Killings
Individual/Serial Rapes 
Assaults/Serial Assaults
Natural Disasters (Severe Weather)
Major Motor Vehicle Crashes/Accidents (Plane, Train, Car, Bus, Boat)
Drownings 
Hostage-Taking 
Catastrophic Physical Injuries 
Arson 
Community Disturbances, Riots 
Suicide/Multiple Suicides 
Trauma of Elderly or Children 
Racial/Involvement of Underserved Groups

“Intervening with victims, survivors, rescuers and others following a trauma is 
the CACRT's most visible activity. This is accomplished by mobilizing community 
response teams as quickly as possible following a tragedy, and by providing 
consultants to local communities. On-scene services are offered at no cost to 
individuals or to agencies.”

While they do address the needs of both direct and indirect victims of a crime, 
they do not specifically address the needs of the lay rescuer. To see whom 
CACRT defines as a crime victim, go to:
http://www.try-nova.org/Victims/victimizationcontents_page2.html

CACRT will train other communities to develop similar programs in their 
community.
http://www.cacrt.org/overview.htm


==National Organization for Victim Assistance
The CACRT evolved out of a group called the National Organization for Victim 
Assistance (NOVA).  From reading NOVAs website, this is yet another amazing, 
impressive organization.
http://www.try-nova.org/index.html

Excerpt from “Providing Critical Incident Stress Debriefing (CISD) to 
Individuals and Communities in Situational Crisis” by Joseph A. Davis, Ph.D., 
LL.D. (hon.), B.C.E.T.S., F.A.A.E.T.S.  Great article that, I believe, align 
with your objectives.
http://www.aaets.org/arts/art54.htm

“Directed by Marlene A. Young, Ph.D., NOVA is a highly respected non-profit 
organization that has responded to many "high profile" tragedies such as the 
Mount St. Helens' eruption in 1980, the Air Florida airline crash of 1982, the 
South Korean airline Flight 007 Disaster of 1983, the Mexico earthquake of 
1985, and the Milwaukee Jeffrey Dahmer serial murders to name only a few 
(Young, 1994)...
When specifically requested, NOVAs main objective is to provide intense and 
immediate emergency consultation, crisis intervention services with additional 
follow-up during a limited period of time. Usually one team of 10 specialists 
will be deployed and will work up to 3-4 days. The activated team will be 
relieved by additional teams as needed depending upon the magnitude of the 
catastrophe.”

Excerpt from NOVAs website:
http://www.try-nova.org/Victims/mission_continued2.html

“NOVA has some 60,000 contacts with victims every year, referring most to 
services near their home through directories that list some 10,000 programs, 
but serving as the primary counselor and advocate for many victims at any given 
time.  Contacts come to NOVA directly from the 24-hour hotline (1-800-TRY-
NOVA), from letters, faxes, and e-mails, and from people who visit the 
Washington office… NOVAs hotline became more of a “lifeline” to thousands of 
victims with the advent of a toll-free number in the early 90’s.  The hotline – 
known as the National Crime Victim Information and Referral Hotline – is the 
only national toll-free hotline that serves all victims and survivors of 
violent crime, providing information and referral, crisis counseling, and case 
advocacy.”

==American Academy of Experts in Traumatic Stress
Another group of note I came across in my research was the American Academy of 
Experts in Traumatic Stress.  They can be found at:  
http://www.aaets.org/.

The article by Dr. Joseph A. Davis referenced above came from my perusing this 
site.  I have posted an message on their website asking if there are any 
proactive programs that service ordinary citizens who are personally involved 
in critical incidents.  When I get a response, I will comment back to you.
Also of note from this site is the book, Acute Traumatic Stress Management 
Practical Approach To Keep People Functioning During Traumatic Events And To 
Mitigate Long-Term Suffering by Dr. Mark Lerner and Dr Raymond Shelton.  When 
you go to the AAETS site, click on the link called “Acute Traumatic Stress 
Management.”

I have not yet received a response from my posting on the AAETS message board 
but I will follow up with you if something should come up or if you’d like to 
visit their discussion board go to:
http://www.aaets.org/cgi/ultimatebb.cgi?ubb=forum;f=14

I hope I have more clearly addressed your question this time.  Thanks again for 
your inquiry.

Be aware that CISD is a controversial area. Research results for its
effectiveness are mixed. Type of incident, timing, and individual vs.
group format are just some of the variables to consider when planning
an intervention. See
http://www.dartcenter.org/News/news_120701.CISD3.html for a balanced
review with references to scientific articles.

That said, your local Red Cross may be a good source for training.

I should have said that the Red Cross might have programs for helping
bystanders, although given your work as a newsletter publisher for
CPR, you're probably quite familiar with what the Red Cross has to
offer.