طرح مداخله در بحران : (فردئ ، خانوادگئ و اجتماعي)

مقدمه :

با توجه به پيچيده ترشدن روابط اجتماعئ و صنعتئ شدن كشور سست شدن روابط عاطفئ حاكم بر خانواده ، جوان بودن جامعه ، مهاجرت بئ رويه به شهرهائ بزرگ ، افزايش حاشيه نشينئ و … زمينه مناسبئ برائ گسترش آسيب هائ اجتماعئ فراهم آمده است كه بررسئ وضعيت شهرهائ بزرگ كشور مويد اين واقعيت تلخ است .

آمارهائ ارائه شده توسط سازمان زندانها و اقدامات تامينئ و تربيتئ كشور در طئ سالهائ 76و77 مبين اين واقعيت است كه تنوع و فراوانئ آسيب هائ اجتماعئ رو به فزونئ است .

همچنين با توجه به آمار مراجعين به مراكز بازپرورئ دختران و زنان آسيب ديده اجتماعئ سازمان بهزيستئ كشور ميانگين سنئ اين گروه متاسفانه از اواخر دهه سوم زندگئ به اوايل دهه و بعضا اواخر دهه دوم يعنئ دوران نوجوانئ و اوايل دوران جوانئ كاهش يافته است .

دورانئ كه فرد با بحران هويت مواجه شده وبيش از هر زمان ديگر آمادگئ ابتلا به رفتارهائ انحرافئ را دارد و نوجوان و جوان برائ حل اين بحران و متناسب با ويژگيها و خصوصيات شخصيتئ خود نياز به هدايت و راهنمايئ والدين آگاه دارد تا با موفقيت اين مرحله از رشد را پشت سر گذارد . اما اكثريت افراد آسيب ديده از خانواده هائ نابسامان برخوردارند و والدين آنها كفايت لازم را برائ كمك به آنان برائ حل اين بحرانها ندارند ودر اين شرايط نوجوانان دچار بحران هائ اجتماعئ ، فردئ و روانئ ميشوند . بحران وضعيت آشفته و درهم ريخته ائ است كه در آن افراد در هدف هائ مهم زندگئ خود با ناكامئ مواجه مئ شوند يا در چرخه زندگئ يا روش هائ تطبيق با عامل تنيدگئ زا را دچار گسيختگئ عميق ميشوند 

بيان مسئله :

دورانئ كه فرد با بحران مواجه مئ شود ، بيش از هر زمان ديگر آمادگئ برائ ابتلا به رفتارهائ انحرافئ را دارد و فرد برائ حل بحران و متناسب با ويژگيها و خصوصيات شخصيتئ نياز به راهنمايئ و هدايت افراد متخصص دارد كه با موفقيت بحران را پشت سر بگذارد .

چنانچه اكثريت اين افراد در شرايط بحرانئ تحت حمايت هائ فورئ و تخصصئ لازم قرار گيرند ، چون در اين شرايط آمادگئ بيشترئ برائ دريافت كمك دارند ، از گرايش آنها به انحراف و انحراف مجدد جلوگيرئ مئ شود . در بحران هائ روانئ ، اجتماعئ ابتدا اضطراب و هيجان به حداكثر رسيده و سپس مكانيزم دفاعئ برائ حل آن فعال مئ شوند ، ميزان موفقيت فرد در حل بحران بسته به نوع مكانيسم هائ دفاعئ دارند . مراكز مداخله در بحران فرد را در استفاده از مكانسيم هائ تطابقئ حل بحران يارئ مئ كنند تا بتواند برائ حل موفقيت آميز بحران توانايئ و مهارت خود را افزايش دهد . در اين مراكز به افرادئ كه در شرايط حاد بحرانئ قراردارند خدمات فورئ و تخصصئ لازم ارائه مئ شود و همچنين ارزيابئ همه جانبه ائ از افرادئ كه توسط نيروئ انتظامئ به مراكز معرفئ مئ شوند به عمل آمده و نظرات تخصصئ خود را به قضات محترم دادگاه ها جهت صدور حكم اعلام مئ كنند ، به افراد و خانواده هائ در معرض آسيب و آسيب ديده اجتماعئ مراجعه كننده به اين مراكز در مقابله با مشكلات زندگئ يارئ مئ كنند .

از اهداف ديگر اين مراكز شناسايئ استعدادها و توانائيها مراجعان و هدايت آنان جهت حرفه آموزئ و ايجاد اشتغال به منظور كسب استقلال و پيگيرئ مستمر جهت بازگرداندن مراجعان به كانون گرم خانواده و اجتماع و برقرارئ ارتباط مستمر با مراكز شبانه روزئ كودكان و نوجوانان به منظور ارائه خدمات مشاوره ائ و مددكارئ لازم و شناسايئ كانونهائ بحران زا و برنامه ريزئ جهت آگاه سازئ با همكارئ واحدهائ ذيربط مئ باشد .

دراين مركزموارد بدرفتارئ با كودكان ، اقدام به خود كشئ ، كودكان و نوجوانان دارائ ناهنجارئ رفتارئ ، دختران و پسران فرارئ ، موارد همسر آزارئ و افراد در معرض آسيب و آسيب ديده اجتماعئ پذيرفته مئ شوند .

اطلاعات كلئ مراكز مداخله در بحران :

اين مراكز در استان خراسان در حال حاضر در شهرهائ مشهد ، بجنورد و سبزوار مشغول به فعاليت هستند در سال 78 تعدا د مراجعين به مراكز 120 نفر و در سال 79 ، 1230 نفر بوده است . در شش ماهه اول سال 1380 نيز 2761 نفر مراجعه كننده داشته است .

كادر علمئ درمانئ در حال حاضر مشتمل است بر هشت مددكار خانواده ، هفت كارشناس ارشد روانشناسئ ، 3 پزشك ، 3 روانپزشك ، 4 مسئول پذيرش كه همراه با همكاران كادر ادارئ برنامه هائ درمانئ و آموزشئ ، پژوهشئ مراكز را طراحئ و اجراء مئ كنند .

  Crisis Intervention in Situations Related to
  Unsupervised Use of Psychedelics

Since the mid-sixties, when experimentation with LSD and other psychedelics moved from psychiatric institutes and clinics to private homes and public places the role of mental health professionals in regard to these substances has been drastically redefined. Instead of being in the forefront as experimenters and researchers they have become the rescuers and undertakers called upon to deal with the casualties of the psychedelic scene. This development has contributed considerably to the present attitudes of most professionals toward these drugs; the primary focus of psychiatrists and psychologists has shifted from the therapeutic potential of psychedelics to their dangers. In the highly emotional atmosphere created by sensational publicity, professionals have allowed their image of LSD to be shaped by journalists and newspaper headlines rather than scientific data generated by research. Consequently, the casualties and complications of unsupervised experimentation with LSD, instead of being attributed to irresponsible and ignorant use, have been interpreted as reflecting dangers inherent in the drug itself.
    Restrictive legislation has practically destroyed scientific research of psychedelic substances, but has not been very effective in curbing unsupervised experimentation. While samples of psychedelic drugs of doubtful quality are readily available in the streets and on college campuses, it is nearly impossible for a serious researcher to get a license for scientific investigation of their effects. As a result of this, professionals are in a very paradoxical situation: they are expected to give expert help in an area in which they are not allowed to conduct research and generate new scientific information. The widespread use of psychedelics and relatively high incidence of drug-related problems are in sharp contrast to the lack of understanding of the phenomena involved; this is true for the general public as well as the majority of mental health professionals.
    This situation has very serious practical consequences. Various emergencies associated with psychedelic drug use are handled in a way that is at best ineffective, but more likely counter-productive and harmful. Crisis intervention in psychedelic sessions and treatment of the long-term adverse effects of unsupervised self-experimentation are issues of such medical and social relevance that they deserve special attention. Much of the information that is essential for understanding the problems involved and for an effective approach to this area has been presented in various sections of this book. However, because of the importance of the problem I will briefly review the most pertinent data here and apply them to the area in question.

THE NATURE AND DYNAMICS OF PSYCHEDELIC CRISES

    Understanding the dynamics of psychedelic experiences is absolutely necessary for effective crisis intervention. A difficult LSD experience, unless it results from a gross abuse of the individual, represents an exteriorization of a potentially pathogenic matrix in the subject's unconscious. If properly handled, a psychedelic crisis has great positive potential and can result in a profound personality transformation. Conversely, an insensitive and ignorant approach can cause psychological damage and lead to chronic psychotic states and years of psychiatric hospitalization.
    Before discussing the difficult experiences that occur in psychedelic sessions, their causes, and the principles of crisis intervention, we will summarize our previous discussions about the nature and basic dynamics of the LSD process. LSD does not produce a drug-specific state with certain stereotypical characteristics; it can best be described as a catalyst or amplifier of mental processes that mediates access to hidden recesses of the human mind. As such, it activates deep repositories of unconscious material and brings their content to the surface, making it available for direct experience.
    A person taking the drug will not experience an "LSD state" but a fantastic journey into his or her own mind. All the phenomena encountered during this journey—images, emotions, thoughts and psychosomatic processes—should thus be seen as manifestations of latent capacities in the experient's psyche rather than symptoms of "toxic psychosis." In the LSD state the sensitivity to external factors and circumstances is intensified to a great degree. These extrapharmacological influences involve all the factors usually referred to as ' set and setting': the subject's understanding of the effects of the drug and purpose of ingestion, their general approach to the experience, and the physical and interpersonal elements of the situation. A difficult LSD experience thus reflects either a pathogenic constellation in the experient's unconscious, traumatic circumstances, or a combination of the two.
    Ideal conditions for an LSD session involve a simple, safe and beautiful physical environment and an interpersonal situation that is supportive, reassuring and nourishing. Under these circumstances, when disturbing external stimuli are absent, negative LSD experiences can be seen as psychological work on the traumatic areas of one's unconscious. It is essential for the good outcome of an LSD session to keep it internalized and fully experience and express everything that is emerging. Psychedelic sessions in which the subject does not stay with the process tend to create a dysbalance in the basic dynamics of the unconscious. The defense system is weakened by the effect of the drug, but the unconscious material that has been released is not adequately worked through and integrated. Such sessions are conducive to prolonged reactions or to subsequent "flashbacks."
    The only way to facilitate the completion and integration of an LSD session in which the experiential gestalt remains unfinished is to continue the uncovering work, with or without psychedelics. It is important to emphasize that the effect of LSD is essentially self-limited; the overwhelming majority of difficult psychedelic experiences reach a resolution quite spontaneously. Actually, those states that are most dramatic and stormy tend to have the best outcome. The use of tranquilizers in the middle of a psychedelic session is a grave error and may be harmful. It tends to prevent the natural resolution of the difficult emotional or psychosomatic gestalt and to "freeze" the experience in a negative phase. The only constructive approach is to provide basic protection to the subject, and support and facilitate the process; the least one can do is to not interfere with it.
    After this brief introduction, we can return to the problem of complications during unsupervised psychedelic experimentation. Although the basic principles discovered during clinical research with LSD are directly applicable to crisis intervention, it is important to emphasize the basic differences between the two situations. The LSD administered in clinical and laboratory research is pharmaceutically pure and its quality can be accurately gauged; most black market samples do not meet these criteria. Only a small fraction of a "street acid" specimen is relatively pure LSD; the black market preparations frequently contain various impurities or admixtures of other drugs. In some of the street samples that have been analyzed in laboratories, researchers have detected amphetamines, STP, PCP, strychnine, benactyzine, and even traces of urine. There have been instances where alleged LSD samples contained some combination of the above substances and no LSD whatsoever. The poor quality of many of the street specimens is certainly responsible for some of the adverse reactions that occur in the context of unsupervised self-experimentation. In addition, uncertainty about quality and dosage and the resulting fears can have a negative influence on the ability of the subject to tolerate unpleasant experiences, which are then readily interpreted as signs of toxicity or overdose rather than manifestations of the users' unconscious.
    However, the quality of drug and the uncertainty about it seem to be responsible for a relatively small fraction of the adverse reactions to LSD. There is no doubt that extrapharmacological elements, such as the personality of the subject and the set and setting, are by far the most important factors.
    In order to understand the frequency and seriousness of psychedelic crises that occur in the context of unsupervised self-experimentation, it is important to take into consideration the circumstances under which many people tend to take LSD. Some of them are given the drug without any prior information about it, without adequate preparation, and sometimes even without forewarning. The general understanding of the effects of LSD is poor, even among experienced users. Many of them take LSD for entertainment and have no provisions in their conceptual framework for painful, frightening and disorganizing experiences. Unsupervised experimentation frequently takes place in complex and confusing physical and interpersonal settings that can contribute many important traumatic elements. The hectic atmosphere of large cities, busy highways in the rush hour, crowded rock concerts or discos, and noisy social gatherings are certainly not settings conducive to productive self-exploration and safe confrontation with the difficult aspects of one's unconscious.
    Personal support and a relationship of trust are absolutely crucial for a safe and successful LSD session, and these are seldom available under these circumstances. Not infrequently the person under the influence of LSD is surrounded by total strangers. In some other instances good friends may be present, but they are themselves under the influence of the drug or are unable to tolerate and handle intense and dramatic emotional experiences. When a group of people take LSD together, the painful experiences of one person can create a negative atmosphere which contaminates the sessions of others. There have even been episodes in which persons who took LSD or were given the drug were, for a variety of reasons, exposed to deliberate psychological abuse. It is easy to understand that such toxic circumstances are highly conducive to adverse reactions.

Crisis Intervention: An Opportunity To Change. ERIC Digest.

Crisis intervention is emergency first aid for mental health (Ehly, 1986). This digest provides a brief, conceptual overview of crisis intervention, and summarizes the steps a worker may use to identify, assess, and intervene with an individual experiencing crisis.

The Chinese language contains two characters which, taken together, connote the concept of crisis. The first character, "wei," indicates a critical or dangerous situation, while the second one, "ji," means an opportunity for change. Thus, these characters together indicate that crisis is a point in time that allows the opportunity to change.

Crisis intervention involves three components: 1) the crisis, the perception of an unmanageable situation; 2) the individual or group in crisis; and 3) the helper, or mental health worker who provides aid. Crisis intervention requires that the person experiencing crisis receive timely and skillful support to help cope with his/her situation before future physical or emotional deterioration occurs.

A crisis may occur when an individual is unable to deal effectively with stressful changes in the environment. A stressful event alone does not constitute a crisis; rather, crisis is determined by the individual's view of the event and response to it. If the individual sees the event as significant and threatening, has exhausted all his/her usual coping strategies without effect, and is unaware or unable to pursue other alternatives, then the precipitating event may push the individual toward psychological disequilibrium, a state of crisis (Caplan, 1964; Smead, 1988).

Psychological disequilibrium may be characterized by feelings of anxiety, helplessness, fear, inadequacy, confusion, agitation, and disorganization (Smead, 1988). At this point, the individual experiencing this disequilibrium may be most receptive to outside assistance, thus providing an opportunity for behavioral change and a return to balance. To summarize, a crisis results from a person's negative perception of a situation.

Psychologists, counselors, social workers, mental health personnel, and therapists are trained to provide services to individuals in crisis. These workers can assist an individual or group in crisis by providing direct intervention, by identifying alternative coping skills, or by consulting with others. A helper's primary goals in a crisis are to identify, assess, and intervene; to return the individual to his/her prior level of functioning as quickly as possible; and to lessen any negative impact on future mental health. Sometimes during this process, new skills and coping mechanisms are acquired, resulting in change.

IDENTIFICATION

Identification recognizes that a problem exists and it focuses on 1) the event's significance in the person's environment, and 2) the person's current functioning. The event or crisis may be categorized as either developmental or situational (Smead, 1988). Developmental crises result from predictable change, and are due to normal growth or development, such as the onset of adolescence. Situational crises are either predictable, arising from certain events, such as divorce or failing a grade, or are unpredictable, such as an accidental death or natural disaster. Both types involve a change in circumstances, usually accompanied by a loss, which can precipitate a crisis reaction in an individual.

Therapists must promptly identify a person in crisis, as well as assess the degree to which his/her functioning is impaired. In addition to psychological disequilibrium, other signs and symptoms may indicate a problem for those experiencing a crisis. Physical symptoms such as changes in overall health, energy, or activity level, as well as in eating or sleeping patterns, may point to a problem. Emotional signs that may indicate a person in crisis include increased tension or fatigue, and changes in temperament, such as angry outbursts or depression. Behavioral signs such as the inability to concentrate, being preoccupied with certain ideas, or social withdrawal may also indicate a person in crisis (Ehly, 1986; Greenstone & Leviton, 1993).

ASSESSMENT

After identifying a crisis situation and a person in crisis, workers assess the crisis's impact on the individual. This assessment usually takes the form of an interview, during which the worker strives to convey an atmosphere of acceptance, support, and calm confidence about the future. Communication with the person experiencing a crisis is vital; this involves establishing eye, and sometimes, physical contact. Questions addressed to the individual may include his/her perception of the problem, the frequency and sequence of events, his/her feelings, and a history of attempts to deal with the problem. Forced choice or open-ended questions may be used to assess the individual's ability to communicate, as he/she may experience difficulty in expressing him/herself, in making decisions, or in solving problems.

Assessment may include what the individual is saying as well as his/her nonverbal communication, i.e., facial expression, posture, body and eye movements, and mannerisms. An essential part of this assessment is an evaluation of the person's current safety as well as any risk to his/her own or someone else's life. Additionally, factors such as alcohol and drug use, current stress level, and emotional affect, such as hopelessness and helplessness, should be identified.

INTERVENTION

After identification and assessment of the crisis and the person involved, the intervention occurs. While specialists (Hoff, 1989; Greenstone & Leviton, 1993; Sandoval, 1988; Sandoval, 1991; Zins & Ponti, 1990) in this area may differ on the name and number of steps involved, they agree that certain points are integral to intervention and are basic to a best-practice, problem-solving approach. First, while supporting and empathizing with the individual in crisis, the worker should listen and avoid using the phrase "I understand" so as to allow the individual full and open expression of feelings and emotions. Second, the individual in crisis should answer the worker's questions so as to define and clarify the incident and acknowledge any social and cultural factors which may relate to the crisis. This second step places the problem in a framework. As Burak (1987, p. 1) states, "Understanding of and respect for the differences inherent in each culture are needed for rapid, effective, and sensitive treatment of emergency situations" (p. 1). Third, the worker develops an awareness of the significance of the crisis from the individual's point of view. These first three steps may have been partly completed during the identification and assessment stages of the crisis; it is important that they be finished before going on to the fourth step.

Fourth, mutual brainstorming of alternatives and discussion of available resources are jointly carried out by the individual in crisis and the worker. At this point, the worker may need to be more directive, by focusing on the current situation, proposing ideas and strategies for action, as well as suggesting other resources for support, instead of just listening and reflecting. (Sandoval, 1988). Fifth, the individual in crisis and the worker choose one or more specific, time-limited goals which take into account the person's significant others, social network, culture, and lifestyle. Complete planning, including recognition of all the steps involved, as well as consideration of any barriers to success, should be completed before the solution is attempted. Some brief education, modeling, role playing or rehearsal of potential situations may be done in this step to empower the individual further. Sixth, the worker and individual implement their plan and, if possible, evaluate its effectiveness. They then adjust the plan as necessary. Seventh, the worker provides for follow-up or refers the individual in crisis to a resource that can provide ongoing support. The worker then terminates the established crisis relationship.

SUMMARY

In summary, crisis intervention provides the opportunity and mechanisms for change to those who are experiencing psychological disequilibrium, who are feeling overwhelmed by their current situation, who have exhausted their skills for coping, and who are experiencing personal discomfort. Crisis intervention is a process by which a mental-health worker identifies, assesses, and intervenes with the individual in crisis so as to restore balance and reduce the effects of the crisis in his/her life. The individual is then connected with a resource network to reinforce the change. Thus, as the Chinese characters suggest, crisis truly holds the opportunity for change.

REFERENCES

Burak, P. A. (1987). Crisis management in a cross-cultural setting Washington, D.C.: National Association for Foreign Student Affairs. (ERIC Document Reproduction Service No. ED 329 870).

Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books.

Ehly, S. (1986). Crisis intervention handbook. Washington, D.C.: National Association of School Psychologists.

Greenstone, J. L. & Leviton, S. C. (1993). Elements of crisis intervention: Crises and how to respond to them. Pacific Grove, CA: Brooks/Cole Publishing Co.

Hoff, L. A. (1989). People in crisis: Understanding and helping (3rd ed.). Redwood City, CA: Addison Wesley Publishing Co.

Sandoval, J. (Ed.). (1988). Crisis counseling, intervention, and prevention in the schools. Hillsdale, NJ: Lawrence Erlbaum Associates.

Smead, V. S. (1988). Best practices in crisis intervention. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology (pp. 401-414). Washington, D.C.: National Association of School Psychologists.

Zins, J. E. & Ponti, C. R. (1990). Best practices in school-based consultation. In A. Thomas, & J. Grimes (Eds.), Best practices in school psychology II (pp. 673-693). Washington, D.C.: National Association of School Psychologists.

What Is A Competent Emergency And Crisis Intervention Professional?

Emergency and crisis intervention requires professionals who have specialized skills and experience dealing with crises.   Unfortunately most professionals lack the training and broad experience necessary to conduct competent crisis interventions.  The ability to assess and intervene during emergencies is not a routine skill. Most doctors, counselors and psychotherapists have good intentions but don't realize how unstable, critical and demanding a crisis can become.  Incorrect assessment, missed opportunities, unskillful behavior and mistakes can prolong a crisis, create new problems, or turn an urgent problem into a dangerous emergency.  In the entire field of mental health, crisis intervention has the highest incidence of negligence and malpractice that results in significant harm. Most of the negligence and malpractice in crisis intervention goes unrecognized by consumers and even professionals. 

Finding a competent and caring crisis intervention professional can be difficult. Very few practitioners identify themselves as a crisis intervention professional. The mere fact that a person provides crisis intervention services or is licensed in medicine, social work, counseling or psychology does not mean they are competent to deal with an emergency or an urgent  problem.  In addition, there is a growing practice in managed health care to employ people with lower qualifications and those professionals who earn the lowest pay. Many people working in crisis intervention have no formal crisis intervention training and may have only a bachelors or masters degree.  Some are not qualified for licensure.

The following are essential background and characteristics of competent crisis intervention professionals.

• Has training in crisis intervention or emergency psychological services.

• Can be reached 7 days a week and 24 hours a day if necessary.

• Can arrange scheduled appointments for up to 3 hours or as frequently as 3 times a week if necessary.

• Is available for phone contact on a daily basis if needed.

• Has experience working in an emergency room, crisis or triage center.

• Has experience providing routine as well as crisis services.

• Has knowledge of medication use, side-effects, risks and benefits.

• Is experience working with patients in a psychiatric hospital setting.

• Is licensed in medicine, social work, counseling or psychology.

Crisis Intervention and Suicide Prevention Centre of British Columbia

The Crisis Centre

Confidential, non judgmental, 24/7, FREE.

Links Available to other Mental Health Resources

The Crisis Centre is committed to working with other groups as part of the larger community providing help to people in distress. That's why we’ve created a list of links to other organizations offering mental health services and information for the Lower Mainland, BC and Canada. If you'd like to make use of this online resource, go to our Useful Links page.

ABSTRACT: The pastoral community represents a large and often untapped resource in times of crisis. It

The term pastoral crisis intervention is offered as a term that represents the functional integration of psychological

Crisis intervention is best understood in the context of the term crisis. A crisis may be thought of as an acute response

is commonly referred to as the critical incident. The term crisis intervention refers to the provision of acute psychological

This then is the practice of pastoral crisis intervention. Simply stated, pastoral crisis intervention is the functional

germane to the practice of emergency mental health (Everly, 1999). Clearly, as is evident from the definition afforded

NOTE: The author wishes to thank the following individuals for helping to shape his perspectives on this topic: Rev. Glenn

Brende, J.O. ( 1991 ). Post-traumatic symptoms and trauma recovery in the Bible. Columbus, GA: Trauma Recovery.

Clinebell, H.J. (1966). Basic types of pastoral care and counseling. Nashville, TN: Abingdon.

Everly, Jr., G.S. (1999). Emergency mental health: An overview. International Journal of Emergency Mental Health, 1,

Everly, Jr., G.S. & Lating, J.M. (in press). A clinical guide to the treatment of the human stress response. New York:

Everly, Jr., G.S. & Mitchell, J.T. (1999). Critica llncident Stress Management (CISM): A new era and standard of care

in crisis intervention. Ellicott City, MD: Chevron.

Flannery, Jr., R.B. & Everly, Jr., G.S. (2000). Crisis intervention: A review. International Journal of Emergency

Mental Health, 2, 117 - 123.

Hunter, R.J. (Ed., 1990). Dictionary of pastoral pare and counseling. Nashville, TN: Abingdon.

Sinclair, N .D. (1993). Horrific traumata. New York: Haworth

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- to respond to critical incidents involving students and to provide for the safety

- to offer counseling, guidance and support to members of the university

- to use the critical incident as a ‘teaching moment’ to enhance the quality of life

- to review and revise the crisis intervention plan every three years or as

THE PROTOCOL MANAGEMENT TEAM (PMT) – The team is responsible for

THE ON-SITE RESPONSE TEAM (ORT) – This team is a subgroup of the

- a response strategy

- who needs to be consulted

- the appropriate spokesperson

- the method of communication to the university community

- accurate account of what really happened

- how the incident is being handled

- what shall be handled in the upcoming hours and days

- who will document the description of the emergency and the response

- notifies university police

- calls 911

- calls COORDINATOR OF THE PROTOCOL MANAGEMENT TEAM

- calls DIRECTOR OF RESIDENCE LIFE

- calls DIRECTOR OF FACILITIES

- calls DIRECTOR OF HUMAN RESOURCES

- notifies VICE PRESIDENT, STUDENT EDUCATIONAL SERVICES

- mobilizes RESIDENCE LIFE STAFF

- notifies related areas (such as FOOD SERVICE, etc.)

- notifies and mobilizes appropriate staff

- designates ON-SITE RESPONSE TEAM (ORT) LEADER

- designate a PMT member to establish a line of communication with

- notifies PMT of meeting (including NEWS AND MEDIA SERVICES, HEALTH

- notifies PRESIDENT/OTHER ADMINISTRATOR/FACULTY

- prepares communication for press release

- implement University System of Maryland (USM) procedures

- provides direct service

- assesses situation and communicates to PMT

- coordinates with the Community Incident Commander

- coordinates with on-site community agencies

- prepares communication for faculty, staff, students and parents

- updates press release

- handles media inquiries and official university statements

- determines if other protocols need to be implemented or monitored

- provides additional resources to ORT as needed

- maintains open communication with community agencies

- consult with counseling staff, health staff and campus clergy for personnel

- work with HUMAN RESOURCES staff regarding employee welfare.

- prepare and submit crisis response report to PMT

- prepare report of projected personnel, financial and academic implications

- provide debriefing for ORT

- monitor need for follow up with external and internal communications

- collaborates responses with WESTERN MARYLAND HEALTH SYSTEM

- notifies UNIVERSITY POLICE

- calls 911, if this has not yet been done, and C3I if this is a Criminal Offense. If

- notifies DIRECTOR OF RESIDENCE LIFE (if on campus)

- insures safety of the area to prevent additional deaths or injury (if necessary)

- calls Coordinator of PROTOCOL MANAGEMENT TEAM

- notifies DIRECTOR OF FACILITIES and DIRECTOR OF HUMAN

- notifies VP FOR STUDENT AND EDUCATIONAL SERVICES or DESIGNEE

- calls together RDs & RAs in affected Residence Hall to work with roommates,

- designates ON-SITE RESPONSE TEAM (ORT) LEADER

- notifies all PROTOCOL MANAGEMENT TEAM members

- determines time for a meeting (most likely on site)

- contacts UNIVERSITY COUNSEL

- meets and determines the appropriate response

- notifies family or guardians and meets with them if they are present

- encourages the use of COUNSELING, CAMPUS MINISTRY, etc. to students,

- contacts MEDICAL EXAMINER’S OFFICE

- notifies PRESIDENT, VP’s, DEANS and any other pertinent administrators or

- begins development of FSU response to Media

- reports to site

- some members may go to the Hospital if the situation warrants

- identifies appropriate friends, acquaintances of the deceased as targets for

special intervention. (Special attention should be given to roommates, close

- informs UNIVERSITY COUNSEL of all pertinent information

- plans for and provides support for those involved in the crisis response (e.g.

- plans for support activities for affected groups (e.g. students in the Residence

- alerts appropriate person involved to target and monitor individuals who may

- makes contact with the family of the victim

- CAMPUS MINISTRY MEMBERS initiate plans for a Memorial Service or other

- prepares official University statement (if necessary) and drafts of written

- handles media inquiries

- prepares personal communication to the family of the victim on behalf of the

- continues response to the family of the deceased and families of those

- continues response to affected students

- meets for a formal debriefing with members

- reviews activities and makes any further decisions that are necessary

- appoints an individual to be in charge of dealing with the needs of the victim’s

- makes arrangements for flowers at the funeral

- determines appropriate persons to represent the University at the funeral

- makes funeral information known to University Community

- works with CAMPUS MINISTRY to schedule a Memorial Service

- helps coordinate any monetary matters of the deceased student with the family

- gathers for another debriefing

- reviews procedures followed during the crisis

- makes recommendations for protocol changes for the future

- COORDINATOR OF ORT makes a Report of the Crisis and Response.

- continues response to family of victim (if necessary)

- continues response to affected students (if necessary)

- initiates a series of “check backs” with the family of the victim

COMMUNITY RESOURCES:

- Red Cross

- MD State Police

- Area Clergy

- Sacred Heart Campus of Western MD Health System 24-Hour Emergency

- Allegany County Health Department

- calls 911 (ALLEGANY COUNTY EMERGENCY MANAGEMENT CENTER

- notifies UNIVERSITY POLICE

- insures safety of the area to prevent injury, with appropriate staff, leads an

- contacts FROSTBURG CITY POLICE for assistance (under Mutual Aid

- calls COORDINATOR of the PROTOCOL MANAGEMENT TEAM

- notifies DIRECTOR OF FACILITIES, DIRECTOR OF RESIDENCE LIFE and

- notifies necessary staff members (clean-up crews, RDs and RAs to

- designates ON-SITE RESPONSE TEAM (ORT) LEADER

- notifies all PROTOCOL MANAGEMENT TEAM members

- determines time for a meeting

- contacts UNIVERSITY COUNSEL

- meets to determine the appropriate action (e.g. evacuation)

- notifies PRESIDENT, VP’s, DEANS and UNIVERSITY SYSTEM OF

- begins development of FSU response and delivers information to campus and

- continues to moderate and assess on-site situation and work with University

- TEAM (or representative) visits site, gathers information and assesses

- informs UNIVERSITY COUNSEL of all pertinent information.

- work with UNIVERSITY POLICE on crowd control by issuing IDs for people to

- make campus-wide judgment calls dealing with evacuation, campus safety,

- make decisions for individuals and offer support for victims (housing,

- coordinates with victims to get in touch with their families.

- assist with relief efforts (EMTs, Red Cross, Brady Health, if needed).

- prepares media statements and drafts of written communication to the

- work with TELECOMMUNICATIONS in developing voice-mail message.

- prepares communication for the victims on behalf of the University

- continues to check on-site progress until problems are resolved

- continues to aid and support victims until resolution

- keeps UNIVERSITY PRESIDENT and COUNSEL informed on situations

- debrief and assess the situation/protocol

- continues to inform the public on situation

- works with the PRESIDENT in writing thank you letters to cooperating

- Chesapeake Dining Hall

- Cordts Physical Education Center

- Beall Elementary

- Beall High School

- Frost Elementary

- Frostburg Armory

- Frostburg Community Center

- Local church halls

- Allegany County School Buses

- Allegany County Transit

- University vehicles

- Allegany County Board of Education

- Allegany County Emergency Management Center

- Allegany County Hazmat Team

- Allegany County Health Department

- Allegany County Sheriff’s Department

- American Red Cross

- Area Clergy

- Area Fire Departments

- City of Frostburg

- Cumberland CERT (Crisis Emergency Response Team)

- Cumberland, Md., National Guard Emergency Unit

- Frostburg City Police

- Local EMT services

- Maryland State Police

- Western Maryland Health System

- notifies UNIVERSITY POLICE

- calls 911

- calls DIRECTOR OF RESIDENCE LIFE

- calls DIRECTOR OF FACILITIES

- calls COORDINATOR OF THE PROTOCOL MANAGEMENT TEAM (PMT)

- notifies VICE PRESIDENT OF STUDENT AND EDUCATIONAL SERVICES

- mobilizes RESIDENCE LIFE STAFF

- designates ON-SITE RESPONSE TEAM (ORT) LEADER

- notifies all PROTOCOL MANAGEMENT TEAM members

- determines time for a meeting

- contacts UNIVERSITY COUNSEL

- notifies PRESIDENT/OTHER ADMINISTRATORS AND FACULTY

- prepares communication for news release

- implements UNIVERSITY SYSTEM OF MARYLAND (USM) procedures

- coordinates campus response with EXTERNAL POLICE AGENCIES

- provides direct service

- assesses situations and communicates to PMT

- coordinates with ON-SITE COMMUNITY AGENCIES

- prepares communication to faculty, staff, students and parents

- updates existing press releases

- determines if other protocols need to be implemented or monitored

- provides additional resources to ORT as needed

- maintains open communication with community agencies

- consult with counseling staff and campus clergy for personnel support

- prepare and submit crisis response report to PMT

- prepare report of projected personnel, financial and academic implications

- provide debriefing for ORT

- monitor need for follow up external and internal communications

- notifies UNIVERSITY POLICE

- notifies the DIRECTOR OF PHYSICAL PLANT OPERATIONS

- notifies COORDINATOR OF PROTOCOL MANAGEMENT TEAM

- notifies DIRECTOR OF RESIDENCE LIFE, if appropriate

- reports to scene as ON-SITE RESPONSE TEAM COORDINATOR

- designates ON-SITE RESPONSE TEAM (ORT) LEADER

- notifies all PROTOCOL MANAGEMENT TEAM members

- determines time for a meeting

- contacts UNIVERSITY COUNSEL

- notifies the PRESIDENT, VICE PRESIDENTS and other pertinent

- coordinates with appropriate community authorities (e.g.: police, fire,

- gathers information available about plant failure

- prepares the plant operations office for a Team meeting

- coordinates police, fire, ambulance activities

- confers with COORDINATOR OF THE ON-SITE RESPONSE

- activates additional personnel as needed (ON-SITE RESPONSE TEAM,

- determines if other emergency protocols should be followed depending on the

- connects with other departments as necessary (e.g. HUMAN RESOURCES if

- drafts communication to university community

- contacts PROTOCOL MANAGEMENT TEAM regarding communication with

- provides additional support for those involved in the crisis response depending

- meets with VICE PRESIDENT OF ADMINISTRATION AND FINANCE to

- schedule a meeting with crisis responders to review procedures and set up a

- follow up with victims and their families as needed

- Library

- Academic Computing/Computing Services

- Chemistry

- Allegany County Board of Education, 301-759-2000

- Allegany County Emergency Management Center, 301-777-5908

- Allegany County Health Department, 301-777-5600

- Allegany County School Buses (contact: Jay Walbert, 301-729-3773)

- Allegany County Sheriff’s Department, 301-777-5959

- Allegany County Transit, 301-722-6360

- American Red Cross, 301-722-1760

- Cumberland, Md., National Guard Emergency Unit, 301-777-9395

- Frostburg City Hall, 301-689-6000

- Frostburg City Police, 301-689-3000

- Maryland State Police, 301-729-2101

- Western Maryland Health System