CISM Services Aid in Trauma Recovery

Sherry Baldwin
Posted on August 1, 2009

For two decades, critical incident stress management (CISM) services have been offered to emergency services professionals for the purpose of reducing the effects of critical incident and cumulative stress. One of these services is the “one-on-one,” which provides a trained debriefer for an individual who has experienced a traumatic incident. Another type of intervention is CISD (critical incident stress debriefing). CISD is designed for a group of people who have experienced a traumatic event.

While Asheville, N.C.-based Buncombe County Schools’ Safe Schools Plan has excellent written procedures, policies and protocols for school bus accidents and emergencies, nothing was provided to the bus drivers for the trauma they experienced during such incidents. School counselors usually assist students involved in a school bus accident, but most often, the bus driver completes his or her accident paperwork and goes home until the next scheduled bus run.

Drunken driver causes school bus accident
In 2008, one of Buncombe County Schools’ bus drivers had a drunken driver pull into the path of his fully loaded bus on the way to a local high school. The bus driver kept the moving bus upright until the bus was stopped by the front of a store.

Although no students were injured, the drunken driver died on the scene, and his passenger suffered serious injuries. As a former firefighter who was familiar with rapid response techniques, the bus driver was able to safely evacuate the students from the bus, call for help and calm the upset students. Shortly thereafter, the passengers were checked on-scene and then transferred to another bus to continue to school.

The bus driver, meanwhile, provided information to the highway patrol, took his mandatory drug test, finished his paperwork and was driven back to his car by Harold Laflin, the district’s director of transportation.

Coping with the trauma
During the ride, Laflin recognized that the driver was exhibiting classic signs of acute trauma — confusion, inability to make decisions, anxiety, crying — and determined that his driver needed assistance.

Laflin contacted our school system’s Student Response Team, a group of crisis-trained counselors and social workers, to ask for an assessment and intervention.

As a crisis and trauma counselor, I was impressed that our transportation director was savvy enough to recognize the needs of his bus driver and ignored the old stigma of “just suck it up and go on” that results in unnecessary cumulative stress for the bus driver.

When I arrived at the high school, the driver’s wife was waiting to drive her husband home, so I was able to debrief her, decrease her anxiety level and educate her on common reactions to stress and ways to help relieve it.

When her husband arrived, she did an excellent job of providing calm reassurance and encouragement for her husband and told him to take as long as he needed to review and process the accident with me.

An immediate look of relief spread across his face as he walked with me to a private conference room. The driver’s wife had told me that her husband didn’t talk much and that I should not be surprised if he declined to discuss the incident with me, so I was comfortable with offering him some decompression and quiet time in the event that he chose not to talk.

Instead, he took over an hour to discuss at length:

1. what happened (known as the Fact Phase),
2. his thoughts about the incident (known as the Thought Phase), and
3. his reactions to the incident (known as the Reaction Phase).

In addition, we were able to discuss the symptoms of stress that he was experiencing and the fact that it was normal to experience those symptoms following an accident. I was also able to do some informal teaching about how to cope with reactions to stress in the future, and how to manage his return to service.

Over the next few months, the driver did well, and although I checked on his progress, we did not need to meet again. The next time I saw this gentleman was at the last school board meeting of the year. I sat with the bus driver and his wife until he was called to the podium to receive an annual award for the most outstanding school bus driver of the year.

CISM training at your operation
Much is now known about critical incident and cumulative stress, and how stress affects people in their jobs and personal lives.

Most individuals who experience a traumatic incident like the Buncombe County Schools bus accident last year eventually recover without intervention. However, the CISM interventions can often speed up the recovery and facilitate an accurate, overall picture of the incident that minimizes self-doubt and emphasizes healthy functioning.

The likelihood that the bus driver whom I worked with will leave his job is reduced because of the concern and support expressed about his welfare and recovery.

CISM can be a part of every school district’s pupil transportation department. The International Critical Incident Stress Foundation (ICISF) Inc. Website,, has information on how to locate trained individuals in your area and information about training that could benefit your operation.

By making CISM a part of Buncombe County Schools’ Emergency Bus Transportation Plan, we have added an additional layer of safety for the healthy functioning of students and, especially, for our valued school bus drivers.

Sherry Baldwin has been a counselor educator and school counselor since 1975 and has worked at Buncombe County Schools since 1983. Upon retirement from Buncombe County Schools within the year, Baldwin will work with local law enforcement agencies to offer crisis services and CISM to officers and crime victims.

ICISF courses and training

The International Critical Incident Stress Foundation (ICISF) Inc. offers multiple ways for organizations to receive CISM training, such as having an ICISF-approved instructor come to a location to teach a course.

The courses include Group Crisis Intervention; Individual Crisis Intervention and Peer Support; Suicide Prevention, Intervention and Postvention; and National Guard-Trained Crisis Responder: Terrorism and Disaster Response, among others.

As a sampling of the skills that can be obtained from these courses, in Group Crisis Intervention, the fundamentals of CISM are outlined. Participants learn tools to provide several group crisis interventions, specifically demobilizations, defusings and CISD.

For referrals of instructors near your operation, contact the Approved Instructor Support department at [email protected]. Your location and which course(s) you are interested in should be included in the e-mail.



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