Seeing Systems, Finding Home

Tag: crisis intervention

A resilience framework – connecting up, down and around

All of us are surrounded by sources of strength, resistance and resilience.  The better connected we are, socially, physically and spiritually, the more stress and challenges we can handle.

You’ll see this theme repeated in my classes and writing. For example, last month, I mentioned “Look up, look down, look around,” which is a wildland firefighting safety lesson about watching out for danger, which inspired this way of looking at resilience. In my pocket guide, Stress Management and Crisis Intervention, the theme of connecting in three dimensions repeats – out, in and up; mind, body, spirit; attitudes, activities and values.

Look around and you see social support, which psychologists repeatedly find has the strongest correlation to our resilience under stress and after trauma. Our co-workers, friends, family, mentors and other supportive people are our first line of strength when challenged or psychologically injured.

Look down and you see your body and the earth – your physical presence in creation. Through activities like yoga, exercise, sports, singing and dancing, we build and maintain connections to ourselves and the physical world. Our minds and bodies are inseparably linked when it comes stress. For example, science has found that a physical measurement, heart rate variability (HRV), correlates to both psychological and physical resilience. HRV is amazing in one respect – it doesn’t just measure your resilience, you can actually improve your ability to handle stress through biofeedback that increases your HRV. If that doesn’t convince you of how intimately our minds and bodies are linked, nothing will.

Look up and be reminded that the universe is vaster than we can comprehend, that as much as we can and should try to dissect and understand it, awe and mystery transcend logic and rationality. Spirituality in this context has to do with values and meaning, which often comes from religious beliefs.

(I included links to the Mayo Clinic web site because unlike so many stress management books and articles, they offer advice that embraces all three dimensions. Their books on stress and resilience are among the few that I recommend.)

When you are connected to these sources of strength and resilience, you know them – and they know you – with your body, heart and spirit. This is a kind of knowing that is beyond familiarity, information or even wisdom. It is a knowing that only arises from living in true relationships. It is knowing the way you know your spouse, your work, your community, your beliefs. This is the knowing that you can never completely put into words.

Looking at resilience as the result of our connections is simple and powerful. It explains our hunger for social media, as well as why it doesn’t truly satisfy (the connections are shallow and often deceptive). It shows why one-dimensional “stress management,” which usually focuses only on the physical, rarely succeeds. It helps us know where to focus when our resilience is low.

The biggest obstacle to connecting is distrust, especially when that distrust was learned at a young age. We all learn, to some extent, that we cannot trust other people, the universe or the divine, so we disconnect and become wary. If we have been deeply betrayed, some of these connections can seem threatening, even terrifying.

Distrust keeps us stuck in the “Ds” – discipline, domination, deception, drama, delay, docility, demandingness, or defiance. We are stuck socially when we don’t have people we can be real with. We are physically stuck when our health prevents us from exercising or experiencing nature. When forgiveness seems out of reach, for ourselves or others, we are spiritually stuck.

When we see and choose how to restore and nurture our weakest connections – which can be very difficult – we move from the “Ds” into the “As” – accepting, accompanying, attending, allowing, authenticity, affection, and agreement. The essence of resilience is how well we build and maintain the attitudes, activities and values that feed these qualities.

Trauma Dogs

K9 First Responders Brad Cole and Spartacus (showing off) at LV Fire & Rescue.

If you follow me, you know that I’ve been looking at the role of dogs in critical incident and trauma responses. A couple of years ago, while working for CAL FIRE at the big Lake County fires, I noticed, as did the rest of the peer support team, that dogs are excellent

icebreakers. The fact is that few firefighters will stop and talk to peer support ordinarily – but that changes when dogs are involved. Nobody judges when you play with a dog.

 

As I wrote last month, we invited many dog teams (a team is a dog and handler) to Santa Rosa during the North Bay fires in October. They certainly proved their worth. We could see people relax and open up while petting or playing with the K9s. A couple of weeks ago, one of the line supervisors, Bill B., told me how he had been doing paperwork in camp, exhausted and cranky, when he saw a dog team approaching. Go away, he thought. I’m too busy. But the team – Michael Jacobs and Molly from Hope AACR – came over to him.

Sharon Martin and Abby from Hope AACR

A minute or later, Bill said, he was relaxed and grateful that they stopped by. That’s the kind of story we want to hear!

Last Thursday, I spent the day visiting Las Vegas Fire and Rescue stations with Brad Cole, the founder of Connecticut-based K9 First Responders (KFR), and his trauma dog, Spartacus. Brad and Spartacus, along with other KFR teams, were deployed to the October 1st mass shootings. KFR has also responded to Newtown for the Sandy Hook shootings and many other crises.

We can learn a lot from dogs about crisis response. They are quite sensitive to our emotions. Recent research demonstrates how well they can read us. Many dogs instinctively go to a person in distress – Brad, others and I have seen this happen many times. It happens in my home, too – when I get frustrated, usually by a computer – Kairo, our Maltese, often comes running to me.

Our dogs, Kasha (Bichon) and Kairo (a very big Maltese)

In other words, the first thing we teach in crisis intervention – to acknowledge emotions – comes naturally to dogs. Equally important, they don’t do things many of us, especially in public safety, have a hard time resisting – they don’t give advice, try to “fix” the person or make it better. They are simply present. The fact that they can’t do anything makes dogs non-threatening; safe to be with.

Dogs don’t understand what happened, but they don’t need to. They just know when we are hurting. They show us that it isn’t necessary to understand what happened. Perhaps responders can tell family and friends that the best way to support them is to act like a dog – just be present.

PALS (Paws As Loving Support) dogs at the Valley Fire, Lake County 2015.

The helpfulness of animals for emotionally distressed people is being researched – primarily horses and dogs, but also dolphins and even cats, despite their aloofness. Eye contact and touch play big roles in helping our nervous systems calm down. Dogs and horses are sensitive to danger, so when they are calm, we know we are safe.

A 2015 literature review of research on animal-assisted intervention concluded that although research is still in early stages, “All reported positive outcomes” for traumatized people. Studies showed reduced depression and reduced PTSD symptoms.

Here in the San Francisco Bay Area, after seeing how effective dogs are, we are increasing our collaboration and integration of K9 teams in crisis response.

 

Pocket Guide to Stress Management and Crisis Intervention

Until now, nobody has offered a pocket guide covering all of the protocols and methods that we use in stress management and crisis intervention.

Good news! Now there is one.

I have written and published a 60-page pocket guide (spiral-bound with durable, Stress Management and Crisis Responsewaterproof covers), including essential references for self-care, peer support, psychological first aid, critical incident stress management (CISM), suicide, death and trauma notification and more. I’ve included sections on helping children and grieving people, and what to keep in mind when dealing with various faiths and cultures – the essentials to review and remember.

In the back of the book, I’ve included a guide on when and how to make referrals, with contact information for national crisis lines and online resources, plus plenty of space for you to write in your own contact and referral information.

For more information, including the Table of Contents, see the Pocket Guides page, where you’ll also find testimonials from the expert reviewers who helped me ensure that this is  a high-quality reference guide.

You can order the guide on Amazon, where you will also find a Kindle version.

Paper: Psychological First Aid: Rapid proliferation and the search for evidence

Psychological First Aid (PFA) – there are many different protocols, great confusion about its relationship to Critical Incident Stress Management (PFA is part of it), and it is increasingly recommended by people and organizations who often don’t seem to recognize that PFA has multiple meanings, is limited in scope and hasn’t yet been confirmed as effective in field evaluations.

I’m not a PFA skeptic – I use it and teach it – but it needs more, careful investigation.

A recent report took a look at PFA’s popularity and lack of field evaluation. The authors are from  two academic centers focused on emergencies and mental health:

The authors give a nod to the down-to-earth nature of PFA guidelines, which are “evidence-informed,” meaning that they are based on related research:

[PFA is] documenting and operationalizing good common sense – those activities that sensible, caring human beings would do for each other anyway.

As the authors observe, the lack of proof that PFA works doesn’t mean it is ineffective. It means that PFA’s effectiveness hasn’t been demonstrated.

They identified forty-eight PFA courses and materials! Yet, oddly, they failed to include one that has been around for quite a while, the SAFER-R model developed by George Everly and incorporated in ICISF CISM training.

Now the bad news.

PFA’s popularity, promotion, and proliferation have not been matched with a commensurate pursuit of evidence demonstrating its effectiveness. Not only is there a dearth of data regarding the benefits of PFA, but there is limited demonstration of widespread commitment to generate such data.

However, like other kinds of crisis intervention, PFA is difficult to study. With nearly 50 different approaches, it is hard for researchers to know exactly what care is being given. There is no way to create control groups – they have to be observed, which is daunting.

The writers offer five recommendations.

  1. Evaluating PFA with first responders, rather than disaster survivors, “may be a good place to start.”
  2. Hospital emergency rooms or other controlled settings might be good places to begin to evaluate PFA for civilians.
  3. We need to figure out how to test its effectiveness for civilians in real disasters. “Predictable disasters” such as annual flooding might create opportunities.
  4. International coordination will make evaluation most effective – agreement on methods and techniques.
  5. PFA should be adapted as the field of trauma evolves. The authors are working on an approach that suggests that early intervention can be tailored to the nature of an incident.

A similar report, by an international group of researchers for the Belgian Red Cross-Flanders, reviewed literature the literature on PFA and came to essentially the same conclusion:

The scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.

© 2026 Through the Smoke

Theme by Anders NorenUp ↑