Information for Clinicians
Download these papers:
A Narrative Approach to Critical and Sub-Critical Incident Debriefings
by Joel Fay, Psy.D 1999
A Residential Milieu Treatment Approach for First Responder Trauma
by Fay, J. Psy.D, Kamena, M. D. PhD, Benner, A. PhD, Buscho, A. PhD
Emergency Responder Exhaustion Syndrome (ERES):
A perspective on stress, coping and treatment in the emergency responder milieu
by Fay, J. PsyD, Kamena, M. D PhD, Benner, A. PhD, Buscho, A. PhD & Nagle, D. - October 11, 2005
The Change in the First Resonder's Trauma Symptoms after Participation in a Residential Recovery Program
by Sally Ann Cantrell - July 2010
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Introduction
The purpose of this letter is to provide relevant clinical information about the West Coast Post-trauma Retreatsm (WCPR) program to assist clinicians in making appropriate decisions regarding referrals to WCPR.
An Overview of our Program
WCPR is a residential program that combines clinical work, education and peer support into a five-day residential treatment model. Six people attend each program. We believe the pre-morbid functioning for public safety personnel who attend WCPR was at an appropriate level before their involvement in a critical incident.
Our Goal
Our goal is to return the individual to their pervious level of functioning. Our experience has demonstrated that in the aftermath of a critical incident the worldview of public safety personnel is often challenged with negative consequences. These can include biased or inaccurate media coverage, the necessary administrative/legal investigation process, temporary suspension from full-duty status, stress upon personal relations, second guessing their own actions during the critical incident and the undermining of confidence and beliefs about oneself. If left unchallenged these altered worldviews can disrupt the lives of otherwise psychologically healthy individuals.
Our Treatment Model
WCPR utilizes a psychosocial model designed to restore the equilibrium in a person's life by challenging faulty cognitive beliefs through education, peer support and clinical work. To accomplish this we utilize an in-depth intake process, individual and group therapy, peer counseling and support, critical incident debriefing protocols, Eye Movement Desensitization and Reprocessing (EMDR), and family of origin work. The psycho-educational portions of our program include classes on alcohol and substance abuse, the physiological effects of stress during and after a critical incident and goal planning and setting.
Our Staff
WCPR is fortunate to have psychologists on staff that are current or retired career law enforcement officers. This provides an elevated level of cultural competence, which is called upon throughout the participant’s stay at the program.
Why It Works
Our experience with the public safety personnel population has shown that although they may engage in treatment, as a group they are prone to taking a “flight into health.” The five-day residential model ensures that such diversionary defenses are minimized and residents remain focused on their core issue(s). Also, the elevated level of cultural competence of the peers and clinicians results in the participant perceiving and evaluating the situation more realistically. The resulting therapeutic alliance(s) is strong and develops quickly. Towards the end of the week, this alliance is easily shared with outside clinicians that come to assist in EMDR or one on one therapy. It has proven an asset to the participants in developing their written 90-day plan of action as part of their relapse prevention program.
The WCPR Participant
The WCPR participant has often received treatment in their community but has not responded favorably or sufficiently. Most of our participants have difficulties functioning at work and/or at home as a result of their involvement in one or a number of critical incidents. Participants are often diagnosed with depression, anxiety, adjustment, eating, sleeping and/or substance-related disorders. About half of our participants are diagnosed with Post Traumatic Stress Disorder.
Why We’re Different
We recognize that there is conflicting literature on the efficacy of “revisiting the incident” for the trauma survivor. Public safety personnel have been highly screened, extensively trained and tend to be more emotionally robust than the general public. Our experience with this population indicates that there is a need to revisit and “master” the situation for most public safety personnel. Mastery can occur through education, cathartic reaction and/or peer support. Mastery occurs when the participant gains greater understanding about and begins to exercise some control over the effects of the critical incident. This allows the participant to reclaim parts of their lives that were taken by the event.
Peer Support Format
The peer support format is key to challenging the participant's belief that their experience is unique. The peer support format allows the participant to realize that they are part of an association of people who have experienced and survived similar incidents. Throughout the program the participant listens to a variety of stories concerning each participant’s critical event and observes and learns from the reactions of others. Having first responders on staff that have experienced and recovered from critical incidents provides hope and recovery modeling to participants.
The Next Step
The WCPR program is not a "stand alone" program. We encourage participants to engage with mental health professionals in their community. We make ourselves available for follow-up consults. Our peer and clinical staff follow each participant's progress, by phone or email, for ninety days after the program's completion; if helpful, even longer.
Questions?
Our Clinical Director is Mark Kamena, Ph.D and he can be reached at (415) 717-3447, or by email: wcpr2001@aol.com
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