What sparked your interest in critical incident (CI) work?

Working with EAPs, employee clients and running my own private practice, I’d attended a range of training events with a trauma focus and had worked successfully with couples in crisis for many years. I began to notice a striking similarity between the two client groups, my employee clients and my couple clients, in that psycho-education was so important to helping clients to normalise their physical, emotional and behavioural responses to the trauma they were experiencing. Infidelity, in particular, can trigger similar responses to those who have suffered threats to their physical or emotional wellbeing and security, leaving them disoriented and confused.

This fuelled an interest in training in psychological first aid and critical incident stress management (CISM), yet the way ahead was unclear. I wanted to change my professional life as a therapist and to become more involved in critical incident work, so I joined in online discussions with those already doing the work and became a member of the UK Employee Assistance Programme Association (EAPA UK). Then, as luck would have it, BACP Workplace announced its conference in Edinburgh, ‘Working with critical incidents: prepared not scared; are you ready to respond?’ Bingo! I booked my place before I had even checked the date.

This event was quite possibly the best value for money I have ever spent on a professional conference. The delegates and speakers consisted of specialists in the trauma and CI field, including innovators, representatives from EAPs and experienced practitioners. I left this event with a huge sense of clarity, purpose and the contacts and network to make it happen.

What does a typical day look like for you?

It’s no surprise that my answer here is, ‘There isn’t one!’ It depends on the nature and location of the incident, intervention type and needs of the group/organisation that I’m working with. Sometimes, if staff redundancy consultations are underway, or if an incident has been particularly distressing, there may be a number of CISM follow-up visits, and in these cases, it’s easy to plan my diary. However, by the nature of the work, most critical incidents occur suddenly and without warning. CISM responders need to be prepared to respond at any time. Often, I need to travel the day I get the call and find a nearby hotel so that I can be on site at 9am the next day. On other occasions, I might get one or two days’ notice.

Risk assessing is vital in this work and it’s an ongoing process from the moment I receive the initial call. The circumstances which people are experiencing are often live, unfolding. Knowing how to respond appropriately is key. Once I have been assigned a CISM case, I telephone the on-site contact to introduce myself, reassure them that I am on my way, check the information given regarding the incident and clarify expectations, eg whether I am providing group intervention or one-to-one support.

What happens once you arrive?

When I arrive on site, I usually introduce myself as one of the ‘wellbeing team’ on behalf of the organisation. I prefer this term, rather than ‘counsellor’, because I find people can be a little reluctant to speak to a counsellor (and it isn’t counselling that I am doing). The purpose of my on-site visits is to ‘contain, ground, and educate’ people and offer an effective debriefing procedure to help normalise the often overwhelming psychological, physiological and emotional responses to minor, moderate and severe CIs. It’s designed to enhance the natural resilience of employees, and provide specialist support to minimise the impacts of trauma and promote positive wellbeing and recovery. The on-site CI support can take place in the form of group briefings, group recovery meetings and/or one-to-one emotional support. I also like to give information for employees to take home to friends and family so that they know how to support their loved ones because, so often, they don’t quite know what to do for the best and can inadvertently create other problems.

What do people want from you at a CI?

The people I see at a CI don’t really know what they want; their needs are high, but they are unaware of what can help. This is where the EAP and CI responders will work together to risk assess and provide their expertise in providing the most appropriate support for the individuals at the time. People are often disorientated and confused and need someone who can take charge. This is no place for being non-directive – you are deemed the expert and trusted wholeheartedly. I may be advising and supporting a manager/business leader to deliver difficult information to a large group (Crisis Management Briefing), providing subsequent one-to-one support sessions where required, or holding a CI debrief for a group of up to 20 staff members. Also, I may simply be on site to offer one-to-one support following an incident that may have occurred within the last few days or even weeks.

What skills or qualities help you to carry out this role?

You have to have confidence and belief in your own abilities to do this work, and stamina. I’m usually attending to an emotionally charged and highly distressing event and people’s needs are high. As a CISM responder, I am the person whom both the EAP and the organisation can trust and they need to know that they are in safe and competent hands. Communication and leadership skills are vital to ensure vulnerable individuals, who can often include the manager who has arranged the CISM, are reassured and have trust in both the process and in me. Due to the nature of the work being out of the ordinary and unexpected, even the most accomplished managers may find themselves completely disorientated and vulnerable – no-one is immune to a very human response. It is important to be punctual, to follow up all agreed action points on time and conduct yourself in a professional and empathic manner.

What do you get from the work?

I love the unpredictability and really thrive on the dynamic, varied nature the role brings. I get to meet people in all sorts of circumstances and venues, from city boardrooms to supermarket stockrooms, seaside hotels to industrial parks – you really never know what to expect, and it keeps me on my toes!

What’s the toughest part about being a CI responder?

The days can be long and the travelling can be tiring. When one-to-one sessions are required, I can be run off my feet with people queuing to speak to me. At other times, I may also be offering one-toone support to staff and have hardly anyone come to see me – this too can be a long, frustrating day.

One of the prerequisites of providing this work is being able to be free to respond at short notice. I’ve found that this does not naturally go hand-inhand with running a private practice and it is quite difficult to find the right balance. You can almost guarantee that if you decide to keep Mondays and Wednesdays free, you will get calls for Tuesdays and Thursdays! It’s the nature of the beast and it is an ongoing challenge to get the balance right.

Have you plans to develop this part of your practice?

Earlier this year, I was invited to train the Gloucestershire Fire Service in defusing after a critical incident and I am currently developing further training and consultancy services for organisations. I am also looking to expand my knowledge and experience into the broader world of CI and disaster planning. I’m really thrilled to have recently been recruited as a Special Assistance Team Member for a leading international disaster response and recovery organisation and I am undergoing the training required for this role currently.

If you hadn’t retrained, what do you think would have happened?

I had already begun to reduce my one-to-one clients to focus more on my couples’ work and was contemplating the idea of training as a yoga teacher. I think the latter may have been a yearning for a lighter caseload (when you leave a CI, there is rarely an ongoing relationship with the people you have met – other than a potential return visit on occasions), and variety and time away from the counselling room. It may seem odd, but CI work has given me all of these things and I feel I have the balance right (for now at least). I can honestly say it has been a welcome change in my career, and it may sound strange, but I’ve found the CI work an antidote to the early signs of burnout which I was beginning to feel after years of working alone in private practice.

What have you learnt about yourself and others through doing the work?

I have learnt that I really am quite resilient. I know how my own experiences have shaped my attitude to life (and death). I recognise how adept I am at accepting what comes at me with flexibility rather than rigidity – when times are tough, I know they will get better.

I continue to be struck by the unique interpersonal relationships and friendships created at work and the depth of care and loyalty towards colleagues. As a workplace counsellor, we often see the negative side of relationships, such as conflict, poor management, bullying and the abuse of power. In CI work, I see the complete reverse of this; I witness the strength and depth of relationships where colleagues may have worked together for up to 20 years or more, and are like ‘family’. This can determine how well the individuals or teams will recover, and it is moving to see how much people care and help their colleagues throughout this process.

There are implications for the organisations too. There can be a huge amount of goodwill towards organisations when they can acknowledge and respond to the human impact of critical incidents in a timely and appropriate way. Of course, there may well be organisational and operational issues raised by certain workplace incidents, but knowing how to respond appropriately and putting the needs of impacted staff above everything else, will reap huge benefits for everyone involved.

If you could sum up your work as a CI responder in three words, what would they be?

Alive. Unpredictable. Satisfying.

Sue Christy is a BACP accredited counsellor in private practice and a Group Crisis Intervention Specialist. She is also a member of Kenyon International Disaster Response Services. www.suechristycounselling.co.uk