San Diego County CISM Team

What is CISM

Additional Information

According to the US Department of Health & Human Services, a Critical Incident is defined as follows:

Critical Incidents (CIs) are highly stressful situations.  Simply put, a critical incident is a traumatic event (or perceived  life-threatening event) that has sufficient power to overwhelm an  individual’s ability to cope. Normal physical and psychological  responses occur which place considerable pressure upon that person.

When stressors becomes extremely threatening, overwhelming or  severe, it often produces a heightened state of cognitive, emotional and  behavioral arousal called Traumatic Stress. (Traumatic Stress [TS] and  Critical Incident Stress [CIS] are terms that are often used  interchangeably.) After having been exposed to traumatic stress,  employees may experience a range of reactions including deterioration of  job performance, personality change, anxiety states, relationship  discord, grief reactions, depression and suicidal idealizations. These  effects can be immediate, appear later or both.

FOH describes a continuum of trauma (special, critical and  catastrophic) each of which requires a different level of response. This  is detailed in the CISD policy.


  • An employee who shoots a supervisor in the workplace
  • Workers at a site witness an industrial accidental death of one of their co-workers
  • An attorney in a large law firm commits suicide over the weekend
  • Bank tellers are held up at gunpoint by masked robbers
  • A city vehicle accidentally runs over a pedestrian who dies in front of other city employees
  • Air-traffic controllers are unable to avert major airline disaster and witness the plane crash
  • A group of school children are held hostage and injured
  • An earthquake occurs at a company branch location
  • Any incident where sights, sounds or odors are so distressing as to  produce an intensive emotional response, i.e. flashbacks to other  traumatic events


Early intervention by both professional and peer-support personnel  who are specially trained and follow an established standard of stress  intervention techniques affect recovery from traumatic stress  positively. Experts believe debriefing can help individuals improve  their coping abilities and dramatically decrease the occurrence of Post  Traumatic Stress Disorder (PSTD). The debriefing is a process in which  traumatized individuals are led through a series of steps to: discuss  their experiences, to be supported and to learn coping strategies.

When efforts to support traumatized employees are limited, delayed or  non-existent, a Traumatic Stress Reaction may develop into  Post-Traumatic Stress Disorder (PTSD), the pathological result of  neglected Traumatic Stress. The EAP is called upon to provide Critical  Incident Stress Debriefings (CISDs) to employees of client organizations  who have been exposed to work-place Critical Incidents.


A Critical Incident is a traumatic event or perceived event that has  sufficient power to overwhelm an individual’s ability to cope. When the  stressor becomes extreme or severe, it often produces a heightened state  of cognitive, physical, emotional and/or behavioral reactions. Critical  Incident Stress Debriefings were developed as a tool to help  individuals cope with their exposure to traumatic events.

The concept of a Critical Incident Stress Debriefing (CISD) embraces  the tenets of a crisis theory which believe that after exposure to a  traumatic event: 1) people may need additional coping skills to deal  with the event and 2) people are usually open to acquiring new skills  after being exposed to critical incidents.

Special Incidents:

Special Incidents usually do not involve the workplace. The  appropriate intervention is at the Staff Counselor level. Examples of  Special Incidents include:

  • Employee involved in an auto accident
  • Employee death due to natural causes
  • Other requests identified by the agency

Critical Incidents: 

Incidents that involve or directly impact the workplace. The level of  trauma can range from low to moderate level of workplace trauma.  Production may be effected in some way. The appropriate intervention is  at the Staff Counselor level with assistance from the Regional  Supervisor if necessary.

Examples of Critical Incidents include:

  • Clerk is robbed
  • On-site death
  • Employee threatens violence or takes violent action against a co-worker
  • Work site accident
  • Employee killed in auto accident
  • Employee suicide

Catastrophic Incident:

Catastrophic Incidents are those situations which have an extreme  impact on the workplace. These incidents significantly impact the work  site, may draw media attention or significantly impact work site  production. The level of trauma to the work site and employees is  extreme. Examples of Catastrophic Incidents include:

  • On-site shooting or hostages involved
  • Bomb explosion
  • Natural disaster, such as earthquake, tornado, hurricane, etc.
  • A severe level of trauma to a large number of employees or the workplace production is severely effected or stopped

San Diego County CISM Team is a 501 c3. We are a sister  organization to International Critical Incident Stress Foundation  (ICISF) and work to educate CISM providers with the most cutting edge  training needed to care for those affected by tragic incidents.