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The
American Academy of Experts in Traumatic Stress
serves a timely and important role in providing
standards of psychological care for those who
regularly work with survivors. The development
of new models for the delivery of crisis intervention,
the heightened frequency and visibility of traumatic
events throughout the past 15 years, and organizational
trends in proactive medical management and ethical
leadership have converged to create a need for
the rapid and widespread delivery of post-trauma
psychological care. The success of such a mission,
given the varying disciplines involved, requires
clearly defined standards of practice by which
all providers from first responders to doctors
may assist victims of trauma in a coordinated
and effective manner.
Identified by George S. Everly,
Jr., Ph.D. and Jeffrey T. Mitchell, Ph.D. as
the harbinger of "A New Era and Standard
of Care in Crisis Intervention," Critical
Incident Stress Management is representative
of the fruit of the renaissance of crisis intervention
now sweeping throughout municipalities, corporations,
and schools. Federal and state level governments
as well as numerous agencies such as the National
Transportation Agency (NTSB), the Federal Emergency
Management Agency (FEMA), the American Red Cross,
and non-profit providers such as the National
Organization of Victims Assistance (NOVA) have
all significantly expanded their roles in the
delivery of post-trauma psychological care.
Coinciding and, in some ways
driving these advancements in post-trauma psychological
care has been a decade of unprecedented media
exposure to enormous loss and human suffering
secondary to natural and man-made disasters.
This heightened awareness and sensitivity to
the needs of those caught in the grips of traumatic
events has also served to advance new federal
laws, recommendations, and recent court rulings
calling for higher levels of accountability
and standards for attending to the emotional
needs of trauma victims.
Firm and unrelenting appeal
to the U.S. Congress by family members voicing
outrage at public hearings over the insensitivity
and mishandling of the response by airlines
following disasters such as USAir flight 427
in Pittsburgh, and ValuJet resulted in sweeping
changes with regard to how the National Transportation
Safety Board, the American Red Cross and airline
companies respond to victims of disaster. The
new protocols, appearing in The Aviation
Disaster Family Assistance Act of 1996 clearly
establishes the NTSB as the agency in charge
of managing airline disaster sites and expands
the role of the American Red Cross to "provide
for the emotional well being of the families
of survivors and those whose lives are lost
in an aviation disaster." Moreover, airline
companies must now comply with a long list of
"assurances" under the Act to ensure
proper response to family members including
prompt notification and the provision of crisis
care services as needed.
Likewise, family members and
loved ones of many of those victimized by the
18,000 workplace assaults and 20 homicides occurring
in the U.S. workplace every week, as reported
by the National Institute for Occupational Safety
and Health in its June 1996 report on Violence
in the Workplace, have also played an important
role in how organizations respond to traumatic
incidents. After two years of review and input
by victim advocates and industry leaders, the
U.S. Department of Labor and the Occupational
Safety and Health Administration published in
April of 1998 its Recommendations for Violence
Prevention Programs in Late-Night Retail Establishment
(OSHA 3153). These recommendations serve
to guide employers in the development of violence
prevention plans, advises employers to "arrange
appropriate treatment for victimized employees,"
and identifies Critical Incident Stress Management
as an "emerging trend" in interventions
used to reduce psychological trauma and stress
among victims and witnesses.
Striving to meet the needs
of the nations 38 million crime victims, the
U.S. Department of Justice, Office for Victims
of Crime released New Directions from the
Field: Victims Rights and Services for the 21st
Century. This compilation of more than 250
recommendations produced through the input of
over 1,000 individuals from different professions
includes the recommendation that "federal
and state laws should be amended to ensure that
the government covers mental health counseling
costs for crime victims."
Where state statutes cease,
the employers responsibility increases. The
Ohio Supreme Court recently ruled in Bunger
vs. Lawson Co. that - in the absence of
a workers compensation remedy - a convenience
store clerk may sue her employer for negligence
for alleged psychological injuries she suffered
after a gunman robbed the store where she worked.
All told, these rulings, recommendations
and laws have served to set a tone of sensitivity
and accountability for addressing the needs
of those victimized by traumatic events. Where
employers and insurers once viewed post-trauma
psychological care as an unnecessary and costly
"therapy" that could in fact imply
liability, today, those who practice proactive
risk management and ethical leadership immediately
acknowledge traumatic events and take responsibility
for providing an immediate response to the psychological
needs of those exposed to traumatic events.
In fact, the crisis management communications,
medical management and post-trauma crisis intervention
that follow most traumatic incidents may now
be most effectively delivered in the context
of a single yet essential and comprehensive
risk management tool referred to as "crisis
care management." Today, federal and state
agencies, school districts, municipalities employers,
EAP providers, third party (claims) administrators,
and insurers increasingly look to professionals
trained in post-trauma psychological care to
meet the needs of those exposed to traumatic
incidents and to assist in the delivery of crisis
care management services.
Now more than ever, those charged
with the responsibility of answering the call
to provide care for victims of trauma look to
the Academy for the leadership, vision, and
professional standards that will guide the advancement
of care provided by those who regularly work
with survivors of trauma.
©1999 by
The American Academy of Experts in Traumatic
Stress, Inc. |
