Saving Our Own Takes On New Meaning
By Eriks Gabliks
When a firefighter calls a Mayday on the fireground, we call on every resource available. We spend countless hours training to ensure we take lifesaving action when a Mayday is declared. We also work so our Rapid Intervention Team (RIT) tasks are proficient.
In contrast, what do we do when a firefighter needs assistance and is NOT at an emergency incident? What do we do when a firefighter cannot use one word, like Mayday, to express distress manifested as anxiety, burnout, depression, and other mental and behavioral health concerns? Root factors may be job related such as a firefighter dealing with the death of a small child at a motor vehicle crash, or factors may not be related to the job such as a firefighter having challenges in his or her personal life.
The National Fallen Firefighters Foundation (NFFF) and its national campaign to reduce and prevent firefighter injuries and deaths through the creation of the 16 Firefighter Life Safety Initiatives are front and center in the fire service community. The Foundation is known for developing comprehensive and well-designed resources and training classes that have been implemented in both training programs and the fire service culture across the nation. Well, they have done it again!
Firefighter Life Safety Initiative 13. Firefighters and their families must have access to counseling and psychological support.
The NFFF unveiled a new “set of tools” on March 1, 2013, in Baltimore, Maryland, to address Life Safety Initiative 13, Behavioral Health. This new model includes three components for emergency responders:
• After Action Review (AAR) is a post-incident assessment procedure adopted from the military “Hot Wash” model. It provides a meaningful way to review the incident response and answer questions. An AAR relieves anxiety and uncertainty and provides a safe environment to discuss the emotional impacts of the event if needed. It should be used at the company or crew level on every call, “every time wheels roll.” Daily use, like daily use of ICS, builds proficiency in the process, contributes to safer operations and provides a solid foundation for using the process that is critical in the aftermath of major events.
• NEW NFFF Training Everyone Goes Home: After Action Review (No Cost at the Fire Hero LEARNING NETWORK) After Action Reviews (AAR) offer the fire service the opportunity to formalize the tradition of informal postincident conversations into a simple, but systematic, guided process of analyzing, refining, and improving incident response. This learning module explains the origins of AAR, its application to the fire service, how to implement it, and the important role it plays in culture change.
• Stress First Aid is a peer-to-peer model with the goal to reduce distress, foster adaptive functioning, provide tangible organizational support and increase the individual’s sense of competence and confidence. Stress First Aid was adapted from the Combat Operations Stress First Aid (COSFA) model used by Marines Corps and Navy personnel. This program is very successful and has been tested in the field in combat situations as well as in noncombat environments. Stress First Aid recognizes that one size does not fit all, that not everyone is equally affected by any given event and that not everyone needs the same things to help them through the stresses that come with fulfilling their mission. Stress First Aid is designed to be an embedded function that is initiated by peers when they observe a change in functioning, hear statements of internal distress, or in the event of a known stress exposure.
• Curbside Manner: Stress First Aid for the Streets is a version of Stress First Aid (SFA) that has been adapted for the fire service to use with civilian applications. It reduces distress, fosters adaptive functioning, and makes people feel cared for and respected. By using these basic skills every day to help the people we serve, Curbside Manner prepares firefighters to automatically apply those same skills to our interactions with one another.
• NEW NFFF Training Curbside Manner: Stress First Aid for the Street (No Cost at the Fire Hero LEARNING NETWORK) Just as doctors talk about “bedside manner” when talking to patients, the “curbside manner” of first responders NAFTD UPDATE really makes a difference in how people experience and process a difficult life event. This learning module teaches “curbside manner,” a set of proven principles and actions that help first responders assist civilians in crisis by ensuring their safety, understanding their individual needs, meeting those needs, and promoting the connectedness and self-efficacy necessary for recovery. Each principle — cover, calm, connect, competence, and confidence — is first shown in action, then explained in detailed, practical language.
The principles taught in Curbside Manner are also the core principles of the Stress First Aid program developed for organizational and peer support in the fire service. However, Curbside Manner differs from Stress First Aid. You can read about these differences in the Student Manual available in the Resources section of this module.
The final segment of this comprehensive NFFF program aids the mental health professionals who serve both career and volunteer fire service personnel. Many of us have sent firefighters to our Employee Assistance Program only to hear later that the firefighter felt it was a total waste of time as the counselor had no idea what fire-rescue personnel do and most of the time was spent explaining the challenging situations that are encountered on the job. To address this, the NFFF staff worked with the Medical University of South Carolina to prepare a web-based training program to train mental health professionals who are or will be providing assistance to the fire service. Helping Heroes is one of a number of programs that the NFFF created over the past five years in partnership with various national fire service organizations including the assistance of the National Center for Posttraumatic Stress Disorder (NCPTSD) and the National Crime Victims Research and Treatment Center (NCVRTC).
Fire departments are typically served by dedicated clinicians who truly desire to provide firefighters and their families with the best care possible. Like most practitioners, the majority of those assisting fire department members and families may not have the time and resources needed to learn all they might need to know about firefighters and their occupation. Few clinicians can afford to take significant time away from their practices to acquire complex new skills, especially if firefighters make up only a portion of their client population.
Helping Heroes provide a web-based (open access) training package designed to run on all popular software and hardware platforms. The program is divided into ten training modules requiring approximately one hour each to complete, and an eleventh component that will serve as a session-by-session tool kit guide. Helping Heroes will reach the full spectrum of mental health care providers who now serve or may be called upon to serve firefighters and their families and to provide them with easily accessible instruction that will enable them to apply the very best evidence-based techniques to the issues their fire service clients present. This training program is available without cost to the learner.
Funding for Helping Heroes was provided through DHS/FEMA’s Grant Program Directorate for Assistance to Firefighters Grant Program - Fire Prevention and Safety Grants. This NFFF project and the free web-based training tool, Helping Heroes for Mental Health Professionals Serving Firefighters were completed a few weeks ago and are available online through the Everyone Goes Home web site at
http://flsi13.everyonegoeshome.com.
We spend a lot of time with our crews in training. We preplan buildings, pull hoselines, practice specialized rescue techniques, review incidents, and discuss strategy and tactics, but we should also ensure our folks are trained to care for each other. Please visit the NFFF web site, or contact your state NFFF advocate for a complete listing of training programs available to the fire service.
About the author
Eriks Gabliks is the President of the North American Fire Training Directors (NAFTD). He also serves as the Director of the Oregon Department of Public Safety Standards and Training (DPSST) and oversees its 212-acre Oregon Public Safety Academy. Eriks has been in the fire service since 1980 and holds a bachelor’s degree in Fire Administration from Western Oregon University and a master’s degree in Public Administration from Portland State University.
