Specialized Training Helps Chaplains Provide Care for First Responders
First responder sirens were wailing nearly non-stop as Hurricane Isaias churned above eastern Pennsylvania. Listening to dispatches about people trapped by flood waters, motor vehicle accidents, and a commercial structure fire, I was concerned and praying for the first responders during this storm. As Isaias swept northward, a cascade of agencies responded. And with this incident, the shoulders of chiefs, deputy chiefs, commissioners, supervisors, and other command personnel grew heavier with disaster responsibilities.
I wonder how agency leaders are keeping it together. The wellbeing of department personnel ultimately falls on the shoulders of chiefs and supervisors, regardless of workload, critical incident, or personal stress. As the saying goes, the buck stops here.
Already exhausted from the plight of COVID-19 victims, chiefs especially are experiencing the daunting task of leading their departments. Police are facing greater scrutiny and cries for defunding police departments have gained momentum, while fire departments are affected by cancer risks and lower volunteerism. At the same time, EMS personnel are often stretched beyond capacity, and the role of the dispatcher is chaotic, to say the least. I turned to Dr. Michael Pittaro for perspective on what public safety professionals are dealing with during these turbulent times:
Mental Health Challenges Facing First Responders
There are strong indications that alcohol relapses, opiate drug overdoses , and suicides are on the rise. Unchecked mental health issues are exacerbated by the uncertainty of what each new day will bring or not bring, and first responders’ duties require that they be at the center of each traumatic incident.
As a profession, first responders are at a far greater risk of developing stress-related symptoms. These symptoms, if left untreated or unresolved, may contribute to a number of debilitating physical and mental impairments, including post-traumatic stress disorder (PTSD)—especially when compared with professions outside the public safety arena.
The demands of their specialized training require that they repeatedly and routinely encounter and be exposed to traumatic incidents. Many of these incidents can have a profound, and at times, debilitating influence on their psychological and physical wellbeing. Despite extensive preparation in the form of ongoing trainings, nothing can truly prepare someone for what they will encounter when responding to an emergency situation.
This widespread emotional state has been dubbed “crisis fatigue,” says Dr. Pittaro. Although not a specific clinical disorder at the moment, it’s probable that it will be included to the next edition of the Diagnostic and Statistical Manual of Mental Disorders.
Why Chaplains are Vital for All Agencies
As a chaplain, my secret to helping public safety professionals is starting to gain traction. All departments should have a professionally trained and embedded chaplain to help support leaders in regards to the wellness of their staff.
The first responder chaplain helps bear the load and a healthy first responder chaplaincy can be a chief’s best partner. However, it’s critical that public safety leaders encourage chaplains to pursue specialized training so they can effectively understand and help first responders.
Training Programs for Chaplains
And what exactly is a properly trained chaplain? Below is a descriptive list of training credentials for chaplains and the benefits of each.
A first responder chaplain aligns themselves with agencies by taking certifications in critical incident stress management (CISM) from the International Critical Incident Stress Foundation (ICISF), the gold-standard for CISM. CISM is a comprehensive, phase-sensitive and integrated, multi-component approach to crisis and disaster intervention.
Its most recognized module is the critical incident stress debriefing (CISD). This is a group meeting occurring within 72 hours of a critical incident, like an active shooter, hurricane, officer-involved shooting or severe vehicular accident. Those invited to the CISD are always and only the first responders directly involved in the incident.
There are several other aspects to CISM which are extremely important to the overall approach of critical incident stress. Pre-event education and resilience building is one, as well as assessment and triage of people in crisis.
This is where the skills of a trained chaplain can be exceptionally effective. Utilizing the SAFER-R model of crisis intervention, one-on-one debriefings, strategic planning, and incident assessment and management, the chaplain, in concert with command staff, offers a unique perspective and significant assistance with incident management as well as personnel care.
When we talk about a critical incident, we must keep in mind that it doesn’t have to be a massive earthquake or an officer-involved shooting. A critical incident is any unusually challenging, powerful event having the potential of creating significant disruption to a person’s normal coping mechanisms. The loss of a child, a divorce, house fire, or a mugging can be distressing enough where the person begins to experience acute stress disorder (ASD); symptoms similar to, but not as pervasive as those experienced in post-traumatic stress injury (PTSI).
In my studies, I’ve come to prefer the reference to injury over disorder. As research has found, traumatic stress can cause injury to the psyche. Additionally, the use of the word “disorder” holds stigma which might prevent some people from seeking help.
For first responders, the potential for exposure to traumatic events is significantly elevated and more likely. In fact, the list of traumatic events for first responders has what is called “the terrible ten.” Suicide of a colleague, line-of-duty death, serious line-of-duty injury, personally threatening situations, and events with excessive or extrapolated media attention, are some of the events that might overwhelm a first responder’s normal, healthy adaptive behaviors resulting in acute stress disorder and potentially post-traumatic stress injury.
For the first responder chaplain, having mastery of the skills needed to engage individuals with the critical incident stress management approach is a near non-negotiable. First responders are facing greater and more frequent stress and threats on a day-to-day basis. The chaplain, trained in CISM and having developed a rapport with department personnel, serves as an immediate asset to the department, especially when a regional CISM team is unavailable or delayed. Additionally, even if an outside CISM response team is utilized, the chaplain will be able to continue care with a watchful eye on those impacted long after the team has departed.
Psychological First Aid
Additionally, chaplains are trained in Psychological First Aid (PFA), techniques for engaging people in the midst of crisis and trauma. Unlike CISM, PFA is employed for a very specific timeframe, in the immediate midst of the crisis.
PFA is especially helpful when engaging community members during a crisis. For instance, PFA is employed with waiting parents when a school has had an active shooter. Instead of leaving parents to themselves while waiting for updates, chaplains and other social service agents trained in PFA immediately engage serving as peace-bringers and even intermediaries between parents and first responders. There is no on-going or after-event component for PFA. It is an intervention applied to those impacted by trauma in the immediacy of an event. Just like physical first aid, PFA can be applied by anyone trained in its approach.
Suicide recognition and engagement is also essential for the first responder chaplain. There has been no lessening of suicides of first responders in recent years despite an increasing focus on its prevalence; the numbers continue to climb. At least 228 police officers died by suicide in 2019, more than those killed in the line of duty. The Firefighter Behavioral Health Alliance has directed their efforts toward the education of firefighter suicide and continually tracks suicides of fire fighters.
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The QPR Institute as well as ICISF, offer excellent approaches for assisting persons with suicidal ideation. There are a lot of misunderstandings with suicide, preventing people from properly addressing a person expressing suicidal warning signs. These expressions can be verbal or physical. Phrases like, “The world would be better off with out me” or “What’s the use of going on.” Likewise, people contemplating or planning suicide might begin to get their affairs in order or give away sentimental items in their preparation. These behaviors should trigger a response to healthfully engage the person in distress.
With the heightened potential for first responders towards suicide, and with police having the means to carry it out – their service firearm – chaplains can be a watchful eye for department personnel, assisting chiefs and others in caring for firefighters, police officers, EMTs and paramedics and dispatchers. Just a little training can help chaplains and others identify these common warning signs for direct intervention.
Suicide is far more about a person wanting their life to change rather than wanting to die; death just seems like the only alternative to the pain and difficulty the person is experiencing. It is important to understand the role depression plays in suicide. With first responders facing increased critique from the public, especially police, the feeling of failure or ineffectiveness is increasing. With a department chaplain, first responders are offered a listening ear before suicidal thoughts take root. If suicide does become an increasing possibility for a first responder, the trained chaplain is in the ideal position of identifying behaviors and seeking help.
Through the QPR Institute, Dr. Pittaro has been certified in facilitating suicide prevention training. Reverend Keady has completed both the general QPR GateKeeper training and those specific to firefighter, EMS and police. Soon, I will be joining Dr. Pittaro as a suicide prevention facilitator with the hopes of saturating first responder agencies with the general QPR GateKeeper training. Every chaplain should have the basic QPR GateKeeper or ICISF suicide training, no exceptions.
Training to Prepare Chaplains for Specialized Duties
Additionally, chaplain-specific organizations, like the Federation of Fire Chaplains (FFC) and The Police Chaplain Program (PCP), offer specialized courses in death notifications, line-of-duty deaths, police ride-alongs, and officer-involved shootings.
The FFC and the PCP also prepare chaplains to understand the unique cultures in first responder agencies, including EMS and dispatch.
This is just a short list of absolutely essential training for first responder chaplains. Chaplains serving agencies must be committed to not only being present but also participating in on-going training to meet the needs and challenges of first responder agencies.
Results of Chaplain Training
Having served as a chaplain in several departments, I have had numerous conversations with chiefs and supervisors about their responsibility for the overall wellness of their departments. The agencies that have added a trained chaplain to their ranks have found a caring and empathic partner.
“What can I do for you?” and “How are you holding up?” are two questions I repeatedly ask. Usually, the response is “okay.” But even when the answer requires no action on my part, I have been told that just my expressed concern brings them comfort in knowing someone has their back.
I was at a commercial structure fire recently in my township. The situation was well contained and there were no injuries. And even though my workload was light, in debriefing with my Fire Commissioner a few days later, I was struck by his comment. “For some reason when you show up on scene there’s a peace that comes over me. A sense of calm. As if I, and the department, am being watched over. I really appreciate it when you are there.”
Perhaps in the back of his mind was the list of my training in acute and critical incident stress, trauma, grief, and emotional spiritual care. He has the freedom to call on me any time, activating my skillset. This is what a chaplain does.
Chaplains serve at the pleasure of department chiefs. They offer at a minimum a Ministry of Presence, bringing calm and a watchful eye. A professionally trained chaplain can be one of the greatest assets in a department, holding the utmost of confidence with integrity and humility.
As President of the First Responder Chaplain Corps, my wish is to see every first responder agency equipped with a professionally trained chaplain. Ready to serve even the most menial of duties, the chaplain should be the perfect partner for every chief and supervisor.
About the Authors:
Reverend Peter Keady has been serving First Responder agencies for over six years. Having 20 years of pastoral ministry experience, he was presented with the opportunity of chaplaincy in serving his local fire department. Discontent with simply ceremonial duties, he sought additional training through the International Critical Incident Stress Foundation, The Federation of Fire Chaplains, and the Police Chaplain Program, holding advanced certificates will all three organizations. He currently serves four local fire departments, two municipal police departments as well as the Pennsylvania State Police. He is a responding member of the Eastern Pennsylvania Regional CISM Team and recently founded the First Responder Chaplain Corps to, develop and support First Responder chaplaincies in agencies requesting them. He has multiple certifications in CISM, suicide engagement, First Responder trauma, disaster response and spiritual care. Learn more about Reverend Keady’s efforts.
Dr. Michael Pittaro is an Associate Professor of Criminal Justice with American Military University and an Adjunct Professor at East Stroudsburg University. Dr. Pittaro is a criminal justice veteran, highly experienced in working with criminal offenders in a variety of institutional and non-institutional settings. Before pursuing a career in higher education, Dr. Pittaro worked in corrections administration. He also served as the Executive Director of an outpatient drug and alcohol facility and as Executive Director of a drug and alcohol prevention agency. Dr. Pittaro has been teaching at the university level (online and on-campus) for the past 18 years while also serving internationally as an author, editor, presenter, and subject matter expert. Dr. Pittaro holds a B.S. in Criminal Justice; an M.P.A. in Public Administration; and a Ph.D. in criminal justice.
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