Firefighters Helping

Firefighters An Overview of

Clackamas Fire District #1’s Peer Support Program

  

2014 Oregon Fire District Directors Association Fire Service Conference 

 

10/28/2014

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Firefighters Helping Firefighters

An Overview of

Clackamas Fire District #1’s

Peer Support Program

“Just Doing Their Jobs”

Hitting Close to Home

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Firefighters Have a High Risk of…

• Divorce

• Substance Abuse Problems

• Mental Health Issues

Stress in the Fire Service

• The Most Stressful Jobs of 20141. Enlisted Military Personnel2. Military General3. Firefighter4. Airline Pilot5. Event Coordinator6. Public Relations Executive7. Corporate Executive8. Newspaper Reporter9. Police Officer10. Taxi Driver

Why are Firefighters #3?

• Personality

• Characteristics of Emergencies

• Characteristics of the Job

• Perception Shift

• Control Issues

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Types of Stress

• General Stress

• Cumulative Stress

• Critical Incident Stress• Normal response of normal people to abnormal

event• 85% of firefighters have experienced stress reactions

after tough call(s)

Types of Stress

• Delayed Stress • Post Traumatic Stress

• 1-2% risk in general population• 16-20% risk in Emergency Responders

• PTSD Warning Signs• Dissociation• Traumatic dreams• Memory disturbances• Self-medication• Out of control anger, hostility, irritability• Persistent depression• Panic attacks• Persistent/intrusive recollections

Stress Response

• Fight or Flight• Enhances ability to work under pressure

• Stress response usually self-regulating• Adrenaline and Cortisol

• Curbs nonessential functions

• Problem when fails to turn off

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Brain Becomes Conditioned

• Firefighters at Higher Risk• Digestive issues (antacids)• Muscle pain, stiffness and fatigue without injury• Decreased immune system

Chronic Stress and Disease

• Excessive stress = health problems• Increased risk of

• Heart disease• Sleep problems• Digestive problems• Depression• Obesity• Diabetes• Memory impairment • Worsening of skin conditions, such as eczema

What is Peer Support?

• Confidential assistance and appropriate support resources to employees and family members when personal or professional issues negatively affect their work performance, family unit or self.

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Why Peer Support?

Oversight Committee

• Representatives from:• Labor• Management• Line Firefighters• Administration• Wellness• Chaplain Program• Human Relations Committee

Initial Selection

Nominated by Peers

Peers Volunteering

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Nomination Survey

ICISF Training

• CISM: Individual Crisis Intervention and Peer Support

• CISM: Group Crisis Intervention

Peer Support = Counseling?

• Peers Mitigate Crisis Response• Acknowledge• Normalize• Encouraging Effective Coping Mechanisms• Assess Need for Follow Up

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Interventions

• Individual

• On-Scene Support

• Defusing

• Formal Group Work (Debriefing)

• Follow-Up

Handbook

Peer Responsibilities

• Provide emotional support during and after times of personal or professional crisis

• Refer peers to appropriate outside resources, when necessary.

• Be available for follow-up support• Maintain general records• Agree to be contacted and, if practical, respond at any

hour• Abide by "Confidentiality Agreement" • To successfully complete the 4 day ICIFS required trainings• Attend one continuing education meeting per year (three is

preferable)

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Confidentiality- ORS 181.860

• Communication is privileged IF

• The communication occurs during a peer support counseling session (meaning both parties are aware that the Peer Supporter is acting in his/her capacity as a Peer Supporter)

• The communication is with a person who has been designated and trained as a Peer Supporter

Confidentiality- ORS 181.860

• The Confidentiality Law does NOT apply to:

• Any threat of suicide or homicide made by a participant in a peer support counseling session, or any information conveyed in a peer support counseling session relating to a threat of suicide or homicide;

• Any information relating to abuse of children or of the elderly, or other information that is required to be reported by law; or

• Any admission of criminal conduct

Confidentiality Agreement

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Compensation

• Training Classes and Peer Support Meetings• Replacement will be covered if it is a normal shift

day• Attendance will be volunteer time if it is not a

normal work day

• Responding to a Call for Peer Support• When responding to a call for Peer Support, Peer

Supporters will be compensated from the time they are called until they are finished with the incident.

Recordkeeping

Adding Peers

• 2011- 11 more trained• 2013: 12 more trained (plus 4 Chaplains)• We currently have 33 trained Peer Supporters

• Fire Chief• 2 Battalion Chiefs• 6 Officers• 5 Apparatus Operators• 8 Firefighters• 2 Administrative Managers• 4 Administrative Staff• 2 Fire Prevention Staff• 2 Volunteers• 1 Liaison to Retiree’s

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Contacting Peers

Types of Contact

• Anytime

• On-Scene

• Post-Incident

• NO SELF DISPATCH!

Triggers

• Like beauty, it’s in the eye of the beholder.

• Response to event- not event itself

• Individual Factors• Personality• Existing Conditions• Coping Skills• Support Systems

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Pre-Incident Education

• Remind• Signs/Symptoms• Effective Coping Strategies• Resources Available

• Recruit• 1st Week of Hire

• Annual by Peer Supporters

Resources for Peers

• EAP• Free• 24-hour crisis assistance• Confidential • 4 visits per issue• Legal and financial services• Personal Advantage website • Supervisor Consultations• Offer CISD’s

Resources for Peers

• Chaplains

• Contracted Behavioral Health Specialist

• Other Fire Agencies

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Resources for Peers

• Education• NW Peer Support Conference• Code 4• ICISF• CFD Couple’s Communication Classes

Resources for Peers

• Web Based• Internal D1net• Oregon Peer Support• IAFF• NVFC

Additional Help

• West Coast Trauma Retreat

• Addiction Treatment Centers

• Mental Fit for Duty Services

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Keeping Peer Supporters Engaged

• Meetings- 3x’s per Year• Housekeeping• Data• Old and New Business• Intervention Updates• Continuing Education

Support for Peer Supporters

• What makes a good peer supporter also makes them vulnerable.

Evaluating Success- Data

Documented Interventions 2010: 112 2011: 98 2012: 159 2013: 257

EAPYear New

CasesF2F Visits

Top 3 Issues

2013 34 91 1. Couples/Relationship 2. Grief 3. Family/Parenting

2012 30 78 1. Couples/Relationship 2. Family Parenting 3. Grief

2011 21 51 1. Couples/Relationship 2. Family/Parenting 3. Depression

2010 13 1. Family/Parenting 2. Couple/Relationship 3. Stress-home

2009 11 1. Couple/Relationship 2. Depression 3. Financial Issues

2008 19 1. Couple/Relationship 2. Family/Parenting 3. Depression

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Evaluating Success- Data

• Mental Health Assessment

Evaluating Success- Data

• Mental Health Assessment

Evaluating Success-In their words

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Growing the Program

• Continue to add Peers

• Liaison to Injured/Ill

• Mini-Academy for EAP Providers

• Spouse Peer Supporters

Peer Support- A Chief’s Perspective

Questions?

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Contact Information

• Heather GoodrichHealth & Wellness ManagerClackamas Fire District #1(503) 742-2686Heather.goodrich@clackamasfire.com

• Fred CharltonFire ChiefClackamas Fire District #1(503) 742-2600Fred.charlton@clackamasfire.com

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Appendix A CLACKAMAS FIRE DISTRICT #1 

PEER SUPPORTER CONFIDENTIALITY AGREEMENT  

I hereby acknowledge that in carrying out my role as a member of the Clackamas Fire District #1 Peer Support Program, I may become aware of confidential personal and/or medical information concerning members of Clackamas Fire District #1 and their families. I agree not to disclose such information to any person outside of the Peer Support Team. I have reviewed O.R.S. 181.860 and understand that the legal protection covering peer support communications does not apply to the following exceptions: 

1. Any threat of suicide or homicide, or any information relating to a threat of suicide or homicide; 

2. Any information relating to abuse of children or of the elderly, or other information that is required to be reported by law; 

3. Any admission of criminal conduct. 

Disclosure of confidential peer support communications to any other party will not be provided 

without the expressed consent of the involved Clackamas Fire District #1 member or family member, 

except in cases involving the above exceptions. I understand that I am expected to notify the Wellness 

Manager of any peer support communications involving the above exceptions. 

I understand that violation of this agreement will subject me to removal from further participation in 

the Peer Support Program. 

 

 

__________________________________         Print Name           

 

_____________________________________      ______________________________________ 

     Signature                  Wellness Manager  

__________________________________      ___________________________________ 

                                  Date                  Date 

 

 

CLACKAMAS FIRE DISTRICT #1 PEER SUPPORT ACTIVITY LOG 

 Name:______________________________________________              Year: _______________ 

 Intervention  Jan  Feb  Mar  Apr  May  Jun 

1‐1 Post Incident 

           

1‐1 Other 

           

1‐1 Follow Up 

           

Group Defusing (Total # people) 

           

Informal Group (Total # people) 

           

Formal Group  

Debriefing (Total # people) 

           

Follow Up Group 

(Total # people) 

           

 

Intervention  July  Aug  Sept  Oct  Nov  Dec 

1‐1 Post Incident 

           

1‐1 Other 

           

1‐1 Follow Up 

           

Group Defusing (Total # people) 

           

Informal Group (Total # people) 

           

Formal Group  

Debriefing (Total # people) 

           

Follow Up Group 

(Total # people) 

           

 

Clackamas Fire District #1 Peer Support Program

After a Critical Incident

Below are some basic stress management principles that have been shown to help mitigate some of the reactions the body has to a critical incident.

WITHIN THE FIRST 24 - 48 HOURS periods of appropriate physical exercise, alternated with relaxation will alleviate some of the physical reactions.

Eat nutritious foods: fresh fruits, vegetables, and a balanced diet (even

if you don’t feel like it).

Moderate your intake of caffeine

Avoid alcohol or other depressants

Keep rested; remain on a schedule for sleep and other relaxing activities

Structure your time, keep busy. Avoid changes in your daily routine

Find a friend or support source to talk about the incident

Do not make any significant life altering decisions for at least 30 days

Try to find time, perhaps just an hour, to do something you enjoy

Help your co-workers as much as possible by sharing feelings and

checking out how they are doing.

Don’t try to fight reoccurring thoughts, dreams or flashbacks - they are normal and will decrease over time and become less painful

If the symptoms of stress do not lessen, seek additional assistance

Reprinted from Tri-County CISM Network 2000 and International Critical Incident Stress Foundation, Inc. 2001

Clackamas Fire District #1 Peer Support Program

Common Immediate Stress Reactions

Eighty-five percent of all people exposed to a critical incident may develop noticeable symptoms within 24 hours. Most of these will disappear within three weeks time. If symptoms worsen, or it they do not begin to dissipate after two weeks, additional intervention is recommended. TENSION: physical and emotional tension, muscle tremors or twitches,

unable to sit still for any length of time. FATIGUE: decreased energy, ability to sleep, or a desire to sleep

continuously. SLEEP DISTURBANCES: insomnia, bad dreams, nightmares, or waking

up too early. DIET: change in eating or drinking habits. Increased or decreased intake. NAUSEA: queasiness, nausea, vomiting other gastrointestinal problems. RECURRING MEMORIES: thinking about the incident or some associated

recurring memory. NEGATIVE FEELINGS: unpleasant feelings that may come without

warning; profound sadness, helplessness, fear, anxiety, anger, rage, discouragement, frustration, sense of vulnerability, depression.

SELF-BLAME: vague feeling of self-blame, fixed on some aspect of the

event. INTERPERSONAL PROBLEMS: increased irritability, insensitivity,

blaming others for your problems, wanting distance instead of closeness.

Reprinted from Schoenfeldt & Associates, 6905 Totem Beach, Marysville, WA 98271, (360) 659-2271

Peer Support Program Resources 

 International Critical Incident Stress Foundation 

http://www.icisf.org/ ‐‐ ICISF provides training for individuals interested in becoming a part of a crisis 

management team, or for an organization that is dedicated to helping individuals or groups recover from 

incidents 

 

Code 4 

http://www.code4.org/ ‐‐ Provides affordable and quality training for public safety personnel‐ 

specifically crisis intervention training. 

 

Oregon Public Safety Peer Support 

http://oregonpeersupport.com/resources.html  ‐‐ This site serves as a resource for all public safety 

workers throughout the State of Oregon.  Whether you are a police officer, firefighter, 9‐1‐1 dispatcher, 

corrections deputy, jailer, state corrections officer, parole & probation officer, paramedic, chaplain, etc., 

if you are looking for stress management resources or support, this is a good place to start. 

 

National Volunteer Firefighter Council Behavioral Health News 

http://www.nvfc.org/behavioral‐health‐news ‐‐ The National Volunteer Fire Council (NVFC) is the leading 

nonprofit membership association representing the interests of the volunteer fire, EMS, and rescue 

services. 

International Association of Firefighters 

http://www.iaff.org/HS/wfiresource/BehavioralHealth/behavioralhealth.html  ‐‐IAFF Wellness Fitness 

Resource for Behavioral Health. 

NW Peer Support Conference 

http://www.clackamas.us/sheriff/peersupport/  ‐‐ The Northwest Peer Support Conference ‐‐ hosted by 

the Clackamas County Sheriff's Office ‐‐ is a bi‐annual training designed to educate members of public‐

safety peer‐support teams in a variety of crisis‐related issues — as well as providing guidance for those 

interested in starting a peer‐support team. 

 

National Fallen Firefighters Foundation 

http://www.everyonegoeshome.com/news/2009/behavioralhealth.html  ‐‐Behavioral Health Initiatives. 

West Coast Trauma Retreat 

http://www.wcpr2001.org/ ‐‐ WCPR is a six day non‐profit residential program and offers a unique 

setting for treatment of first responders who have been involved in critical incidents that affect not only 

their ability to work, but also their personal and home lives. It is one of only two such programs in the 

country and has been in existence since 1999. The program is peer‐based and clinically guided.