Magellan CISM Provider Training

Magellan CISM Provider Training

Objectives Review the history of Magellan s CISM Team Review the pertinent research evidence Review the current Magellan Model of CISM services

History of CISM at Magellan Initial Focus Initially services focused around the traditional Mitchell Model The CISM Team screened for Mitchell Model trained providers Team members trained at ICISF Team members and providers even carried small reminder cards, so they would not forget any of the Mitchell Model steps

History of CISM at Magellan Evolution About 10 years ago the CISM Team began to review the current research. Research revealed traditional debriefing models were not effective and some participants were actually being damaged by use of these models. The CISM Team stopped utilizing many of the traditional debriefing methods and began to move in a direction guided by research and Leaders in the field.

History of CISM at Magellan...Today Magellan Model of CISM closely resembles what is now being called Psychological First Aid. This is an advantage as our CISM affiliates can access the many resources available on Psychological First Aid. We are also able to draw a lot of material for handouts and training from the Psychological First Aid literature.

The Pertinent Literature The work of Carol North, MD and Barry Hong, PhD: 95% of people exposed to trauma recover on their own. Only 5% develop PTSD The 95% are initially very distressed and report steady improvement over time The 5% have symptoms of shock and numbness and do not improve over time Some participants in traditional debriefing models report their symptoms worsened due to hearing about the trauma of other participants

The Pertinent Literature. The work of Bessel van der Kolk MD Best current treatment for PTSD is EMDR Most clients who develop PTSD following a traumatic event already have a hx of PTSD (usually due to childhood trauma) Clients with a single incident of PTSD can be fully treated with just 1 session of EMDR Clients with a hx of childhood trauma need supportive therapy, mindfulness training, movement therapy, and EMDR

The Pertinent Literature. The work of Mark Hubble, Barry Duncan, & Scott Miller: What Really Works in Therapy 40% of change comes from client s own resiliency 30% of change comes from a supportive relationship with the therapist (primarily due to being a good listener) 15% of change is caused by the placebo effect (simply that the client becomes hopeful) 15% of change is due to actual therapy techniques or methods

Current Magellan Model of CISM Primarily Psychological First Aid with an emphasis on Resiliency Providers are aware most clients will improve utilizing their own normal resiliency Providers are aware clients benefit most from being heard and being reassured Providers are aware client s most likely to have PTSD are those who appear to be in shock. Providers know these clients should be seen individually and helped with referrals Providers make appropriate referrals (e.g. therapists or programs that offer EMDR)

Current Magellan Model of CISM.Providers are Mindful to control discussion of highly traumatic material as it can result in group participants being additionally traumatized. Careful in who is included in group sessions. Groups should consist of clients with similar exposure and similar roles. Discussions within mixed groups are closely controlled. Educating on coping techniques and enhancing resiliency at the end of sessions.

Quick Review of What CISM Affiliates Do Intervene carefully and thoughtfully Listen Normalize Reassure Teach Resiliency Refer as Needed Call for support 800-997-2273 as needed

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