| 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. |
