Certified Interfaith Pastoral Counseling, Coaching and Trauma Relief Service


Our Mission

The Tuff Services Peer Support and Assistance CISM Team provides trained peer support to emergency responders and our local community to effectively build resilience and manage critical incident stress for healthier lives, families and communities, through education, support, and assistance for incidental or cumulative critical incident stress experienced in the performance of their jobs and/or in the event of major emergencies or natural disasters. And we are supported and made up of volunteer Peers, Retired First Responders, Trained Chaplains and Mental Health Professionals.

Understanding CISM

Critical Incident Stress Management, or CISM, is an intervention protocol developed specifically for dealing with traumatic events.  It is a formal, highly structured and professionally recognized process for helping those involved in a critical incident to share their experiences, vent emotions, learn about stress reactions and symptoms and given referral for further help if required.  It is not psychotherapy.  It is a confidential, voluntary and educative process, sometimes called 'psychological first aid'.

First developed for use with military combat veterans and then with civilian and first responders (police, fire, ambulance, emergency workers and disaster rescuers), it has now been adapted and used virtually everywhere there is a need to address traumatic impact in peoples lives.

There are several types of CISM interventions that can be used, depending on the situation.  Variations of these interventions can be used for groups, individuals, families and in the workplace.

Debriefing  is a proactive intervention involving a group meeting or discussion about a particularly distressing critical incident. Based on core principles of crisis intervention, the CISD is designed to mitigate the impact of a critical incident and to assist the persons in recovery from the stress associated with the event. The CISD is facilitated by a specially trained team which includes professional and peer support personnel. Also called Critical Incident Stress Debriefing (CISD). Ideally it is conducted between 24 and 72 hours after the incident, but may be held later under exceptional circumstances.

Defusing  is an intervention that is a shorter, less formal version of a debriefing . It generally lasts from 30 to 60 minutes, but may go longer and is best conducted within one to four hours after a critical incident. It is not usually conducted more than 12 hours after the incident. Like a debriefing, it is a confidential and voluntary opportunity to learn about stress, share reactions to an incident and vent emotions. The main purpose is to stabilize people affected by the incident so that they can return to their normal routines without unusual stress. Where appropriate, a formal debriefing also be required.

Grief and Loss Session  is a structured group or individual session following a death and assists people in understanding their own grief reactions as well as creating a healthy atmosphere of openness and dialogue around the circumstances of the death.

Crisis Management Briefing  is a large, homogeneous group intervention used before, during and after crisis to present facts, facilitate a brief, controlled discussion, Q & A and info on stress survival skills and/or other available support services.  May be repeated as situation changes.

Critical Incident Adjustment Support provides multi-faceted humanitarian assistance to individual, families or groups for coping with the aftermath of an incident and overcoming the ongoing impact of a death or injury.

Pre-Crisis Education provides a foundation for CISM services.  It includes incident awareness, crisis response strategies and develops stress management coping skills that can prevent major problems should an incident occur.  It takes the form of an employee handbook, e-book and/or workshops and training seminars.


Things to Do After A Critical Incident

  • WITHIN THE FIRST 24 - 48 HOURS periods of appropriate physical exercises alternated with relaxation will alleviate some of the physical reactions.
  • Structure your time - keep busy.
  • You're normal and having normal reactions - don't label yourself crazy.
  • Talk to people - talk is the most healing medicine.
  • Be aware of numbing the pain with overuse of drugs or alcohol You don't need to complicate this with a substance abuse problem.
  • Reach out - people do care.
  • Maintain as normal a schedule as possible.
  • Spend time with others and talk about what happened to you.
  • Help others who were affected as much as possible by sharing feelings and checking out how they are doing.
  • Give yourself permission to feel rotten and share your feelings with others.
  • Keep a journal. Write down your thoughts and feelings about the incident. Research has shown this is very effective for symptom reduction and resolution of the trauma.
  • Do things that feel good to you.
  • Realize those around you are under stress.
  • Don't make any big life changes.
  • Do make as many daily decisions as possible which will give you a feeling of control over your life, i.e., if someone asks you what you want to eat - answer them even if you're not sure.
  • Get plenty of rest.
  • Reoccurring thoughts, dreams or flashbacks are normal - don't try to fight them - they'll decrease over time and become less painful.
  • Eat well-balanced and regular meals (even if you don't feel like it).

For Family and Friends

  • Listen carefully.
  • Spend time with the traumatized person.
  • Offer your assistance and a listening ear if they have not asked for help.
  • Reassure them that they are safe.
  • Help them with everyday tasks like cleaning, cooking, caring for the family, minding children.
  • Give them some private time.
  • Don't take their anger or other feelings personally.
  • Don't tell them that they are "lucky it wasn't worse" - traumatized people are not consoled by those statements. Instead, tell them that you are sorry such an event has occurred and you want to understand and assist them.

SOP Guidelines and Conditions


For more information or assistance requests, you can contact us at:  (800) 649-0925 or use the form below. We are here to help you!

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