Critical Incident Peer Support for Law Enforcement

1. Critical Incident Peer Support for Law Enforcement Module Three: Responsibilities of a Critical Incident Peer Supporter

2. Learning Objectives • The participant will be able to explain the responsibilities of a critical incident peer supporter. • Participant will be able to: • Recognize critical incident stress reactions. • Identify coping strategies. • Describe the process for referral of a peer. • Recognize how to train law enforcement in suicide prevention. • Identify the issues related to peer support programs.

3. Module Overview • Stress reactions • Coping strategies • Suicide prevention • Referrals • Peer support program issues

4. Module Three Introduction Video

5. Recognizing Critical Incident Stress Reactions • Manifestations of typical stress symptoms • Duration of the reaction will depend on: • Severity and duration of the event • Meaning of the event • Prior coping behavior • Professional and personal support system • Level of functioning as indicator of need for professional assistance

6. Physical Reactions to Stress • Chest pain • Irregular heartbeat • Difficulty breathing • Fainting or dizziness • Collapse • Unusually high blood pressure • Numbness or paralysis of body parts • Excessive dehydration • Frequent vomiting • Blood in stool

7. Coping Strategies Unhealthy coping strategies Healthy coping strategies Coping with specific symptoms

8. Unhealthy Coping Strategies Use of drugs or alcohol Social isolation Dropping out of activities Anger Continuous avoidance Working all the time – “workaholic”

9. Healthy Coping Strategies • Exercise, physical activity, or leisure • Relaxation techniques • Sufficient sleep • Proper diet and nutrition • Humor • Diversion or distraction • Cognitive reframing • Hobbies • Emotional outlets • Finding someone to talk to

10. Exercise, Physical Activity, or Leisure • Aerobic Exercise (Cardiovascular) • Jogging • Running • Bicycling • Swimming • Racquetball/squash • Tennis • Cross-country skiing

11. Relaxation Techniques Muscular relaxation exercises Breathing exercises Meditation Stretching Yoga Prayer Listening to quiet music Spending time in nature

12. Sufficient Sleep • Many people cannot sleep when they are stressed and deal with the following problems: • Getting to sleep • Waking up during the night • Disturbing dreams • Waking too early

13. Proper Diet and Nutrition • American diet is heavy in fatty and starchy foods and lacks vitamins and minerals. • Proper diet and nutrition techniques: • Foods to avoid • Anti-stress foods • Vitamins

14. Humor • Good stress reducer—at home or work • Relieves muscular tension • Improves breathing • Pumps endorphins—the body’s natural painkillers—into the bloodstream • Dark humor

15. Diversion or Distraction Take time out. Get away from things that bother you. Calm down. Think logically.

16. Cognitive Reframing Cognitive distortions aren't helpful and can lead to dysfunctional responses and symptoms. Cognitive reframing (changing the way you talk to yourself) allows you to begin to think in a more constructive way.

17. Talking Learn to talk openly and honestly with someone. Learn where you can display emotions. Learn to share your problems. Learn to discuss your feelings with someone you trust.

18. Coping with Specific Symptoms Distressing memories, images, or thoughts Sudden feelings of anxiety or panic Flashbacks Trauma-related dreams or nightmares Difficulty falling or staying asleep Irritability, anger, and rage Difficulty concentrating Difficulty expressing positive emotions

19. Suicide Prevention

20. Suicide Prevention • Recognizing risks for suicide is an important responsibility of the peer supporter. • Look for warning signs: • Violanti’s IS PATH WARM • Intervention strategies: • AID LIFE • QPR • ALGEE • Rolling Backup Video

21. Violanti’s IS PATH WARM • Ideation  • Substance abuse  • Purposelessness • Anxiety • Trapped  • Hopelessness • Withdrawal • Anger   • Recklessness • Mood changes 

22. AID LIFE • Ask the question. • Intervene immediately. • Don’t keep it a secret. • Locate help. • Involve command. • Find someone to stay with the person. • Expedite.

23. QPR Question the meaning of suicidal communication. Persuade the person to get help. Refer to competent counseling. QPR Web site (http://www.qprinstitute.com/)

24. ALGEE • Assess for risk of suicide or harm. • Listen in a nonjudgmental way. • Give reassurance and information. • Encourage appropriate professional help. • Encourage self-help and other support strategies.

25. Referrals • Referral is a process of getting affected peers the best help as quickly as possible. • If a referral is effective, the peer will feel better and work better. Future problems may be reduced. • Referrals help mitigate civil, legal, and ethical considerations.

26. How to Make Referrals Serve as a bridge by referring appropriately. Become familiar with and know your resources. Emphasize and reinforce that seeking help when one needs it is a sign of strength and courage. Develop/recognize needed support systems.

27. How to Make Referrals • Decide which category of clinician: • Experiencing signs of mental illness and may need medication? Psychiatrist • Alcohol is the primary underlying problem? Treatment center or clinician • Marriage or family issues? Family therapist • General issues? Individual therapist

28. How to Make Referrals Check with referral source to be certain that peer can be accepted. Discuss with peer the reason for making referral. Help peer secure an appointment. Be available to accompany peer. Follow up afterward.

29. Referral Procedure Will the referral help? Is the peer willing to seek assistance other than peer support? Do not force referrals—sell them. Don't become a guardian or the decision-maker for your peer.

30. Choosing a Referral Agency Stay in touch with resources or referrals that may be used in the future. Make sure the quality of the program is maintained. Keep an eye out for new resources.

31. Peer Support Program Issues Legal issues Ethical issues Cultural issues

32. Legal Issues Communication Confidentiality Role conflicts

33. Ethical Issues • Exercising power over the peer • Gaining personally from helping others • Offering services without having been trained • Not limiting records of peer support contacts

34. Cultural Issues • Cultural differences • Trauma • Personal space • Stereotypes • Gender differences • Flexibility

35. Review—Check on Learning What are critical incident stress reactions? What are two coping strategies a peer supporter can use? How do you process a referral for a peer? How does QPR train law enforcement in suicide prevention? What issues are related to peer support programs?