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PTSD and the 911 Call Taker: A PowerPhone Webinar

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PTSD and the 911 Call Taker: A PowerPhone Webinar

A new study finds emergency call takers and dispatchers can exhibit symptoms of PTSD through indirect exposure to traumatic events. The results of the study shows the need to provide these "virtual responders" with the same prevention and intervention support provided to their on scene colleagues. Join PowerPhone Trainer George Deuchar for this one-hour webinar to learn more about how critical incidents can affect you and your staff, how to identify symptoms of PTSD and learn some of the latest treatment techniques for dealing with stress in your communications center.

A new study finds emergency call takers and dispatchers can exhibit symptoms of PTSD through indirect exposure to traumatic events. The results of the study shows the need to provide these "virtual responders" with the same prevention and intervention support provided to their on scene colleagues. Join PowerPhone Trainer George Deuchar for this one-hour webinar to learn more about how critical incidents can affect you and your staff, how to identify symptoms of PTSD and learn some of the latest treatment techniques for dealing with stress in your communications center.


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PTSD and the 911 Call Taker: A PowerPhone Webinar

  1. 1. Copyright © 2013, PowerPhone, Inc. Stress and PTSD (Post Traumatic Stress Disorder) in the Call Handler Welcome to this webinar on recognizing and dealing with Critical Incident Stress and PTSD (Post Traumatic Stress Disorder) in the communications Center
  2. 2. Copyright © 2013, PowerPhone, Inc. •  Webinar is being recorded •  Telephone of VoIP •  Your phones are muted •  Q&A via Webinar Chat •  #PTSD911 ~ @PowerPhone For Your Information Type your questions here. #PTSD911
  3. 3. Copyright © 2013, PowerPhone, Inc. About Your Speaker George Deuchar, MAS; PowerPhone Law Enforcement Training Consultant !  Retired 26-year police veteran !  19+ years with PowerPhone !  Tens of thousands trained worldwide !  Crisis Negotiator and certified facilitator for CISD #PTSD911
  4. 4. Copyright © 2013, PowerPhone, Inc. MODULE I: Introduction Welcome to Module I, an introduction to the Emergency Medical Dispatch Recertification Course. MODULE 1: Critical Incident Stress 4
  5. 5. Copyright © 2013, PowerPhone, Inc.5 Critical Incident Stress •  Stress is normal and comes from the many demands and pressures that we all experience, at some level, each day. •  We have demands on us that are physical, mental, emotional, or even chemical in nature. •  The word "stress" includes both the stressful situation, known as the stressor, and the symptoms you experience under stress, your stress response. http://thefullmoxie.com/2013/01/14/dont-over-think-things/stress/#PTSD911
  6. 6. Copyright © 2013, PowerPhone, Inc.6 Dealing With Critical Incidents A Critical Incident is an event that may overwhelm an individual’s capacity to cope, possibly resulting in a subsequent state of emotional turmoil They are sudden powerful events which are outside the range of ordinary human experience •  Sandy Hook Shootings in Newtown, CT (December 14, 2012) •  Boston Marathon Bombing (April 15th, 2013 •  Texas Fertilizer Plant Explosion (April 17th, 2013) •  Moore, OK Tornados (May 20, 2013) #PTSD911
  7. 7. Copyright © 2013, PowerPhone, Inc. Critical Incidents You May Experience •  Violent death or traumatic injury of public safety personnel in the line of duty •  Taking a call related to a tragedy involving a family member or close friend •  Infant or child mortality or life threatening injury •  Suicide of a fellow worker •  Multiple fatalities/Mass Casually Incident: fire, accident, or other tragic event •  A rescue operation where the victim expires •  Suicide caller, barricaded suspect, hostage taking •  Violent homicide or suicide of a resident 7 #PTSD911
  8. 8. Copyright © 2013, PowerPhone, Inc. Critical Incident Stress Critical Incident Stress is the stress that follows an extraordinary life event. It is normal to feel, think, and act different for a period of time. •  Physical: Loss of appetite, insomnia, upset stomach, headaches, sweats, muscle weakness, poor coordination •  Emotional: Anger, sadness, grief, mixed emotions, guilt •  Behavioral: Withdrawal, isolation, increased consumption of alcohol, recklessness, avoidance •  Cognitive: Distractibility, forgetfulness, preoccupation with detail, flashbacks, nightmares, intrusive thoughts 8
  9. 9. Copyright © 2013, PowerPhone, Inc.9 Critical Incident Stress Debriefing •  Peer support process •  Not Therapy •  Confidential •  No fee •  Educational in nature •  Not a critique of the response •  Facilitated Ventilation and Validation •  Referral to a Mental Health professional, when necessary Managers should be alert to personnel in crisis and direct them when needed to Employee Assistance Programs (EAP) through their agencies if available or arrange for a CISD.
  10. 10. Copyright © 2013, PowerPhone, Inc. Critical Incident Stress Debriefing Facts: What was the call? What was your role in the call? Thoughts: What was your first thought when the call was reported? Reactions: What was the worst part for you? What is going through your mind right now? Symptoms: Any symptoms during the incident? Any symptoms after the incident? 10
  11. 11. Copyright © 2013, PowerPhone, Inc. CISD: The Teaching Phase The Teaching Phase •  Stress may or may not happen •  Normal reactions to abnormal events •  Watch diet and stimulant intake •  Exercise •  Rest •  Give yourself time to recover •  Maintain normal routine •  Use your support system(s) •  Talk to others •  If reactions are intense or prolonged, seek help 11
  12. 12. Copyright © 2013, PowerPhone, Inc. Principles of Trauma-Related Stress •  Trauma is in the eye of the beholder: What bothers you, may not affect the person next to you •  The traumatic response is a normal response to an abnormal event •  There is a wide range of responses to trauma •  Traumatic stress is a psycho-biological event •  Previous traumas that are unresolved have a significant influence in amplifying current traumatic events and hindering recovery •  What you resist, will persist 12 #PTSD911
  13. 13. Copyright © 2013, PowerPhone, Inc.13 Contributing Factors to a Telecommunicator’s Burnout and Depression •  Working in a perceived low position within the departmental hierarchy •  Insufficient training •  Lack of support and positive reinforcement from officers, supervisors, and administration •  Not feeling like you are part of the team •  Shift work •  Antiquated equipment and facility •  Confinement and lack of interpersonal communication
  14. 14. Copyright © 2013, PowerPhone, Inc.14 Contributing Factors to a Telecommunicator’s Burnout and Depression (Cont.) •  Lack of breaks •  Negative citizen contacts •  Lack of personal development •  Chronic exposure to tragedy and human misery •  Inability to bring closure to critical incidents you are involved in •  Government bureaucracy and overbearing rules and regulations #PTSD911
  15. 15. Copyright © 2013, PowerPhone, Inc. MODULE I: Introduction Welcome to Module I, an introduction to the Emergency Medical Dispatch Recertification Course. SECTION 2: What is PTSD? 15
  16. 16. Copyright © 2013, PowerPhone, Inc.16 What is PTSD? •  PTSD is a syndrome of psychological and often physical symptoms that develop in a person (or persons) following a traumatic event that may effect you directly or indirectly. •  Normally associated with soldiers in military combat, we now know that any overwhelming life experience can result in PTSD. #PTSD911
  17. 17. Copyright © 2013, PowerPhone, Inc.17 What is PTSD? •  PTSD develops in different ways for each person. The symptoms of PTSD usually develop in the hours or days following the traumatic event, but can sometimes take weeks, months, or even years before they appear. #PTSD911
  18. 18. Copyright © 2013, PowerPhone, Inc.18 What is PTSD? •  Any traumatic event that threatens our safety or makes us feel helpless can trigger stressful responses that may include anger, guilt, depression, suicidal thoughts, physical aches and pains, substance abuse, feeling alienated and alone, sleeplessness, increased anxiety, and more. #PTSD911
  19. 19. Copyright © 2013, PowerPhone, Inc.19 Who is Affected by PTSD? •  Post-traumatic stress disorder (PTSD) may happen to those who directly experience the traumatic event, but may also appear in those who witness it, and those who respond to it, including emergency workers and law enforcement officers, and call-handlers. •  It can even occur in the friends or family members of those who went through the actual trauma.
  20. 20. Copyright © 2013, PowerPhone, Inc.20 PTSD vs. the Normal Response to Trauma •  It’s common after a traumatic event to have some recurring bad dreams, feel afraid, and rethink the trauma frequently. •  But normally these have a short life and fade away. When this normal response becomes stuck and won’t go away, and may even become worse, then you probably are experiencing PTSD. #PTSD911
  21. 21. Copyright © 2013, PowerPhone, Inc.21 Signs and Symptoms of PTSD? There are three main types or clusters of symptoms associated with PTSD: 1.  Re-experiencing the traumatic event 2.  Avoiding reminders of the trauma 3.  Increased anxiety and emotional arousal
  22. 22. Copyright © 2013, PowerPhone, Inc.22 Re-experiencing the Traumatic Event Re-experiencing a traumatic event can take the form of upsetting memories, flashbacks that make you feel like the trauma is happening again, nightmares, intense physical reactions like sweating and a pounding heart, and rapid breathing. #PTSD911
  23. 23. Copyright © 2013, PowerPhone, Inc.23 Avoiding Reminders of the Trauma Some persons will avoid activities, places , or even feelings that remind them of the trauma. They lose interest in life and feel emotionally detached from others and their jobs. They become emotionally numb and feel their future is limited. #PTSD911
  24. 24. Copyright © 2013, PowerPhone, Inc.24 Increased Anxiety and Emotional Arousal Some persons will experience increased anxiety and emotional arousal including difficulty falling or staying asleep, inability to concentrate, being in a state of hyper- vigilance, or feeling jumpy or nervous. #PTSD911
  25. 25. Copyright © 2013, PowerPhone, Inc. MODULE I: Introduction Welcome to Module I, an introduction to the Emergency Medical Dispatch Recertification Course. SECTION 3: PTSD in the Call-Handler and Contributing Factors 25 Heather Pierce is a former 911 telecommunicator with ten years of experience. Currently she is a Research Associate at Northern Illinois University. Heather Pierce Heather and Dr. Lilly conducted the research that is the basis of this section.
  26. 26. Copyright © 2013, PowerPhone, Inc.26 PTSD and the Call-Handler Research Questions: •  What types of calls are being handled and what is the frequency of exposure to potentially traumatic events? –  Reported handling on average 15 of the 21 different call types –  Many reported exposure occurring daily •  Did the call handlers experience intense and distressing emotional reactions, such as fear, helplessness, or horror in response to these events? –  Indicated experiencing a reaction to 32% of the calls identified •  Call handlers that experienced 15 calls, may have experienced distress in reaction to 5 of those calls
  27. 27. Copyright © 2013, PowerPhone, Inc.27 PTSD and the Call-Handler Research Questions: (Continued) •  Was the exposure to potentially traumatic calls and emotional distress associated with PTSD symptomology? –  A significant relationship was found between exposure, distress, and PTSD symptomology, such that, as exposure and distress increased so did the scores of PTSD symptom severity.
  28. 28. Copyright © 2013, PowerPhone, Inc.28 PTSD and the Call-Handler •  About 16% of the calls dispatchers identified as their worst, involved the unexpected injury or death of a child. About 13% were suicidal callers, 10% were police- officer shootings and another 10% involved the unexpected death of an adult. 0" 2" 4" 6" 8" 10" 12" 14" 16" Child" death"or" injury" Suicidal" caller" Police" shoo:ng" Death"of" adult" 16% 13% 10% 10% Percent #PTSD911
  29. 29. Copyright © 2013, PowerPhone, Inc.29 PTSD and the Call-Handler The participants reported having experienced a high level of distress while handling and in the time period shortly after the call. Comparatively, call handlers rated their distress twice that of a sample of police officers and civilians. #PTSD911
  30. 30. Copyright © 2013, PowerPhone, Inc.30 PTSD and the Call-Handler •  3.5% of the participants reported PTSD symptoms severe enough to qualify for a diagnosis •  PTSD symptoms that may be present in telecommunicators can impair decision-making abilities and functioning, which could pose significant risk to the general population that relies on them to quickly and effectively coordinate an emergency response. “……. this is the first study on emergency dispatchers, who experience the trauma indirectly.”
  31. 31. Copyright © 2013, PowerPhone, Inc.31 Prevention and Intervention “The results of the PTSD study show the need to provide these workers with prevention and intervention support as is currently provided for their front-line colleagues. This includes briefings and training in ways to handle emotional distress.” http://www.koreysufka.com/prevention_comes_first.htm#PTSD911
  32. 32. Copyright © 2013, PowerPhone, Inc. MODULE I: Introduction Welcome to Module I, an introduction to the Emergency Medical Dispatch Recertification Course. SECTION 4: Newly Discovered Treatments for PTSD 32
  33. 33. Copyright © 2013, PowerPhone, Inc.33 The Problem with Unresolved Stress •  The problem with stress is that it turns on your sympathetic nervous system and stimulates the release of stress hormones throughout your body. •  These hormones give you super energy and cause other changes in the body such as the "fight or flight" response. Speeds up body Sympathetic •  Dilates pupil of eye •  Inhibits flow of saliva •  Speeds heartbeat •  Inhibits stomach secretions •  Secretion of adrenaline •  Inhibits bladder contraction #PTSD911
  34. 34. Copyright © 2013, PowerPhone, Inc.34 The Problem with Unresolved Stress •  Therefore, stress over a long time can be very harmful. When stress hormones remain elevated, there is a gradual but steady stream of harmful changes to the body. •  Long-term stress can suppress the immune system, which may lead to the development of diseases, and can lead to physical and psychological problems. #PTSD911
  35. 35. Copyright © 2013, PowerPhone, Inc.35 The Problem with Unresolved Stress Some studies show that the hormones associated with chronic stress are linked to increased fat in the abdomen. That, in turn, increases the risk of chronic and serious illness such as diabetes. #PTSD911
  36. 36. Copyright © 2013, PowerPhone, Inc.36 Symptoms of Stress •  Being overwhelmed or pressured is among the most common signs of stress. Other symptoms include: •  Physical complaints such as stomach aches, diarrhea, headaches, nausea, and a sensation of numbness or tingling in your hands, arms, and face. •  There maybe unexplained anger, crying for no reason, or having a short temper. •  There may be issues with family members, friends, and even teachers. •  Some people no longer act their age, and regress.
  37. 37. Copyright © 2013, PowerPhone, Inc.37 Symptoms of Stress •  There may difficulty falling asleep, or even oversleeping. •  There may be personality changes where you withdraw or requiring more attention than usual. •  Impatience may be elevated. •  If you are recognize some of these symptoms in you or a colleague, chances are that the level of stress is high. •  Treatment is needed, because stress can lead to permanent feelings of helplessness and ineffectiveness.
  38. 38. Copyright © 2013, PowerPhone, Inc.38 Stress Reduction •  You can reduce normal stress symptoms using many of the following techniques: •  Identify the sources of stress •  Talk it out. Talk to a friend, family member, or therapist if your stress level is too high. •  Take time out. Before you reach your breaking point, take time out for solitude. •  Set limits. Never hesitate to say "no" before you take on too many commitments #PTSD911
  39. 39. Copyright © 2013, PowerPhone, Inc.39 Stress Reduction •  Try exhaling. Breathing can measure and alter your psychological state, making a stressful moment increase or diminish in intensity.. •  Exercise daily. Exercise is thought to increase the secretion of endorphins, naturally produced substances in the brain that induce feelings of peacefulness. •  Proper Nutrition to provide your stressed mind and body with essential nutrients. #PTSD911
  40. 40. Copyright © 2013, PowerPhone, Inc.40 Treating PTSD •  Unfortunately, PTSD doesn’t normally respond to these methods of reducing stress. You are psychologically stuck and the symptoms persist with all of the possible damages to the body, to relationships such as family and friends, and to job performance. •  It is important to recognize that yourself or a co-worker has PTSD and involve professional intervention. #PTSD911
  41. 41. Copyright © 2013, PowerPhone, Inc.41 Treating PTSD •  Treatment for PTSD relieves symptoms by helping you deal with the trauma you’ve experienced. •  You will be expected to recall and process the emotions and sensations you experienced during the original event. •  Treatment for PTSD will also help restore your sense of control and reduce the strength of the traumatic memory. #PTSD911
  42. 42. Copyright © 2013, PowerPhone, Inc.42 Treating PTSD In treatment for PTSD, you’ll: •  Learn how to deal with and control bad memories •  Examine your thoughts and feelings about the trauma. •  Cope with feelings of guilt, self-blame, and mistrus.t •  Address problems PTSD is causing in your life and relationships. #PTSD911
  43. 43. Copyright © 2013, PowerPhone, Inc.43 Types of Treatment for PTSD •  Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. •  Since PTSD affects both you and those close to you, family therapy can be especially productive. •  Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. •  EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive- behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. #PTSD911
  44. 44. Copyright © 2013, PowerPhone, Inc.44 EMDR (Eye Movement Desensitization and Reprocessing) •  EMDR (Eye Movement Desensitization and Reprocessing) is a fairly new and nontraditional form of therapy developed by Francine Shapiro Ph.D., in 1987. •  During EMDR sessions, the therapist asks the client to think about a traumatic event and at the same time, move their eyes rapidly - following the movement of a pencil or a finger by the therapist. •  What is happening during this process and why this seems to work is still largely unknown #PTSD911
  45. 45. Copyright © 2013, PowerPhone, Inc.45 Treating PTSD •  The theory is that the rapid eye movement in EMDR creates similar brain activity to REM (rapid eye movement) that we experience during sleep. •  This REM helps us to process and rearrange ideas and to resolve conflicts. •  We are able to work through things. We still retain the memory but without the emotional pain and the feelings of smell, taste, terror of the event. #PTSD911
  46. 46. Copyright © 2013, PowerPhone, Inc.46 Treating PTSD •  The credibility of EMDR has been elevated by recently posted guidelines that define who may benefit from the treatment. For example: •  The American Psychiatric Association (APA) declares that EMDR is effective for treating symptoms of acute and chronic PTSD. •  The Department of Veterans Affairs and the Department of Defense have issued joint clinical practice that "strongly recommend" EDMR for the treatment of PTSD in both military and non-military populations. #PTSD911
  47. 47. Copyright © 2013, PowerPhone, Inc.47 Treating PTSD •  An EMDR session can last up to 90 minutes during which the EMDR therapist will have you recall a disturbing event as they have you follow finger movement with your eyes quickly switching back and forth. Some therapists use alternatives to finger movements, such as hand or toe tapping or musical tones. •  Gradually, the therapist will help to shift your thoughts to more pleasant ones. #PTSD911
  48. 48. Copyright © 2013, PowerPhone, Inc.48 Treating PTSD Although most research into EMDR has examined its use in people with PTSD, EMDR is being used to treat a number of other psychological problems. They include: •  Panic attacks •  Eating disorders •  Addictions •  Anxiety, such as discomfort with public speaking or dental procedures
  49. 49. Copyright © 2013, PowerPhone, Inc. Stress Management Training by PowerPhone •  Host or contract PowerPhone to provide this training at your location. •  8 hour class; conducted by subject matter experts. •  $229 per person. Quantity discounts available. •  PowerPhone.com or 800.53.POWER for more info. #PTSD911
  50. 50. Copyright © 2013, PowerPhone, Inc. Thank You! Webinar Survey sent to you today. Please respond. Link to Webinar recording sent to you early next week. PTSD Resource Page including slide deck and PTSD White Paper soon. Contact Us with any questions or feedback. learn@powerphone.com
  51. 51. Copyright © 2013, PowerPhone, Inc.51 Question and Answer