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FBI's Employee Assistance Program: An
       Advanced Law Enforcement Model
                              SSA Vincent J. McNally, MPS, CEAP, BCETS

ABSTRACT: As we approach the 21st century the FBI has enhanced its Employee Assistance Program
(EAP) to include EAP services, Peer Support and Critical Incident Stress Management/Debriefing (CISM/
D) and Chaplains' Program. This EAP is now anticipating the future to include a Compassion Fatigue
Program for its counselors and coordinators, as well as developing CISD protocols for incidents involving
weapons of mass destruction. As the FBI has accepted new challenges in the investigative arena
throughout the world, so the FBI's Employee Assistance and related programs have set out to support
their employees and family members with a continuum of integrated confidential services. The FBI
recognizes that its most important asset is its personnel, and EAP is the vehicle to assist the FBI family in
remaining healthy and strong for the continuous quest to fulfill its mission. [International Journal of
Emergency Mental Health, 1999, 2, 109-114.]

KEY WORDS: FBI; employee assistance; peer support program; post critical incident; CISM; eye
movement desensitization and reprocessing; EMDR; critical incident stress management

Introduction

The purpose of the Federal Bureau of Investigation's (FBI) Employee Assistance Program (EAP) is to
provide free, confidential, short-term counseling and referral assistance to all employees with personal
problems that adversely affect their job performance and health. Each FBI office has an EAP Coordinator
(EAPC) who is trained to identify an underlying problem and to refer the employee to an appropriate
resource in the community. The EAP also helps employee family members deal with stressful situations
by affording appropriate counseling and referral services.

The EAP helps employees identify problems, resolve issues and improve productivity while on the job; the
goal is to help individuals in a time of personal crisis. Some of the on-the-job behaviors that may indicate
an employee needs assistance are:

1. Frequent accidents

2. Missed deadlines

3. Withdrawal from co-workers

4. Frequent absences

5. Frequent mistakes

6. Frequent tardiness

Other issues that could adversely affect job performance include substance abuse, financial difficulties,
health issues, the death or serious injury of a family member, or a shooting incident The role of the EAPC
is to link employees or family members with the proper community resource and ensure continued
recovery.

The emotional baggage we carry, whether it is depression, stress, or family issues, impacts upon our
work. The key to surviving at work lies in how much we like our job and how we manage stress. EAP is
the primary vehicle to address those issues and minimize the trauma associated with them, with
confidentiality as the cornerstone of the program

.

In late 1993, Director Louis I Freeh recognized the potential of Employee Assistance programs,
particularly in an organization with nearly 25,000 employees with roughly 75,000 immediate family
members. He elevated the program, making it a high priority within the Bureau. The EAP, previously a
subprogram of the Health Care Program Unit, became the self-contained Employee Assistance Unit
(EAU). The new unit has evolved into a major support component for the FBI family, and now consists of
four programs including the Critical Incident Stress Management/Debriefing Program (CISM/D), Peer
Support Program, and the Chaplains' Program, which were formerly administered by the Behavioral
Science Unit at the FBI Academy, Quantico, Virginia, as well as the EAP.

EAP: New and Improved

Today, there are more than 300 EAP coordinators counselors, and agent and professional support
groups: located throughout the field and at FBI headquarters, ready at a moment's notice to help
employees and family members cope with a problem.

EAP is a peer-based program. The coordinators and counselors are well trained, with some having
advanced degrees or certification in a variety of professional fields. They are mandated to participate in
annual training on a wide variety of subjects, including depression and suicide awareness, workplace
violence and crisis intervention, death notification, stress management, the effects of various medications,
financial counseling, resolution of traumatic experiences, and issues concerning the use of alcohol, drugs,
and other substances.

The EAP provides assessment, short-term counseling, and referral to a mental health professional within
the employee's insurance plan or to a low-cost or no-cost community resource. It also provides follow-up
services. The EAP also finishes training for and guidance to Bureau supervisors and management and
educational instruction for employees when requested.

To enhance EAP training in the field, Supervisory Special Agent Vincent J. McNally, current head of the
EAU, has assigned four full-time Special Agent EAP Regional Manager positions in New York, Chicago,
Houston, and Los Angeles. These Regional Managers, who serve a five-year term, will be responsible for
the training of EAP coordinators, along with supervisors and managers in the field.

Another first for the EAP was the employment of a full-time clinical psychologist and psychiatrist who both
came aboard in 1998. Prior to their employment, the EAP used the services of contract mental health
professionals. The psychologist, as Chief of Counseling Services for the EAP, provides oversight and
guidance to EAU's five full-time counselors, and also offers guidance and consultation to EAP
coordinators, counselors and regional program managers in the field. The psychiatrist is the medical
consultant to the unit and its four programs, and frequently conducts emergency psychiatric evaluations.

The EAP gets its business from several different sources. If the employee is the one who recognizes a
problem or feels overwhelmed with-what is taking place in their life, they can contact an EAP counselor
directly, or a concerned family member may do it for the employee. If the problem is adversely impacting
work, the supervisor, after first letting EAP know that this step is officially being taken, may refer the
employee to the EAP. Whether the employee contacts the EAP or not is totally up to the employee. If a
family member is experiencing some difficulties, the employee or the family member can contact the
program and receive help for that person.

FBI Chaplains' Program

There are over 100 volunteer Chaplains nationwide. Each office has one or more Chaplains depending
upon the size and territory covered. Most offices have two Chaplains and some large offices have more.
Chaplains are called upon to respond to the most difficult circumstances and critical incidents/trauma,
e.g., shooting at the District of Columbia Police Headquarters where two FBI agents were killed and one
seriously wounded, the Oklahoma City bombing, TWA Flight 800 crash, Los Angeles earthquake,
Hurricane Andrew in Florida, traumatic death of a spouse or child, suicides, line of-duty death or injury,
etc… In addition, they provide a number of professional services including counseling on a number of
issues (e.g., spiritual, long-term & debilitating illness, death and bereavement coping skills, marital issues
and family problems, stress and anger management, family members with substance abuse problems),
as well as response and debriefing services for FBI families in the event of the death of an employee or
family member. FBI Chaplains provide the Bureau with an estimated 20,000 hours of direct services
annually at little cost to the FBI.

The majority of FBI Chaplains are experienced Police Chaplains who have extensive credentials and
depth of background which enable them to respond to a wide variety of matters. Chaplains are
investigated, receive top-secret security clearances, FBI credentials, unrestricted and unescorted access
to FBI personnel, and space to ensure confidentiality.

The Visiting Chaplain Program at the FBI Academy, Quantico, gives FBI Chaplains the opportunity to
spend two or more weeks at the training facility providing a number of services to the New Agent classes,
National Academy students, and FBI employees at the facility. They also participate in ceremonies at the
training academy and hold religious services in the chapel.

FBI Chaplains play an important role as members of the four regional Critical Incident Stress Debriefing
teams, providing support to FBI employees, family members and task force members involved in a critical
incident or suffering from a traumatic experience.

Critical Incident Stress Management/Debriefing (CISM) Program

The purpose of the Critical Incident Stress Management (CISM policy is to afford those individuals who
are exposed to or involved in critical incidents (e.g., shooting, death or serious injury, suicide, homicide,
hostage situation, SWAT activity) a confidential program that will mitigate the adverse impact of the
critical incident through peer counseling and critical incident stress debriefing (CISD).

The trauma of a critical incident is catastrophic to the person experiencing the event. A critical incident is
not only one single situation in a person's life, but it can also be a series of events, which add up to
cumulative stress. No two individuals have the same reaction to a critical incident. In a study of police
officers who had been involved in a shooting incident Stratton, Parker, and Snibbe (1987) found that 35%
of the officers reported that the event had little long-term impact upon them while 60% indicated that the
incident had a substantial impact on their lives after the event. How an individual responds to a critical
incident depends upon the nature and extent of the "emotional baggage" the person is carrying. The
failure to resolve personal issues often leads to a variety of negative thought or behavior patterns. Some
individuals overreact to perceived threats, while others under-react to clear dangers. While some
employees quit their jobs prematurely, others develop performance problems due to increased
absenteeism, burnout, stress disorders, alcohol abuse problems or a host of other personal problems that
can interfere with functioning at home and on the job.

Agents are trained, equipped with firearms and bulletproof vests to help them survive critical incidents.
The FBI is also responsible for equipping its employees with the ability to deal constructively with and
survive, the emotional aftermath of critical incidents. A comprehensive CISM program includes a set of
interventions that help FBI employees cope with the physical and emotional effects of a critical incident.

In June, 1995, the FBI instituted four CISD Regional Teams throughout the United States for immediate
response to the following critical incidents:

• Death of an employee, spouse or other family members

• Natural and man-made disasters and catastrophes (earthquakes, bombings, etc.)
• Taking a life in the line-of-duty

• Suicide of an employee, spouse, or other family member

• Violent traumatic injury to an employee

• Death of a crime victim

• Witnessing and handling multiple fatalities

• SWAT operation where dangers are present

• Hostage taking, barricaded suspect and negotiation

• Observing an act of corruption, bribery or other illegal activity

• A suspension and/or threat of dismissal

• Other traumatic incidents

Agents and support personnel who are members of the four Regional CISD Teams have been certified in
Basic and Advanced CISM training conducted by the international Critical Incident Stress Foundation.
There are approximately 100 team members consisting of EAU Headquarters and field staff FBI
Chaplains and mental health professionals with experience in police psychology and trauma response.

Bi-annual Advanced Peer Support training is afforded team members. This is a week-long comprehensive
program that brings team members together to discuss difficult debriefing, team use scenarios, the
chaplain's role, compassion fatigue, and strategies for surviving a critical incident.

CISD team responses have increase dramatically over the years since their inception in 1995, when there
was just one response. Responses increased to 18 in 1996,29 in 1997, and 45 responses in which 1,550
personnel were provided services in 1998.

CISD teams worked with those involved in the TWA Flight 800 investigation and the bombing of the
Oklahoma City Federal building. The teams work with affected employees, and family members when
necessary, to help everyone involved or adversely impacted come to terms with what has happened.
Sometimes a critical incident, especially one involving the death or injury of a co-worker, can adversely
impact an entire office. In those cases, the CISD team will help managers in that office understand how
they can be supportive in the emotional aftermath of an incident.

Peer Support Program/Post Critical incident Seminars (PCIS)

In July 1983, 14 agents attended the first PCIS at the FBI Academy. This group explored the issue of
post-shooting trauma with a goal of establishing an FBI policy to neutralize die effects of the agent’s
reactions in a shooting incident A questionnaire, interview, group discussion and follow-up interviews with
spouses of the attendees were the agreed upon protocols developed by this group. From the seminar
interviews the following reactions to a shooting were noted:

1. Some agents noted that despite their physical and mental preparation, they had trouble believing it was
really happening to them

2. Generally, agents responded automatically based upon their training.

3. Some agents felt a rush of adrenaline while others felt fear.

4. Some thoughts included "Am I legally, procedurally, and morally correct
5 Some: agents experienced distorted perceptions, seeing the event in slow motion or through runnel
vision, and some did not hear the gunshots during a shooting incident.

6. Some agents experienced a "cross over syndrome' whereby the affected person believed that he or
she was now the "bad guy." This occurred when the agent was on the side of the law one minute, then
under investigation by their own organization as well as the community, media, and also themselves in
the aftermath of the shooting.

7. It has been determined that agents who were wounded during a gun battle understood that they must
give themselves time to recover mentally and emotionally from the incident. Those agents who were at
the scene and were not physically wounded became disconcerted by their personal response to the
inevitable reaction to the stress. Results of the July 1993, seminar closely matched findings of earlier
police studies on post-shooting reaction by Schaefer (1987).

Since 1983 there have been 37 PCISs with approximately 1,000 attendees and a waiting list of more than
100 individuals. A PCIS is staffed by two Certified Employee Assistance Professionals, two mental health
professionals, and an FBI Chaplain. The seminar is set for approximately 25 attendees and lasts for four
days. Originally, only agents were invited to attend the PCIS. Now family members, professional support
employees and their family members, as well as law enforcement Task Force members are invited.
Through training and education, attendees acquire appropriate coping skills to deal with the effects of the
trauma.

Issues at PCISs have expanded from shooting incidents to any incident that impacts an individual such
as:

• Death of a loved one

• Accidental shooting or death

• Depression

• Suicide or attempted suicide

• Homicide of a family member

• Victim of a violent crime,

• Severe car accident

• Life threatening diseases (e.g., cancer)

• Hostage situation

• Sexual abuse

• Major investigation where there were multiple fatalities (e.g. Waco, Oklahoma City bombing & TWA
Flight 800 crash).

The PCIS format is structured in the following manner:

1.Statement of the goals of a PCIS, an introduction to EAP and CISD, and an emphasis placed on
confidentiality

2.A brief history of PCIS
3. Individual disclosure regarding the sustained trauma.

4. Presentation on the dynamics of stress and stress management

5. Presentation on the dynamics of grief

6. Presentation on depression and suicide

7 Individual work with mental health professionals and chaplain

8. Peer support training

9. Positive reinforcement

After the individual disclosures of the critical incidents, those participants who are experiencing difficulty
have access to professional services in a safe environment. They have the opportunity, on a voluntary
basis, to work one-on-one with mental health professionals who specialize in law enforcement issues
such as post-traumatic stress disorder (PTSD) and may choose to avail themselves of eye movement
desensitization and reprocessing (EMDR; Shapiro and Ronast, 1997).

By openly sharing their traumatic experiences with other attendees, participants receive peer support,
which promotes normalization of their reactions. Participants also learn about trauma and coping
strategies that facilitate healing and recovery. A block of training on providing Peer Support enables
participants to offer constructive personal support to fellow employees who may experience critical
incidents.

The PCIS is often the vehicle which enables individuals who are "stuck” to resolve their incident, as the
following example illustrates:

One agent who attended a PCIS was experiencing distress from a seemingly minor incident during a
surveillance, the suspect realized he was being followed and proceeded to drive at speeds in excess of
100 miles-an-hour. The suspect eventually pulled over on the highway, got out of his vehicle, and
approached the agent. The agent identified himself and the suspect surrendered upon command. Despite
the positive outcome, the incident still bothered the agent. At the PCIS the agent spoke about this incident
and realized that the fear he had experienced stemmed from the accumulation of several past traumatic
experiences. These included Vietnam experiences, being on-scene at two air disasters and engaging in
several hostage negotiations. The agent recognized the connection between the successful pursuit/arrest
and these other situations where he faced his own mortality. With EMDR, further discussion and peer
support, the cumulative stress was resolved. Follow-up has shown the gains to be stable over the past
two years.

Issues of vulnerability, as illustrated in the above example, are commonly dealt within PCIS. The trauma
of witnessing one's partner being shot the grief stemming from the sudden death of a loved one, guilt from
having to use deadly force, and the horror that comes from working at scenes where there have been
mass casualties and fatalities following a bombing or transportation disaster, are some of the other types
of situations dealt with in the PCIS.

Many of those who attend a PCIS volunteer to assist others in the future who experience critical incidents.
These PCIS alumni make up the FBI's Peer Support Program. These agents, employees, and spouses
are valuable resources who provide enlightened interpersonal support to their peers following traumatic
events, The FBI experience has proven that them is no better person to offer support than those peers
who have experienced, and emotionally worked through, a similar event.

The One-Two Punch: Integrating EMDR with PCIS & CISD

The combination of EMDR with the PCIS has led to rapid recovery in attendees experiencing post-
traumatic stress from a single episode. (Permission is granted by the FBI agent to disclose this example.)
Although EMDR is generally effective in one to three 90-minute sessions, the experience of the author is
that the therapeutic gains are even more rapid when EMDR is used within the context of the PCIS.
Though EMDR does not work for everyone, experience with single episode trauma in a 20 to 40 minute
session results in a significant reduction of posttraumatic reactions. The safe atmosphere, peer debriefing
and education initiates a positive working through process which prepares the attendee for further
processing with EMDR.

Similarly, Mitchell and Solomon (1997) found that using EMDR soon after a CISD or a one-an-one
defusing session - the "One-Two Punch” - has been found to be helpful for personnel suffering from
single episode trauma who have a stable support system. The CISD or one-on-one defusing structure
facilitates an understanding of the impact of the event and provides support and guidance toward
adaptive resolution. EMDR appears to have a very powerful and rapid effect after such intervention,
perhaps because of this initial processing. EMDR is not one-shot therapy; several sessions of EMDR may
be needed to resolve the incident. Therefore, follow-up is essential.

It must be emphasized that EMDR following a CISD or a one-on-one defusing, or used within the context
of a PCIS, works best for individuals experiencing acute symptoms from a specific incident who have a
stable support system and living situation. Though EMDR is applicable for complex PTSD reactions or
symptoms due to cumulative stress, a more thorough preparation and assessment should be completed
before initiating EMDR. Further, EMDR can sometimes open up other emotional issues and bring
unresolved traumas to the fore. Therefore, EMDR should be administered by a trained clinician who can
determine the appropriateness of EMDR. Follow-up is essential to ensure treatment effects are
maintained and to deal with other emotional material that may arise.

The "One-Two Punch" has led to an enhanced role for Peer Support personnel and increased interaction
between peers and mental health professionals. Under supervision by the clinician, peers often help
prepare the person for EMDR by discussing the impact of the incident prior to the EMDR session, debrief
the person following EMDR session, and provide follow-up contact. Peer Support personnel report a
greater sense of satisfaction because of their close involvement in the healing process. Clinicians
appreciate the peer involvement because the initial preparation can save time. The close working
relationship between clinicians and peers has led to earlier intervention than conventional referral may
afford, which ultimately benefits the affected person (McNally & Solomon, 1999).

Conclusions

EAU has evolved into a broad-brush program involving, in a confidential environment, prevention and
intervention services for problem that interfere with job performance. The scope of EAP services has
broadened since the formation of EAU in 1994, including the CISD Regional teams which respond to all
critical incidents and the PCISs which address specific critical incidents.

EAP exists to help troubled employees and management to resolve performance problems without
incurring the unwanted costs associated with absenteeism, administrative inquiries, and potential
termination of employment which may result when problems go unaddressed. EAU follows a proactive
model, which has provided specialized trauma reduction programs for Bomb Technicians, Evidence
Response Teams and Engineering Research Facility personnel. As a preventative measure, EAU not
only introduces EAP and other related programs and services to all new agents, but they are forearmed
with the knowledge of the kind of trauma they my experience during the tenure of employment.

The FBI environment is highly stressful due to the mature of the work and increased violence directed at
law enforcement FBI agents typically build walls around their emotions to suppress and deny their
unwanted feelings or emotional pain in order to maintain an image of strong self-control. Expectations of
FBI employees are mirrored through their friends, parents and especially one's peers. Our expectations
directly affect the amount of trauma we suffer, whether it is from a shooting incident or the death of a
loved one. We all react differently in any critical incident. Asking for help is not a sign of personal
weakness or failure, but one of inner strength. The motto of EAU is "Serving Those Who Serve!” We are
not talking jobs; we are talking about human lives.

As the FBI approaches the 21st Century, there is an expected increase in the use of EAU's CISD
responses as the Bureau is now confronted by extremists and criminal enterprises who used to surrender
when confronted by agents, but are now armed with armor piercing bullets and bulletproof vests. We have
witnessed the advent of terrorism on US soil, e.g., bombings of the World Trade Center and the Federal
building in Oklahoma City, and more nuclear, biological and chemical terrorist threats are on the horizon.

EAU is a strategic investment by the FBI in its most important resource - FBI employees. The myriad of
stressors inherent in fulfilling the highly demanding everyday pressures of law enforcement in a fast-
paced and everchanging society requires a proactive and preventative approach by EAU.

References

McNally, V.J. & Solomon, R.M. (February 1999). 'The FBI's critical incident stress management program.
The FBI Law Enforcement Bulletin, 68, (25).

Mitchell, J.T. & Solomon, R.M. (1997). "ClSM and EMDR!' paper presented at the Fourth World Congress
on Stress, Trauma, and Coping in the Emergency Services Professions, Baltimore, Maryland.

Schaefer, R. (Winter, 1987). Post shooting trauma the role of the FBI manager. Management Quarterly
(US Department of justice-Federal Bureau of Investigation; Volume 1, Number 1). Washington, DC.

Sharpiro, F. & Forrest, R. (1997). Eye Movement Desensitization and Reprocessing. NY: Basic Books.

Stratton, J., Parker, D., & Snibbe, J. (1987). Post-Traumatic Stress disorder and perennial stress -
diathesis controversy. Journal of Nervous and Mental Disease, 175, (5)_

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Fbi EAP Prog Article

  • 1. FBI's Employee Assistance Program: An Advanced Law Enforcement Model SSA Vincent J. McNally, MPS, CEAP, BCETS ABSTRACT: As we approach the 21st century the FBI has enhanced its Employee Assistance Program (EAP) to include EAP services, Peer Support and Critical Incident Stress Management/Debriefing (CISM/ D) and Chaplains' Program. This EAP is now anticipating the future to include a Compassion Fatigue Program for its counselors and coordinators, as well as developing CISD protocols for incidents involving weapons of mass destruction. As the FBI has accepted new challenges in the investigative arena throughout the world, so the FBI's Employee Assistance and related programs have set out to support their employees and family members with a continuum of integrated confidential services. The FBI recognizes that its most important asset is its personnel, and EAP is the vehicle to assist the FBI family in remaining healthy and strong for the continuous quest to fulfill its mission. [International Journal of Emergency Mental Health, 1999, 2, 109-114.] KEY WORDS: FBI; employee assistance; peer support program; post critical incident; CISM; eye movement desensitization and reprocessing; EMDR; critical incident stress management Introduction The purpose of the Federal Bureau of Investigation's (FBI) Employee Assistance Program (EAP) is to provide free, confidential, short-term counseling and referral assistance to all employees with personal problems that adversely affect their job performance and health. Each FBI office has an EAP Coordinator (EAPC) who is trained to identify an underlying problem and to refer the employee to an appropriate resource in the community. The EAP also helps employee family members deal with stressful situations by affording appropriate counseling and referral services. The EAP helps employees identify problems, resolve issues and improve productivity while on the job; the goal is to help individuals in a time of personal crisis. Some of the on-the-job behaviors that may indicate an employee needs assistance are: 1. Frequent accidents 2. Missed deadlines 3. Withdrawal from co-workers 4. Frequent absences 5. Frequent mistakes 6. Frequent tardiness Other issues that could adversely affect job performance include substance abuse, financial difficulties, health issues, the death or serious injury of a family member, or a shooting incident The role of the EAPC is to link employees or family members with the proper community resource and ensure continued recovery. The emotional baggage we carry, whether it is depression, stress, or family issues, impacts upon our work. The key to surviving at work lies in how much we like our job and how we manage stress. EAP is the primary vehicle to address those issues and minimize the trauma associated with them, with
  • 2. confidentiality as the cornerstone of the program . In late 1993, Director Louis I Freeh recognized the potential of Employee Assistance programs, particularly in an organization with nearly 25,000 employees with roughly 75,000 immediate family members. He elevated the program, making it a high priority within the Bureau. The EAP, previously a subprogram of the Health Care Program Unit, became the self-contained Employee Assistance Unit (EAU). The new unit has evolved into a major support component for the FBI family, and now consists of four programs including the Critical Incident Stress Management/Debriefing Program (CISM/D), Peer Support Program, and the Chaplains' Program, which were formerly administered by the Behavioral Science Unit at the FBI Academy, Quantico, Virginia, as well as the EAP. EAP: New and Improved Today, there are more than 300 EAP coordinators counselors, and agent and professional support groups: located throughout the field and at FBI headquarters, ready at a moment's notice to help employees and family members cope with a problem. EAP is a peer-based program. The coordinators and counselors are well trained, with some having advanced degrees or certification in a variety of professional fields. They are mandated to participate in annual training on a wide variety of subjects, including depression and suicide awareness, workplace violence and crisis intervention, death notification, stress management, the effects of various medications, financial counseling, resolution of traumatic experiences, and issues concerning the use of alcohol, drugs, and other substances. The EAP provides assessment, short-term counseling, and referral to a mental health professional within the employee's insurance plan or to a low-cost or no-cost community resource. It also provides follow-up services. The EAP also finishes training for and guidance to Bureau supervisors and management and educational instruction for employees when requested. To enhance EAP training in the field, Supervisory Special Agent Vincent J. McNally, current head of the EAU, has assigned four full-time Special Agent EAP Regional Manager positions in New York, Chicago, Houston, and Los Angeles. These Regional Managers, who serve a five-year term, will be responsible for the training of EAP coordinators, along with supervisors and managers in the field. Another first for the EAP was the employment of a full-time clinical psychologist and psychiatrist who both came aboard in 1998. Prior to their employment, the EAP used the services of contract mental health professionals. The psychologist, as Chief of Counseling Services for the EAP, provides oversight and guidance to EAU's five full-time counselors, and also offers guidance and consultation to EAP coordinators, counselors and regional program managers in the field. The psychiatrist is the medical consultant to the unit and its four programs, and frequently conducts emergency psychiatric evaluations. The EAP gets its business from several different sources. If the employee is the one who recognizes a problem or feels overwhelmed with-what is taking place in their life, they can contact an EAP counselor directly, or a concerned family member may do it for the employee. If the problem is adversely impacting work, the supervisor, after first letting EAP know that this step is officially being taken, may refer the employee to the EAP. Whether the employee contacts the EAP or not is totally up to the employee. If a family member is experiencing some difficulties, the employee or the family member can contact the program and receive help for that person. FBI Chaplains' Program There are over 100 volunteer Chaplains nationwide. Each office has one or more Chaplains depending upon the size and territory covered. Most offices have two Chaplains and some large offices have more. Chaplains are called upon to respond to the most difficult circumstances and critical incidents/trauma,
  • 3. e.g., shooting at the District of Columbia Police Headquarters where two FBI agents were killed and one seriously wounded, the Oklahoma City bombing, TWA Flight 800 crash, Los Angeles earthquake, Hurricane Andrew in Florida, traumatic death of a spouse or child, suicides, line of-duty death or injury, etc… In addition, they provide a number of professional services including counseling on a number of issues (e.g., spiritual, long-term & debilitating illness, death and bereavement coping skills, marital issues and family problems, stress and anger management, family members with substance abuse problems), as well as response and debriefing services for FBI families in the event of the death of an employee or family member. FBI Chaplains provide the Bureau with an estimated 20,000 hours of direct services annually at little cost to the FBI. The majority of FBI Chaplains are experienced Police Chaplains who have extensive credentials and depth of background which enable them to respond to a wide variety of matters. Chaplains are investigated, receive top-secret security clearances, FBI credentials, unrestricted and unescorted access to FBI personnel, and space to ensure confidentiality. The Visiting Chaplain Program at the FBI Academy, Quantico, gives FBI Chaplains the opportunity to spend two or more weeks at the training facility providing a number of services to the New Agent classes, National Academy students, and FBI employees at the facility. They also participate in ceremonies at the training academy and hold religious services in the chapel. FBI Chaplains play an important role as members of the four regional Critical Incident Stress Debriefing teams, providing support to FBI employees, family members and task force members involved in a critical incident or suffering from a traumatic experience. Critical Incident Stress Management/Debriefing (CISM) Program The purpose of the Critical Incident Stress Management (CISM policy is to afford those individuals who are exposed to or involved in critical incidents (e.g., shooting, death or serious injury, suicide, homicide, hostage situation, SWAT activity) a confidential program that will mitigate the adverse impact of the critical incident through peer counseling and critical incident stress debriefing (CISD). The trauma of a critical incident is catastrophic to the person experiencing the event. A critical incident is not only one single situation in a person's life, but it can also be a series of events, which add up to cumulative stress. No two individuals have the same reaction to a critical incident. In a study of police officers who had been involved in a shooting incident Stratton, Parker, and Snibbe (1987) found that 35% of the officers reported that the event had little long-term impact upon them while 60% indicated that the incident had a substantial impact on their lives after the event. How an individual responds to a critical incident depends upon the nature and extent of the "emotional baggage" the person is carrying. The failure to resolve personal issues often leads to a variety of negative thought or behavior patterns. Some individuals overreact to perceived threats, while others under-react to clear dangers. While some employees quit their jobs prematurely, others develop performance problems due to increased absenteeism, burnout, stress disorders, alcohol abuse problems or a host of other personal problems that can interfere with functioning at home and on the job. Agents are trained, equipped with firearms and bulletproof vests to help them survive critical incidents. The FBI is also responsible for equipping its employees with the ability to deal constructively with and survive, the emotional aftermath of critical incidents. A comprehensive CISM program includes a set of interventions that help FBI employees cope with the physical and emotional effects of a critical incident. In June, 1995, the FBI instituted four CISD Regional Teams throughout the United States for immediate response to the following critical incidents: • Death of an employee, spouse or other family members • Natural and man-made disasters and catastrophes (earthquakes, bombings, etc.)
  • 4. • Taking a life in the line-of-duty • Suicide of an employee, spouse, or other family member • Violent traumatic injury to an employee • Death of a crime victim • Witnessing and handling multiple fatalities • SWAT operation where dangers are present • Hostage taking, barricaded suspect and negotiation • Observing an act of corruption, bribery or other illegal activity • A suspension and/or threat of dismissal • Other traumatic incidents Agents and support personnel who are members of the four Regional CISD Teams have been certified in Basic and Advanced CISM training conducted by the international Critical Incident Stress Foundation. There are approximately 100 team members consisting of EAU Headquarters and field staff FBI Chaplains and mental health professionals with experience in police psychology and trauma response. Bi-annual Advanced Peer Support training is afforded team members. This is a week-long comprehensive program that brings team members together to discuss difficult debriefing, team use scenarios, the chaplain's role, compassion fatigue, and strategies for surviving a critical incident. CISD team responses have increase dramatically over the years since their inception in 1995, when there was just one response. Responses increased to 18 in 1996,29 in 1997, and 45 responses in which 1,550 personnel were provided services in 1998. CISD teams worked with those involved in the TWA Flight 800 investigation and the bombing of the Oklahoma City Federal building. The teams work with affected employees, and family members when necessary, to help everyone involved or adversely impacted come to terms with what has happened. Sometimes a critical incident, especially one involving the death or injury of a co-worker, can adversely impact an entire office. In those cases, the CISD team will help managers in that office understand how they can be supportive in the emotional aftermath of an incident. Peer Support Program/Post Critical incident Seminars (PCIS) In July 1983, 14 agents attended the first PCIS at the FBI Academy. This group explored the issue of post-shooting trauma with a goal of establishing an FBI policy to neutralize die effects of the agent’s reactions in a shooting incident A questionnaire, interview, group discussion and follow-up interviews with spouses of the attendees were the agreed upon protocols developed by this group. From the seminar interviews the following reactions to a shooting were noted: 1. Some agents noted that despite their physical and mental preparation, they had trouble believing it was really happening to them 2. Generally, agents responded automatically based upon their training. 3. Some agents felt a rush of adrenaline while others felt fear. 4. Some thoughts included "Am I legally, procedurally, and morally correct
  • 5. 5 Some: agents experienced distorted perceptions, seeing the event in slow motion or through runnel vision, and some did not hear the gunshots during a shooting incident. 6. Some agents experienced a "cross over syndrome' whereby the affected person believed that he or she was now the "bad guy." This occurred when the agent was on the side of the law one minute, then under investigation by their own organization as well as the community, media, and also themselves in the aftermath of the shooting. 7. It has been determined that agents who were wounded during a gun battle understood that they must give themselves time to recover mentally and emotionally from the incident. Those agents who were at the scene and were not physically wounded became disconcerted by their personal response to the inevitable reaction to the stress. Results of the July 1993, seminar closely matched findings of earlier police studies on post-shooting reaction by Schaefer (1987). Since 1983 there have been 37 PCISs with approximately 1,000 attendees and a waiting list of more than 100 individuals. A PCIS is staffed by two Certified Employee Assistance Professionals, two mental health professionals, and an FBI Chaplain. The seminar is set for approximately 25 attendees and lasts for four days. Originally, only agents were invited to attend the PCIS. Now family members, professional support employees and their family members, as well as law enforcement Task Force members are invited. Through training and education, attendees acquire appropriate coping skills to deal with the effects of the trauma. Issues at PCISs have expanded from shooting incidents to any incident that impacts an individual such as: • Death of a loved one • Accidental shooting or death • Depression • Suicide or attempted suicide • Homicide of a family member • Victim of a violent crime, • Severe car accident • Life threatening diseases (e.g., cancer) • Hostage situation • Sexual abuse • Major investigation where there were multiple fatalities (e.g. Waco, Oklahoma City bombing & TWA Flight 800 crash). The PCIS format is structured in the following manner: 1.Statement of the goals of a PCIS, an introduction to EAP and CISD, and an emphasis placed on confidentiality 2.A brief history of PCIS
  • 6. 3. Individual disclosure regarding the sustained trauma. 4. Presentation on the dynamics of stress and stress management 5. Presentation on the dynamics of grief 6. Presentation on depression and suicide 7 Individual work with mental health professionals and chaplain 8. Peer support training 9. Positive reinforcement After the individual disclosures of the critical incidents, those participants who are experiencing difficulty have access to professional services in a safe environment. They have the opportunity, on a voluntary basis, to work one-on-one with mental health professionals who specialize in law enforcement issues such as post-traumatic stress disorder (PTSD) and may choose to avail themselves of eye movement desensitization and reprocessing (EMDR; Shapiro and Ronast, 1997). By openly sharing their traumatic experiences with other attendees, participants receive peer support, which promotes normalization of their reactions. Participants also learn about trauma and coping strategies that facilitate healing and recovery. A block of training on providing Peer Support enables participants to offer constructive personal support to fellow employees who may experience critical incidents. The PCIS is often the vehicle which enables individuals who are "stuck” to resolve their incident, as the following example illustrates: One agent who attended a PCIS was experiencing distress from a seemingly minor incident during a surveillance, the suspect realized he was being followed and proceeded to drive at speeds in excess of 100 miles-an-hour. The suspect eventually pulled over on the highway, got out of his vehicle, and approached the agent. The agent identified himself and the suspect surrendered upon command. Despite the positive outcome, the incident still bothered the agent. At the PCIS the agent spoke about this incident and realized that the fear he had experienced stemmed from the accumulation of several past traumatic experiences. These included Vietnam experiences, being on-scene at two air disasters and engaging in several hostage negotiations. The agent recognized the connection between the successful pursuit/arrest and these other situations where he faced his own mortality. With EMDR, further discussion and peer support, the cumulative stress was resolved. Follow-up has shown the gains to be stable over the past two years. Issues of vulnerability, as illustrated in the above example, are commonly dealt within PCIS. The trauma of witnessing one's partner being shot the grief stemming from the sudden death of a loved one, guilt from having to use deadly force, and the horror that comes from working at scenes where there have been mass casualties and fatalities following a bombing or transportation disaster, are some of the other types of situations dealt with in the PCIS. Many of those who attend a PCIS volunteer to assist others in the future who experience critical incidents. These PCIS alumni make up the FBI's Peer Support Program. These agents, employees, and spouses are valuable resources who provide enlightened interpersonal support to their peers following traumatic events, The FBI experience has proven that them is no better person to offer support than those peers who have experienced, and emotionally worked through, a similar event. The One-Two Punch: Integrating EMDR with PCIS & CISD The combination of EMDR with the PCIS has led to rapid recovery in attendees experiencing post-
  • 7. traumatic stress from a single episode. (Permission is granted by the FBI agent to disclose this example.) Although EMDR is generally effective in one to three 90-minute sessions, the experience of the author is that the therapeutic gains are even more rapid when EMDR is used within the context of the PCIS. Though EMDR does not work for everyone, experience with single episode trauma in a 20 to 40 minute session results in a significant reduction of posttraumatic reactions. The safe atmosphere, peer debriefing and education initiates a positive working through process which prepares the attendee for further processing with EMDR. Similarly, Mitchell and Solomon (1997) found that using EMDR soon after a CISD or a one-an-one defusing session - the "One-Two Punch” - has been found to be helpful for personnel suffering from single episode trauma who have a stable support system. The CISD or one-on-one defusing structure facilitates an understanding of the impact of the event and provides support and guidance toward adaptive resolution. EMDR appears to have a very powerful and rapid effect after such intervention, perhaps because of this initial processing. EMDR is not one-shot therapy; several sessions of EMDR may be needed to resolve the incident. Therefore, follow-up is essential. It must be emphasized that EMDR following a CISD or a one-on-one defusing, or used within the context of a PCIS, works best for individuals experiencing acute symptoms from a specific incident who have a stable support system and living situation. Though EMDR is applicable for complex PTSD reactions or symptoms due to cumulative stress, a more thorough preparation and assessment should be completed before initiating EMDR. Further, EMDR can sometimes open up other emotional issues and bring unresolved traumas to the fore. Therefore, EMDR should be administered by a trained clinician who can determine the appropriateness of EMDR. Follow-up is essential to ensure treatment effects are maintained and to deal with other emotional material that may arise. The "One-Two Punch" has led to an enhanced role for Peer Support personnel and increased interaction between peers and mental health professionals. Under supervision by the clinician, peers often help prepare the person for EMDR by discussing the impact of the incident prior to the EMDR session, debrief the person following EMDR session, and provide follow-up contact. Peer Support personnel report a greater sense of satisfaction because of their close involvement in the healing process. Clinicians appreciate the peer involvement because the initial preparation can save time. The close working relationship between clinicians and peers has led to earlier intervention than conventional referral may afford, which ultimately benefits the affected person (McNally & Solomon, 1999). Conclusions EAU has evolved into a broad-brush program involving, in a confidential environment, prevention and intervention services for problem that interfere with job performance. The scope of EAP services has broadened since the formation of EAU in 1994, including the CISD Regional teams which respond to all critical incidents and the PCISs which address specific critical incidents. EAP exists to help troubled employees and management to resolve performance problems without incurring the unwanted costs associated with absenteeism, administrative inquiries, and potential termination of employment which may result when problems go unaddressed. EAU follows a proactive model, which has provided specialized trauma reduction programs for Bomb Technicians, Evidence Response Teams and Engineering Research Facility personnel. As a preventative measure, EAU not only introduces EAP and other related programs and services to all new agents, but they are forearmed with the knowledge of the kind of trauma they my experience during the tenure of employment. The FBI environment is highly stressful due to the mature of the work and increased violence directed at law enforcement FBI agents typically build walls around their emotions to suppress and deny their unwanted feelings or emotional pain in order to maintain an image of strong self-control. Expectations of FBI employees are mirrored through their friends, parents and especially one's peers. Our expectations directly affect the amount of trauma we suffer, whether it is from a shooting incident or the death of a loved one. We all react differently in any critical incident. Asking for help is not a sign of personal weakness or failure, but one of inner strength. The motto of EAU is "Serving Those Who Serve!” We are
  • 8. not talking jobs; we are talking about human lives. As the FBI approaches the 21st Century, there is an expected increase in the use of EAU's CISD responses as the Bureau is now confronted by extremists and criminal enterprises who used to surrender when confronted by agents, but are now armed with armor piercing bullets and bulletproof vests. We have witnessed the advent of terrorism on US soil, e.g., bombings of the World Trade Center and the Federal building in Oklahoma City, and more nuclear, biological and chemical terrorist threats are on the horizon. EAU is a strategic investment by the FBI in its most important resource - FBI employees. The myriad of stressors inherent in fulfilling the highly demanding everyday pressures of law enforcement in a fast- paced and everchanging society requires a proactive and preventative approach by EAU. References McNally, V.J. & Solomon, R.M. (February 1999). 'The FBI's critical incident stress management program. The FBI Law Enforcement Bulletin, 68, (25). Mitchell, J.T. & Solomon, R.M. (1997). "ClSM and EMDR!' paper presented at the Fourth World Congress on Stress, Trauma, and Coping in the Emergency Services Professions, Baltimore, Maryland. Schaefer, R. (Winter, 1987). Post shooting trauma the role of the FBI manager. Management Quarterly (US Department of justice-Federal Bureau of Investigation; Volume 1, Number 1). Washington, DC. Sharpiro, F. & Forrest, R. (1997). Eye Movement Desensitization and Reprocessing. NY: Basic Books. Stratton, J., Parker, D., & Snibbe, J. (1987). Post-Traumatic Stress disorder and perennial stress - diathesis controversy. Journal of Nervous and Mental Disease, 175, (5)_