The Power of Debriefing After An Incident

Travis:
You are listening to all clear a firefighter health and wellness podcast, season one, episode three, the power of debriefing after an incident. I am Travis McGaha and this is my cohost Eric Stevenson. How you doing today, Eric?

Eric:
Good, how are you?

Travis:
Oh man. I'm just hanging in there having a wonderful week. Ah, so, uh, looks like we're going to be talking about something that falls into your realm of expertise today. Talking about debriefing. What's your, uh, So there's a lot to be said there. I know I have some ideas about what debriefing is. I've been through quite a few of them in my time, but I'm sure you've got a unique perspective and how beneficial it can be.

Eric:
I really do, both on the receiving end of them and the giving end of them. Unfortunately, throughout my career, there were a lot of incidents that probably should have had some stress management involved in them from the organizational side that never really took place. And then being part of the peer team now. we do get the request to go in and help other agencies with making sure that their people are taken care of after critical incidents. As a matter of fact, we have been dealing with an agency fairly close to Carter County that had a pretty bad incident take place. And they requested our services last week and just recently scheduled over the last couple days where we will be back up there and we are going to be doing a debriefing for their organization.

Travis:
Ah, excellent. Excellent. So I know that when we start talking about debriefing, you mentioned that you've been on both the receiving end and also on the giving end.

Eric:
Yeah.

Travis:
And I know a lot of attention has been given to that more and more as we talk about mental health and wellness. It's kind of coming to the fore, you know, probably eight, 10 years ago. How many people was like, ah, we got to go to a debriefing. Oh man, I don't want to go talk about it. Oh, what is this for? Um, you know, it used to be more about just talking about, you know, the tactics that were used at the scene. Were they effective? Were they not? But is that what you're talking about? Are you talking about something a little different?

Eric:
Now we're talking about something completely different. We try to leave the tactics of how the incident happened, what took place on the incident, decisions that were made, things like that. We try to take that side out of an actual debriefing because we're trying to mitigate the stressful part of the incident. get in touch with people's emotional side and the feelings that they're having. You know, the actual debrief, the purpose of a debriefing is to mitigate the impact of the incident. Not necessarily... what our roles and responsibilities were, command, could have made better decisions or whatever else, you messed up on this, you messed up on that. That's not what the debriefing's all about. It's to start to mitigate the impact on what it's having on your personnel and hopefully be able to speed up the recovery process.

Travis:
OK, all right, so this is the code enforcement side of me coming out. Are there any standards or requirements that are in place for a for a debriefing session after a major incident?

Eric:
make sure I'm tracking correctly. So like an individual agency having things in place

Travis:
Well, other than what

Eric:
or

Travis:
the, other than what the agency would have, are you required to do one? Does a chief have to do one or does the captain have to do one? Or is that just kind of at the discretion?

Eric:
And this brings up a whole realm of ideas, discussion points. You know, you've opened up a box here.

Travis:
That's what I was poking for.

Eric:
Yeah. And that's really, really good because just like on the fire side, the EMS side, law enforcement side, we are regulated with some of the things that we have to do. But there is nothing that mandates that I'm aware of. that mandates that after a critical incident, you should be sitting down with your people talking about it. Is that the correct thing to be doing? Is that the logical, sensible thing to be doing? Absolutely it is. But I don't know of anything, and I don't wanna speak out of context here that I am aware of that mandates departments to have to do this.

Travis:
Okay. So obviously this is an elective thing, but no doubt it has immense value. So when you do a, um, a debriefing, say after the incident you were mentioning earlier,

Eric:
Mm-hmm.

Travis:
how soon do you try to conduct it after the actual incident?

Eric:
This agency, for instance, was very proactive. As soon as they realized they had an incident with a negative impact on one of their own personnel, while they were still on scene, they reached out and they contacted our team. So that evening, we were up there at that specific agency. Is that the time to be doing actual debriefings and things like that? No. It's too early in... too early of an onset. That's very acute right there. So usually what we will do, we'll honor the request, we'll go sit down, and we do what we call a crisis management briefing. We get engaged in a field of everybody that was involved in the incident. We allow them to talk if they would like to talk about certain feelings, certain emotions. fears that might be coming up. So we do have talks, but really what we do during the CMB is we talk about the physical and the mental, emotional side of that incident. We give them a heads up that this is early on into an incident. These are some of the things that you might be experiencing physically or emotionally. is a reaction due to a horrible situation that you were just a part of. And that's one thing that we find a lot of people really don't understand when it comes to critical incidents, that the way your body responds, that is a normal reaction to an abnormal situation that we were put in. Witnessing death, having a close call of your own, personal loss. involved with an incident, seeing traumatic results of an accident. We see a lot of things that a lot of people should not be witnessing. And we do that repeatedly in our line of work. So we let people know that no matter what they're feeling due to that incident, it is, it is a normal reaction to be having and how to, how to try to mitigate. some of those feelings, some of those emotions. Emotional regulation is extremely important, but when we are exposed to bad things on a regular basis, sometimes that's difficult to do. When it comes down to actually doing a debriefing, we try to keep it in the wheelhouse of 10 to 12 days after the actual critical incident. If we can do that. You know, coming in initially like we did the other night, doing a defusing, get a gauge on everybody, do the crisis management briefing, let them know what resources are available to them, things of those lines. And we do follow-ups. We do follow-ups with the agency, we do follow-ups with individuals that we think might be struggling the most, informing. supervisors and coworkers of signs and symptoms of what to be looking out for for each other is extremely important. So we go over all of those. And then if we have people that are still struggling 10, 12, 14 days out from that incident, we need to be thinking along other lines of how we can start to to relieve some of the stress that these people are carrying around with them.

Travis:
So this makes me think of two things right off the top of my head. Number one, you can have impacts days, weeks, months after the actual incident. and different people react in different ways. And you know, I think about, and you know this is the case, first responders and you know, the firefighters tend to have, a lot of them tend to have a very morbid, very dark sense of humor. They laugh at things that other people might just be absolutely freaked out about when you hear it, and they would think it would be disrespectful. Can that possibly serve as a pressure relief for some people? I mean, obviously not for everybody, but do you think that might be one of the coping mechanisms that we develop in our line of work?

Eric:
Oh, absolutely. Yeah, that's 100%. It happens all the time. Um, and can it be healthy? Sure. It can. Um, you know, we're joking around, we're cutting up, hanging out with the, with the crew and yeah, there, there's going to be some dark humor, probably. Um. Can it be a porcopy mechanism as well? Yes, absolutely it can be. Where do we draw the line? That's knowing your people.

Travis:
Mm-hmm.

Eric:
If you notice somebody that is using dark humor a lot more than they usually do, or maybe they've never used it before, yeah, that'd be a red flag for me. That'd be one of those warning signs that this individual, I've... I might just go put my hand on his shoulder and, hey, you okay? And

Travis:
So.

Eric:
give him a simple question.

Travis:
So in addition to, uh, out of ordinary humor, things like that, that you mentioned like the morbid humor, what are some of the other symptoms that I should be looking for? Our listeners should be looking for, you know, especially if they're in a leadership role, whether it be company officer, chief officer, what are, what, I guess what would be a thumbnail sketch of some of the things that could indicate that even after a debriefing that things, uh, things might need to be stepped up a little bit.

Eric:
That's a good question. Some of the warning signs that we tell people to look out for, behavioral changes. Any type of behavioral change, mood swings, attitudes, work performance, those are all indicators, potential indicators anyway that somebody might be struggling. The demeanor, the way an individual is carrying themselves. If they're usually a happy-go-lucky person at work and all of a sudden they're, uh, you know, down in the dumps or just not acting themselves, that's something we should be paying attention to as well. Just asking simple questions, you know, hey, how are you sleeping today? If they tell you that they're not sleeping well, that's a problem. Eating, emotional eating is a huge indicator. Whether that is overeating to compensate and try to make themselves feel better, or they just stop eating altogether. You know, somebody that's usually eating three or four times a day on shift, and you only see them eat once. That could be a problem where we need to be asking some questions.

Travis:
And one of the things that I know can be an issue is self-treatment. When, when I say self-treatment, I'm referring to maybe abuse of alcohol or increased use of alcohol. You know, that's not a good thing anytime that safety's involved, but, you know, whether it be drugs, alcohol, whatever, is that a real thing that, that could be a, I guess, a secondary impact from a really traumatic situation.

Eric:
Yes sir, and we see that a lot. We really do. That is probably, anytime I have a contact with a peer, that ranks up there in the top five questions that I always ask is alcohol consumption. Do you drink? Do you socially drink? Are you seeing yourself drinking more than what you usually do in the past? And we do see alcohol use or abuse quite frequently. And there's several different reasons behind that. One on the negative coping mechanism side, it's a numbing agent. It's going to be that place where people think they can escape and get a little loopy in the head. And it's going to help them deal with that. whatever that situation is. Is that a fact? No, it's actually very false. I'm here to tell you right now that you will not find the solutions to your problem at the bottom of a bottle.

Travis:
And I think that that is a conversation that I think, you know, deserves its own attention and, and, uh, episode at some point in the future, but

Eric:
Yeah.

Travis:
yeah. So, you know, it really is sad because I know of cases, um, that I've heard of secondarily of people that have had really good people on their cruise that have just literally fallen apart. after something happens. From my untrained experience, just from the people I know, anytime children are involved in a situation that tends to be really hard hitting. If there's mass casualty, things like that tend to be pretty rough.

Eric:
Yeah.

Travis:
But once you guys identify there is a need. and you guys have been called in, whether it be, I know you kind of mentioned almost like a chaplaincy type of deal when you initially get there, but you know, within a day or two, then that's when I guess the real debriefing begins, but how do you guys conduct a debriefing? What, what do you do? What, what, what's the, I guess the basic process.

Eric:
The first thing that I like to do is read the room. I've got to pick up very quickly on how we are being perceived in that room. And I could either make it better or I could make it worse if I don't read it correctly. You mentioned some things, you know, a few years back. you noticed that it was kind of a hot topic of, oh my gosh, we're having to do this debriefing, we're having to do that debriefing. If a particular agency is saying, everybody that was on this incident needs to be here at this location at this particular time because we were having a debriefing, critical incident stress management, there's gonna be some people that do not wanna be in that room. You know, I don't need to be here. I don't want to be here. I'm okay. That call didn't bother me. Whatever the excuses are, they're being mandated to have to be there. That can be a good thing or a bad thing. I've seen people that have been exactly that way and by the end of the night or throughout a session, they're opening up. because of vulnerability of other people in the room. But what we do... We bring our trained peer team members in with us anywhere between three to four peers, whether it's from our agency or other agencies that we've worked with, that we can rely on that peer support presence. So we'll have anywhere between three to four peers there. We will have a mental health professional there with us as well, especially for those acute. emotional reactions that people might experience during our time in the room together, that we always make sure that we have a mental health professional there with us. We will have a chaplain there with us also, because some people might not feel comfortable talking in front of a group of their peers, and they would feel more comfortable with somebody on the chaplaincy side. They could, you know... maybe help them in a different way than what we can. So we always have our peers, we always have a mental health professional, and we always have a chaplain with

Travis:
And

Eric:
us.

Travis:
you, and you know, that's one of the things that I greatly, um, respect about, uh, you know, your organization in particular is the fact that you guys have resources set up lined up. Like you mentioned, the chaplains, the mental health professionals, I know you guys have resources in place. Hey, it's really bad. We need to, we need to get this guy some, you know, some inpatient help, things like that. You guys are, are, are really, um, well equipped for lack of a better term to handle that stuff. And I know a lot of times there's always classes that are offered through the community colleges and things like that, that any firefighter can go take to be involved and learn how the critical incident management process works. And I myself encourage people to go take that, be knowledgeable. I mean, you may not necessarily be the one that's the best for the job. But if you know what's going on, you see the value and what's happening, you know, there you go. But then we have the folks that are like, you know, the, the, the, the top level, like y'all that know how to do this. But when, when you do start calling in professionals and things like that, how important is it from your experience for that professional to not just be a regular, Hey, I'm a psychiatrist. Hey, I'm a. you know, whatever, but it'd be someone who is well-versed in the needs of first responders, in the realm in which we live sometimes, which is kind of weird and dark and, you know.

Eric:
To me, that's extremely important. Just like any other peer contact that we have, if we make a referral out to a mental health professional, no matter what type of mental health professional, we do a pretty stringent vetting process and we make sure that they understand the work that a first responder does. And that if they have... personal experience in the first responder world, that's even better. Because there is nothing more powerful than. the power of connection, somebody that truly understands what you're going through, what you do for a living, mentioning certain things about a job. If we refer somebody to a mental health professional that does not understand the work of what a first responder does, and we start talking about certain aspects of the job, maybe we bring up the term a hearse tool, hydraulic cutting tool, we know what that is. But if somebody doesn't understand the work that we do, the terminology that we might use, it might not be that warm, fuzzy feeling and that personal connection that somebody might be looking for when they're actually seeking help. So we do do that vetting process and we make sure that they're gonna be compatible as can be between the clients and the person that we're referring them to.

Travis:
And you know, I can speak to it not necessarily from the same angle that you're talking about, but I know like when we've gone to talk to different organizations about, um, you know, our cancer education and programs and things like that, I've seen other organizations try to engage with firefighters, but what's the first thing they do? They shut down and they're not going to listen to what this company or this individual has to say, but the minute that a firefighter comes in and says, Hey, brother, let me tell you, let me tell you about this. The minute that happens, lights come on and friendships are made pretty quick. So...

Eric:
And then, on our side of things, that could make or break, you know, the patient-doctor relationship. It might put a bad taste in their mouth about seeking mental health, professional help, because they didn't have a compatible fit. So we try to make it as smooth and as easy and as enjoyable. of being able to make that connection. How everything works out after that, that is between the counselor, the therapist, mental health professional, and the client that's been referred.

Travis:
Okay. So once your team has been called in to, you know, to handle a debriefing, how long are you guys engaged with that department? Those individuals, is it something that's over after a week or two weeks? Or I know there's probably one or two that might still be a, you know, Hey, this guy really needs some help, but how long are you guys typically engaged with the situation or even from a personal standpoint, do you follow what happens with some firefighters in their career?

Eric:
Yes, absolutely. So let's just take a, we get a request to go to Joe Blow Fire Department to help him with a debriefing. If I don't know anybody in that agency or I don't know that department before the request, we will grant the request, we'll go in, we'll do our thing with them. And I do take it. kind of personal. And that's something that I've had to work on also, not taking this too personal where it becomes problematic for me. But I love what we do and I'm very passionate on what our team does. And so when we get that request, it's kind of like an aha moment. Not that we like to see people that are stuck in the mud, so to speak, but we really enjoy the opportunities that are afforded to us. And I feel like every agency that requests our services, we create a bond. And so the follow-ups, yes, the follow-ups especially within the first few weeks, at least the first two weeks, you know, doing the follow-ups, making phone calls, sending an email to the chief or whoever, hey, just checking, how are your people doing? Do you need anything else from us right now? A lot of the times what we have happen, we'll have, after we do the actual debrief or the critical incident stress management class with them. We have a lot of people that want to open up, but they don't want to open up in a group setting. So we'll do little breakout sessions, have one-on-one peer counseling. And those are the people that we really make our connections with, the one-on-ones, just like every one-on-one that calls into the team. One of the things that we do afterwards is we put an action plan together. And a lot of times that involves follow ups and those are either going to be face to face follow ups or they're going to be phone call follow ups. So we do take it fairly seriously. And to answer your question, maybe a little more specific. Did a debriefing about two years ago with an agency that I really wasn't all that familiar with. It was several counties away from us. And even to this day, I'm in contact with several of their team members, several of their fire department members. Some of my team members still making follow-up calls, check-ins, things like that. So we do get to build, we have the opportunity to build a personal relationship out of this.

Travis:
Yeah, no doubt. No doubt. Well, I, you know, I saw your eyes light up when we started talking about debriefing and things like that, because I know that's something you're very passionate about in your organization. And, and I appreciate you taking some time today to talk about the debriefing process. And we've just begun to scratch the surface and I'm sure at some point

Eric:
Oh yeah.

Travis:
we'll, we'll, we'll dig in a little bit more on it. But, uh, You know, it's really awesome to see that these things are available, even if your own individual department, you know, and I encourage our listeners, if they're not, um, engaged in some type of peer support program, Chris, critical incident stress management, get. You know, get some training. Um, you know, you can reach out to Eric. I'm sure he can, um, guide folks to, uh, some good resources. Um, I

Eric:
Absolutely.

Travis:
know there's people, I know there's people outside of North Carolina listening to us. Heck. I learned that there are people in Germany and, uh, the UK that are actually downloading our podcast that, uh, you know, that's kind of, yeah,

Eric:
That's amazing.

Travis:
kind of awesome and humbling at the same time. So hopefully our information will be helpful, but, uh, you know, uh, One of the things that we try to do is get out among people and talk to them. And I just wanted to kind of talk about a few places that will be over the next few months heading toward the end of this year. I can't believe we're already almost halfway through it,

Eric:
It's

Travis:
but

Eric:
crazy.

Travis:
uh, I know coming up June 13th and 14th, you and I both will be at the North Carolina Association of Fire Chiefs Leadership Conference. It'll be right down there not far from you in Wilmington, North Carolina. I think we've got SAFER, which is the fire rescue expo up in Raleigh, in August 10th through 12th. That's always a big one for us. We always have fun with that. We will be teaching at the... Fire Chiefs Association Executive Officer School on October 24th. And tentatively we will be teaching at the Cleveland Community Fire College on November 11th out there near Shelby, North Carolina. But that's just a few, I'm sure more will come and go. And what, what do you have lined up that might be some good opportunities for folks to come out and see you guys and

Eric:
Uh,

Travis:
us maybe.

Eric:
yeah, like you mentioned, uh, we will be joining you in Wilmington in June. Uh, June is that week, especially in June is pretty busy for us. Uh, because the day we pack up from Wilmington, we're headed down to South Carolina to the South Carolina state, uh, fireman's association conference, which is pretty much like the North Carolina safer convention, uh, we'll be down there the 14th through the 17th of June. July, I will be presenting a surviving to thriving class presentation at the Emergency Services Behavioral Health Summit in Mount Pleasant, South Carolina. And that is an excellent one-day conference. There are some people from your agency, Travis, that attend. But that is a one-day Behavioral Health Summit. We're first responders, mental health professionals, peer teams, line officers, firefighters, paramedics, you name it, everybody attends. And that is hosted by our partners, the Low Country Firefighter Support Team in South Carolina. So we're excited to be down there for that. Of course, August, we've got Safer. And then October, we were going to try to be with you at the executive officers program as well. So yeah, busy couple months coming up, man.

Travis:
Absolutely. And I wouldn't have it any other way. I thoroughly enjoy getting to get out and meet people and see them and talk with them and, you know, getting to hang out with you in person. So pretty, pretty cool too. Um, you know, uh, the other thing, um, that we are going to be encouraging you to do more and more, uh, we are getting our website up now for the podcast. It is all clear podcast.com. Um, You should be seeing that coming live here soon. We'll have our calendars on there and we want people to, you know, email and text or not text us, but email us and communicate with us. Let us know what you want to hear. you know, people talk about, um, it's not just going to be me and Eric. I think we've got some really cool guests lined up in the next couple of weeks. And, um, you know, we really want everybody to refer a friend, uh, let people know, uh, Hey, these guys, they're not totally wackos. They're actually pretty

Eric:
Hehehehe

Travis:
cool. Um, you know, and Hey, we're about to break, I think 50 people. And that isn't just my mom anymore. So we actually have real people listening now and

Eric:
That's

Travis:
we really,

Eric:
great!

Travis:
yes. And you can find us just about everywhere. Um, you know, whether it be, uh, you know, Apple podcast, uh, tune in, um, Heck, we're even on Amazon now. If you ask your lady in the box, I can't mention her name or she'll wake up here next to me. Say, hey, can you play the next episode of the All Clear podcast? And guess what? You'll hear our wonderful dulcimer tones coming through your speaker. So we are there on smart speakers too.

Eric:
It's awesome.

Travis:
Yeah, no doubt. So for right now, if you want to get a hold of me, you can reach me at T.M.C.G.A.H.A. at. ncfirefightercancer.org. Eric, how can they get ahold of you?

Eric:
Mine's a little easier than yours. It is info at frpsn.org.

Travis:
Alrighty. Well, once again, folks, we appreciate you taking time listening to us. Please rate rank us. Let folks know that there's a new podcast out here that deals with firefighter health and wellness and having fun. And one more thing, I do have a question for you, Eric, do you know how to make an egg roll?

Eric:
I'm being set up.

Travis:
Yes, you are being set up because I'm going to hold everybody hostage with dad jokes until we get to at least a hundred listeners.

Eric:
Oh my

Travis:
Um,

Eric:
gosh.

Travis:
so yeah, it's going to be a while. I got

Eric:
People,

Travis:
a bunch of.

Eric:
people, please like and share this immediately.

Travis:
No, but

Eric:
Go ahead with it.

Travis:
you

Eric:
I...

Travis:
know how to make an egg roll, right? You push

Eric:
Sure

Travis:
it.

Eric:
you push it.

Travis:
You push it, absolutely. All right, well, out on that dumb note, we'll talk to y'all later, and we'll see you on the next episode of All Clear.