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Indications for Support Critical incidents that may require a Peer Support response may include but are not limited to Line of Duty Death Line of Duty Injury Multi Casualty Incident Use of Deadly Force Suicide of an Individual or First Responder Event Involving Children Knowing the Victim Excessive Media Interest Prolonged Incident Natural Disasters An Event That is Overwhelming For Any Individual or First Responder What We Offer To Our Community Arms Of Support Survivors Support Group Certified Pastoral Counseling and Coaching Services Drug Addiction Alcoholism Counseling and Support Groups Mental Health Classes Suicide Prevention Workshops SafeTalk and ASIST Mental Health Coaching BCMHC Volunteer and Chaplain Services Toll free 800 649 0925 The Critical 24 hours a day Incident Stress E mail Management Peer chaplainbryano gmail com Website www tuffservicescism org Support Program

About Our Services The Tuff Services Peer Support and Assistance CISM Team provides trained peer support to emergency responders and our local community to effectively build resilience and manage critical incident stress for healthier lives families and communities through education support and assistance for incidental or cumulative critical incident stress experienced in the performance of their jobs and or in the event of major emergencies or natural disasters And we are supported and made up of volunteer Peers Retired First Responders Trained Chaplains and Mental Health Professionals The purpose of this support is to minimize overwhelming reactions you may have to traumatic experiences Our goal is to keep you safe physically mentally emotionally and spiritually so that you can return to your normal activities Emergency services personnel are special in many ways You have special training and special equipment In addition you accept unique challenges exposing yourself to situations that few people in non emergency settings would even consider It is not unusual for you to carry out extraordinary tasks that benefit the lives of your community members as well as others with whom you may come in direct contact Yet no matter how extraordinary your job is how long it takes or the number of people involved you remain a normal human being You are subject to the effects of exposure to excessive danger destruction and overwhelming human misery grief and death Services Provided Pre incident Education In service including o Self Care for the individual or group o Stress Management One to One Support for a peer in crisis Crisis Intervention including o Defusing up to 12 hrs after an incident o Debriefing 12 72 hrs post incident o Crisis Management Briefing also called a Town Meeting for entire crews groups or squads while an event is ongoing or after the event Rest in Transition Services for crews or units as they are demobilized Post Incident Follow up Referrals to a higher level of care Our Tuff Services Peer Support and Assistance Team is trained in the International Critical Incident Stress Foundation s ICISF Mitchell Model for crisis intervention A peer mental health provider or chaplain may be called to assist you based on your individual needs or the needs of your group crew unit Signs of Stress Reactions Physical chills fatigue and exhaustion nausea twitches vomiting headaches grinding teeth profuse sweating and or difficulty breathing Emotional crying or fearfulness feeling numb intensified or unfamiliar feelings guilt grief panic denial anxiety agitation irritability intense anger emotional outbursts overwhelmed feelings and or emotional response Behavioral withdrawal at work or home inability to rest change in social activity change in speech patterns loss or increase in appetite increased alcohol consumption change in social activity intensified pacing change in sleep patterns fear of being alone in the dark arguing or disobeying rules Cognitive confusion nightmares uncertainty hyper vigilance suspiciousness intrusive images blaming someone difficulty problem solving poor concentration disorientation and or poor memory We offer confidential informal meetings on your turf There are no cameras notes or records All responses are held in confidence unless a responder indicates harm to self or others The CISM meeting is not an investigation operational debriefing or after action report Your emotional well being is important to us We try to provide you with a safe structured environment to discuss the incident Talking about it with others who were on scene often helps you to release stress restore your confidence and recover your emotional health We like to refer to our services as helping you get back to a new normal These reactions are common among most individuals and may occur immediately or days after the incident The important part to remember is that these are reactions you might expect You may also experience other reactions not listed If they continue after a period of four six weeks consider talking with a trained CISM peer about your reactions Help is available Spiritual questioning why change in beliefs about God or higher power change in attendance at services or religious activities