Peer Review
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PEER REVIEW
Abstract
Critical incidents are tragic occurrences within human society in the contemporary world; thus, there is a concern to devise appropriate mechanisms of curbing such happenings. The World Health Organization (WHO) defines critical incidents as a situation that is out of the range of everyday experience and becomes a threat to the lives of the involved persons. In most cases, these incidents are abrupt and unexpected, resulting in trauma and disrupting normal operations within a region (Workpositive, 2020). The primary triggers of these incidents are natural calamities such as; hurricanes, cyclones, and floods; however, some traumatic experiences occur as a result of human activities like technological disasters. The magnitude of critical incidents is often high, overwhelming the response teams to contain the situation appropriately. As a result, the emotional and psychological effects of the occurrence, most often emanating from its consequences such as death, injuries, and destruction of properties, have a lasting impact on the victims (Bott & Tourish, 2016). Hence, there is a need to come up with early intervention mechanisms to help the victims fully recover from the incident through well-defined sequential approaches to restore normalcy.
Causes of critical incidents
Critical incidents often occur abruptly without an expectation that they will occur. In most cases, they occur as a result of technological disasters involving multiple participants for an explosion to occur. In most cases, equipment accidents or explosions within companies occur as a result of human activities. It is important to report when such incidents occur to allow the management teams to take necessary measures to help the individuals recover from the terrible ordeals. The impact may not be huge, but it has repercussions on the victims’ memory and emotional lives. According to Fetherston (2015), critical incidents are likely to occur within a hospital setting than within public transport; this is because of complexities such as workload and funding challenges in healthcare. For instance, in the United Kingdom (UK), the National Health Service (NHS) believed that up to 10 percent of critical incidents occur in the facilities during admission. Human errors, crocked procedures, and fault equipment underline most of the disasters.
Addressing Critical Incidents
Due to the nature of critical incidents and their effect on the lives of workers and the surrounding area, the situation should be addressed to restore normalcy and relieve individuals from experience. A critical period occurs in the aftermath of critical incidents or exposure to trauma, which may cause traumatic stress. There exist several factors that can be utilized to modulate its effects and recovery process; necessary measures entail, stress management training, and availing peer support. There is a possibility of other factors escalating the distress level through continued exposure to the victims’ distress and pending investigations. Tertiary measures entail confidential advice, access to specialized clinical services, and counseling support for those in need (Workpositive, 2020). The nature of jobs within some professional regions such as the military, it is not easy to minimize reduce exposure prove a challenge to the management. As a result, employers and executive teams within occupational groups at higher risk of exposure to critical incidents are expected to adopt a robust set of intervention approaches to reduce psychological effects on victims (Fetherston, 2015). This review focuses on the early EMDR intervention and critical intervention technique (CIT) approaches to societies after a critical incident has occurred.
The EMDR intervention journal
Critical incidents usually occur without prior knowledge; thus, the emergency response teams may fail to adopt appropriate methods to handle a given scenario. For example, in 2012, a missile fired from Gaza landed on a building in a religious community. Three people lost their lives in the event, while others were injured in the process, the neighborhood area is congested, and they became anxious following the tragic incident (Elan & Brunt, 2015). The residents were disturbed since they always believe in divine protection; thus, psychologists from the region sorted the services of EMDR-Israel Association to help the community recover from the incident.
Early psychological intervention methods were adopted after three months of the missile incident. Despite the physical impacts of war or calamities, there is always an emotional and psychological impact of such an occurrence. The earlier intervention mechanisms are aimed at the treatment and prevention of post-traumatic stress disorder (PTSD). The intervention approaches unveiled that brief trauma-focused cognitive behavioral therapy (TF-CBT) were considered to be effective. This is because many trauma victims face transient symptoms of stress; however, approximately 75 percent of the victims usually recover within three months. At the same time, other victims are susceptible to secondary complications, which affect their quality of life and relationship with others (Elan & Brunt, 2015). Traumatic stress is an example of a risk factor resulting from somatic and psychological complaints; clinical symptoms may be visible; however, PTSD usually manifests later. Individuals suffering from trauma are likely to seek medical intervention as a remedy; however, this could be avoided when early interventions are comprehensively implemented.
EMDR is an evidence-based approach to treating PTSD and has gained global recognition by the World Health Organization (WHO), among other international bodies. It conceptualizes a traumatic event through various stages to avoid generalization of facts based on a single incident. Through this method, a client is asked to explain the traumatic event highlighting the most pressing issues that require urgent attention. The problems are then processed through standard EMDR protocol to initiate a positive cognition process sequentially. When the patient has gained stability to visualize the event, they are required to develop positive cognition for the entire scenario with sobriety and bilateral stimulation (BLS). The traumatic incidents, coupled with its impacts, are regarded as an ongoing activity since the experiences are not yet consolidated (Ignacio, Susana, Lucina, & Martha, 2016). It digs deeper into the root causes of the incident, its effects, and the current situation of the victims.
EMDR is recommended for the treatment of all cadre of persons within the society; it was developed by Dr. Shapiro as a comprehensive approach to the treatment of trauma and advance life experiences. Early psychological intervention usually begins within the first quarter of a year after an incident to prevent PTSD or ongoing distress, among those with symptoms of trauma, acute stress disorder (ASD), or risk of PTSD (Ignacio et al. 2016). The scope of stressful events presenting similar emotions, sensory, and cognitive information does not guarantee the state-dependent traumatic memory enough time to consolidate into an integrated whole. As a result, the memory remains in a permanent state of recalling the previous incidents causing the risk of PTSD, and comorbid disorders increase with continued exposures.
EMDR most often apply eight phased mechanism; the first and the second phase involve gathering history on how an incident occurred through witnesses. Evaluation of affected memory parts is conducted in the third phase, where the client identifies the post disturbing cognitive effect caused by the experience. In the fourth phase, memory is individually assessed incorporating dual attention stimulation; this helps in processing each of the memory fragments individually. The fifth phase involves the event as a whole with side-effects and designing a PC for the entire critical incident. The sixth phase applies standard EMDR approaches in the seventh stage, post-disaster strategies focused on soothing and consoling the victims. The final step entails, application of the standard approaches in addressing the issues.
Critical Incident Techniques (CIT) journal
Critical incidence techniques (CIT) comprise of a set of procedures utilized in the collection of primary observation of individual behavior to facilitate potential usefulness in mitigating real challenges. It has been a common phenomenon for investigative teams to gather information revolving around a problem, which is not a sure way of obtaining the underlying data. Most investigative teams utilize the golden hour, ignoring the possibility of underlying factors to propel the incident (Bott & Tourish, 2016). It has merits over other techniques based on its inductive properties of not restricting the respondents into a fixed paradigm. It allows for a detailed understanding of intricacies and the contextual factors surrounding such behaviors. Secondly, the CIT interview model is flexible, semi-structured, thus, incorporating varied views. The interviewers are always striving to eradicate biases in the process and to offer clarity and dialogue without insinuating unnecessary conversation, which may add no value to the research. The questions are always in-depth to unravel the chronological pattern on how incidents transpired from the first to the last.
The critical incidents technique is a sequential procedure of obtaining data about significant events from observers with first-hand information. The gathered data help the researchers and expert teams to understand vital aspects of how an event took place (Rosala, 2020). The interviewees are asked to recall and describe when a critical incident happened, the effects, and outcomes. CIT is often utilized in interviews, questionnaires, focus group discussions, and structured diary examination. It is a method of gathering information to understand how to boost the performance of the involved individuals (MBA Skool Team, 2020). It is used to look for the cause of human system problems to loss of vital data, which may be essential in improving the performance of activities.
Christian perspective on critical incidents
Critical incidents are inevitable from the Christian perspective and were and are still occurring in human societies. Example of such incidences are in the book of Genesis, throughout the journey of the Israelites in the wilderness, sudden and abrupt incidences took place. Thus, Jennings (2007) described critical incidents as any episode or sequence of events with both positive and negative outcomes that the practitioners utilize elaborately to reflects on different levels of an incident. The Bible and its teachings play an essential role within human society and instill hope in distressed individuals. In most instances, after a tragic incident, the scriptures become a point of reference for those who profess the Christian faith and a belief that there is life at the end of the tunnel. It also gives assurance that the hurdles are just but for a little while.
The Biblical perspective on counseling falls in two broad categories; grand apologies focus on the relationship between scriptures and counseling techniques, or specific issues linking Biblical passages to societal challenges. Even though scriptures do not speak directly into the problems or incidents; it has a life-changing impact in every situation (Monroe, 2017). The Bible addresses specific issues such as depression, anxiety, trauma, or marital discord; Jesus said that the words he spoke are Spirit and life. Thus, scriptures play an integral role in restoring normalcy and calming hearts of depressed persons. Religion as an institution has an obligation of inserting morals in societies and ensuring peace and stability (Doda, 2005); therefore, the role taken by Christian leaders who understand scriptures has a lasting impact. For example, a pastor may interview victims of a tragic incident on their experience, the effect of the occurrence in their lives, any changes that may be experienced as a result of the incident. Then, he or she can relate their case with scriptures and sequentially design an approach to relieve them from the traumatic effects.
A Biblical verse or passage may be applied to an individual circumstance to have greater credibility. Through such, a victim gains comfort and encouragement to protect them from advanced effects such as PTSD or ASD. Christians believe that scripture is the word of God to humanity; hence, individuals turn to them when troubled, confused, hurt, or in any situation around us (Monroe, 2017). In Paul’s epistle to Timothy (2nd Timothy 3;16, n.d), he instructs the word of God is basic in teaching, training, and correcting us to be effective servants. When critical incidents occur, the word of God can be used as a point of reference to remind of what God expects since the scripture in itself regulates morals and will prevent individuals from indulging in weird traits such as suicidal thoughts.
Recommendation on the journals
Critical incidents are inevitable within human societies due to the advancement of war through technological methods and the natural forces of nature. As a result, the success of a community relies on its ability to handle the disastrous situation to restore normalcy within its jurisdiction. Most often, the governments have reacted based on “gold rush hour” without digging in-depth on the psychological effects of the incident. These journals are multifaceted and provide a broader view of how disastrous and emergencies can be handled. Thus, I recommend the journals on the following grounds; first, they offer a comprehensive way of understanding a situation by interviewing the observers from the society in which it took place. Thus, it provides a sure means of obtaining first-hand information. Secondly, most of the response teams have been trained to handle the physical aspects of an incident, neglecting psychological and emotional impacts. These aspects are usually long-lasting compared to physical; thus, the journals need to be adopted for addressing such vital areas.
Improvement
Technology has become part of every intervention mechanism in the contemporary world, offering solutions to perennial human challenges. As the world progresses, social problems such as war and terrorism attacks have become significant challenges. As a result, these journals need to incorporate a digital response strategy for critical incidents to ease information sharing between various stakeholders. Through automated response gadgets, alerts about an experience can be enriched, enabling the response teams to focus on high priority cases that require immediate attention.
References
The Holy Bible (n.d). Paul’s letter to Timothy (2nd Timothy 3;16)
Bott, G. & Tourish, D. (2016). The critical incident technique reappraised; using critical
Incidents to illuminate organizational practices and build theory
Elan, S. & Brunt, L (2015). Early EMDR intervention following a community critical incident
https://connect.springerpub.com/content/sgremdr/9/1/17
Fetherston, T. (2015). The importance of essential incidents reporting and how to do it
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675258/
Ignacio, J., Susana, U., Lucina, A. & Martha, G. (2016). EMDR protocol for recent critical
Intervention; a randomized controlled trial in a technological disaster context
https://connect.springerpub.com/content/sgremdr/9/4/166
Jennings, B. (2008). Ethical incidents; experiential learning in an introductory Christian Ethic
Course
Monroe, P. (2017). Using scriptures in counseling
https://thecrossingchurch.com/wp-content/uploads/pdfs/usesOfScriptureInCounseling.pdf
MBA Skool Team, (2020). Critical incidents method
Rosala, M. (2020). Critical incidents techniques
https://www.nngroup.com/articles/critical-incident-technique/
Workpositive (2020). What are the critical incidents?
https://www.workpositive.ie/information/whatarecriticalincidents