Re: FW: [EMS_Research] More heap on the CISM pile

[Guest guest]

Come on. The airplane had been missing over the Pacific for three days.

Should they have held of of CISM in hopes that the lost crew were abducted

by aliens. Boy, ya'll are reaching for straws to discredit a study. So you

are saying that stress does not begin until after the bodies are found. I

would maintain that uncertainity is more stressful and, by your definitions,

more amenable to intervention.

Re: FW: [EMS_Research] More heap on the CISM

pile

>

> Doc, you only accept the research when the research fits with your

opinion,

> and when I point out that the research isn't about CISM you start

all this

> RCT nonsense that isn't even about CISM. I've read the negative

studies and

> you might be surprised to know that I agree with many of them. I'm

the first

> in line to tell Bissson to get out of the frickin burn unit!!!!!

>

> You continually misconstrue the studies as evidenced by your topic

last week

> regarding CISM, when the article didn't even mention CISM.

>

> The study from BC is an excellent example of BAD, REAL BAD CISM.

> Truly, this is not what CISM is about, and that team either needs

to cease

> and desist or get retrained. I have no problem admitting that

people doing

> fouled up CISM can be detrimental.

>

> Now, I wasn't the one who started this, but I am getting tired of

reading

> the waste being posted.

>

> The good Dr. said.............

>

> " But, my bias is not because I have a financial interest in the

> product or a similar product, "

>

> Doc, I hereby challenge that statement.

>

> As far as the woman goes, my wife told me to quit arguing with Dr.

> Bledsoe on the listserver. You might want to ask Dr. Gist about

the woman.

>

> But tell me how Bisson's study is an evaluation of CISM.

>

> By the way, go ahead and break the news to the list about the RCTs

showing

> the power and presence of God.

>

> As far as ad hominem, read McNally's stuff or Bledsoe's stuff, or

better

> yet, attend one of Bledsoe's presentations and you'll get enough

ad hominem

> to make you sick.

>

>

> Vaughn

>

>

>

>

>

>

[Guest guest]

Then why did you throuw the inuendo out:

" This debate has nothing to do with crisis intervention, CISM or CISD. This

debate is about money, jealousy, envy, a woman, and an intense dislike of

Jeff and Everly. "

What was its purpose?

Re: FW: [EMS_Research] More heap on the CISM pile

, once again you say things that aren't said. No one has accused Gist

of infidelity.

Are you saying you're not participating in ad hominem attacks?

I'd never try to tell a psychiatrist from England, US, or Timbuktu how to do

therapy, but I have my doubts about some of their abilities to do crisis

intervention with fellowfirefighters.

As far as being familiar with the research, I'm using some of the studies

you quote becasue there is some awesome information contained in the

studies.....I go back to the burn unit in the hospital re-emphasize these

people need primary care, not some psychiatrist doing " psychological

debriefing. "

Once again, I want you to explain that you have no financial interest in

this debate. Are you saying you're not being paid for your talks slamming

CISM?

McNally's latest article is nothing more than a condensed version of his

article from last year yet you posted the link like it's " More heap on ths

CISM pile. " It's not.

I've heard about your presentation, and to be truthful, I think you're

helping the CISM field, but sometimes you take it entirely too far and

misrepresent or fail to represent the whole story.

While I can't promise to attend your presentation at the Fire Chief's

conference, I'm glad to sit down and discuss some of these issues with you

in a constructive, civil manner.

Vaughn

[Guest guest]

stressful? yes! Need CISD.....no! They needed information worse than

they CISD. Crisis intervention as the stage goes back to meeting

basic needs and at this point they needed to know the fate of the

crew. They didn't know if the crew was dead or not.

Now, some of the other actions taken by the team were very

appropriate. Sitting up a place where co-workers could go and get

updates, and having psychological first aid available for those who

wanted it was entirely appropriate, but CISD would not be

appropriate.

> Come on. The airplane had been missing over the Pacific for three

days.

> Should they have held of of CISM in hopes that the lost crew were

abducted

> by aliens. Boy, ya'll are reaching for straws to discredit a

study. So you

> are saying that stress does not begin until after the bodies are

found. I

> would maintain that uncertainity is more stressful and, by your

definitions,

> more amenable to intervention.

>

>

>

> Re: FW: [EMS_Research] More heap on the

CISM

> pile

> >

> > Doc, you only accept the research when the research fits with

your

> opinion,

> > and when I point out that the research isn't about CISM you start

> all this

> > RCT nonsense that isn't even about CISM. I've read the negative

> studies and

> > you might be surprised to know that I agree with many of them.

I'm

> the first

> > in line to tell Bissson to get out of the frickin burn unit!!!!!

> >

> > You continually misconstrue the studies as evidenced by your

topic

> last week

> > regarding CISM, when the article didn't even mention CISM.

> >

> > The study from BC is an excellent example of BAD, REAL BAD CISM.

> > Truly, this is not what CISM is about, and that team either needs

> to cease

> > and desist or get retrained. I have no problem admitting that

> people doing

> > fouled up CISM can be detrimental.

> >

> > Now, I wasn't the one who started this, but I am getting tired of

> reading

> > the waste being posted.

> >

> > The good Dr. said.............

> >

> > " But, my bias is not because I have a financial interest in the

> > product or a similar product, "

> >

> > Doc, I hereby challenge that statement.

> >

> > As far as the woman goes, my wife told me to quit arguing with

Dr.

> > Bledsoe on the listserver. You might want to ask Dr. Gist about

> the woman.

> >

> > But tell me how Bisson's study is an evaluation of CISM.

> >

> > By the way, go ahead and break the news to the list about the

RCTs

> showing

> > the power and presence of God.

> >

> > As far as ad hominem, read McNally's stuff or Bledsoe's stuff, or

> better

> > yet, attend one of Bledsoe's presentations and you'll get enough

> ad hominem

> > to make you sick.

> >

> >

> > Vaughn

> >

> >

> >

> >

> >

> >

[Guest guest]

I think we have beat the CISM horse too long here and it is becoming too

much about the people and not about the process. On another note, are there

any EMS services that have a high-angle and swift-water rescue team that

might have some pictures to share?

[Guest guest]

:

Please forward this to you list on my behalf . . . it's kinda' long, but I

got here late. Those who have become as weary of this silliness as have I

can hit " D " and resume their normal lives, but those who are curious to

talk with folks that others choose only to talk about are welcome to pour a

cup of coffee and read on.

_________________________________________________________

My, my, my . . . petulant rants are never very enlightening to serious

discussion, nor are they very becoming to those involved. When the rants

also liberally mix ad hominem with superficial and ill-informed

recapitulations of sophomoric silliness publishable only on the ICISF web

pages, it sinks the discussion to truly unfortunate depths without even the

redeeming image of the Titanic's orchestra playing its final hymn. Much

like the other apologetics from those vested in selling their " new,

improved, but essentially unchanged " version of a 1980s approach to 21st

Century issues, it misses the most essential point of all--research moves

us forward by showing us which bags to leave behind. This debate has been

getting increasingly pissier without getting any pithier at all . . .

In serious circles all around the globe, there's no debate about the CISD

stuff . . . the jury's back, the verdict's in, the argument's over. It's

one of those ideas whose time has come--and gone. The investment

everywhere else has been in looking at what works, how the best practices

and efficacy research can be reconciled to deliver the best of today's

capabilities with the best promise for even better service tomorrow.

There's exciting stuff available now from many, many quarters and it's

coming together to offer new approaches based on the best evidence now

compiled and the best of what we've learned from more than 20 years of

practice. Such approaches are the sum and substance of how science and

practice unite to enhance our capacity to advance the essential missions of

our various and collective disciplines and professions--to wit, to enhance

health and performance, protect against deleterious impacts, prevent or

limit adverse consequences of injury or exposure, foster resiliency and

support, effectively treat diagnosable conditions, and facilitate

incremental but consistent improvement in the efficacy of our efforts.

Contrast that set of objectives with what's seemingly driving this

increasingly acrimonious raving from the Balto Boys and you'll quickly

surmise about everything you probably need to know to place this in its

proper perspective. Embed it in its proper historical context and you'll

readily reveal how these motivations and machinations have characterized

the enterprise almost since its inception. A large number of us from all

around the globe described the CISM enterprise almost a decade ago (see

attached text of entire JEMS piece for complete context) as " a sad but

convincing lesson in what distinguishes scholarship from salesmanship--a

lesson that merits serious exploration in an evolving profession whose

practices and principles are derived of science and its methods " We went

on to note " that those few entries form the principal literature of the

psychological disciplines either have nothing to say about CISD (4, 18,

30), criticize the concept directly (22, 24), or commit what Everly and

contend to be a fatal flaw by not directly following their model

in their context (9, 31)—a rather peculiar standard that would effectively

negate any scientific generalizations whatever, from animal studies of

pharmaceuticals to the basic manipulations of the psychological

laboratory. " We observed further that " (t)he remainder of their list

consists principally of unpublished conference presentations,

dissertations, theses, and such--worth considering carefully, perhaps, but

also very cautiously since none of the checks, balance, or quality controls

inherent in the refereed scientific press necessarily apply. " Same stuff,

different day, eh? It's sad that it hasn't changed.

A decade of progress has, however, given us an accumulating mass of RCTs,

solid quasiexperimental contrasts, and even several metaanalyses of solid

studies from the serious refereed literature of our disciplines; these have

been done by a growing body of the most established and respected

*independent* researchers around the planet, and they consistently resonate

with the same findings we outlined a decade ago, to wit: No preventive

efficacy; some paradoxical inhibition of natural recovery; no differential

benefit from " brand name " CISD/M (indeed, a strong tendency for other

approaches to fare better in one major metanalysis); no valid evidence

supporting the sales pitches. Mr. son--with his baccalaureate degree

in psychology (a certification that generally nets one about thirty hours

of basic coursework in the broadest topics of a broadening field)--tells us

instead that these well established clinicians and scientists, publishing

findings rigorously vetted for the some of the world's most respected

scientific venues, are bumbling idiots who haven't a clue and we should

instead get our information from the ICISF web page (or its vanity press

surrogate and proxy, the " International Journal of Emergency Mental

Health " ). I'll let each colleague decide where he or she should best

invest credence.

Finally, son asserts that it's all about " money, jealousy, envy, a

woman, and an intense dislike of Jeff and Everly. " I have

no idea where he's going with that. The only money being made is perhaps

by the friends and associates of Mr. son, who (as others have noted)

holds a position roughly analogous to an Amway distributor in the marketing

pyramid of ICISF. I certainly do not envy persons who disingenuously deign

to peddle inert and even iatrogenic interventions to my friends, associates

and colleagues in times of real need, and it would be hard indeed to harbor

jealousy toward those you do not envy in the least. A woman? I give

up--here, we're unravelling to new depths of ad hominem desperation. And

what affect I or anyone else may harbor toward , Everly, my cousin

ll, or 's Aunt Ethel are hardly relevant to the data we're

discussing. And it's data we're discussing, Vaughn--the rat is always

right.

We ended that JEMS piece so long ago like this:

Let's not lose sight of the basic principle that gave this social

movement its impetus--like most such things, it is related much more

to what we learned form grandma than what we learned in grad school.

It helps, in times of challenge, to talk with those who share our

experiences

and those who share our worlds; such exchanges help to restore

perspective and equilibrium while helping us to incorporate the

events of our lives into our evolving views of our worlds. But we've

no need to turn that simple observation into a cottage industry or

quasi-cult, no reason to assume that a few hours of contrived

hyperbole and the concomitant forfeiture of a few hundred dollars

will markedly improve our capacity to help, and no evidence that

self-proclaimed and self-venerated mechanisms of intervention greatly

improve outcome or that failure to invoke such interventions greatly

inhibits it. The truth, the whole, truth, and nothing but the truth

translates in the end to a few simple aphorisms: People are

resilient; friends are important; conversation helps; time is a great

healer; look out for others while you look out for yourself. Attempts

to translate such simple wisdom into proclamations of pathology and

peril do us no particular favor and do some of us harm.

We haven't changed our view. We've worked hard on issues like IMS, 'cause

if you want to control incident stress, you need to start by controlling

incidents. How much good can you really do by circling the wagons after

the war party had ridden off into the mesas? We've worked on assessments

that can actually determine who's not accomplishing that natural resolution

that most always manage with or without us, so we can get those few the

help they really need in a truly timely fashion. And we've concentrated on

advancing serious clinical treatments that really will--in measured,

demonstrable ways--held those to come to need it. But most of all, we've

learned that Grandma had at least as much to tell us as did grad school,

and that in those immediate moments of disequilibrium, it's very basic

stuff that holds us together.

You can't teach that stuff; you can't train it in days of color slides and

hyperbole or wrap it into sound bites and circle dances after the fact.

It's part of who we are, what we do, and how we treat each other. It's

essential, but it's not the stuff that requires weekend seminars and secret

decoder rings. As for me and my colleagues, we've chosen to serve that

bigger mission . . . other folks can choose, I guess, to hang on to their

fifteen minutes of fame as the clock ticks on to sunset.

R.

Gist, Ph.D.

Principal Assistant to the Director

Kansas City, Missouri Fire Department

Associate Professor of Psychology

University of Missouri-Kansas City

[it goes without saying, I suppose, but the views communicated by e-mail

are those of the writer and not official positions of any organization,

entity, enterprise, or individual, whether real, factitious, or even

fictitious ;>]

(See attached file: JEMS 22(5).doc)

[Guest guest]

So Dr. Gist, as an educator, would you be willing to tell us what

was behind your falling out Dr. and CISM? Were't you once

on the board of directors of the ICISF?

I'm glad to take this off list...

vdonaldson@...

Vaughn

[Guest guest]

It belongs off list, Vaughn, to the extent that it warrants

discussion at all. The short story is that I was on the Board of

what was supposed to have been a nonprofit corporation--it was

actually revealed to be a proprietary stock corporation benefiting a

couple of principals, but the flocks were being conned about that

(and many, many other things). I asked at the first Board meetings

for the financials, then insisted that they be revealed . . . still

haven't gotten them, any more than I've ever gotten the data from

that " rescue personality " research that apparently never quite

happened as reported. That was the last straw, but the bales had

been packing higher and higher for some time.

ICISF later became a 501©(3)--what it should have been all along--

and its tax records became open for inspection. Read 'em some time--

Ostrow did, and that's what led to her " follow the money "

piece in JEMS some years ago. It's become more interesting since

then, but basic story is that it's a pecuniary enterprise, not any

sort of " foundation " as most of us might ordinarily understand such

an enterprise to be. Not for profit doesn't mean you don't make any

money--if you're even slightly clever, you pay yourself through

salaries, and again through fees (see who's raking in the speaker's

fees), through promotion of products fed through nonaffiliated " spin

offs' (such as Chevron), ad nauseum. Now, there's not a darned thing

wrong with people making money, Vaughn, as long as they're honest and

up front with everyone about what they're doing. And as long as they

first do no harm.

These things really start to reek when the egos and the economics

intersect to give us road show evangelism at its most tawdry. While

all that Chautauqua stuff kept churning away, the serious world of

research and practice was busy digging quietly into the very

questions these guys *should* have been pursuing all along if they

really were intent on providing folks the help they truly deserve. As

the evidence continued to accumulate--as it always will--did ICISF

and its principals seek to reconsider, redesign, and reploy? Heck,

no--they sought to stifle discussion, discredit critics, deny

significant findings, and bury important information in fog and

fantasia. They now sit at precisely the juncture I warned them they

would reach more than a decade ago when responding to their

first " lawyer letter " inanely trying to intimidate academic disussion-

-if I can find it around here, I'll post it to this list . . .it's

still cause for a giggle now and then.

Regarding your question about on a personal level, I'm not

going to take that bait. is as deserving of privacy and

confidence as is any other party, and I'm not going to betray his no

matter how I may feel about things he may have done in any context.

I've never much cared for that peculiar amphibole of telling folks

that their lvies and issues will be held in strictest confidence,

then peddling their stories for thirty pieces of silver at the next

tent revival of the Curch of the Critical Incident . . . since what's

sauce for the goose should always fairly be made sauce for the

gander, I'll decline to do anything parallel here.

R.

> So Dr. Gist, as an educator, would you be willing to tell us what

> was behind your falling out Dr. and CISM? Were't you once

> on the board of directors of the ICISF?

>

> I'm glad to take this off list...

>

> vdonaldson@t...

>

> Vaughn

[Guest guest]

Thank you Dr. Gist and I really appreciate a clear, complete story. Not

innuendoes. This is another reason I no longer am a part of a CISM team nor do

I

allow it to be brought to my employees.

Here is my name Vaughn\

Andy Foote\

Manager

City of Beaumont EMS

[Guest guest]

Thank you Dr. Gist and I really appreciate a clear, complete story. Not

innuendoes. This is another reason I no longer am a part of a CISM team nor do

I

allow it to be brought to my employees.

Here is my name Vaughn\

Andy Foote\

Manager

City of Beaumont EMS

[Guest guest]

I think cism is a joke I rember my first trauma Code it was not easy and it

being my frist major trauma incident I really didnt know how to take it after

we cleared it also didnt help

that is was my first major exeposure as well the pt was trapped and had

ruptred varrices with projectitle vomit I did get through it I spoke to seinor

medics guys that have been in ems for over 10 years asked them what could have

been done differnt and what they would have done and the they would have did

what

i did and thats that

I think its just better to have a paramedic thats been in ems 10 + give me

advice

than some guy with a PHD that has no idea what its like out here

[Guest guest]

I know this horse is buried, but Dr, McNally from Harvard emailed the

following query and I promised I would post it.

E. Bledsoe, DO, FACEP

Midlothian, TX

Re: FW: [EMS_Research] More heap on the CISM

> pile

>

> Doc, you only accept the research when the research fits with your

> opinion, and when I point out that the research isn't about CISM you

> start all this RCT nonsense that isn't even about CISM. I've read the

> negative studies and you might be surprised to know that I agree with

> many of them. I'm the first in line to tell Bissson to get out of the

frickin burn unit!!!!!

>

> You continually misconstrue the studies as evidenced by your topic

> last week regarding CISM, when the article didn't even mention CISM.

>

> The study from BC is an excellent example of BAD, REAL BAD CISM.

> Truly, this is not what CISM is about, and that team either needs to

> cease and desist or get retrained. I have no problem admitting that

> people doing fouled up CISM can be detrimental.

>

> Now, I wasn't the one who started this, but I am getting tired of

> reading the waste being posted.

>

> The good Dr. said.............

>

> " But, my bias is not because I have a financial interest in the

> product or a similar product, "

>

> Doc, I hereby challenge that statement.

>

> As far as the woman goes, my wife told me to quit arguing with Dr.

> Bledsoe on the listserver. You might want to ask Dr. Gist about the woman.

>

> But tell me how Bisson's study is an evaluation of CISM.

>

> By the way, go ahead and break the news to the list about the RCTs

> showing the power and presence of God.

>

> As far as ad hominem, read McNally's stuff or Bledsoe's stuff, or

> better yet, attend one of Bledsoe's presentations and you'll get

> enough ad hominem to make you sick.

>

>

> Vaughn

>

>

>

>

[Guest guest]

I know this horse is buried, but Dr, McNally from Harvard emailed the

following query and I promised I would post it.

E. Bledsoe, DO, FACEP

Midlothian, TX

Re: FW: [EMS_Research] More heap on the CISM

> pile

>

> Doc, you only accept the research when the research fits with your

> opinion, and when I point out that the research isn't about CISM you

> start all this RCT nonsense that isn't even about CISM. I've read the

> negative studies and you might be surprised to know that I agree with

> many of them. I'm the first in line to tell Bissson to get out of the

frickin burn unit!!!!!

>

> You continually misconstrue the studies as evidenced by your topic

> last week regarding CISM, when the article didn't even mention CISM.

>

> The study from BC is an excellent example of BAD, REAL BAD CISM.

> Truly, this is not what CISM is about, and that team either needs to

> cease and desist or get retrained. I have no problem admitting that

> people doing fouled up CISM can be detrimental.

>

> Now, I wasn't the one who started this, but I am getting tired of

> reading the waste being posted.

>

> The good Dr. said.............

>

> " But, my bias is not because I have a financial interest in the

> product or a similar product, "

>

> Doc, I hereby challenge that statement.

>

> As far as the woman goes, my wife told me to quit arguing with Dr.

> Bledsoe on the listserver. You might want to ask Dr. Gist about the woman.

>

> But tell me how Bisson's study is an evaluation of CISM.

>

> By the way, go ahead and break the news to the list about the RCTs

> showing the power and presence of God.

>

> As far as ad hominem, read McNally's stuff or Bledsoe's stuff, or

> better yet, attend one of Bledsoe's presentations and you'll get

> enough ad hominem to make you sick.

>

>

> Vaughn

>

>

>

>

[Guest guest]

I know this horse is buried, but Dr, McNally from Harvard emailed the

following query and I promised I would post it.

E. Bledsoe, DO, FACEP

Midlothian, TX

Re: FW: [EMS_Research] More heap on the CISM

> pile

>

> Doc, you only accept the research when the research fits with your

> opinion, and when I point out that the research isn't about CISM you

> start all this RCT nonsense that isn't even about CISM. I've read the

> negative studies and you might be surprised to know that I agree with

> many of them. I'm the first in line to tell Bissson to get out of the

frickin burn unit!!!!!

>

> You continually misconstrue the studies as evidenced by your topic

> last week regarding CISM, when the article didn't even mention CISM.

>

> The study from BC is an excellent example of BAD, REAL BAD CISM.

> Truly, this is not what CISM is about, and that team either needs to

> cease and desist or get retrained. I have no problem admitting that

> people doing fouled up CISM can be detrimental.

>

> Now, I wasn't the one who started this, but I am getting tired of

> reading the waste being posted.

>

> The good Dr. said.............

>

> " But, my bias is not because I have a financial interest in the

> product or a similar product, "

>

> Doc, I hereby challenge that statement.

>

> As far as the woman goes, my wife told me to quit arguing with Dr.

> Bledsoe on the listserver. You might want to ask Dr. Gist about the woman.

>

> But tell me how Bisson's study is an evaluation of CISM.

>

> By the way, go ahead and break the news to the list about the RCTs

> showing the power and presence of God.

>

> As far as ad hominem, read McNally's stuff or Bledsoe's stuff, or

> better yet, attend one of Bledsoe's presentations and you'll get

> enough ad hominem to make you sick.

>

>

> Vaughn

>

>

>

>