The Police Psychology Program is a clinical practice in Westborough, Massachusetts that provides services to law enforcement and first responder agencies across the state and New England. Its goal is to measure police officer stress and provide pre-employment screening, fitness for duty evaluations, training, and defusing/debriefing after critical incidents or loss of a member. We provide psychiatric treatment including medication management.

The question always arise when should the “handoff” be made transferring the case to a licensed practitioners following CISD debriefing? That depends of the incident but generally critical incident stress debriefing (CISD) is conducted within 24-72 hours of a traumatic event. We have also done them immediately after the shift ends or 2 hours before the men and woman who answered the call return to work. A great deal of trust is established during the first hours after a critical incident among both the peer supporters and peer supported. Officers are sometimes heard saying “can’t I just keep talking to you?” Trust.

CISD is often a peer support program led by trained members of law enforcement or the fire service. They do not provide psychological care; although many of the CISM teams have been through similar experiences with shared results along with the officer they are charged to help.

I have done both but you clearly see when the frontline troops are not ready to speak.

Whereas, formal debriefing, often led by a single licensed clinician, or a small group, may not take place for 1-2 weeks which allows sufficient time for sleep to restore and for memory to encode and restored or add to feelings of distress and anxiety. A follow-up meeting in 30 to 45 days is recommended.

At times of high demand such as after a critical incident, referrals to psychotherapists who are skilled in acute trauma as well as informed about the cultural nuances of police and first responders is essential. there are times when the group needs to be cut in half or less. In these cases there are usually co-therapists. I have always recommended reaching out to community clinicians to build a bridge for members of law enforcement to receive restorative, HIPPA compliant psychotherapy to rule out acute stress reaction.

A word about department or organizational EAP. Employee assistance program offer same day service when called up by a member of the department who is in need of help. But these clinicians are contracted for very limited number of sessions, often untrained in the specific issues and culture seen in law enforcement or first responders. The EAP is fast and most of the clinicians are well trained. The EAP is often contracted to the city or town; broad responsibilities for many of the city departments including helping employees make a budget, connecting members with delivery services and even carpools.

I try and keep a growing list of clinicians that understand law enforcement and the importance of building a trusting relationship often not possible in the EAP setting.

After a crisis, I will continue working with an officer until the handoff to another licensed person who can walk in officer’s shoes and gain a quick understanding of complex problems.

There are several CISM teams in the commonwealth and activating the is pretty automatic. Recently I had a call from a police chief who wants two officers debriefed because they were on the scene at a barricade situation at which one officer had multiple GSWs and a civilian was shot as well. The shooter was fatally wounded by law enforcement. I will suggest to the chief that his officers defrief with the local CISM team (as a group) with follow-up for more targeted support later either in their station or at our offices.

Michael Sefton, Ph.D.

Police Consulting Psychologist