When we think of crisis intervention, especially deployed after a critical incident, simplicity comes to mind. Simple strategies to apply to a wide array of disruption. For instance, if we could deploy one group process that would meet the needs of all the different crisis scenarios and populations that are presented in workplaces, that would be great. Let’s not forget though, we tried that. Historically, when the International Critical Incident Stress Foundation’s CISM process promoted the CISD group for EAP work, we believed and were told, that this was the group. Sometimes, with moderate adjustments, it was very effective. Other times, not so much. The circumstances, nuance, variables presented in EAP response resulted in calling for another group process. Enter, Psychological First Aid. PFA was never designed as a group intervention, (it since has) but the concepts were basic, simple, unlikely to cause harm, but again, there were times that this group process fell short of the response needs on the ground in our EAP work.
The EAP CIR, Multi-Systemic Resiliency Approach has five different group interventions. I do not apologize for that. Afterall this is EAP.
In EAP response, every workplace is different. At the very least, nuanced. Each with its own culture, operational needs, organizational levers, multi-stakeholders, sources of resilience and a response approach that demands a dual-client focus.
Yes, Five is about right.
Groups are only effective, however, when the following information is synthesized correctly: Accurate assessment of the impact to employees and organization; sources of individual and organizational resilience; timing of group delivery; culture of population and delivered by a professional who understands the mission of EAP.
Here is an overview of each group. Details and nuance are discussed in our training.
Corporate Briefing- Often the first onsite group intervention and recommended, in some form, for every EAP CIR. The Corporate Briefing is an informational group designed to position leadership and key personnel, including EAP CIR responders, in taking the lead in the aftermath of the incident. It provides a much-needed message delivered by leadership of a "return to order." It encourages unity, offers clarity in the initial response to secure safety, and educates on communication channels. All highly needed after experiencing the chaos of the event. If offers culturally sensitive, workplace resources available to employees including the EAP. Any number can attend. It is the only group process that can be considered “required” attendance. Many organizations may have already initiated this process before contacting the EAP which is important to know if you are going on site. If it hasn’t been done, it is an excellent opportunity to partner with the client organization at a critical time in recovery, as it sets the stage for the interventions to come. Corporate Briefings can be virtual. *
Collegial or Resilience Grief Group
The Collegial or Resilience Grief Group is the primary group for when there is a death of an employee that occurs outside of the workplace and the workplace is notified of the death. It recognizes that the connections between colleagues are different than that of family members or loved ones, in which traditional grief groups are designed for. Because of this, it incorporates and leans on a process of resilience building vs. an overall focus on mourning or stages of grief. It is a voluntary group, best kept up to 12 attendees. It can also be a secondary group when there is an employee death as a consequence of a critical incident (act of workplace violence, accident, etc.) where stabilization and safety are the first priority. In-person group preferred, can be virtual* or mixed.
Psychological First Aid Group
PFA groups are considered when employees have had high exposure and impact from the incident and a short time to recover or process. It is also likely to be appropriate if the EAP CIR provider arrives on site on the same day as the incident or up to 24 hours post incident. It is usually held for those employees in the immediate proximity of the event and as a result, higher risk for significant impact. The group is designed to restore safety and stability through connections, ventilation, normalization and universality (Everly, 2006). Additional requirements need to be met before deploying such a group, i.e. medical attention or concrete needs. Key to this group is that it recognizes that due to the power of the incident, employee’s ability to cognitively process is reduced. As a result, the focus is on mitigating stress reactions through stabilization and connection, hallmarks of PFA. Homogeneous grouping is an important component. Group set up should be discussed in the management consultation, however, these groups are also herded together for the counselor to meet with by onsite managers and so the voluntary nature, an important component to safety, may be compromised. Take great care in not creating further agitation for any employee in attendance. Most employees prefer to go home, and home is likely the better place for them to be. These can be short groups. In-person only.
RALLI Group- The RALLI Group is designed for the essential employee that due to the nature of their work, there are inherent risks for critical incident exposure. Despite undergoing this risk, they are still expected to perform their duties as their roles are essential to the operation of the workplace or community. We often think of essential workers in hospitals and first responders, but this has been expanded as a result of Covid 19. The RALLI Group is a strength based, resilience building group that utilizes skills from PFA, Mental Health First Aid, and the research on resilience, that builds connectivity within the team and skills to offer relief from distress. It promotes stability through restoration/recognition of important personal attributes relevant to their job mission. A RALLI Group is designed to help workers access “positive stress” (Eustress) and to stay engaged with the mission of their work. In person preferred, can be virtual. *
Resilience Group - The Resilience Group is a voluntary process group where attendees have already secured safety and stability. Now they are ready to reengage in the many different routines and roles in their life and may experience challenges in doing so. There are three components towards achieving resilience: Confronting the incident, establishing a sense of direction (rebound), and utilizing active coping skills (Smith, 2010). This group aids attendees in this process. In person preferred, can be virtual* or mixed.
Critical Incident Response is most effective when each response system coordinates together and operates in sync. Utilizing any of these groups requires a process for accurate assessment, systemic partnership, and appropriate staging for multiple interventions (management consultations, use of 1:1s etc.) as needed.
The Multi-Systemic Resiliency Approach has been recognized in the book, The History of Employee Assistance Programs in the United States (Dale Masi, EARF, 2020) as the "promising CIR model with greater applicability to the EAP milieu."
This article is designed to educate. It is not offered in lieu of training.
For more information and training inquiries, contact Robert Intveld LCSW, CEAP at Robert Douglas Associates. rdintveld@gmail.com
*Virtual application requires additional training.
Everly, G., Phillips, S., Kane, D., Feldman, D., (2006) Introduction to and Overview of Group Psychological First Aid. Brief Treatment and Crisis Intervention, 6:2 May 2006.
Masi, D. (2020) The History of Employee Assistance Programs in the United States, Employee Assistance research Foundation, (EARF)
Smith, B., (2010) Resilience as the ability to bounce back from stress: A neglected personal resource? Journal of Positive Psychology, Vol. 5, No. 3, May, 166-176.