Lessons Of September 11 For Fire
Lt. Robert L. Smith, Ph.D., Stress
Washington Township Fire Department
Fire Chief, Dec 1, 2001
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The events of Sept. 11 will prove to be pivotal in our nation's
history. The shift in behavior and attitude that will take place in
American society will have a significant impact on the attitudes and
behaviors of firefighters and fire service managers.
In other words, the fire service will never be the same as it was prior
to the attacks. As fire chiefs, we'll be forced to examine the way we
conduct operations and how we take care of our brothers, sisters and their
families. Addressing the psychological and emotional care of our
firefighters has become an important aspect of our mission.
The fact that the fire service is a caretaking profession has some
bearing on this discussion. Firefighters are trained and socialized to
respond to the needs of others, and this mission is an important facet of
the firefighter's job. Individuals in other caretaking professions, such
as nurses and physicians, also are trained to respond to the needs of
others. We know that job stress and burn out are issues that people in
these caretaking professions should pay attention to. Consequently, we
must place a higher emphasis on the psychological and emotional health of
firefighters so they are physically and mentally prepared to serve the
New questions have developed and are being asked by fire chiefs in
response to the attacks. How will we treat a high-rise fire? How will we
ensure safety on the fireground during a suspected terrorist attack? Will
we handle hazmat incidents differently? It's important to note that
questions like these now are emotionally charged rather than simply
tactical. How can we take care of our firefighters' emotional,
psychological and stress management needs as these tactical questions are
Traditionally, fire departments have taken a response approach rather
than a management approach to stress. Often, we're slow to respond until
something goes wrong. We send a firefighter to addictions treatment for a
drinking problem, or we mandate employee counseling sessions when behavior
is problematic. As a result of this strategy, firefighters are forced to
resolve their problems in a time of stress while at odds with their
Instead, a management/prevention approach to stress could better serve
the firefighter. Recent events have signaled a need to end the reactive
approach. Fire service managers no longer have the luxury of waiting for a
problem to occur before responding.
Stress Management Units
The management of firefighter stress is complex and multifaceted. The
average firefighter encounters stress, not only from critical incidents,
but also from non-critical incidents such as personality conflicts within
the firehouse, family problems, common hardships of a long tour of duty or
the death of a family member.
My Global Fire Service Stress Management Model strives to focus on all
fire department stress rather than only focusing on stress that is
encountered by exposure to a critical incident. As stress is cumulative,
it doesn't matter if the particular stressor is critical incident stress
or other more routine firefighter stress.
For example, firefighters tend to be socialized as task-oriented
perfectionists. Firefighters will encounter significant stress over failed
equipment that hindered a rescue or a department policy that they do not
agree with. In short, stress is stress — we can't overlook any of it.
The Global Fire Service Stress Management Model goes beyond Critical
Incident Stress Management and other models while integrating CISM as part
of the package.
The Washington Township Fire Department Stress Management Unit was
developed to address these critical and non-critical issues and to follow
the Global Fire Service Stress Management Model. The model seeks to
address difficulties early in the problem process, as early treatment is
the key to effective management.
Members of the Washington Township Fire Department SMU are trained in
CISM; however, the central focus of the unit is the management of
multifaceted firefighter stress. The SMU is composed of one clergy member
and two firefighters who are licensed as mental health practitioners to
act as trainers, supervisors and facilitators.
The SMU operates in a non-intrusive manner, and the call for response
is often initiated by the affected firefighter or by their supervisor. The
unit's response can provide support, as well as initiate a possible
assessment for further mental health assistance.
The model has several areas of concentration, including stress
education, mentoring, unit response guidelines, new recruit education,
spiritual care, public relations and assessment. Education includes stress
awareness/management training for the firefighter as well as relationship
skills workshops for spouses and families.
One example of the stress management component is the coaching of the
firefighter and spouse around the single-parent phenomenon of the fire
service: The spouse can be left to parent the children without assistance
from the firefighter during long tours of duty and beyond, especially if a
part-time job is included in that time of absence.
Assessment is a function of the department SMU. All members meet for
quarterly training and are introduced to basic stress management skills.
The SMU in a fire department must address firefighter stress with an
However, the SMU must be a conduit to introduce firefighters into a
mental health system that understands the specific needs of firefighters
and their families. Too often, firefighters gain access to an unfamiliar
mental health system that attempts to treat them like non-firefighters and
devalues their coping mechanisms and loyalties. The SMU addresses and can
improve this problem.
Pastoral care is an important aspect in the model. The Washington
Township Fire Department has three chaplains: a rabbi and a minister who
are certified firefighters, and a Catholic priest. Members of our pastoral
care staff are trained to function in both the pastoral care role and the
peer counselor role. The peer training is important for pastors and mental
health clinicians to become involved in and be accepted as part of the
It's been shown that firefighters respond best to other firefighters as
they understand the built-in coping mechanisms developed by those in the
fire service. Individuals who attempt to assist firefighters should
understand the nature of the occupation and the cohesion of the group. Too
often, firefighters are put off by a mental health professional who fails
to understand firefighter coping methods. The helper must know how to
enable these socialized methods.
Internal public relations is a very large consideration for the fire
department SMU. Firefighters depend on the maintenance of confidentiality,
loyalty and prompt service of the unit. The connection firefighters
experience with members of the SMU is tantamount to the unit's success.
Unit members are very aware of their image with firefighters and are
selected on their merits. The unit also functions as a diplomatic arm of
the fire department administration. Firefighters soon understand that the
administration values their ability to function on the job without
Unit response guidelines are an important consideration in the Global
Fire Service Stress Management Model. The SMU has responded to conflicts
in fire stations, in addition to being called on to assist hospitalized
firefighters or firefighters on light duty. At times, SMU members provide
a meal or transportation to another firefighter in need. These examples
range from simple acts of kindness to the referral for more complicated
mental health intervention. The goal of all responses is to enable proper
coping and assist the firefighter in the reduction of stress.
New recruit education and firefighter mentoring are additional aspects
of the Global Fire Service Stress Management Model. New recruits at the
Washington Township Fire Department receive training in stress management
and coping techniques as a part of their fire academy curriculum.
Each new recruit is assigned a mentor from the SMU. The mentors assist
with orienting new recruits to their assignments in a manner that promotes
development of appropriate coping techniques and good mental health
awareness. In addition, they also teach many of the emotional mechanics of
the fire service job. These include getting along with other firefighters
in the new environment and the introduction of spouses and family members
to the fire service circle.
Many interventions exist to assist firefighters in this time of stress.
The fire service must begin to recognize stress as a cumulative phenomena.
Firefighters should learn in advance how to deal with the stress from
critical incidents such as the ones in New York, Washington and
Pennsylvania. Firefighters who respond to critical incidents in a lower
state of stress have a greater chance of sustaining psychological wellness
and avoiding burnout during their career.
Critical incident debriefing
A fire department plan for critical incident stress debriefing is
essential in the wake of recent events. This should encompass two areas:
lower-profile incidents and large-scale critical incidents.
Unfortunately, many departments don't have a plan for handling these
types of large-scale incidents. Departments shouldn't depend on outside
agencies alone to formulate this plan. A department representative should
be involved in the planning stages because fire department managers know
their personnel best.
Your department's plan for a large incident should include the
- The lead mental health practitioner should be familiar with the
firefighters of your department, their job roles and your
- The counselor or therapist should have exposure to the fire station
environment and should build rapport with the firefighters in your
- The lead counselor should have a license to practice mental health
and access to the latest research about the mental health care of
- The involvement of a qualified CISM team is essential. The team
should be fully trained, experienced and include other firefighters.
- Firefighters are most comfortable talking to other firefighters.
While others may be well intentioned, they may not have the same
credibility as a CISM team composed of firefighters trained in CISM.
- Department chaplains should be involved in the response to a
large-scale incident. Fire chiefs should commission chaplains of
firefighter-represented denominations prior to a tragedy.
- Fire departments should have stress-related material available for
both critical incidents and stress prevention. Departments should
consider seminars and classes that address stressors other than
critical incidents prior to a tragedy. Tragedies can be easier to
handle if fire departments adopt a stance of prevention.
- Protocols should be developed to direct fire departments to assist
families in the event of line of duty death or injury. Family care
should be considered when long deployments of firefighters are
necessary. Families could need extra assistance due to the combination
effect of an absent spouse and the emotional hardships of worrying
about their firefighter family member.
Your department can make a difference. We'll have better prepared and
more effective rescuers if we work to reduce stress before large
Use these methods to help firefighters deal with everyday stress
- Establish a Stress Management Unit for your organization.
- Make contact with interested mental health practitioners and
employee assistance programs that want to be involved in the stress
management process of your organization. Be sure these counselors
spend time in the fire stations, riding along on the apparatus and
learning about how to work with fire department families based on
- Have a plan for ongoing stress education for your department. This
should include stress management presentations that focus on both
critical and non-critical incidents. Current research exists to
support the idea that non-critical incident stress also plays a role
in cumulative stress.
- Provide basic stress education to new recruits. Firefighters are
socialized or indoctrinated into their jobs. Fire chiefs and
departments can supply early messages to recruits by including
information about proper coping methods.
- Provide structured firefighter mentoring for all ranks.
- Provide good information about stress management to your
firefighters. Put information and contact numbers in the stations and
provide peer contacts who are accessible to your firefighters. Police
departments and industrial plants have had peer support teams for
years. These individuals do not practice mental health but assist
other firefighters in gathering information about stress, mental
health and mental health resources.
- Create a way for firefighters to enter the mental health system if
needed. Contract with licensed mental health practitioners in advance.
The counselors and therapists who are most familiar with your
department should train other therapists about your department and
- Listen to the new concerns of firefighters since Sept. 11. Start a
continual process of assessing the newest concerns of your
firefighters. How do they feel about the possibility of future
attacks? Find a new way to show support for your firefighters on a
regular basis, such as telling them you appreciate their efforts and
visiting the stations. Address the needs of your firefighters.
- Showcase your firefighters — get caught telling the public, the
media and elected officials how good they are. Specifically, tell
others about how your department is ready for disasters and further
- Allow your firefighters to participate in addressing their job
concerns. For example, create a safety committee or an advisory
committee to formulate new operating guidelines or procedures. This
will help your firefighters emotionally by helping them to feel in
control of their job situation.