Critical incident stress management (CISM): the assaultive psychiatric patient

Critical Incident Stress Management (CISM; Everly & Mitchell, 1999) is an integrated, multicomponent crisis intervention approach that is helpful in mitigating and preventing the potentially adverse consequences associated with critical incidents. The CISM model may serve a valuable heuristic purpose in the planning and development of CISM approaches in a wide variety of organizations and industries. This paper reports on the use of the CISM approach (Everly & Mitchell, 1999) as a guide or template in developing an enhanced and updated Assaulted Staff Action Program (ASAP; Flannery, 1998) approach to service delivery. ASAP is a voluntary, peer-help, CISM approach for staff who are assaulted by patients. The updating of its comprehensive services was necessitated by recent research and clinical experience on the changing nature of the assaultive psychiatric patient.