Arizona

Department of Public Safety

Peer Services Manual

January 1, 2005

DPS 932-02046 Rev. 1/2005

Peer Services Manual
 Peer Services Manual
January 1, 2005

Table of Contents
Page

I. Overview ...................................................................................................................... 1-1

A. Purpose and Philosophy.................................................................................... 1-1

B. Peer Support Program ....................................................................................... 1-2

C. Critical Incident Stress Management Program (CISM).................................... 1-2

II. Confidentiality............................................................................................................. 2-1

A. Confidentiality Guidelines ................................................................................ 2-1

B. Confidentiality Exceptions................................................................................ 2-1

C. Breach of Confidentiality Consequences.......................................................... 2-2

D. Breach of Confidentiality: Non-Emergency Procedures ................................. 2-2

E. Breach of Confidentiality: Emergency Procedures.......................................... 2-2

III. Peer Support Program ............................................................................................... 3-1

A. Administration .................................................................................................. 3-1

1. Peer Support Goals ............................................................................... 3-1

2. Program Coordinator Responsibilities.................................................. 3-1

3. Peer Support Committee ....................................................................... 3-2

B. Peer Support Member Selection ....................................................................... 3-2

1. Membership Requirements ................................................................... 3-2

2. Selection Process .................................................................................. 3-2

3. Training Requirements.......................................................................... 3-3

4. Removal of Member ............................................................................. 3-3

5. Appeals ................................................................................................. 3-4

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C. Requests for Peer Support Program Services ................................................... 3-4

D. Authorized Peer Support Interaction ................................................................ 3-4

E. Overtime Guidelines ......................................................................................... 3-4

F. Travel Guidelines.............................................................................................. 3-5

G. Vehicle Use Guidelines..................................................................................... 3-5

H. Scheduling Guidelines ...................................................................................... 3-5

I. Peer Support Member Activity Documentation ............................................... 3-5

IV. Critical Incident Stress Management (CISM) Program .......................................... 4-1

A. Administration .................................................................................................. 4-1

1. Program Coordinator Responsibilities.................................................. 4-1

2. CISM Supervisor Selection and Training Requirements....................... 4-1

B. CISM Activation................................................................................................ 4-2

1. Mandatory Activation of the CISM Supervisor..................................... 4-2

2. Discretionary Activation of a CISM Team/Member ............................. 4-2

3. Activation Procedures........................................................................... 4-3

4. CISM Supervisor’s Activation Responsibilities.................................... 4-3

5. CISM Team ........................................................................................... 4-4

6. Debriefings............................................................................................ 4-4

7. Defusing................................................................................................ 4-4

C. CISM Team Selection........................................................................................ 4-4

1. Application Process .............................................................................. 4-4

2. Selection Process .................................................................................. 4-5

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3. Training Requirements.......................................................................... 4-5

4. Assignments.......................................................................................... 4-5

D. Overtime Guidelines ......................................................................................... 4-6

E. Travel Guidelines.............................................................................................. 4-6

F. Vehicle Guidelines............................................................................................ 4-6

G. Scheduling Guidelines ...................................................................................... 4-6

H. Activity Documentation.................................................................................... 4-6

V. Program Affiliates....................................................................................................... 5-1

A. Family Support Network (FSN) ........................................................................ 5-1

B. Family Support Group (FSG), Inc..................................................................... 5-1

Appendices: A. Confidential Crisis/Financial Assistance Application

B. Peer Support Member Application/Peer Support Member Commitment

C. Confidentiality Agreement

D. Confidentiality Handout

E. Peer Support Members Monthly Activity Sheet

Glossary

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Introduction
The Department’s Peer Support Program (PSP) offers confidential assistance and support to all
department employees and their family members in times of personal need or due to traumatic
incidents

The PSP augments the Employee Assistance Program (EAP) and does not replace psychological
treatment. The objectives of the PSP is to minimize psychological trauma department employees
and their families may experience throughout their career and render assistance in an attempt to
accelerate normal recovery to abnormal events, some of which are unique to the Department.

Department employees, support staff, retirees, and family members have been trained and
certified as a Peer Support and Critical Incident Team Member (PSM/CISM) to provide peer
support services. The PSM/CISM members are not licensed counselors or therapists but act as a
peer support provider, offering information, and opportunity to obtain information and direction
to resolve emotional charged matters in a confidential setting. (Refer to Section II regarding
confidentiality.)

This manual provides information regarding the administration, selection of members, and the
training required for the PSP/CISM program. GO 2.3.40, Peer Services, provides the
Department’s policy regarding PSP and the CISM program.

Comments or questions pertaining to this manual should be referred to the EAP supervisor in
Human Resources.

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I. Overview
A. Purpose and Philosophy
1. Peer Services is designed to use the Department’s resources and financial
leverage with the assistance from Family Support Group (FSG), Inc. to
benefit our employees in times of need. This program is a visible means
for demonstrating commitment to the concept that we are a Department of
Public Safety (DPS) family. Below shows the organizational structure:

1.1: Organizational Structure

Director

Agency Support Division

Human Resources Bureau

EAP/Behavioral Services Peer/CISM Services

Program Coordinator

Peer Support Committee Chaplains Program

Family Support Group, Inc Family Support Network

Members

2. In modern society, work related or externally-caused stressors have the

potential to jeopardize relationships, health, safety, and work performance.
Peer Services, supported by FSG, Inc., (see Section V.) and the
Department is designed to help employees and their families reduce stress,
deal with crises, and obtain immediate, short-term help during and after
critical incidents, or family problems. Employees must complete the

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Confidential Crisis/Financial Assistance Application (DPS 802-07158)

form to obtain financial assistance (see Appendix A).

3. Peer Services includes the Peer Support network and Critical Incident
Stress Management (CISM) programs.

B. Peer Support Program

1. The Peer Support program provides a network of concerned public safety
employee members offering volunteer services to peers in need. Members
are trained by mental health professionals and have expertise to assist with
many types of problems. Members receive 40 hours of basic training in
Peer Support and CISM; which includes, listening and assessment/referral
skills. Additionally, members receive eight hours of workshop training
annually. One of the most significant skills members possess is their
ability to be listeners and effectively communicate with others. Peer
support members are supervised and guided by a licensed psychologist
and the Employee Assistance Program (EAP) supervisor. Appendix B is
an example of the Peer Support Member Application (DPS 802-07160F)
and the Peer Support Member Commitment form (DPS 802-07160B).

2. Peer Support Members are located throughout the state. A current list of
members is posted in district offices, the Duty Office, and the Employee
Assistance Program (EAP) located in Human Resources.

C. Critical Incident Stress Management Program (CISM)

1. The Department recognizes employees may be subjected to high levels of
stress during the performance of their duties. These stressors may have a
direct impact on the employee and family. CISM program provides a
structured process in which stress and reactions, which occur as a result of
a critical incident, may be vented in a controlled setting.

2. CISM services are provided by Peer Support members who have received
advanced training in stress related matters. Members form a CISM team
when providing CISM services. Team member selection is based on the
member’s skill, education, training, and knowledge. The team shall
include a mental health professional.

3. CISM team members may provide a defusing during or immediately after a

major incident. A defusing is directed at stabilizing the incident. The
defusing allows employees impacted by the critical incident to vent
reactions or emotions and permits CISM team members to assess the need
for a formal group debriefing. A debriefing is a confidential, structured
group meeting which is attended by individuals directly and indirectly

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involved in a critical incident. CISM team members may facilitate the

meeting, along with a mental health professional who is present to provide
any immediate assistance and guidance. CISM team members also provide
individuals with information about possible normal symptoms and
reactions to unusual events.

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II. Confidentiality
Confidentiality is essential to promoting trust and anonymity between peer support
members and individuals requesting assistance. Confidentiality is essential to protect the
identity of employees and content of any contact by a member of the Peer Support or
CISM team. It must be clear though PSM/CISM members are not licensed counselors or
therapists but act as a peer support provided offering information and opportunity to
obtain information and direction to resolve emotional charged matters in a confidential
setting. Each member of the PSM/CISM must complete the Confidentiality Agreement
form (DPS 802-07157). See Appendix C for an example.

A. Confidentiality Guidelines
1. Peer Support member and individual interactive sessions are considered
confidential by the Department in order to ensure trust, anonymity, and
effectiveness of assistance requested. Confidentiality cannot be absolute
because of the seriousness of a circumstance or legal requirement. While
every reasonable effort to protect anonymity shall be taken by the Peer
Support member, there are confidentiality exceptions to the Department’s
confidentiality policy.

2. In order for groups (debriefings) to be effective, group members must feel

what they share about themselves will remain private and within the
group. In other words, members must feel their statements are
confidential (not privileged). Therefore, all members are responsible to
“keep the privacy” of their fellow members by not discussing the
statements or other material in any way could be used to identify what a
specific group member stated. They must only speak for themselves and
not for others in the group.

B. Confidentiality Exceptions
The rights and privacy of employees will be safeguarded to the maximum extent
possible, while balanced with the Department’s compelling interest in maintaining
a safe and productive workplace and work force. There are some situations where
confidentiality cannot be absolute. While every effort will be made to protect
anonymity, the gravity of some situations will demand attention by management.
Confidentiality will be maintained except in the following circumstances:

1. Where there is a serious breach of department policy.

2. When a crime has been committed.

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3. When circumstances indicate those being assisted are in danger or a threat

to themselves or others.

4. When child/elder abuse is alleged or apparent.

5. When there indications of domestic violence.

6. When subpoenaed, the subpoenaed information should be discussed with a

legal advisor to insure the requested information or testimony should be
provided.

C. Breach of Confidentiality Consequences

Compromising a confidence for any other reason than stated in exceptions to
authorized confidentiality will be considered a violation of department policy. A
Peer Support member, who violates confidentiality, may be subject to
investigation and discipline as prescribed by GO 2.2.40, Complaints and
Discipline Procedure Manual.

D. Breach of Confidentiality: Non-Emergency Procedures

1. Whenever a Peer Support member believes a confidentiality exception is
present, the Peer Support member will, as soon as possible, contact the
program coordinator and provide a briefing on the general circumstances
of the situation.

2. If, in the judgment of the program coordinator, immediate attention is

required, the Peer Support member will disclose all information about the
situation including the identity of the employee or individual(s) involved.
The program coordinator will initiate appropriate steps to resolve the
matter.

3. If, in the judgment of the program coordinator, a confidentiality exception

is not present, the matter will be considered confidential and the matter
will go no further than the program coordinator and Peer Support member.

E. Breach of Confidentiality: Emergency Procedures

If a Peer Support member becomes aware of an emergency situation involving a
confidentiality exception and the program coordinator cannot be immediately
contacted, the Peer Support member will contact any department supervisor or
commander/manager and disclose all information.

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III. Peer Support Program

A. Administration
1. Peer Support Goals

a. To develop a referral system of appropriate professional assistance

through mental health professionals or other human services and
self-help support groups.

b. To provide intervention which assists in defusing problems before

they become crisis situations.

2. Program Coordinator Responsibilities

The program coordinator is the Employee Assistance Program supervisor

in Human Resources. The program coordinator’s responsibilities
include, but are not limited to:

a. Establishing the general direction of the program consistent with

sound administrative practices.

b. Collecting and evaluating statistical data on the use of the program

and reporting the findings to the Director annually, through
Agency Support.

c. Keeping the Director or designee informed of any disturbing trends

and making recommendations regarding those trends.

d. Assessing the need to breach confidentiality between Peer Support

members and employees.

e. Overseeing the selection and appointment of Peer Support

members and CISM Team members.

f. Coordinating the training of Peer Support members and CISM team

members and establishing training standards in conjunction with
recommendations from a mental health professional(s) experienced
in handling Peer Support and CISM issues.

g. Serving as an advisor to Peer Support members and acting as a

liaison between Peer Support members and their department
supervisors.

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h. Serving as liaison to the FSN, FSG, Inc., Peer Support Committee,

other agencies, and department employees in all matters pertaining
to Peer Services.

i. Investigating cause allegations against Peer Services members and

recommending to the Peer Support Committee retention or
removal of the Peer Support member from the program if cause is
sustained.

j. Maintaining a liaison between the program psychologist, who

advises and oversees the Peer Support program.

3. Peer Support Committee

Peer Support Committee members are Peer Support members appointed

by the EAP supervisor with the concurrence of the Director and serve at
the discretion of the Director. Committee member responsibilities
include, but are not limited to:

a. Reviewing cause allegations of Peer Support members and

removal of a member upon the recommendation of the program
coordinator.

b. Assisting the program coordinator with the application and

selection processes for Peer support members and CISM team
members.

c. Assisting the program coordinator with program activities which

may include fund-raising, training, and trends analysis.

B. Peer Support Member Selection

1. Membership Requirements

Members are required to be employee volunteers and agree to adhere to

policy and procedures established in this Peer Services Manual.

2. Selection Process

a. As Peer Support members are needed, they will be solicited

through various department media.

b. Applicants must submit a memorandum through their chain of

command to be forwarded to the program coordinator. The

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memorandum should express the applicant’s interest and

willingness to serve as a volunteer.

c. The program coordinator will provide a Peer Support member

application form to the applicant.

d. Applicants must attest they are not currently the object of a

disciplinary investigation that could result in their suspension,
demotion, or termination.

e. Applicants must sign their application agreeing to abide by

program guidelines.

f. Applicants must obtain their supervisor and commander/manager’s

endorsement on the completed application prior to forwarding the
completed application to the program coordinator.

g. The program coordinator and Peer Support Committee will review

the applicant’s qualifications and work history. The quality of the
applicant’s job performance, as well as any previous disciplinary
actions will be considered in the selection process. The program
coordinator may interview the applicant’s chain of command.

h. Peer Support members will be notified of their selection status

through the chain of command and program coordinator.

i. Peer Support Members will sign a Confidentiality Agreement form

(see Appendix C) upon completion of their basic peer training.

3. Training Requirements

Members are required to complete a 40-hour basic training program prior

to becoming active as a Peer Support member. Thereafter, members are
required to complete a minimum of eight hours training annually. Any
Peer Support member failing to attend annual training may be removed
from the program. Training content and requirements are determined by
the program coordinator and the program psychologist. Upon completion
of training, members will sign a Confidentiality Agreement (see Appendix
C).

4. Removal of Member

a. Peer Support Members and CISM team members may be removed

for cause from their volunteer positions in Peer Services.

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Conditions which will be considered cause may include, but not be

limited to:

(1) Any substantiated breach of confidentiality (including

substantiated rumors of a breach in confidentiality).

(2) Failure to comply with training requirements when absence

from training is not excused by the program coordinator.

b. Removal for cause of a Peer Support member or CISM team

member shall be initiated by the program coordinator.

5. Appeals

When a removal for cause is initiated against a Peer Support member or

CISM team member, the concerned member may appeal removal to the
Peer Support Committee. Appeals will be reviewed on a case by case
basis.

C. Requests for Peer Support Program Services

Individuals requesting Peer Support Program services may contact a member as
follows:

1. Obtain the member’s name, home, and work telephone numbers from Peer
Support Program lists posted within department work units.

2. Contact the Department’s EAP coordinator and obtain confidential

assistance in locating a Peer support member.

3. Contact the Duty Office.

D. Authorized Peer Support Interaction

Peer Support member interactive sessions with individuals are conducted when
the individual and peer support member are in an off-duty status. Any on-duty
interactive sessions which occur other than during an authorized break period,
will require approval of affected employees’ supervisors. Overtime will not be
approved for any peer support interaction.

E. Overtime Guidelines

Overtime is authorized, with supervisory approval, for travel related to training,

critical incident response, and program meetings. Overtime is not authorized for

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individual peer interactive sessions. Established department policy and

procedures for overtime approval and compensation shall apply (reference GO
2.4.120, Overtime Management and Compensation).

F. Travel Guidelines

Lodging and per diem expenses are authorized for travel related to training,
critical incident response, and required program meetings. Established
department policy and procedures for lodging and per diem reimbursement will
apply (reference GO 7.3.20, Travel Charge Card and Travel Reimbursement).

G. Vehicle Use Guidelines

An assigned department vehicle may be used to travel to training, critical incident
response, and program meetings (reference GO 5.2.40, Vehicle Assignment and
Use).

H. Scheduling Guidelines
1. Employees will notify their immediate supervisor when participating in
any Peer Services activity to ensure there is no scheduling conflict.

2. If a conflict occurs, the Peer Support member will notify the program
coordinator. The program coordinator will work with the immediate
supervisor in an attempt to resolve the conflict.

3. With the immediate supervisor’s approval, on-duty time may be claimed.

Otherwise the Peer Services activity will be considered off-duty time. No
overtime will be granted.

I. Peer Support Member Activity Documentation

Each month, Peer Support members shall document the hours of services and
number of employees served on the Peer Support Program Activity Report
(Appendix E). The completed activity report will be forwarded to the program
coordinator no later than the 10th of each month.

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IV. Critical Incident Stress Management (CISM) Program

The Department’s purpose for the CISM Program is to help mitigate any adverse impact
of a critical incident. The goal of the CISM Program is to provide a process in which
stress, the reactions, and emotions resulting from a critical incident may be vented in a
controlled structured setting.

A. Administration
1. Program Coordinator Responsibilities

The program coordinator is responsible for the overall administration of

the CISM Program that includes but is not limited to:

a. Overseeing the selection process of CISM team members.

b. Coordinating required training for CISM team members.

c. Determining whether confidentiality will be breached or

maintained when CISM team members encounter circumstances of
a serious nature and require direction/advice.

d. Responding to requests for CISM team/member services from other

agencies.

e. Arranging briefings and maintaining contacts with mental health

professions who assist at briefings.

f. Assisting immediate supervisors in resolving CISM team member

scheduling conflicts.

2. CISM Supervisor Selection and Training Requirements

a. CISM supervisors are selected by the program coordinator.

b. CISM supervisors are required to complete peer support and basic

and advanced critical incident stress management training.

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B. CISM Activation

1. Mandatory Activation of the CISM Supervisor

The critical incident on-scene commander shall activate the CISM

supervisor whenever the following occurs:

a. An on-duty incident in which action taken by or against a

department employee or employee of another agency participating
in a department-led task force operation results in death or serious
physical injury.

b. A collision involving a department vehicle or aircraft, or a vehicle

or aircraft authorized for use in conducting department business,
which results in death or serious physical injury.

c. An off-duty incident involving an employee where a department-

issued or authorized firearm has been discharged, causing death or
serious physical injury.

d. Any on-duty incident where shots have been fired by an employee,

and is not listed below in the exceptions.

e. Exceptions:

(1) The discharge of a firearm by department officers for the

dispatch of dangerous or severely injured animals per GO
4.1.120, Animal Euthanasia, by Crime Lab personnel for
firearms forensic testing, by commissioned officers and
security officers for firearms qualification training, and the
authorized use of less lethal ammunition which does not
result in death or serious physical injury.

(2) The off-duty discharge of a department-issued or

authorized firearm at a firing range to maintain shooting
proficiency or while lawfully engaged in the sport of
shooting or hunting.

(3). The threat of deadly physical force or the display of a

weapon.

2. Discretionary Activation of a CISM Team/Member

The critical incident on-scene commander may activate a CISM

team/member whenever the following occurs:

a. Prolonged or violent tactical operations.

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b. Major disasters.

c. Other stressful situations, depending on the needs of the employees

involved.

d. Any incident deemed serious enough by the magnitude of the

circumstances to mandate critical incident investigation and
review.

3. Activation Procedures

a. The Duty Office shall notify the program coordinator, who will
then decide which CISM supervisor will be notified.

b. The Duty Office shall notify the specified CISM supervisor. If the
supervisor is not available, the program coordinator will be
notified.

c. The Duty Office will advise the program coordinator or CISM

supervisor as to the nature of the critical incident.

4. CISM Supervisor’s Activation Responsibilities

1. When a critical incident occurs, the CISM supervisor will

communicate with the critical incident on-scene commander to
evaluate the need for CISM services. The CISM supervisor will:

a. Determine if a defusing or debriefing is needed.

b. Initiate contact of CISM team members and coordinate with

their appropriate supervisor(s) in order to facilitate on scene
action.

c. Contact the supervisor in charge of the investigation or

incident to coordinate on-scene defusing.

d. Determine the number of CISM team members needed for a

particular incident. Activation of all or part of the CISM
team may depend upon the type and scope of the incident
and the number of employees involved.

e. Coordinate with the program coordinator, as needed, when

a debriefing is requested for employees who are directly or
indirectly involved in the incident.

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5. CISM Team

The CISM team shall respond when there is a likelihood employees will be
subjected to significantly abnormal levels of stress either during an
incident or at its conclusion.

6. Debriefings

a. At the conclusion of an incident, a CISM supervisor, any employee

or any other supervisor may request a debriefing be conducted for
employees directly or indirectly involved in the incident.

b. Participation in debriefings is voluntary.

c. Debriefings will normally be held within three days (72 hours) of

the incident.

d. A mental health professional shall be present for a debriefing.

e. Individuals from other agencies directly involved in the incident

may attend the debriefing.

7. Defusing

Any employee can arrange a one-on-one defusing by contacting a CISM

supervisor or the program coordinator.

C. CISM Team Selection

Any employee who is an active Peer Support member is eligible to apply for
membership to the CISM team.

1. Application Process

a. When it becomes necessary to select employees for the CISM team,

the program coordinator will solicit applicants by publishing
announcements in various department media.

b. Announcements will include the application period and

information required in an applicant’s memorandum.

c. Applicants are required to express their interest in CISM team

membership to their immediate and second level supervisors.

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Positive written recommendations from both supervisors will be

part of the application process.

2. Selection Process

a. Applicants will complete a resume and forward it to the program

coordinator.

b. Applicants will be required to provide two “peer references.”

c. Questionnaires will be provided to the two “peer references” and

the applicant must receive a favorable response from both
references.

d. Qualified applicants may be invited to participate in an oral

interview process.

e. A psychological evaluation by a mental health professional may be

required.

f. The program coordinator will select the most qualified individuals

and their names will be presented to the Director for final approval.

g. The program coordinator will notify new CISM team members of

their appointment.

3. Training Requirements

New CISM team members are required to attend basic and advanced CISM
training and remain current with their Peer Support member training
requirements.

4. Assignments

a. Prior to responding to any incident, CISM team members will

notify their immediate supervisors and obtain approval for the
response.

b. If a scheduling conflict occurs, the member will immediately

notify the program coordinator.

c. CISM team members will notify their immediate supervisors of any

required training, program meetings or scheduled debriefings.

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d. Requests for CISM team services from other agencies or

individuals will be directed to the program coordinator for
response.

D. Overtime Guidelines
Overtime is authorized, with supervisory approval, for all travel related training,
program meetings and approved response to critical incident situations. Every
effort will be made to use on-duty CISM team members to reduce overtime.
Established department policy and procedures for overtime shall apply (reference
GO 2.4.120, Overtime Management and Compensation).

E. Travel Guidelines
Lodging and per diem expenses are authorized for travel related to training,
program meetings and approved response to critical incident occurrences.
Established department policy and procedures for travel shall apply (reference GO
7.3.20, Travel Charge Card and Travel Reimbursement).

F. Vehicle Guidelines
An assigned department vehicle may be used to travel to training, program
meetings and approved critical incident occurrences (reference GO 5.2.40,
Vehicle Assignment and Use).

G. Scheduling Guidelines
1. Employees will notify their immediate supervisor when participating in
any CISM activity to ensure there is no scheduling conflict.

2. If a conflict occurs, the CISM team member will notify the program
coordinator. The program coordinator will work with the immediate
supervisor in an attempt to resolve the conflict.

3. With the immediate supervisor’s approval, on-duty time may be claimed.

Otherwise the activity will be considered off-duty time. No overtime will
be granted.

H. Activity Documentation
Each month, CISM team members shall document the hours of services and
number of employees served on the Peer Support Program Activity Report
(Appendix E). The completed activity report will be forwarded to the program
coordinator no later than the 10th of each month.

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V. Program Affiliates
A. Family Support Network (FSN)
1. The Department recognizes the importance of the employee’s family life
and the effect it can have on work performance, productivity, and the
employee’s ability to cope with the stresses inherent to employment. The
Department prides itself on extending the DPS family membership to
employee family members, retired employees and family, chaplains, and
survivor families. This extended family network helps the Department to
continue to accomplish the goals and objectives of its mission. It is this
philosophy that helped establish the Family Support Network (FSN).

2. FSN allows for continued lines of communication between department

employees, family members, and retired employees. FSN members may
obtain Peer Support services from FSN peer support members. FSN peer
support members are select volunteers who receive the same training as
employee peer support members. The FSN peer support member contact
list is posted with the Department employee Peer Support member list.
FSN members may also qualify for emergency funding, financial aid, and
FSN Peer Support member training assistance through application to
Family Support Group (FSG), Inc. (see Appendix A).

B. Family Support Group (FSG), Inc.

1. State law does not permit the Department to provide services and benefits
to FSN members. Family Support Group, Inc. was formed to provide
services and benefits for employees and FSN members. FSG, Inc., is
funded, managed, and maintained outside the Department. FSG, Inc. is a
non profit corporation with a Board of Directors who are non-employee
family members, retired employees, members of survivor families, and at
least one citizen. FSG, Inc., solicits tax deductible funds from individuals,
businesses, and organizations.

2. FSG, Inc. provides funding for employee and FSN peer support member
training, financial assistance for families in crisis, and sponsorship of
wellness and stress prevention classes for employees and FSN members.
Assistance may be obtained by application through the program
coordinator and application review by two members of the Peer Support
Committee and one FSG, Inc., member. The three review members must
be in agreement for assistance approval (see Appendix A).

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Appendices
 Appendix A
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Confidential Crisis/Financial Assistance Application

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 Appendix B
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Peer Support Member Application

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Appendix B
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Peer Support Member Commitment

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 Appendix C
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Confidentiality Agreement

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 Appendix D
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Confidentiality Handout

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 Appendix E
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Peer Support Members Monthly Activity Sheet

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Appendix E
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Glossary

Cause Peer Support Members and CISM team members may be removed from
their positions in Peer Services for cause. Conditions which will be
considered cause may include, but not be limited to:

1. Any substantiated breach of confidentiality (including

substantiated rumors of a breach in confidentiality).

2. Failure to comply with training requirements when absence from

training is not excused by the Program coordinator.

3. Fraternization, affairs or developing inappropriate relationships

with individuals requesting assistance or being provided peer
services.

Removal for cause of a Peer Support Member or CISM team member

shall be after review by a Peer Support Committee, established by the
Employee Assistance supervisor.

Critical Incident Provides teams of peer support members having advanced training in
Stress Management critical incident stress management and who respond to and assist in
(CISM) Program critical incident situations.

CISM supervisor CISM supervisors are selected by the program coordinator. CISM
supervisors are required to be trained in Peer Support and CISM. CISM
supervisors evaluate the need for defusing, debriefing and initiate
contact of CISM team members for critical incident scene response.

CISM team Employee volunteer Peer Support members having advanced training in
critical incident stress management. Members are selected on the basis
of their skills, knowledge and education. Primary responsibilities
include responding to critical incident scenes, providing defusing and
assisting/facilitating group debriefings. The team shall include a mental
health professional.

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Critical incident As defined by:

1. GO 4.1.40, Critical Incident Management, for employee/work-

related incidents.

2. Another agency requesting department CISM team assistance.

3. For Family Support Network (FSN) members and incidents not

defined by department general order: an event which has
sufficient emotional impact to overwhelm an individual's usual
abilities to cope.

Debriefing Is a confidential, more structured, seven-phase group crisis

intervention (consistent with the protocol established by the
International Critical Incident Stress Foundation [ICISF]) which is
facilitated by a CISM team member(s) and a mental health
professional. The intervention is used to facilitate psychological
closure and reconstruction. The CISD is a group discussion wherein
participants are encouraged to discuss the critical incident and their
reactions to the incident. Suggestions are provided for coping and
stress management, while the group member support is certainly
welcomed, when appropriate.

The CISM team members may provide information about possible

reactions and symptoms which are normal to unusual events as
established by the ICISF established model. The debriefing is usually
conducted sometime within the first 14 days following the incident.
The debriefing is not a critique of the incident.

Defusing Occurs during or immediately after a major critical incident and is

directed at stabilizing the incident. Defusing are generally 20 to 30
minute, three-phase, semi-structured discussions within the first 12
hours of a crisis event. Defusings are designed to provide an initial
forum for cathartic ventilation and information exchange. The
defusing may also allow initial venting of employee reactions and
emotions. Defusing assists the CISM team member in determining if a
formal debriefing is needed. The guidelines have been established
using the ICISF established model.

Family Support Group A nonprofit corporation with the purpose of providing financial support
(FSG) Inc. for department Peer Services (see Appendix A).

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Family Support Consists of employees, retired employees, employees= families,

Network (FSN) chaplains, survivor families and significant others.

FSN support member A family member, retired employee, or survivor family member who
has received peer support training and provides peer support services or
CISM services to FSN members (see Appendix B).

Intervention An action taken to assist employees or FSN members who are

experiencing a crisis and immediate assistance is necessary to reduce
the possibility of a serious negative outcome from the crisis.

Peer Services A psychologist licensed by the State of Arizona.

psychologist

Peer Support Peer support members recommended by the Employee Assistance

Committee Program supervisor, with the concurrence of the Director or his
designee. Committee members assist the program coordinator with
selection of volunteers for Peer Services, review removal for cause
situations and make recommendations, assist with fund raising
activities and provide active support to the program coordinator for
program administration.

Committee composition includes: One employee from the Office of

the Director or his designee, the EAP coordinator/supervisor, a
representative from FSG, Inc., and one ad hoc member.

Peer Support member Employees trained in listening and assessment skills who respond to
employee requests for help and/or referral to professional counseling or
psychological services. Peer support member and employee
interactions are on a one-to-one basis.

Peer Support services Provides a network of trained employees who assist individuals
experiencing personal and job-related problems in a positive and
structured manner.

Program coordinator The Employee Assistance Program supervisor assigned to Human

Resources who will coordinate and administer the activities and
training of Peer Services. The program coordinator also serves as the
department liaison to FSN, FSG, Inc., other agencies, and members of
the Peer Support Program, Peer Support Committee, CISM teams and
all department employees.

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