On Oct. 30, Holt was awarded the bronze order of the de Fleury Medal for his leadership as the director of CISM program implementation for the Corps. The program was first implemented in Holt’s division, and later was implemented by the national organization.
Holt, a Marion resident, said he was humbled by the honor and since he is approaching the end of his career, it was tremendous “to go out on that note.”
History of CISM
CISM was developed in the 1970s by Jeffrey Mitchell and George Everly.
Mitchell, a firefighter, started studying the psychological impact certain events had on firefighters and emergency service personnel.
“It relates to various other terms, like ‘shell-shock’ with veterans from World War II, and later on as the terminology changed, with the development program we’ve started to call ‘post-traumatic stress syndrome,’” Holt said.
“There are also other chronic stress disorders or acute stress disorders that can develop from a bad experience.”
The CISM program has been adapted by many organizations including airlines, the Environmental Protection Agency, counties, states and emergency services.
“(CISM) is an overall term for a number of interventions,” Holt said. “It just doesn’t surround one particular intervention.
“The program attempts to take the effects of an incident through a variety of interventions or education programs.”
Holt said he became interested in stress management after he experienced a critical incident in 1979. He defined a critical incident as “anything that happens that can overwhelm your normal coping skills.”
“In fact,” he said, “a large portion of our population will encounter a critical incident in their lives. They might come up on a car wreck, they might be in a car wreck, they might be in a disaster, a tornado, a hurricane—all of those things can produce stress disorders.”
The critical incident that Holt remembers was the drowning of a 3-year-old girl in French Creek Cove nearly three decades ago.
“After the event—even until this day—I could tell you what she was wearing, what she looked like, what the parents’ faces looked like, the sights and sounds,” he said. “Even after 28 years, I can still remember those things very vividly. You don’t forget those things.
“I was thinking, am I the only one that has problems with this? And as it turns out, anyone there was probably experiencing the same reaction.
“What we try to do in some of these (CISM) interventions is normalize your reactions.”
Although Holt’s critical incident occurred in 1979, he, along with another employee, didn’t begin the implementation process for the Corps of Engineers until 2000 when they attended a CISM training seminar.
“That (1979) instance and other instances like that were always in the back of my mind,” Holt said. “There was something that could be done to help people get through those things. As this program developed, and it came to be known more throughout the emergency community, a light bulb went off.”
Holt worked to implement the program first in the Southwestern Division of the Corps, which includes Marion County.
CISM implementation gained momentum in 2001 and Holt continued to work toward making the program compatible with other Corps of Engineers procedures.
“We used the standard, but our operations manual has to adapt the program features to the Corps culture,” he said.
One of the first times the program responded to a critical incident in the Southwestern Division was during the the Interstate 40 bridge collapse in Oklahoma in 2002. Holt said Corps of Engineers employees recovered 13 of the 14 bodies. It was a traumatic experience for the employees, but the CISM program was successful throughout the crisis.
“After our success at the I-40 bridge incident and other things during our time of development, our headquarters operations office in Washington, D.C., caught wind of the program, and the commanding general authorized a program development team to develop a national model for the Corps of Engineers,” said Holt, a member of the development team.
Holt said the program was developed and accepted as a national program in 2006. Currently, it has 50 trained peer supporters, and the intention is to train more.
“Actually, to consider moving from a regional program in 2001 to a national program in 2006—that’s moving in government warp-speed, if you will,” Holt said. “It was probably because it was recognized by other people in the agency who have been through things like this—this is what we need. Everyday, somewhere, someone encounters a critical incident in our organization.”
Aiding Katrina workers
Before the program was implemented nationwide, a team of four, including Holt as team leader, traveled to Louisiana after Hurricane Katrina to aid Corps employees.
After arriving at the Corps office in Baton Rouge, the team traveled 16,000 miles in four months and conducted 364 one-on-one interventions with employees working in the areas of hurricane destruction.
“We base a lot of our program’s success on education,” Holt said. “Say, for example, you’ve never been to a disaster, so you would be coming in and you wouldn’t have any idea what to expect. You’re a blank slate.
“Now, rather than throw you in with the lions and tigers and bears, we’re going to let you know what those lions and tigers and bears are all about.”
Holt said the “blank slates” were taught what sites were like, what people were complaining about, how others were reacting to the situation, and even what smells to expect.
“Retention of a certain smell related to an incident can come back and trigger memories long after the event,” Holt said.
People working on the levy in New Orleans were instructed to wear chaps because of the snakes displaced by the flooding.
“Essentially, by telling people about the environment they’re going into, we lessen the psychological impact,” Holt said. “You go there and you go, yeah, I was told I might smell something like this, so no big shock.”
The final national implementation includes a seven-step process that takes volunteers who participate in the program from cognitive thinking to emotional thinking and back to cognitive thinking.
The process is generally done in a group setting, but at times can be applied on an individual basis.
“They’ve actually had a chance to think and respond and think about and express reactions to the event,” he said.
The seven phases of the program are introduction, fact, thought, reaction, symptoms, teaching and re-entry.
The Corps as family
The CISM program is important, Holt said, because the Corps of Engineers is a family.
The Corps employs 34,000 people in 200 countries. Many experience critical incidents on a daily basis, and need stress-management education.
“Whether it’s a park ranger or a contract inspector or an engineer or administrative person, anyone in those situations can encounter a critical incident. You take those things home, and unless you have a productive way of talking about it, it can really start to bother you.”
Because the program has Corps employees helping other Corps employees, the program has gained credibility quickly.
“Who knows better what a park ranger’s going through than another park ranger?” Holt asked. “Who knows what another disaster worker’s going through other than someone else that’s been in the same situation?
“(CISM) is a tool that we can use to help take care of ourselves.”