FDNY Crisis Counseling: Innovative Responses to 9/11 Firefighters, Families, and Communities

Preface xiii

Acknowledgments xix

Chapter 1 Introduction 1

Chapter 2 Coping with Chaos 10

The Counseling Service Unit Pre-9/11 11

The CSU Response to 9/11 16

Assessing the Community 18

Receiving Outside Help 21

CSU Expansion 23

Connecting with the Firefighting Community 23

Connecting with Families 24

Family Liaisons 26

Moving Forward 29

Defining a Timeline for Your Community 30

Chapter 3 Understanding Culture 33

Cultural Identity 35

Applying Cultural Identity to Intervention 37

Firefighting History and Tradition in New York 39

Modern Firefighting in New York City 45

The FDNY as a Paramilitary Organization 47

Everyday Life in the Firehouse 48

Rituals and Rank 50

Common Bonds 54

Family Ties That Bind 56

Heroics, Media, and Politics 60

The Brotherhood and Its Loss 63

Chapter 4 Shaping Services to Meet Emerging Needs 68

Assessment and Planning 69

How the Nature of the Event Shapes the Response 74

Listening and Responding to Emerging Needs 79

Strengthening the CSU Identity 82

Establishing Provider Networks 83

Building a Staff: Both Peer and Professional 87

Care for the Caregivers 90

Keeping the Machinery Going: Funding and Resource Development 95

Thoughts for the Future 96

Chapter 5 Providing Help in the Workplace: The Firehouse Clinician Project 98 

The Mindset of FDNY Firefighters 98

The Intervention: Placing Clinicians in Firehouses 100

The Population: Defining Who Needed Services 103

Theoretical Orientation 106

Intervention Goal 107

Selecting and Training Firehouse Clinicians 111

The First Visit to the Firehouse 115

Revamping Professional Boundaries 120

Preparing to Be a Firehouse Clinician 125

Termination Countertransference: The Time to Leave the Firehouse 134

Chapter 6 Modifying Psychotherapy for Individuals 136

Individual Psychotherapy with Firefighters 136

The Parameters of Individual Treatment 140

Choosing Individual Psychotherapy 143

Implications for Psychotherapy Technique 149

Summary 153

Chapter 7 Finding Comfort in Groups 154

Why Group Intervention? 155

Therapy Groups versus Support Groups 156

Trauma Groups 156

On-Site Interventions 159

Office-Based Groups: Middle and Later Phase 162

Importance of Homogeneity in Group Formation 164

Traumatic Bereavement Groups 165

Single-Session Groups 176

A Final Word about Groups 178

Chapter 8 Providing a Home-Based Therapeutic Program for Widows and Children 180

Understanding the Experience for Mothers and Children 181

Developing CSU Services for Bereaved Families 187

Creating a Preliminary Model for the Family Program 189

Preliminary Trauma, Grief, Reconstitution Model 191

Implementing the Family Program 196

Intervention Goals for Children and Adolescents 198

Intervention Goals for Adults 199

Therapeutic Approaches 199

Lessons Learned 207

Chapter 9 Strengthening Connections within the Family at Home 212

The Impact of Trauma on Relationships 215

Reaching Out to Families 217

Developing an Effective Intervention 219

The Couples Connection Weekend 220

Lessons Learned 228

Chapter 10 Assisting Retirees in Transition 231

When the Losses of 9/11 Were Compounded by the Loss of a Job 231

The Retiree Experience 234

The Stay Connected Program 236

Lessons Learned 243

Chapter 11 Conclusion 246

Protracted Time Lines 248

Community of Grievers 249

Crisis Counseling over the Long Haul 250

Public versus Private Mourning 251

The Value of Pre-planning 253

Posttraumatic Growth 255

Postscript 257

References 259

Index 265