From controversy to confirmation: crisis support services for the twenty-first century

The field of Critical Incident Stress Management (CISM), a comprehensive, integrated, systematic, and multi-component staff support program, developed, expanded in its scope, and spread rapidly with little criticism for over a decade. The next ten years (1996-2006) could be characterized as a period of intense scrutiny and opposition. CISM has recently emerged from the hostile inspection process stronger and more organized, in many ways, than earlier in its history. Numerous positive outcome studies were completed during the period of evaluation; these support the principles of CISM. Most importantly, the United Nations has recently adopted the concepts of CISM for support of its personnel.