Developing a Law Enforcement Stress Program for Officers and Their Families.

MENU TITLE: Developing a Law Enforcement Stress
Program for Officers and Their Families            
    
Series: NIJ Issues and Practices
Published: March 1997
321 pages
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U.S. Department of Justice
Office of Justice Programs
National Institute of Justice 

Developing a Law Enforcement Stress 
Program for Officers and Their Families

by
Peter Finn and Julie Esselman Tomz

March 1996

Issues and Practices in Criminal Justice is a
publication series of the National Institute of
Justice. Each report presents the program options
and management issues in a topic area, based on a
review of research and evaluation findings,
operational experience, and expert opinion on the
subject. The intent is to provide information to
make informed choices in planning, implementing,
and improving programs and practice in criminal
justice.

National Institute of Justice

Jeremy Travis
Director

Samuel C. McQuade
Program Monitor

Advisory Panel

James J. Carr
Executive Director 
Family Service Society
Pawtucket, Rhode Island

John Firman
Coordinator for Research and Analysis
International Association of Chiefs 
of Police
Alexandria, Virginia

William E. Garrison
Sergeant/Supervisor
Health Services Section
Metro-Dade Police Department 
Miami, Florida

Robert S. Hurst
Administrator
Fraternal Order of Police
Dental, Optical and Prescription Fund
Philadelphia, Pennsylvania

Ellen Freeman Kirschman
Health Resource Coordinator 
Palo Alto Police Department
Palo Alto, California

David M. Kunkle
Chief of Police
Arlington Police Department
Arlington, Texas

Elizabeth Langston
Executive Director
Center for Criminal Justice Studies
Fraternal Order of Police
Washington, D.C. 

John Pitta
National Executive Vice President
Federal Law Enforcement Officers 
  Association
Mellville, New York

Ellen Scrivner
Deputy Director for Training and Technical 
Assistance
Office of Community Oriented Policing 
Services
U.S. Department of Justice
Washington, D.C.

Robert T. Scully
Executive Director 
National Association of Police 
Organizations
Washington, D.C.

Prepared for the National Institute of Justice,
U.S. Department of Justice by Abt Associates Inc.,
under contract #OJP-94-C-007. Points of view or
opinions stated in this document are those of the
authors and do not necessarily represent the
official position or policies of the U.S.
Department of Justice.

The National Institute of Justice is a component of
the Office of Justice Programs, which also includes
the Bureau of Justice Assistance, the Bureau of
Justice Statistics, the Office of Juvenile Justice
and Delinquency Prevention, and the Office for
Victims of Crime.

NCJ 163175

_____________________

Foreword
___________________________________________

Law enforcement has always been a stressful
occupation. However, there appear to be new and
more severe sources of stress for law enforcement
officers than ever before. Some of these stresses
are related to increased scrutiny and criticism
from the media and the public and to anxiety and
loss of morale as a result of layoffs and reduced
salary raises. Even positive changes in law
enforcement have increased stress for some
officers: while community policing can increase
officer job satisfaction and overall departmental
efficiency and morale, the transition to this
approach can cause apprehension. Furthermore, in
recent years there has been increased recognition
of longstanding sources of stress, including those
that some police organizations themselves may
inadvertently create for officers because of their
rigid hierarchical structures, a culture of
machoism, minimal opportunities for advancement,
and paperwork requirements.

It is also becoming increasingly clear that law
enforcement frequently exacts a severe toll on the
family members of the officer. We should be
concerned about the stress that law
enforcement work creates for family members for its
own sake, and we also need to recognize that a
stressful home environment can impair an officer's
ability to perform his or her job in a safe and
effective manner.

In response to these issues, we have seen
heightened interest in identifying and implementing
strategies that will prevent and treat law
enforcement stress, including its impact on stress
on officers' families. This  Issues and Practices
report provides a
comprehensive and up-to-date look at a number of
law enforcement stress programs that have made
serious efforts to help departments, individual
officers, civilian employees, and officers'
families cope with the stresses of a law
enforcement career. The publication is based on
nearly 100 interviews with mental health
practitioners, police administrators, union and
association officials, and line officers and their
family members. It provides pragmatic
suggestions that can help every police or sheriff's
department reduce the debilitating stress that so
many officers experience and thereby help these
officers do the job they entered law enforcement to
perform--protect the public.

Jeremy Travis
Director
National Institute of Justice
___________________________________________

Acknowledgements
___________________________________________

We wish to thank the many individuals who patiently
answered our questions and sent us materials about
their programs. In
particular, we thank the following study site staff
members whose programs we visited:

o Gary Kaufmann, Jeffrey L. Atkins, and Richard G.
Smith of the Michigan State Police Department's
Behavioral Science Section;

o Nancy Bohl of the San Bernardino (California)
Counseling Team;

o Cindy Goss of the Erie County (New York) Law
Enforcement Employee Assistance Program; and

o Yvonne Connor of the Drug Enforcement
Administration in
Washington, D.C.; Peter Mastin and Rhonda Bokorney
of the Bureau of Alcohol, Tobacco, and Firearms in
Washington, D.C.; and Christine Prietsch of the
U.S. Department of Justice's Employee Assistance
Program.

We also thank John J. Carr of the Rhode Island
Centurion Program; William E. Garrison of the
Metro-Dade (Florida) Police Department's Health
Services Section; Douglas Gentz of Psychological
Services in Tulsa, Oklahoma; Michael McMains of the
San Antonio Police
Department's Psychological Services; and Len
Wildman and Joseph Davis of the Rochester (New
York) Police Department's Stress Management Unit.
We are also especially appreciative of the valuable
information shared by the many law enforcement
officers and family members at these sites.

In addition, several other individuals provided
useful information for this report, including Alan
Benner of the San Francisco Police Department;
Theodore Blau of the Manatee County (Florida)
Sheriff's Office; Stephen Curran of the Police
Psychological Services Section of the International
Association of Chiefs of Police; Edward Donovan of
the International Law Enforcement Stress
Association; Ben Elliott of the U.S. Department of
Justice's Employee Assistance Program; Audrey Honig
of the Los Angeles County Sheriff's Office; Nels
Klyver and Kris Mohandie of the Los Angeles Police
Department's Behavioral Science Services Section;
John Nicolleti of the Denver Police Department;
Phillip Trompetter, who serves several departments
in Modesto, California; and Jane Sachs, an NIJ
dissertation fellow.

The following advisory board members (whose titles
are listed on the inside front cover) provided
comments by participating in a one-day meeting in
Washington, D.C., by reviewing the draft report, or
both: John J. Carr, John Firman, Ellen Freeman
Kirschman, William E. Garrison, Robert S. Hurst,
David M. Kunkle, Elizabeth Langston, John Pitta,
Ellen Scrivner, and Robert T. Scully.

Samuel C. McQuade, Program Manager for this project
at the National Institute of Justice (NIJ), was a
model monitor, providing guidance that was always
wise and timely, and support that was always
welcome and needed. Cheryl Crawford, the
Contracting Officer's Technical Representative at
NIJ, suggested a number of useful revisions to the
report. Several colleagues at Abt Associates also
provided valuable assistance. Joan Mullen reviewed
two drafts of the report. Linda Truitt conducted
the site visits to the ATF and DEA. Mila Ghosh,
Ellen McCarthy, and Tanutda Pittayathikhun
conducted telephone interviews. Sarah Minden
rewrote the chapter on confidentiality. Mary-Ellen
Perry and Myraida Rivera produced the numerous
report drafts. Karen Minich desktopped the final
copy.
______________________________________________

Executive Summary 
_______________________________________________

Contents and Background of This Report

This publication provides practical guidance
regarding the
development and maintenance of a law enforcement
stress program. The information is based largely on
interviews with nearly 100 people, including mental
health practitioners, law enforcement
administrators, union and association officials,
and almost 50 line officers and family members from
both large and small agencies. The publication does
not discuss specific counseling approaches but does
include references to counseling literature and
related resources.

Law enforcement officers face a number of sources
of stress particular to their field, ranging from
organizational demands (e.g., shift work) to the
nature of police work itself (e.g., exposure to
violence and suffering). In addition, some officers
report new or increasing sources of stress,
including those which result from the
implementation of community policing, negative
publicity, and reduced resources. It is important
that stress programs address the needs of the
family members of department personnel, who can be
a source of considerable stress or support for
officers and who themselves frequently experience
difficulties associated with their spouse's or
parent's law enforcement work.

Planning the Program

A program planner or independent practitioner who
expects to provide mental health services to law
enforcement agencies--or wishes to improve or
expand existing services--needs to include key law
enforcement administrators, labor representatives,
officers, and family members in the planning or
expansion process, and to conduct a needs
assessment, form an advisory board, formulate
program objectives, and develop written policies
and procedures that identify the extent and
limitations of program activities. Law enforcement
stress experts recommend a systematic and holistic
approach to program development, focusing on both
the prevention and treatment of stress at the
individual and organizational levels.

Structuring the Program 

To provide such services, a planner can establish
an in-house program, an independent external
organization, or a combination of the two. Each
option has advantages and drawbacks. Regardless of
program structure, stress program services must be
delivered in a location that is accessible and
completely private--typically, not in a law
enforcement department building.

Choosing Among Staffing Options

Stress program staffing configurations may differ
and may include nonsworn mental health
professionals, sworn mental health
professionals, interns, chaplains, volunteers, and
peer supporters. Careful screening, thorough
training, and strong management support are
especially essential for peer supporters to be of
benefit.

Establishing a Referral Network

Program staff and independent practitioners need to
select and monitor qualified external service
providers to whom they can refer selected officers
and family members in the event of lack of time to
treat them in-house or if special counseling skills
are
required.

Dealing With Confidentiality

Strict confidentiality (within the limits of the
law) is essential to program success. However,
there are exceptions to the privileged nature of
communication between clients and licensed mental
health practitioners, some of which vary from State
to State. To help ensure confidentiality, program
staff can distribute clear
confidentiality guidelines, maintain appropriate
client records, and either send mandatory referrals
to external counselors or clearly distinguish
between the treatment of voluntary and
mandatory referrals within the program. In
addition, staff need to consult with legal counsel
in order to clarify their legal
responsibility for maintaining confidentiality and
reduce their exposure to lawsuits.

Marketing the Program

To be successful, a stress program must generate
awareness, support, and referrals from
administrators, mid-level managers, union or
association officials, line officers, nonsworn
personnel, and family members of all personnel. In
order to generate support, program staff involve
these target groups in program planning, provide
training, and make themselves available around the
clock. In the end, however, word of mouth is the
best source of support.

Preventing Stress and Stress-Related Problems

Training officers and their families to recognize
sources and signs of stress and to develop
strategies for coping with it is a primary goal of
any stress program. Most practitioners believe that
the academy is the best time to begin, but in-
service training is useful for reinforcing and
extending basic concepts and strategies.

Reducing Organizational Stress

Because certain structures and practices within law
enforcement agencies themselves can be a
significant source of stress for officers and
family members, program staff and independent
clinicians sometimes work with departments to
modify agency policies and procedures. Program
staff have worked to alter rigid hierarchical
structures, to make shift work more flexible, to
improve supervisors' training methods, to provide
conflict
management among officers, supervisors, and
managers, and to help create better matches between
officer skills and the needs of a given job. In
addition to reducing stress for individual officers
such organizational changes can improve the overall
efficiency of the agency itself.

Responding to Stress-Related Problems After They
Occur

Among the treatment services that law enforcement
stress programs can provide are short- and long-
term counseling, critical incident stress
debriefing, crisis intervention, and assessment and
referral to other providers.

Services for Family Members: Treatment and Training

Since many practitioners report that most problems
for which officers seek assistance involve
relationship difficulties, programs are
increasingly providing services, including peer
support, for family members.

Monitoring and Evaluating the Program

Program staff and independent practitioners who
regularly monitor and can evaluate their own
services are more likely to be able to maintain or
increase their funding and to find ways of
improving program operations and effectiveness.
Several guidelines suggest how to conduct useful
process and impact evaluations.

Managing Program Costs and Funding

Program staff and consulting mental health
professionals can benefit by estimating both their
total operating expenses and their unit costs, such
as cost per client or counseling hour. While
practitioners consulted in this study have found a
variety of ways to save money and to secure
funding, it should be noted that some managed care
plans limit the ability of programs and individual
counselors to provide services.

Tapping Other Resources

A limited search identified organizations and
written materials and that can provide assistance
in establishing or improving a stress program.
Experienced staff from several stress programs are
available to provide consultation by telephone.

_________________________________________

Chapter 1
__________________________________________

Contents and Background of This Report

Key Points

o This publication provides practical guidance
regarding the development and maintenance of a law
enforcement stress program, with detailed
descriptions of existing programs that serve small,
medium-sized, and large agencies across the
country.

o Information in the report is based largely on
interviews with nearly 100 individuals, including
mental health practitioners, law enforcement
administrators, union and association officials,
and almost 50 line officers and family members.

o The publication examines a wide range of stress
program services, including treatment services,
training and other prevention efforts, and
consultation regarding the elimination or
mitigation of organizational sources of stress. An
entire chapter is devoted to treatment services and
training for family members of law enforcement
personnel.

o Despite limited resources, many law enforcement
agencies have implemented stress programs not only
to benefit officers and their families but also to
improve efficiency, morale, and image, to protect
the significant financial investment they have made
in officers, and to help ensure that officers are
in the best
condition to protect and serve the public.

o Law enforcement officers face a number of
unusual, often highly disturbing, sources of
stress, including organizational stresses (e.g.,
the hierarchical, autocratic structure of the
agency), stresses inherent in law enforcement work
(e.g., frequent exposure to violence and human
suffering), frustration with other parts of the
criminal justice system (e.g., perceived leniency
of court sentences), and personal difficulties
(e.g., not having enough time with their families).

o Some officers report increasing levels and new
sources of stress, including the implementation of
community policing, the high level of violent
crime, the perceived increase in public scrutiny
and negative publicity, the reduction in resources
and job security due to fiscal uncertainty, a
decrease in camaraderie among officers, the fear of
air- and blood-borne diseases, and an increased
emphasis on cultural diversity and political
correctness.

o Commonly reported effects of these stresses on
officers include intense cynicism, suspiciousness,
physical ailments, and family and other
relationship difficulties.

o It is important that stress programs address the
needs of family members who not only frequently
experience stress-related
difficulties associated with the officer's work but
who also can be tremendous sources of added stress-
-or support--for officers.

o Stress programs also need to include nonsworn
department members, who are not only vitally
important to department operations but may also
experience severe work-related stress that deserves
attention.

Who Can Use This Publication?

This publication is a guide to the development and
improvement of services to prevent, reduce, and
treat stress-related problems among law enforcement
officers and their families. It is primarily
intended for:

o administrators and mid-level managers in small,
medium-sized, and large law enforcement agencies at
the Federal, State, and local levels; and

o police psychologists and other mental health
professionals, directors of employee assistance
programs (EAPs) or personnel departments, and other
law enforcement stress program planners and staff.

Law enforcement union or association officials,
researchers, officers, and family members may also
find the publication's overview of law enforcement
stress and its description of stress programs
useful. Finally, many of the report's guidelines
are applicable to nonsworn personnel and
corrections officers.

What Is in the Publication?

A considerable amount of existing research
literature describes the sources and effects of
stress among law enforcement officers and specific
services available to assist personnel with stress-
related problems. Within this body of work,
however, there is little to guide mental health
professionals, law enforcement administrators, or
other planners in developing or improving a
comprehensive stress program. As interest in law
enforcement stress services has continued to grow,
and as these programs have developed and expanded
across the country, the need for such guidance has
become clear. This publication is distinctive
because it combines in one volume five features.

(1) Many previous publications on law enforcement
stress are dated.[1] This report provides an up-to-
date look at the nature of law enforcement stress
and the principal elements of stress programs.

(2) The publication also examines the sources and
effects of stress within the families of law
enforcement officers and describes program services
for family members.

(3) The publication considers the stresses
sometimes associated with certain characteristics
of law enforcement agencies themselves (as opposed
to those inherent in the nature of police work,
close media scrutiny, and the criminal justice
system), and describes efforts to reduce these
organizational sources of stress.

(4) The publication provides guidelines for action,
rather than discussions of theory, and includes
detailed descriptions of what agencies are actually
doing to prevent and treat stress. Because most
police departments across the country have 10 or
fewer officers[2]--and, consequently, limited
resources--descriptions of low-cost stress services
for small departments are presented. In addition,
many of the suggestions in the publication can be
put into practice by employee assistance programs
that already serve small agencies. (Some study site
programs are highlighted more often than others in
various chapters because their staff members were
able to provide more information on the topics in
question.)

(5) Finally, the publication reflects not only a
survey of research literature and consultation with
selected law enforcement
researchers but also interviews with nearly 100
individuals, from stress program administrators and
staff to family members and civilian employees (see
the box "Sources of Information for This
Publication").

Why Should a Stress Program Be Started or Expanded?

At a time when resources are scarce at most law
enforcement agencies, why should time, space, and
money be spent on a law enforcement stress program,
particularly when many agencies have access to city-
 or countywide employee assistance programs (EAPs)?
Law enforcement administrators, union and
association officials, and stress program directors
cite several reasons:

o to provide a confidential, specialized approach
to treating and reducing stress for officers and
their families, and to improve their ability to
cope with stress on their own (most officers do not
trust--or use--city or county programs);

o to increase officer morale and productivity;

o to increase the agency's overall efficiency and
effectiveness;

o to reduce the number of early retirements and
workers'
compensation claims due to stress-related
disabilities;

o to reduce the number of on-the-job accidents;

o to reduce the potential for civil liability due
to officers' stress-related inappropriate
behavior;[3]

o to reduce negative media attention, and

o to improve the general well-being of police
families.

Several police chiefs and other law enforcement
administrators attest to the value of their
agency's stress programs. As Robert Peppler,
Assistant Sheriff of the San Bernardino Sheriff's
Department, says, "We have a tremendous investment
in cops, and if they leave after one traumatic
incident, we have lost a tremendous amount. A
dollar in psychological services now can save us
hundreds of thousands down the road." Aristedes W.
Zavaras, former chief of the Denver Police
Department, told a congressional hearing in 1991,

From my perspective of chief, I am obviously
concerned about the well-being of the officers, but
it goes beyond that. I also look at the financial
end of it, and I look at the tremendous cost. We
look at an officer at the end of one year and
realize that we have probably over $1 million
invested in that person. From the
administrative perspective you don't want to lose
that person. That is a little mercenary to look at
it that way, but it is a reality. . . . I don't,
quite frankly, think that departments can afford
not to have psychological services for their
officers.[4]

If program staff can help an officer overcome
stress-related problems, the department may benefit
not only by retaining a valuable employee but also
by inspiring the officer to be more motivated,
compassionate, and loyal to the department.[5]
Furthermore, as Samuel C. McQuade, a former police
officer and current Social Science Program Manager
at the National Institute of Justice, notes; "to
the extent that individual officers have less
stress, agencies will have less stress, and this in
turn will afford greater ability for police and
their agencies to act in efficient ways, producing
more effective results."

Administrators may be concerned that a stress
program will be abused by some officers who will
see the program as a way to escape discipline for
substandard job performance.[6] With clear program
policies and procedures, however, this should not
be a problem (see chapter 2, "Planning the
Program"). Furthermore, none of the individuals
interviewed for this report suggested that programs
were being abused in this manner.

A stress program in and of itself cannot ensure
that all officers will cope more effectively with
stress. To a great extent, coping depends on
individual characteristics such as personality,
physical condition, and spiritual and family
support. A stress program can, however, educate
officers about how to reduce and cope with stress,
and it can provide needed services at critical
moments. No single example of stress programming
will be suitable for all types of law enforcement
agencies; departments need to tailor their services
to the size of the organization, its geographic
jurisdiction,
available resources, officers' career levels and
particular needs, and other agency characteristics.

Why Extend Program Services to Family Members?

As discussed below, law enforcement work can take a
tremendous toll on an officer's family. By
training, counseling, and otherwise supporting
family members, programs can do much to ensure that
these individuals not only receive the help they
need but also remain or become sources of support
rather than additional stress for officers. As one
researcher said, "Police families do not wear the
badge or carry the weapon but are very much
affected by those who do. Their support role
clearly contributes to maintaining law enforcement
services in the community."[7] Furthermore, because
family members are often the first to recognize
when an officer needs help, they can play a crucial
role by encouraging that officer to seek assistance
before the problem becomes severe. This recognition
and referral is more likely to occur if families
have been properly trained regarding the signs of
stress-related problems and the availability of
services to treat these
difficulties.

Although an increasing number of law enforcement
agencies provide stress services (see box "Law
Enforcement Stress Services Are Not New"),
comprehensive stress programs are still the
exception; most departments that do offer stress
services do not extend them adequately--or at all--
to officers' family members. Providing these
services requires an accurate and up-to-date
understanding of the nature of law enforcement
stress.

Overview of Law Enforcement Stress

Because stress can be defined in a number of
different ways, it has become a catchall "buzz
word" for all kinds and levels of emotional and
mental problems. Although some researchers have
pointed out that stress can have a positive
influence, the term generally carries a negative
connotation. This publication uses the common
dictionary definition of stress: a mentally or
emotionally
disruptive and upsetting condition occurring in
response to adverse external influences, and a
stimulus or circumstance causing such a condition.

Of course, people in all walks of life experience--
and must find ways to cope with--some degree of
stress. However, since the 1970s, criminal justice
officials and researchers have highlighted causes
and effects of stress that are unique to, or more
pronounced among, law enforcement officers. Many
researchers, as well as officers and family members
themselves, consider law enforcement to be one of
the most stressful of all occupations, with
correspondingly reported high rates of divorce,
alcoholism, suicide, and other emotional and health
problems.[11,12] Furthermore, despite the growing
number of departments that offer training and
treatment for stress-related problems, and despite
the reported increased recognition among some
officers that experiencing stress is normal but
sometimes avoidable, much of the literature and
many
respondents indicate that officers feel they are
under considerably more stress now than were law
enforcement personnel 10 or 20 years ago. As a
result, no one disagrees that it is essential to
continue to address--and to address ever more
effectively--the stress that law enforcement
officers and their families face, for the sake of
their own personal well-being, their productivity
on the job, and improved performance of police
services.

The discussion below briefly reviews commonly
reported sources and effects of stress among law
enforcement officers and family members. Endnotes
identify studies that provide more in-depth
information (see the box "Additional Sources of
Information").

Sources of Stress for Law Enforcement Officers

Different officers are likely to perceive different
events as stressful, depending on their individual
background, personalities, expectations, law
enforcement experience, years on the job, type of
law enforcement work they perform, and access to
coping
resources.[13] Nevertheless, sources of stress that
seem to be common among--and in some cases unique
or particularly burdensome to--law enforcement
officers fall into four categories: (1) those
related to the law enforcement organization, (2)
those that relate to law enforcement work, (3)
those that stem from the actions of the criminal
justice system and the general public, and (4)
those related to the individual officer's personal
life and approach to stressful events. A summary
prepared by the International
Association of Chiefs of Police of many of the
stresses that fall into the first three categories
is provided in the box "Sources of Psychological
Stress."

From the Law Enforcement Organization

Although many people perceive the danger and
tension of law enforcement work (glamorized in
books, movies, and television shows) to be the most
serious stress for officers, the
literature[14] reviewed and the interviews
conducted for this publication make it clear that
in fact the most common sources of stress result
from the policies and procedures of law enforcement
agencies. These sources of stress may include

o shift work (with some shifts perhaps more
stressful than others);

o paramilitary structure;

o unproductive management styles;

o inconsistent discipline and enforcement of rules
(e.g.,
commanders arriving late for work);

o equipment deficiencies and shortages;

o perceived excessive or unnecessary paperwork;

o perceived favoritism by administrators regarding
assignments and promotions;

o antagonistic "subcultures" within the department
(e.g., between different squads, units, or shifts)

o lack of input into policy and decision making;

o second-guessing of officers' actions and lack of
administration support;

o inconsistent or arbitrary internal disciplinary
procedures and review;

o lack of career development opportunities (and
perceived
unfairness of affirmative action), with resulting
competition among officers, especially in small
departments, for the few available openings;

o lack of adequate training or supervision;

o frequent transfers (for Federal and State law
enforcement agents);

o police culture (e.g., machoism, code of silence
regarding corruption);

o the police grapevine (e.g., gossip, lack of
privacy, feeling that a few fellow officers are not
trustworthy); and

o lack of reward or recognition for good work.

Individuals interviewed for this publication told
many stories of how one or another of the factors
listed above caused them
frustration and anxiety. One officer was upset that
his chief's secretary had a private parking spot in
a busy urban area while officers did not. The wife
of an officer who ended up resigning due to the
stress of dealing with his administrators reported,
"My husband came home more screwed up with
department problems than with anything he ever
encountered on the streets." One officer chose to
work the midnight shift so he could avoid "the
brass" whom he hated to deal with during the day,
while another gave up a promotion because he could
not work with his new supervisor.

From the Job

Although organizational factors and department
policies may be the most prevalent and frustrating
sources of stress for many law enforcement
personnel, certainly the job itself entails a
number of others, including

o role conflict (e.g., between being at once an
enforcer of the law, a social worker, a counselor,
and a public servant);

o a "roller-coaster" routine of frequent boredom
interrupted by the sudden need for alertness and
quick action;

o fear and danger on even supposedly routine calls;

o critical incidents such as shootings, hostage
situations, environmental disasters, and crime
scenes involving death or severe injury;

o the pressure of the responsibility for protecting
other people;

o particularly stressful assignments, such as
undercover duty or drug raids;

o frequent exposure to human depravity and human
suffering; and

o shift work (also a type of organizational
stress).20

Most law enforcement personnel have compelling
stories to tell of particularly difficult work
conditions. One seasoned police officer said he
began drinking heavily after a fellow officer was
killed in a shooting. Another had trouble sleeping
for many days after seeing a man stabbed several
times and then trying to stop the bleeding. As one
officer who had worked 29 straight hours
investigating a deadly arson scene said, "You'd
think everybody would run right home, but we all
just sat in the back room--just trying to compose
[ourselves]. . . . There's no switch you can just
turn on, turn off: I'm going home--okay turn the
emotion switch back on. It doesn't work like that.
If anybody says so, they're mistaken."[21]

From the Criminal Justice System and the Public

Significant sources of stress also result from the
perceived inefficiency of the criminal justice
system and from what are seen as negative attitudes
toward law enforcement among the media and society
at large. In particular, officers complain of

o court rulings perceived as too lenient on
offenders;

o court rulings perceived as too restrictive on
methods of criminal suppression and investigation;

o perceived premature release of offenders on bail,
probation, or parole;

o inconveniently scheduled court appearances and
long waits before testifying;

o lack of follow-up with police to tell them how
cases turned out;

o perceived lack of respect from judges, lawyers,
and others in the criminal justice system;

o perceived lack of respect from the public
(including surveillance by watchdog groups such as
Police Watch);

o negative media coverage; 

o perceived inaccessibility and ineffectiveness of
social service and other agencies to which officers
must refer people; and

o lack of understanding among family and friends
about the
difficulties of law enforcement work. 

One officer spoke for many when he expressed
intense frustration with making arrests only to see
cases dismissed or reduced through plea bargaining,
adding that he felt powerless to reduce crime in
his city. Even an officer whose partner had been
killed in a shooting cited the court system as his
primary source of
frustration. Several others said that they do not
receive the respect they deserve; one was
incredulous that a citizen had called his
department supervisor to complain that he was
driving too slowly while on patrol. Many officers
are disturbed by the
ramifications of negative press coverage of
departments other than their own (e.g., the
widespread condemnation of the Los Angeles Police
Department due to the Rodney King beating and the
O.J. Simpson trial). Still others observed that
even if citizens are not necessarily critical of
law enforcement, they do not understand what it is
really like. One officer reported that her friends
"want to hear the gruesome stories; they do not
want to hear about the day-to-day pressures";
another said, "People don't realize cops have
feelings, too."[22]

Personal Stresses

In addition to the common personal stresses faced
by most people during their lifetimes (e.g., one's
own poor health, the illness of a loved one,
relationship problems, buying a new house),
officers may also have to cope with the following:

o anxiety over the responsibility to protect the
public (as one officer put it, "After 20 weeks of
training, all of a sudden you're the protector of
the innocent");

o disappointment when high expectations are not met
(e.g., officers may expect the job to be exciting
and glamorous, only to be disappointed by boredom
and by disrespect from the public);

o worry about their competency to do the job well
(in one study, two thirds of the responding
officers reported never or almost never feeling
confident about their ability to handle work-
related problems[23]); and

o fear of doing something against regulations or
being
second-guessed.[24]

Responses to these internal stresses are influenced
by individual officers' personalities and
backgrounds. Stress tolerance levels vary a great
deal from one individual to the next; conditions
that some officers find stressful may not have the
same effect on other officers.

Emerging Sources of Stress

In addition to those listed above, the research
literature and interview respondents identified
several new or emerging sources of stress for law
enforcement officers and their families. Some of
these may be due to changes in crime or policing,
while others may not be new but simply newly
recognized.

Community policing. In the last 10 years, community
policing has emerged as the philosophy guiding many
police departments across the country. While exact
definitions differ, community policing is generally
considered to have three ingredients: an
orientation to problem solving rather than
responding one-by-one to each citizen call for
assistance; the development of partnerships with
neighbors, community groups, code enforcement
agencies, and others to address problems facing the
community; and the delegation of considerable
decision making power within the law enforcement
agency to officers who are given the responsibility
for solving problems and for lining up the outside
resources to do so. Some police departments have
implemented community policing
departmentwide, while others have incorporated it
into only some aspects of department activities.

Some officers report they like being involved in
community policing because they have a chance to
interact more with residents and because they can
see increased benefits from their work. Others,
however, say they experience added pressure and
burnout quickly because of high expectations that
they will be able to solve community crime problems
with only limited resources. One chief said he
frequently has to remind his community policing
officers that they cannot "take on the world."
Involving police officers closely with the lives of
neighborhood residents makes them vulnerable to
being hurt emotionally if people get injured or
turn out to be unreliable.

Although many officers may like having increased
influence in department decisions, this can also be
stressful since they are not accustomed to this
role.[25] Community policing requires
interpersonal, verbal, and problem-solving skills
that some officers may not possess. Two officers
from two different agencies said it was a lack of
adequate training, not their new
responsibilities, that created added stress.
Furthermore, some community policing officers
report that they face the disdain of fellow
officers who do not view their activities as "real
police work," and even officers who are not
directly engaged in their department's community
policing efforts may feel the strain of the changes
involved (e.g., due to reassignments).[26] However,
many organizations are working to smooth the
transition to community policing, and, as the
growing pains involved in its implementation are
dealt with, many law enforcement experts expect the
community policing approach will provide
significant long-term satisfaction for officers.

Increase in violent crime. The widespread rise in
violent crime in the late 1980s and early 1990s has
been an added source of
stress.[27] Although the threat of danger and
violence has always been a part of law enforcement
work, several respondents said that they no longer
feel they have the upper hand over heavily armed
criminals who will not think twice about shooting
an officer. As one officer said, "The criminal of
today is much nastier and meaner." Dealing with a
larger number of incidents involving irrational or
excessive violence can also take its toll.

In most jurisdictions the number of officers on
staff has either remained the same, decreased, or
not kept pace with increases in population or crime
rates, further exacerbating the stress of dealing
with violent crime. One captain said he had 21
people under his command, down from 32 just three
years ago; yet the amount of work his unit handles
has increased during that time.

Perceived increase in negative publicity, public
scrutiny, and lawsuits. In light of the Rodney King
beating in Los Angeles, the burning of the Branch
Davidians' Waco compound in Texas, the exposure of
corruption in several of the country's largest
police departments, and other events which
generated unfavorable publicity in the 1990s, many
officers report feeling stress from heightened
public scrutiny and negative press and public
opinion. Although negative publicity is warranted
for unacceptable police behavior, the attention
generated by high-profile cases may create the
erroneous image that all or most law enforcement
officers are worthy of blame. In addition, negative
publicity may obscure the high level of confidence
that many people do have in law
enforcement, leading officers wrongly to assume
that most or even all of the public does not trust
or appreciate them.

Many officers said they resented their work being
criticized or distorted and their actions being
watched so closely.[28] Some also believe that the
media focus too much attention on offenders' rights
and not enough on the harm done to victims and
officers or on the difficulty of law enforcement
work. Associated with negative publicity and public
hostility are officers' increased fears of lawsuits
by citizens. While it is primarily law enforcement
managers and administrators who have to deal with
litigation, some line officers complain that
administrators do not publicly support officers who
are defendants in lawsuits and that they have more
laws, rules, and regulations to follow--and to
worry about
forgetting to follow--because of the threat of
being sued. In addition to the threat of civil
litigation, many law enforcement officers also feel
anxious about the increasing threat of criminal
prosecution and even imprisonment for using a level
of force that they may feel is legitimate given the
dangerous situations in which they find themselves.
As a result, they may feel they constantly have to
choose between second-guessing themselves--and, as
a result, endangering their lives--or using the
amount of force they feel is required and then
worrying about whether they will be investigated
for doing so.[29]

Fiscal uncertainty, flattening of law enforcement
agencies, and lack of job security. Whereas people
in the field of law
enforcement used to have a high degree of job
security, many departments have recently undergone
downsizing or hiring and promotional freezes
because of budget cuts. The implementation of
community policing also brings about "flattening"
of law
enforcement agencies. More officers are losing
their jobs, not being promoted, or living under the
strain of uncertainty about their future.[30]

Less socializing among officers and their spouses.
Several officers and spouses noted that there is
less "bonding" among officers and their families
than there used to be. Explanations for this
apparent trend included

o increased use of fixed shifts, which allows
officers to plan social activities with their
families and friends outside the agency (as opposed
to always "going out with the boys," often for
several hours, whenever one's shift is over);

o more wives working outside the home,[31] leaving
less time for socializing with the wives of other
officers (as one said, "It's everyone out for
herself now"); and

o increased recognition among younger officers that
there is "life outside of the badge," leaving them
less inclined, as one said, to spend their free
time with other officers, and resulting in less
clannishness--and less camaraderie.

While a reduced level of bonding can represent an
additional source of stress (or the loss of a
former source of support in the face of stress) for
some, it may also be a positive trend if it
enhances home life. There may also be a split among
older and younger generations of officers in their
need for different types of socializing. One young
spouse attended a "wives' group" meeting and was
offended by the traditional roles the other women
present played in their husbands' lives and by
their naivete about law enforcement work. She would
like, she said, to meet with officers' spouses of
her own generation to talk seriously about problems
they face, not just to gossip, as she felt the
women in the group she attended were doing. Her
husband, rather than drinking with fellow officers
after work, has become absorbed in leading his
department's baseball league.

Fear of air- or blood-borne diseases. Several
respondents reported experiencing increased fear of
the risk of contracting diseases such as AIDS,
hepatitis B, and tuberculosis. Corrections
officials in particular may feel anxious about the
dramatic rise in the number of inmates with these
diseases. Because some of this stress may be based
on misinformation, apprehension could be reduced
with up-to-date information and education about
these diseases and their transmission routes as
well as improved training in universal precautions
relating to contact with body fluids and proper
search techniques.[32] 

Cultural diversity and political correctness.
Several of the white officers interviewed objected
not only to what they perceived to be reverse
discrimination in hiring and training but also to
the emphasis on "political correctness" in
officers' language and actions. One officer said
that he had been passed over several times during
recruitment and then for promotions despite scoring
higher than some minority and female candidates.
Whether it stems from formal departmental policy or
perceived pressure from
administrators and colleagues, increased scrutiny
of behavior and language is also reportedly a
source of stress in some departments. Another
officer, for example, complained that "everything
is becoming too sensitive" and that he always has
to watch what he says because "people have
forgotten how to laugh" and are offended too
easily. Of course, the latter trend may well
alleviate stress for the increasing number of
minority officers who are entering law enforcement
and who experience difficulties because of their
ethnic or racial status, gender, or sexual
orientation--difficulties which range from verbal
abuse from colleagues, supervisors, and the public
to discrimination in promotions and mistrust on the
part of nonminority citizens about their
capabilities. (See the box "Additional Stress for
Female, Gay, and Ethnic Minority Officers.")

Effects of Stress on Law Enforcement Officers

The stresses just mentioned can have a number of
damaging physical and emotional effects on law
enforcement officers which in turn can affect their
job performance. These will vary from officer to
officer, depending on such factors as the intensity
of the stress and the officer's personality, coping
mechanisms, and sources of support. Commonly
reported effects of stress for law enforcement
officers include the following:

o cynicism and suspiciousness,

o emotional detachment,

o post-traumatic stress disorder,

o heart attacks, ulcers, weight gain, and other
health problems,

o suicide,

o reduced efficiency in performing duties,

o reduced morale,

o excessive aggressiveness and an increase in
citizen complaints,

o alcoholism and other substance abuse,

o marital or other relationship and family problems
(e.g.,
extramarital affairs, divorce, or domestic
violence),[33]

o absenteeism, and

o early retirement.

Stress typically affects the behavior of officers
along a continuum that can include (a) underlying
stress not yet manifested in outward effects, (b)
mid-level stress, manifested in such ways as
excessive drinking or an unacceptably high number
of discourtesy complaints, and (c) debilitating
stress, resulting in inadequate job performance,
severe health problems, or suicide.

Stress and the Law Enforcement Officer's Family 

The effects of work-related stress on law
enforcement officers' family members have been
recognized for many years. In 1975, the Los Angeles
County Sheriff's Office established an eight-week
program for spouses of recruits; in 1978, Arthur
and Elaine Neiderhoffer published The Police
Family: From Station House to Ranch House, which
examined many of the difficulties faced by spouses
(primarily wives) and children of police officers.

In recent years, the law enforcement family has
received increasing attention. Congress held
hearings in 1991 on stress-related problems among
officers' families, and the 1994 Violent Crime
Control and Law Enforcement Act included
legislation requiring additional support for
officers' families. According to
Congresswoman Patricia Schroeder, who chaired the
1991
congressional hearings, "We must ensure that police
departments make the availability of education,
stress-reduction training, and family support
services an integral part of their work."[34]

As described below, many of the sources of stress
for law
enforcement officers end up affecting the people
closest to them, and even conditions or events that
do not bother the officers themselves--or which
they may even enjoy--such as shift work or
undercover work can cause serious problems for
their families. Alternatively, family members can
be a source of stress for officers; many program
counselors say that marital difficulties are the
most common problem for which they treat officers.
At the same time, families can be a major source of
support for officers. As a result, it is possible
that the stress officers experience may sometimes
be prevented or reduced if members of their
families have access to stress program services,
learn to understand the demands of police work, and
develop ways to cope with stress as a family.

In one study of 479 spouses of police officers, 77
percent reported experiencing unusually high
amounts of stress from the officers' job.[35]
Commonly cited sources include the following:

o shift work and overtime (which disrupt family
activities and reduce the amount of time family can
spend together);

o an officer's cynicism, need to feel in control in
the home, or inability or unwillingness to express
feelings;

o the fear that the officer will be hurt or killed;

o officers' and other people's excessively high
expectations of their children;

o avoidance, teasing, or harassment of children
because of their parent's job;

o the presence of a gun in the home;

o friends' discomfort because of the officer's
weapon and 24-hour role as a law enforcer;

o an impression that the officer would prefer to
spend time with fellow officers rather than with
his or her family;

o either excessive or too little discussion about
the job;

o the officer's perceived paranoia or excessive
vigilance and subsequent overprotection;

o helping the officer cope with work-related
problems; and

o critical incidents or the officer's injury or
death.36

Family members interviewed for this report offered
glimpses into the stressful nature of being related
to a law enforcement officer:

o One officer's wife described the difficulty of
coping with her husband's rotating shifts while she
also worked a full-time job and they tried to raise
three children. Friends stopped inviting her to
social functions because (she felt) they were
uncomfortable about the absence of her husband. She
and her husband finally settled on the 11 p.m. to 7
a.m. shift as the best option because it gave him
the most time with the family.

o Another wife spoke of being constantly worried
about her
husband's safety: "I would hear reports of officers
being shot and just have to wait to see if it was
him. I even listened to the police scanner at night
until he came home."

o A female officer said that her marriage had
suffered because her difficult shift hours required
her husband to do much of the child rearing, which
he resented.

o Another officer said that his eight-year-old
daughter had witnessed one of his flashbacks to a
shooting incident and had been frightened by her
father "talking in tongues." "I never want to see
my kids exposed to that again."

Officers married to other law enforcement personnel
may be less affected by some of the stresses listed
above because they may have a mutual understanding
of the difficulties of each other's jobs and may
share the same friends socially. However, dual-
officer couples may also suffer the added burdens
of blurred personal and
professional roles, gossip among colleagues about
their
relationship, and, with both working different
rotating shifts and working overtime, even less
time for each other at home.

Effects of Stress on Law Enforcement Agencies

The cumulative negative effects of stress on
officers and their families typically hurt law
enforcement agencies as well, leading to the
following:

o impaired officer performance and reduced
departmental
productivity;

o reduced morale;

o public relations problems (e.g., after a suicide
or case of police brutality);

o labor-management friction;

o civil suits because of stress-related failures in
personnel performance;

o tardiness and absenteeism;

o increased turnover due to leaves of absence,
early retirement as a consequence of stress-related
problems and disabilities, and the resulting
expense of training and hiring new recruits; and

o the added expense of paying overtime when the
agency is left short of staff.

Even what may appear to be small-scale problems can
cause
significant negative effects. For instance, the
exposure in the media of a single incident of a few
officers abusing alcohol or other drugs can create
disrespect and diminished public trust for an
entire agency,[37] and small agencies in particular
can suffer enormous costs when employee turnover
increases as a result of stress-related early
retirement or long-term disability.

Stress among law enforcement personnel and their
families has serious consequences. With a growing
awareness of the nature of these problems and
increased departmental and stress program efforts--
such as those described on the following pages--to
address them, officers and their families may be
able to steer clear of some types of stress and to
obtain the help they need in dealing with those
stresses they cannot avoid.

Endnotes

1. Goolkasian, G.A., R.W. Geddes, and W. DeJong,
Coping With Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985; Ayres,
R.M., Preventing Law Enforcement Stress: The
Organization's Role, Washington, D.C.: U.S.
Department of Justice, Bureau of Justice
Assistance, 1990. See also Employee Assistance
Programs: A Manual for the Development and
Implementation of EAPs in Law Enforcement Agencies,
a brief review of police EAP services and models,
developed by the Central New York Coalition for
EAPs, Syracuse, New York (a limited supply is
available from the New York State Office of
Alcoholism and Substance Abuse Services, [518]
485-2132); Employee Assistance Program Desk
Reference for Law Enforcement Administration,
developed in 1990 and being revised in 1996, with a
focus on alcohol abuse and alcoholism, by the New
York Division of Criminal Justice Services, Bureau
for Municipal Police, in conjunction with the
Division of Alcoholism and Alcohol Abuse, (518)
457-2667; and Williams, F.E., and J.E. Bratton, "A
Step-By-Step Guide to Developing Employee
Assistance Programs in Small Police Agencies," The
Police Chief (February 1990): 43-46, a brief review
of considerations for administrators of small
police departments.

2. Kirschman, E., E. Scrivner, K. Ellison, and C.
Marcy, "Work and Well-Being: Lessons from Law
Enforcement," in Stress and Well-Being at Work:
Assessments and Interventions for Occupational
Mental Health, ed. J.C. Quick, L.R. Murphy, and
J.J. Hurrell, Washington, D.C.: American
Psychological Association, 1992: 178-192.

3. For an assessment of legal issues related to
workplace stress and law enforcement, see Dunning,
C., "Mitigating the Impact of Work Trauma:
Administrative Issues Concerning Intervention," in
Critical Incidents in Policing, revised, ed. J.T.
Reese, J.M. Horn, and C. Dunning, Washington, D.C.:
U.S. Department of Justice, Federal Bureau of
Investigation, 1991: 73-82.

4. "On the Front Lines: Police Stress and Family
Well-Being," Testimony by A.W. Zavaras, Hearing
Before the Select Committee on Children, Youth, and
Families, House of Representatives, 102nd Congress,
1st Session, May 20, 1991, Washington, D.C.: U.S.
Government Printing Office, 1991: 71.

5. Klein, R., "Police Peer Counseling: Officers
Helping Officers," FBI Law Enforcement Bulletin, 48
(1989): 2.

6. Sewell, J.D., "Administrative Concerns in Law
Enforcement Stress Management," in Psychological
Services for Law Enforcement, ed. J.T. Reese and
H.A. Goldstein, Washington, D.C.: U.S. Department
of Justice, Federal Bureau of Investigation, 1986:
191.

7. "On the Front Lines," Testimony by E. Scrivner,
12.

8. Delprino, R.P., and C. Bahn, "National Survey of
the Extent and Nature of Psychological Services in
Police Departments,"
Professional Psychology: Research and Practice, 19
(1988): 421-425.

9. Ibid, 423.

10. Reese, J.T., A History of Police Psychological
Services, Washington, D.C.: U.S. Department of
Justice, Federal Bureau of Investigation, 1987: 35.

11. See text and references in Ayres, Preventing
Law Enforcement Stress, 1; and Gruber, C.A., "The
Relationship of Stress to the Practice of Police
Work," The Police Chief, 67 (February 1980): 16,
17. 

12. French, J.R.P., "A Comparative Look at Stress
and Strain in Policemen," in Job Stress and the
Police Officer, ed. W.H. Kroes and J.J. Hurrell,
Washington, D.C.: U.S. Department of Health,
Education, and Welfare, 1975: 60. French found that
police scored higher on some stresses but lower on
others compared with 22 other occupations (blue-
and white-collar). See also Spielberger, C.D., The
Police Stress Survey: Sources of Stress in Law
Enforcement, Monograph Series 3: no. 6, Tampa,
Florida: Human Resources
Institute, 1981: 43.

13. Ayres,  Preventing Law Enforcement Stress, 9;
Kirschman et al., "Work and Well-Being," 181.

14. For a thorough review of organizational sources
of stress, see Ayres, Preventing Law Enforcement
Stress, 11-21. Numerous other articles examine
organizational sources of stress, including
Kirschman et al., "Work and Well-Being," as well as
Phelps, L., "Police Tasks and Related Stress
Factors from an Organizational Perspective," and
other articles in Kroes and Hurrell, Job Stress and
the Police Officer. Also see, Hurrell, J.J. Jr.,
"Some
Organizational Stressors in Police Work and Means
for Their Amelioration," in Reese and Goldstein,
Psychological Services for Law Enforcement.

15. Literature provided by the National Center on
Women and Policing, 8105 West Third St., Suite 1,
Los Angeles, California 90048, (213) 651-0495. Also
see Fletcher, C., Breaking and
Entering: Women Cops Talk About Life in the
Ultimate Men's Club, New York: Harper Collins,
1995.

16. Morash, M., and R.N. Haarr, "Gender, Workplace
Problems, and Stress in Policing," Justice
Quarterly, 12 (1995): 113-140.

17. McDowell, J., "Are Women Better Cops?" Time,
February 17, 1992, 70-72.

18. Morash and Haarr, "Gender, Workplace Problems,
and Stress in Policing," 113-140.

19. Morrison, P., "Female Officers Unwelcome--But
Doing Well," Los Angeles Times, July 12, 1991.

20. Again, there are abundant articles describing
sources of stress related to law enforcement work.
See, in particular, Kroes and Hurrell, Job Stress
and the Police Officer.

21. Count, E.W., Cop Talk: True Detective Stories
From the NYPD, New York: Pocket Books, 1994.

22. Martin, D., "Officers on Diet Patrol to Shed an
Old Image," New York Times, August 18, 1995.

23. Graf, F.A., "The Relationship Between Social
Support and Occupational Stress Among Police
Officers," Journal of Police Science and
Administration, 14 (1986): 178-186.

24. Jacobi, J.H., "Reducing Police Stress: A
Psychiatrist's Point of View," Job Stress and the
Police Officer, 85-116.

25. Scrivner, E., and J.T. Reese, "Family Issues
With No Easy Answers," in Law Enforcement Families:
Issues and Answers, ed. J.T. Reese and E. Scrivner,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1994: 5-6.

26. Mohandie, K., "Law Enforcement Turmoil and
Transitions and the Evolving Role of the Police
Psychologist," Draft paper presented at the FBI
Academy symposium, "Organizational Issues in Law
Enforcement," Quantico, Virginia, January 25-27,
1995.

27. "Firearms and Crimes of Violence: Selected
Findings from National Statistical Series,"
Washington, D.C.: U.S. Department of Justice,
Bureau of Justice Statistics, February 1994.

28. Scotland, E., "Self-Esteem and Stress in Police
Work," in Kroes and Hurrell, Job Stress and the
Police Officer, 3-16. Scotland argues that
officers' self-esteem is lowered by public
hostility and negative publicity, reducing their
immune system's capabilities and making them more
vulnerable to stress-related health problems. 

29. Robert Scully, executive director, National
Association of Police Associations, Personal
communication. December 21, 1995.

30. Havassy, V.J., "Police Stress in the 90s, and
Its Impact on the Family," in Reese and Scrivner,
Law Enforcement Families, 27-34; and Grossman, I.,
"Peter's Other Principle: When Organizations
Flatten, So Do Families and Careers," ibid.,
281-285.

31. See Schmuckler, E., "The Dual Career Family in
Law Enforcement: A Concern for Management," ibid.,
41-50.

32. Hammett, T., AIDS and the Law Enforcement
Officer: Concerns and Policy Responses, Issues and
Practices, Washington, D.C.: U.S. Department of
Justice, National Institute of Justice, June 1987.

33. Delprino, R.P., C.L. Kennedy, J. Cardarelli,
and C. Goss, "Law Enforcement and the Police
Family," Cassette Recording No. APA 95-081,
Washington, D.C.: American Psychological
Association, 1995.

34. "On the Front Lines," Testimony by P.
Schroeder, 2.

35. "On the Front Lines," Testimony by L.B.
Johnson, 32.

36. Borum, R., and C. Philpot, "Therapy With Law
Enforcement Couples: Clinical Management of the
`High-Risk Lifestyle,'" American Journal of Family
Therapy, 21 (1993): 122-135.

37. Springer, K., "When the Helper Needs Help:
Stress and the Law Enforcement Employee," EAP
Association Exchange, 25 (1995): 6-11.

What Is a Stress Program?

A law enforcement stress program can take many
forms, including an employee assistance or
psychological services program set up within the
agency, a group of officers trained to provide
support and referrals to other officers, a private
mental health practice or independent practitioner
who serves one or more law enforcement agencies, or
a combination of these arrangements. The common
characteristics among these arrangements are that
they have some kind of formal structure and are set
up with the express purpose of preventing and
reducing stress among law enforcement officers.
(Chapter 3 reviews various organizational
structures of stress programs.)

Sources of Information for This Publication

The information presented in this report comes from
four principal sources:

o literature on law enforcement stress and stress
programming;

o in-person interviews with stress program
directors, other mental health providers, law
enforcement administrators, union and association
officials, officers, family members, and civilians
at four sites: San Bernardino, California; the
State of Michigan; Erie County, New York; and the
Bureau of Alcohol, Tobacco, and Firearms (ATF) and
the Drug Enforcement Administration (DEA) in
Washington, D.C.;

o telephone interviews with similar individuals in
San Antonio, Texas; Tulsa, Oklahoma; Metro-Dade
County, Florida; Rochester, New York; and Coventry,
Rhode Island; and

o less comprehensive telephone interviews with
several other stress program directors across the
country.

The jurisdictions studied in depth were selected
based on the suggestions of the project's advisory
board (see page ii) and police mental health
professionals gathered at a January 1995 FBI law
enforcement symposium on organizational issues in
law
enforcement. The programs contacted from these
jurisdictions represent different organizational
approaches, serve both large and small law
enforcement agencies, and have different
jurisdictional responsibilities (municipal, county,
State, and Federal).

Stress Services: A Generational Split?

The mere fact that more and more law enforcement
agencies are making stress services available to
their personnel indicates that these services have
attained a critical threshold of acceptance. Based
on anecdotal evidence from interviews conducted for
this publication, skepticism and outright hostility
regarding stress services seem to be decreasing.
The extent of this change in 
attitude, however, is unclear, and considerable
opposition to stress services remains.

Most of the program directors interviewed for this
publication said that, although it took a long
time, the importance of stress services has been
acknowledged among many officers, due in part to
efforts to market the programs but also to the
increased
educational level--and resulting awareness of
physical and
emotional reactions to stress--of younger officers.
One command officer said, "This generation of
police is different. Officers used to be mainly
military veterans who either hid their stress
better or didn't know the terms or could handle
things better. More college-oriented cops
understand the value of social service programs to
improve their careers." Another reported that he
and many of his fellow administrators are more
understanding of the need for psychological
services and more willing to devote
resources to a stress program because they have had
more opportunities for higher education.

Older officers, however, still frequently question
the usefulness of stress services. "The biggest
obstacle," one chief said, "is the old-timers who
think officers should still tough it out. The older
generation is derisive toward what the new
generation wants." To be sure, even among younger
officers the stigma--or fear of stigma--attached to
psychological counseling remains strong in many
agencies. As one officer said, "When you mention
psychologists, everyone runs."

(Chapter 7, "Marketing the Program," provides
suggestions for gaining acceptance of the stress
program among skeptical officers.)

Law Enforcement Stress Services Are Not New

The provision of stress services for law
enforcement officers is not a passing fad. Some
departments, in fact, have operated programs
staffed with full-time counselors since 1976. In
the past two decades, the number of law enforcement
agencies that have full-time psychologists, EAPs,
or other types of mental health services has grown
significantly. In a 1979 survey of police
departments across the country, only 20 percent
offered some kind of
psychological services.[8] In a 1988 national
survey of State and municipal police departments,
however, more than half provided some kind of
psychological service to officers. Fifty-three
percent offered counseling to police officers for
job-related stress, 52 percent provided counseling
to officers for personal and family problems, and
42 percent counseled officers' family members.[9]
Whereas psychological services staff once focused
mainly on basic counseling services, testing of
officers, and assistance with criminal
investigations,10] often on a part-time consulting
basis, many programs now offer around-the-clock
services that include critical incident debriefing,
training on stress management, peer support, and
consultation regarding organizational change in the
department.

Additional Sources of Information on Sources and
Effects of Law Enforcement Stress

The Behavioral Science Services Unit of the Federal
Bureau of Investigation has compiled several
comprehensive collections of articles on law
enforcement stress. These include:

James T. Reese and Roger Solomon, eds.
Organizational Issues in Law Enforcement.
Washington, D.C.: U.S. Department of Justice,
forthcoming, 1996.

James T. Reese, James M. Horn, and Christine
Dunning, eds. Critical Incidents in Policing.
Washington, D.C.: U.S. Department of Justice, 1991.

James T. Reese and Ellen Scrivner, eds. Law
Enforcement Families: Issues and Answers.
Washington, D.C.: U.S. Department of Justice, 1994.

James T. Reese and Harvey A. Goldstein, eds.
Psychological Services for Law Enforcement.
Washington, D.C.: U.S. Department of Justice, 1986.

To order these publications, contact the FBI
Employee Assistance Unit in Washington, D.C., at
(202) 324-5244.

An older but still useful book on sources of stress
for both officers and their families is:

Arthur Niederhoffer and Elaine Niederhoffer, The
Police Family: From Station House to Ranch House,
Lexington, Massachusetts: Lexington Books, 1978.

Sources of Psychological Stress

I. Intra-Organizational Practices and
Characteristics

1.Poor supervision. The actions and attitudes of
police supervisors can either increase or help
alleviate the stress of the job.

2. Lack of career opportunities. The promotional
process is frequently viewed as being limited and
unfair, causing frustration among officers.

3.Inadequate rewards. Recognition for a job well
done is rare; however, criticism for mistakes is
frequent.

4. Offensive policies. Many departmental
requirements are viewed as threatening or
unreasonable.

5. Excessive paperwork. The need for duplicate
forms of every police transaction is often
questioned.

6. Poor equipment. An officer's well-being may
depend on the quality of his or her equipment;
therefore, faulty equipment is a significant source
of anxiety.

II. Inter-Organizational Practices and
Characteristics

7. Lack of career development. In most police
departments, there is little room for advancement
regardless of the performance of the officer.

8. Jurisdictional isolationism. There is often an
unfortunate lack of cooperation between neighboring
jurisdictions; sometimes an unhealthy competitive
relationship exists.

III. Criminal Justice System Practices and
Characteristics

9. Ineffectiveness of corrections system. Officers
are alarmed by the recidivism rate of criminals who
seem to be perpetually "on the street" rather than
incarcerated.

10. Unfavorable court decisions. Many court
decisions are viewed by officers as unfairly
increasing the difficulty of police work.

11. Misunderstanding of judicial procedure.
Officers find the adversary system difficult to
adjust to, particularly when their testimony is
challenged.

12. Inefficient courtroom management. Delays,
continuances, and inconvenient scheduling make
courtroom appearances a frustrating experience.

13. Preoccupation with street crime. The police
officer must focus on street crime, often committed
by disadvantaged people, yet the officer knows that
"white collar" crime in business and politics
flourishes.

IV. Public Practices and Characteristics

14. Distorted press accounts. Reports of incidents
are often inaccurate and perceived as derogatory by
officers, whether or not the inaccuracy is
intentional.

Sources of Psychological Stress (continued)

15. Unfavorable minority attitudes. Allegations of
brutality and racism are often viewed as unfair and
damaging by police officers.

16. Unfavorable majority attitudes. The police are
frequently accused of being incompetent by majority
members of a community.

17. Criticism from neighbors. The criticisms of
neighbors,
relatives, or acquaintances about the police
profession are felt deeply by police officers.

18. Adverse local government decisions. Issues of
local importance such as budgetary restrictions or
police-citizen hearing boards may have an impact on
police officers.

19. Ineffectiveness of referral agencies. The lack
or
ineffectiveness of social service agencies often
frustrates the officer who views these agencies as
the only viable source of assistance.

V. Police Work Itself

20. Role conflict. Officers often experience
conflict, for example, attempting to apprehend a
criminal yet ensuring that none of his or her
rights are abridged.

21. Irregular work schedule. Shift work is
disruptive to the personal lives of most police
officers.

22. Fear and danger. The police profession contains
many elements of danger that affect officers in
both obvious and subtle ways.

23. Sense of uselessness. The inability to resolve
completely people's problems confronts the police
officer daily. 

24. Absence of closure. Much of police work is
fragmented,
opportunities for follow-up on a case are limited,
and feedback on the results is minimal.

25. Human suffering. Officers are constantly
exposed to the inequities and brutalities of life.
Such experience must take its emotional toll on
even the most well-adjusted individuals.

26. "The startle." At most any time a quick
response to a
particular condition is required, and such a
response is jolting to the officer's physical and
mental state.

27. Consequences of actions. The seriousness of the
issues and consequences of police work is both
physically and mentally demanding.

28. Twenty plus years. Stress is cumulative in
nature, and
stressful events are connected to one another with
long-term continuity.

This box is adapted from "Job Stress and the Police
Officer: Identifying Stress Reduction Techniques,"
by Dr. Terry Eisenberg. It appears in a "training
key" developed by the International Association of
Chiefs of Police.

Additional Stress for Female, Gay, and Ethnic 

Minority Officers

The number and acceptance of women, homosexuals,
and ethnic minorities in law enforcement have
increased over the years, but not enough, many
members of these groups report, to alleviate
additional stress these officers often face. For
example, women make up less than 10 percent of
sworn police officers nationwide and occupy few top
administrative posts, and this is due in part, some
researchers say, to hostile working environments,
discrimination, and sexual harassment.[15]

Some female, gay, and minority officers may have
the added stress of

o lack of acceptance by the predominantly white,
male force and subsequent denial of needed
information, alliances, protection, and sponsorship
from supervisors and colleagues;

o lack of role models and mentors;

o pressure to prove oneself to colleagues and the
public;

o exclusion from informal channels of support; and

o lack of influence on decision-making.16

One female officer went to investigate a
neighborhood dispute in the countryside only to be
told by the caller that he would not speak with
her--that she should "go home and send a real cop."
When the officer refused, the man called the
department and was told to deal with the female
officer; instead, the man went back inside his
house and ignored her. Another female officer
experienced constant harassment from a male officer
who kept telling her she wasn't up to the job. On
the advice of another male officer, she finally
dropped her belt at the stationhouse and told him,
"OK! Let's go at it." They engaged in a tussle
before the sergeant separated them. Later, the
hostile officer changed his entire attitude toward
the woman, becoming her friend.

Many female officers take less aggressive--yet what
they feel are no less effective--approaches to
stressful work situations than men typically
adopt.[17] In fact, one researcher has suggested
that despite the extra sources of stress they face,
many women do not report actually feeling a
substantially higher level of stress than men
because "they are willing to talk about their
feelings and the related stress, reject
competitiveness, and make a conscious effort to
reduce stress through actions such as taking time
off from work."[18] Also, depending on individual
personality and
experience, some women may be more offended and
intimidated by degrading language than others. Some
female officers may 
even find exchanges of insults to be a way to use
humor to relieve stress.[19]

Sources of Stress for Nonsworn Employees

Civilian employees of law enforcement agencies also
face the four general types of stress described in
the text; however, they typically have the added
problems of being perceived as
second-class employees within the agency and being
denied some of the benefits enjoyed by sworn staff,
such as training and
opportunities for career development. Law
enforcement stress programs need to include
nonsworn employees in outreach, stress training,
and treatment services. Dispatchers who handle
calls regarding traumatic incidents, for example,
may need critical incident debriefing as much as
(or in some cases even more than) the officers who
respond to the calls, because they typically feel
tremendous responsibility for protecting officers
and therefore may experience enormous guilt when
things go wrong. 

How Do Programs Define "Family"?

In the 1970s, attempts to help officers' families
were fairly narrow in scope. A police department in
Pennsylvania held an orientation titled, "The
Officer's Lady," to welcome male officers' wives,
fiancees, and mothers, for example, and the
Indianapolis Police Department held a "Seminar for
Wives and Fiancees of Recruits."

Now, however, most stress programs define "family"
broadly, incorporating not only spouses and
children but also parents, in-laws, siblings,
"significant others," and anyone else with whom an
officer has a close relationship. The Erie County
program in New York State, for example, will
provide counseling to anyone who is "important to
the officer"; the director of the Rhode Island
Centurion Program defines a family member as
"someone you're emotionally connected to and care
about," and the Counseling Team, an organization
that works with law enforcement agencies in San
Bernardino, California, includes gay partners as
eligible family members.

Some programs, however, place stricter limits on
whom they serve. The Metro-Dade program in Miami is
designed to provide services to department
employees, their immediate family members, and
significant others (for couples issues) but
considers extended family members and adult family
members living outside the
household to be beyond the scope of services except
in cases of major trauma to the employee.

Program staff must be attentive to the difficulties
that arise if administrators, officers, association
officials, insurance
companies, and counselors do not agree with the
program's broad--or narrow--definition of family.
For instance, insurance companies may reimburse
treatment provided only to immediate family
members, such as parents, spouses, and children,
and refuse to cover marriage counseling. When this
happens, some other mental health
professionals end up charging these clients a
sliding fee or providing counseling pro bono.
______________________________________________

"Police stress is found wherever there are
functioning police officers. In our [FBI Nationwide
Law Enforcement Training Needs Assessment] surveys,
the activity statement, `handle personal stress,'
has consistently been rated a top priority activity
for all types and sizes of State and local law
enforcement agencies."--James T. Reese, former
supervisory special agent and assistant unit chief,
Behavioral Science Services Unit, FBI, in Testimony
presented to the 102nd Congress, Washington, D.C.,
May 1991

"My husband came home more screwed up with
department problems than with anything he ever
encountered on the streets."--Wife of an officer
who ended up  resigning due to stress

"You're telling an officer he's going to be
penalized if he doesn't get there quickly, and, if
he risks some safety factors to get there quickly,
he's going to be penalized as well. That creates an
enormous amount of stress. That famous quote about
`damned if you do, damned if you don't' appears to
be the department policy."--Richard B. Costello,
President, Philadelphia Fraternal Order of Police,
quoted in Law Enforcement News, March 15, 1995

It probably won't be the bullet that will strike
down an officer, but the effects of chronic
stress." --Sergeant Robin Klein, Long Beach
(California) Police Department, quoted in FBI Law
Enforcement Bulletin, Vol. 58, no. 10 (1989)

"We have a tremendous investment in cops, and if
they leave after one traumatic incident, we have
lost a tremendous amount." --Robert Peppler,
Assistant Sheriff, San Bernardino Sheriff's
Department

_______________________________________

Chapter 2

Planning the Program
_______________________________________

Key Points

o Patience and thoughtful, careful preparation both
at the
beginning of a stress program and during later
adjustments in program operations are likely to pay
off with an efficient, supported, and well-used
program.

o Law enforcement stress experts recommend a
systematic approach to program development,
focusing on the prevention as well as the treatment
of stress at both the individual and organizational
levels.

o Involving key law enforcement administrators,
labor representatives, managers, line officers,
family members, and others in planning will help to
ensure their support and use of the program.

o When determining a program's target population
(that is, whether it will include individuals other
than officers, and if so, whom and to what degree),
planners need to consider the limits of their
resources (e.g., staff qualifications and time),
the preferences of the program sponsor, a needs
assessment, and how the choice of target
populations will affect program credibility.

o Initial and periodic needs assessments are
crucial to ensure that the program addresses
officers' and family members' primary problems and
may also be helpful in promoting the program among
clients, administrators, labor representatives, and
potential funding sources.

o An advisory board, including representatives of
both labor and management, is one of the most
useful sources of guidance for program planners.

o Formulating an overall program mission and
specific objectives provides a clear picture of
what others can expect from the program, focuses
program efforts on priority clients and services,
facilitates program evaluation, and can impress
agency
administrators and potential funding sources.

o In determining which services to provide, program
planners need to consider clients' needs, other
available services and their current or potential
effectiveness, staff credentials, and which mix of
services (e.g., broad-based or focused) will help
ensure program credibility, quality, and support.

o Written policies and procedures, especially with
regard to confidentiality, are essential for
generating awareness and support and for guiding
staff activities. It is best if policies and
procedures are developed in collaboration with
agency administrators, labor representatives,
officers, and other targeted clients.

Careful planning is particularly important in the
development of a law enforcement stress program
because of the several
organizational options available, the sometimes
competing interests of labor and management,
limitations on financial resources, and officers'
common skepticism of mental health services. Even
one misstep--such as neglecting to ensure union
involvement or locating the program in a place that
officers consider too public--can result in long-
term, even permanent, mistrust. Although they may
delay program implementation, patience and
thoughtful preparation in the early stages are
likely to pay off with an efficient, supported, and
well-used program.

Furthermore, program planning should be considered
an ongoing activity as staff seek ways to improve
services and respond to changing fiscal, political,
and other circumstances. For instance, the Michigan
State Police Department's Behavioral Science
Section added a trooper who is a recovering
alcoholic to its staff after it became clear that
many troopers with drinking problems were not
comfortable talking to the program's psychologists.

After examining typical factors that spark the
development of a stress program, the remainder of
this chapter reviews seven important steps in
program planning: 

(1) selecting the program's target population;

(2) conducting an initial and ongoing needs
assessment;

(3) establishing a planning and steering committee;

(4) formulating a mission and objectives;

(5) selecting services to offer and identifying
referral sources within and outside the agency;

(6) estimating funding needs and identifying
potential funding sources; and

(7) establishing and disseminating written policies
and procedures, particularly with regard to
confidentiality.

Determining the organizational structure of the
program and recruiting staff, two additional major
elements of program planning, are discussed
separately in chapters 3 and 4,
respectively. Obtaining early support from
administrators, union officials, and other
individuals is addressed in chapter 7. Planning and
conducting a program evaluation are covered in
chapter 12. Program practitioners recommend that
planners maintain a "holistic" focus in moving
through these planning steps, making sure that the
program addresses personal and organizational
sources of stress, officers and family members, and
prevention and treatment. The sequence and exact
manner in which program planners follow these
steps, and the time that each step takes, will
depend on local opportunities and constraints.

Getting Started: Responsibility and Resources

In most of the programs contacted for this
publication, administrators initiated program
planning by identifying the need for services and
selecting a program director, who was generally
charged with developing program policies and
services. For example, department administrators
gave the director of the Metro-Dade Health Services
Section considerable latitude in planning and
implementing the program after they chose him for
the job.

Although one person typically has primary
responsibility for planning the program, planning
should be considered a collaborative endeavor,
involving key law enforcement department
administrators and managers, line officers, labor
representatives, family members, and other
individuals with an interest in the program.
Involving these individuals will help to ensure
that (a) the program is responsive to their needs
and receives their support, (b)
duplication of effort is avoided, and (c) "turf"
battles are prevented between the program and other
groups that may also serve targeted clients (e.g.,
a citywide EAP or private mental health
professionals). Cindy Goss, Director of the Erie
County Law Enforcement Employee Assistance Program,
met frequently with the sheriff and police chiefs
throughout the county, as well as with a
representative of the union representing the
county's largest police department, to develop
program policies and procedures to which everyone
could subscribe. In fact, Goss leaves membership on
her advisory board open to whoever wishes to
participate because she does not want to exclude
any interested parties from the planning process.
(See chapter 7, "Marketing the Program," for
further information on involving various groups.)

The one person in charge of the planning process
must be clear about who will have the final say in
making decisions but must strive to create a
collaborative, not competitive, spirit among those
involved in the process.

With many individuals offering suggestions,
however, conflicts may occur when one individual's
or group's ideas are chosen over another's. When
the views of professional clinicians prevailed over
those of line officers at one point in the
development of the Rochester Police Department's
Stress Management Unit, the officers felt
resentful. One commented, "We thought that this was
going to be our program, and we felt overruled and
second-guessed by an outsider."[1] The one person
in charge of the planning process must be clear
about who will have the final say in making
decisions but must strive to create a
collaborative, not competitive, spirit among those
involved in the process.

Directors of programs that began in the 1970s and
early 1980s had few programs or practitioners they
could contact for guidance. Today, however,
numerous agencies of all sizes have stress programs
whose administrators, staff, and consulting mental
health
practitioners are likely to be willing to offer
suggestions on program implementation and
operation. Program planners have also been able to
obtain advice from the Psychological Services
Section of the International Association of Chiefs
of Police, meetings of the American Psychological
Association's Police Psychology
Division, and symposiums sponsored by the Federal
Bureau of Investigations's Behavioral Science
Services Unit at the Quantico Training Academy in
Virginia. Individuals outside the law
enforcement field--such as directors of EAPs in
other public agencies and in the private sector,
university researchers, and local mental health
providers--may also be helpful. (See chapter 14,
"Tapping Other Resources," for the names and phone
numbers of program directors contacted for this
report, as well as a list of pertinent
organizations and publications.) An advisory board
can also be a particularly valuable source of
guidance for program planning, as discussed below.

Selecting Target Groups

Although it may seem clear that the primary
beneficiaries of a law enforcement stress program
will be police officers, choosing the program's
client population can be a complex consideration.
Planners and staff must decide whether and how the
program will serve the following groups: 

o line officers, command staff, and administrators;

o dispatchers;

o nonsworn personnel;

o retired officers;

o employees of more than one department;

o other nearby law enforcement personnel, such as
Federal agents or corrections officers;

o other public safety and emergency personnel, such
as firefighters or paramedics; and

o family members.

If family members will be served, program planners
must decide which of them will be eligible--
spouses, significant others, parents, children, or
close friends. Program planners may want to
distinguish between eligible and specifically
targeted clients--that is, whether to serve all
individuals within certain categories but promote
the program actively to only certain priority
groups. This section discusses the selection of
client populations; chapter 7, "Marketing the
Program," suggests methods of generating
referrals from the targeted groups.

All of the programs surveyed for this publication
and described in the literature target primarily
line officers because they make up the largest
group in any police department, are perceived as
experiencing the most stress, deal with the public
day in and day out, and may have limited financial
resources to pay for extended counseling on their
own. Most programs also provide at least minimal
services (that is, referral to other treatment
providers) to nonsworn personnel and former
employees, as well as to officers' and other
employees' relatives and close friends who may need
assistance. (See the box "How Do Programs Define
`Family'?" in chapter 1.)

Most commonly, then, a wide range of clients is
eligible, but only officers, and sometimes family
members, are specifically targeted for services.
For example, Erie County's program services are
available to county corrections officers and
nonsworn employees, but most of the program's
marketing is directed at police officers and
sheriff's deputies. However, there are cogent
reasons for targeting at least three other groups,
if not initially, then after the program is solidly
established:

o dispatchers, because they often experience
significant stress in handling critical incident
calls and feel responsible for the safety of
officers in the department;

o other nonsworn personnel, because they often
report being left out of many of their agency's
programs and also frequently
experience stress associated with their work, the
organization of the agency, or other factors; and

o management, because they may also experience
considerable stress, because they can actively
facilitate the development and acceptance of the
program, and because they are in a position to
change features of the organization that may be
creating stress for personnel.

Staff of some programs may prefer and be well
positioned (if, for example, the program has a
large clinical staff) to serve a wide range of
clients during the early stages of the program when
it needs to gain initial support, credibility, and
referrals. In other cases, however, it may be more
practical to focus at first only on the primary
target group; in this way, staff can build
credibility by providing high-quality services and
avoiding being stretched too thin. As one program
director warned, staff need to be wary of trying to
be "all things to all people." Reflecting this
concern, the brochure for Psychological Services in
Tulsa lists as eligible clients employees of the
Tulsa police and fire departments and their
immediate families, retired police officers and
firefighters, but other city employees only "as
time allows." The Bureau of Alcohol, Tobacco, and
Firearms EAP provides up to five free counseling
sessions to employees each year, but only three to
family members, defined as "your relatives who live
with you; any dependent children up to age 22
residing with you, with your former spouse, or at a
school or college; and a significant other (someone
with whom you have a close, intimate relationship
and who lives with you)."

For guidance in selecting, limiting, and modifying
their clientele, program planners and staff may
want to examine the following considerations:

o Limited resources. Limitations in the number and
qualifications of staff are the most influential
factors in determining the range of potential
program clients. One psychologist in Modesto,
California, for instance, reported that his time is
stretched so thinly among the several police
departments he serves that he is able to counsel
family members only in association with an
officer's problem.

o Program sponsorship. Programs established by law
enforcement management may be more likely to target
all department employees, including managers, than
a union-sponsored program, which usually targets
only member officers and their families. Programs
that serve more than one department may need to
give priority to officers of those departments that
have the largest contracts with the program. After
being funded by the county for several years to
serve all county employees, Cindy Goss, Director of
the Erie County program, responded to the large
demand for assistance among law enforcement
agencies by focusing her efforts exclusively on law
enforcement and establishing individual contracts
with each department that wanted program services.
(The county hired another counselor to work with
other county employees.) As a result, Goss now
gives priority to officers employed by the Buffalo
Police Department, the largest department in the
county and the program's largest source of funds.

o Needs assessment. Usually it is best to identify
the program's primary target populations before
conducting a needs assessment in order to decide
which groups to survey (see the following section).
For example, if a program is only going to be able
to serve law enforcement officers, it may be a
waste of time and resources to survey civilian
employees. A needs assessment, however, can help
confirm, justify, and refine the choice of target
populations. The needs assessment conducted by the
Drug Enforcement Administration prior to
implementing its employee assistance program helped
demonstrate the need to extend services to
employees' family members.

o Program credibility. Although some programs may
from the beginning accept a wide range of clients,
staff may not find it worthwhile to promote the
program among some groups until its counselors have
achieved a certain level of acceptance in the
department. The director of the Erie County program
began soliciting referrals from family members only
after she felt she had established an adequate
level of support among officers, who would then be
willing to encourage their family members to
participate.

Conducting Initial and Periodic Needs Assessments

Why Conduct a Needs Assessment?

Some program planners consider a needs assessment
unnecessary because they feel that the needs of
officers and their family members are obvious or
because enough information about law enforcement
stress is available from other jurisdictions and
written materials. This view is misguided. Indeed,
there are at least five compelling reasons for
conducting a needs assessment, both in the initial
stages of a program and periodically
thereafter:

(1) To identify the perceived sources of stress
experienced by officers and other target clients.
Although some sources of stress are commonplace
among most officers and family members (e.g., shift
work), a needs assessment can reveal how widespread
and severe stress-related problems are among the
target groups and what specific problems are unique
to the department or jurisdiction (e.g., a detested
supervisor, a hostile local press, deficient
equipment).

(2) To identify the services already available to
clients, how extensively they are being used, and
gaps in efforts to reduce and treat stress-related
problems. Even when program administrators or
consulting mental health practitioners believe that
existing services are sufficient, a needs
assessment may reveal that officers seldom use
these services or are dissatisfied with them.
Information from such an assessment may also help
program planners identify those services they can
expand and avoid duplication of effort.

(3) To identify types of services that target
clients want. In addition to giving clients a sense
of ownership, asking questions regarding desired
services, staff characteristics, location, and
other program features--and paying attention to the
answers--will help ensure that the program will be
both accepted and effective. Nearly all the
respondents to the Erie County survey indicated,
for example, that they would want to attend stress
debriefings if they were involved in a critical
incident.

(4) To generate information for use in selling the
program to administrators, labor representatives,
officers, and other potential clients, and to
funding sources. Assessments conducted in Erie
County revealed that nearly two thirds of officers
reported feeling serious stress because of their
work duties in the previous year, a statistic that
surprised most law enforcement
administrators in the county.

(5) To familiarize officers, family members, and
others with the program. When distributing a needs
survey, program staff can take the opportunity to
promote the program if it is currently or soon to
be operational. If the needs assessment is
conducted using face-to-face conversations (see
below), staff can also begin to gain the trust of
targeted clients.

A task force in Georgia conducted a study of
stress-related problems among State public safety
personnel and the efforts departments were making
to address these problems. Using the study results,
the task force asked for and received funding from
the State legislature for a statewide stress
management program.[2]

Types of Needs Assessments

A formal needs assessment involves developing a
questionnaire and either distributing it in writing
or using it for phone or
in-person interviews; an informal assessment
consists of
unstructured telephone or face-to-face
conversations. Structured surveys are time-
consuming to design and conduct and can be somewhat
impersonal, but they usually yield comprehensive
and credible results. Informal conversations can
provide an inexpensive in-depth look into the needs
and desires of officers and their family members,
but, unless many respondents are contacted, the
results may not be as representative of the entire
target population and therefore not as credible. Of
course, in small departments informal group or
individual conversations may be the most practical
way to determine officers' needs. Even in such
settings, however, officers' concerns about keeping
their comments confidential may make it advisable
to use a written questionnaire.

Whom To Survey

To obtain a comprehensive picture of stress-related
factors in a department, information should be
solicited from officers, nonsworn employees,
administrators, managers, family members, other
service providers, and anyone else whose opinions
may be useful. Of course, program staff might also
conduct a formal needs assessment among one group
(e.g., line officers) and have informal
conversations with others (e.g., administrators).

To improve the chances of obtaining a large number
of responses, a needs assessment should reach as
many members of the target population as possible.
The director of Psychological Services in Tulsa,
Oklahoma, distributed critical incident survey
questionnaires to all 720 officers in the city
police department, but only half were returned.
Program staff can also contact a random sample of
officers, representing a range in ranks and, if
possible, in gender and ethnicity. The Drug
Enforcement
Administration EAP surveyed a 10 percent stratified
random sample of DEA employees. When the Erie
County program sampled personnel in each county law
enforcement agency, a large percentage of the
officers responded (254 out of a total of 400),
but, in retrospect, the director wished she had
distributed surveys to every officer in the county
to obtain more representative--and therefore more
convincing--results. Program administrators and
practitioners report a need to approach surveying
family members with caution: some officers may feel
that program staff are going behind their backs in
asking their spouses about stress-related issues.

Information To Collect

Issues that might be addressed in a needs
assessment survey include the following:

o sources of stress, including severity and
frequency (probe for sources related to law
enforcement work, the agency, the criminal justice
system, the media, and family life);

o effects of stress, including physical, mental,
and emotional problems, as well as reduced work
productivity and family
difficulties (probe for frequency and severity);

o sources and effects of stress on the family;

o types of stress-related services and training
options the respondent knows about, and the
respondent's opinion of and experience with these
services;

o other ways that respondents prefer to cope with
stress (e.g., exercise) and how effective these
methods are;

o stress-related services the respondent feels he
or she would use (e.g., what kind of counseling,
provided by whom and where); and

o other suggestions for the development of the
stress program.

It may be useful to ask administrators about their
perceptions of the nature, severity, and effects of
stress-related problems in their departments, as
well as how they detect and handle these problems
(e.g., referral to services, training, discipline).

Program planners may want to request demographic
information from survey respondents (e.g., age,
gender, years of experience, marital status, rank),
but they must be careful to preserve anonymity--and
the perception of anonymity. Closed-ended questions
(that require a yes/no response or a numerical
ranking on a scale) facilitate analysis of the
data, but respondents should be given the
opportunity to comment in writing on anything they
feel was not adequately addressed in the survey.
The survey of Erie County officers, for instance,
included the following questions:

o What are the three most important things that
could be initiated or changed which would make your
job more satisfying and less stressful?

o What are the three most important things that
could be initiated or changed which would make your
family life more satisfying and less stressful?

o How can the Erie County Law Enforcement Employee
Assistance Program help to reduce the stress you
may be experiencing?

Data Collection Options

Phone calls may sometimes fail to generate many or
useful responses because they lack both the
anonymity of a written survey and the intimacy of
in-person conversations. It may also be difficult
or inappropriate, especially with shift workers who
may be sleeping during the day or working during
the evening, to reach officers and other
respondents by phone. Nevertheless, some program
staff have found phone surveys to be a quick,
inexpensive way to survey potential clients.
Psychological Services in Tulsa attempted to
telephone the 284 officers in the department who
had at least 15 years of police experience to ask
about their marital status and attitudes regarding
divorce; twenty-five officers who could not be
contacted were sent a written questionnaire, and 86
percent of the officers agreed to be interviewed by
telephone or responded to the written survey.[3]

In-person contacts may consist of structured
interviews or informal conversations with officers
and other employees during ride-alongs or visits to
the station house or union lodge. It may also be
possible to conduct an informal forum at a union
meeting or gathering of officers' family members;
however, it is usually best if the in-person
conversations are conducted on a one-on-one basis
to encourage open, honest responses. When possible,
officers to be interviewed should be selected
randomly. The director of the San Antonio Police
Department's Psychological Services spent his first
year on the job doing ride-alongs, asking officers
about the job, whether it lived up to their
expectations, and what impact it was having on
their families. He learned that organizational and
supervisory issues were the primary sources of
stress, and
subsequently made efforts to address these
problems. (See chapter 9, "Reducing Organizational
Stress.")

Department records and statistics can be valuable
components of a needs assessment. The chaplain who
set up the New York City Police Department's first
program for alcoholic officers searched through the
department records of officers with numerous
absences or accidents and through disciplinary
records to tally the number of officers who might
have a drinking problem and then to encourage such
officers to seek assistance.[5] Administrators or a
department's office of internal affairs may be able
to provide similar information on an anonymous
basis, as well as aggregate statistics regarding
citizen complaints, use of excessive force,
disability, and turnover rates. However, program
staff need to consult first with their department's
legal counsel to find out whether a planned records
search is legal, and they must be careful to avoid
the impression that they are prying into officers'
private affairs.

A university researcher or a graduate student may
be willing to design and conduct a needs assessment
survey at little or no cost. A law enforcement task
force in Georgia enlisted the help of the
Department of Human Resources, the Criminal Justice
Coordinating Council, the Department of Community
Affairs, law enforcement executives, academicians,
and others in conducting a statewide assessment.[6]
While using an independent person or organization
would appear to make the results of a survey even
more objective and credible, some officers may view
an outside researcher's findings with skepticism or
disdain. As a result, when a university professor
designed and distributed a questionnaire to law
enforcement officers in Erie County, the enclosed
envelopes for responses were addressed to the
county's stress program.

After conducting a needs assessment, staff would do
well to thank respondents for their assistance and
inform them of the survey's results, something the
Erie County program did through an article in a law
enforcement newsletter. Staff can also accomplish
this by sending a letter to the officers. According
to the Erie County program director, "Following up
with survey participants shows them that the
program is responding to their concerns and that
the time they took to answer questions will benefit
themselves and the rest of the agency."
Furthermore, these thank-you's serve to publicize
further the program's availability.

Establishing Planning and Ongoing Steering
Committees

Some program directors and independent
practitioners use only individual conversations
with key people to obtain information for the
planning process. This approach may be perfectly
adequate in working with very small law enforcement
agencies and in small towns and rural jurisdictions
where considerable collaboration occurs on an
informal basis because people already know each
other. However, many planners have found the
establishment of a formal advisory board or
steering committee representing diverse
perspectives to be especially helpful for several
reasons:

o Forming a steering committee helps to demonstrate
to administrators, labor representatives, and
potential funding sources the commitment of program
planners to making the program work.

o Regular committee meetings may enable planners to
obtain a wealth of information and to reach
consensus more efficiently than through individual
conversations.

o Having a steering committee demonstrates
planners' receptivity to considering the views of
all involved parties (for example, including an
officer and a family member on the board, along
with high-level administrators and union or
association representatives, shows that program
planners consider the view points of people at all
levels to be equally important and enhances the
legitimacy of the program).

o A committee can periodically assess the
effectiveness of the program and how it might be
improved.

o Including legal counsel on the steering committee
can help guard the program against legal liability.

It is critical to represent both labor and
management on any planning or advisory committee.
The director of the Erie County Law Enforcement EAP
already had an advisory board for the general
county EAP, which initially administered the law
enforcement program, but she put together a
separate advisory board, consisting of
administrators and union representatives from
throughout the county, for the law enforcement
program when it split off from the county EAP. The
advisory board of Psychological Services, a private
corporation contracted by the Tulsa police and fire
departments, consists of the police and fire
chiefs, and an independent
psychologist from Tulsa, as well as a retired
budget director; a broader advisory board,
consisting of these individuals plus a city auditor
and representatives of the police and firefighters
unions, advised the organization's director on the
development of the program in 1982.

Formulating the Program's Mission and Objectives

Although program staff may think that the purposes
of stress services are obvious, goals can vary
significantly in content and emphasis from program
to program. Formulating and articulating an overall
program mission, as well as specific objectives, is
important for the following reasons:

o to give potential clients, administrators, union
representatives, and others a quick, clear picture
of what to expect from the program (this is
particularly critical because officers may
inadvertently view the program as a management
tool, while at the same time managers may not
realize how it can help them deal with difficult
personnel issues);

o to focus staff efforts on the clients and
services that have the highest priority and avoid
inconsistent, conflicting, and
superfluous activities;

o to facilitate evaluation of program services; and

o to explain and legitimize the program to clients,
administrators, and potential funding sources, as
well as to program staff members themselves.

Although most of the programs surveyed for this
publication have not done so, it may be beneficial
to distinguish between a program mission statement
and more specific objectives. A mission statement
can convey the program's overall ambition, for
instance at the individual level (e.g., prevent and
treat stress-related problems among the target
population in a strictly confidential manner), the
departmental level (e.g., maintain and improve the
department's effectiveness), and the community
level (e.g., ensure a high quality of law
enforcement services to citizens).[7] Program
objectives would be more specific, focusing on both
the intended operation of services and their
anticipated effects. Objectives will vary depending
on the size of the department or departments
served, available resources, and other factors, but
they might include the following:

o provide stress management training sessions each
year to all officers and nonsworn employees, or to
a certain percentage of them;

o conduct at least two family workshops on stress
management each year;

o recruit at least two peer supporters from each
department served by the program;

o reduce the number of divorces among officers by
25 percent within three years;

o reduce the department's rate of absenteeism,
disability leave, turnover, and citizen complaints
by a given percentage over a specified period of
time; and

o improve department morale.

Generally speaking, program objectives should be
stated in terms of measurable effects. Furthermore,
the more operationally defined a program's
objectives are, the more useful they will be as
measures of achievement, statements of purpose, and
guidelines for staff. (See chapter 12, "Monitoring
and Evaluating the Program," for a more detailed
discussion of planning and conducting program
evaluation.) Staff therefore need to think through
their mission statements and specific objectives
carefully. The director of the Erie County stress
program emphasized that it is important to be
realistic about what the program can do and not to
promise what staff cannot deliver. Also, staff may
find it necessary to revise their mission and
objectives from time to time to respond to local
circumstances, such as program growth, budget cuts,
or newly identified needs or target populations.

A program's mission and objectives should flow
naturally from the initial needs assessment and
from the factors that motivated the program's
development in the first place. When a stress
program was first established in Providence, Rhode
Island, in response to the 1978 on-the-job suicide
of the city's police chief, the director's overall
goal was simply "to keep cops from killing
themselves." It may be helpful to develop the
program's mission and objectives during a planning
or steering committee meeting to ensure that they
address each group's needs and are articulated in a
clear way that will help the program gain support
among all parties represented.

Selecting Service Mix and Referral Sources

The "service mix" of law enforcement stress
programs ranges from peer support or individual
counseling alone to a wide combination of
components. Determining which services are most in
demand and most feasible involves careful
forethought. Planners and staff can review other
programs as a preliminary means of identifying the
services they may wish to consider providing.
Chapter 10, " Responding to Stress-Related Problems
After They Occur," describes the services offered
by programs contacted for this publication. Below
is a discussion of factors that program staff might
consider in deciding which services to offer.

Clients' needs and desired services. The needs of
most officers and family members are similar across
law enforcement agencies, regardless of a given
agency's size or location. Chapter 1 reviews some
of the common causes and effects of stress and
suggests sources of additional information about
them. Program planners should be sure, however, to
select services that will address any specific
needs that were identified in their own needs
assessment survey; they should also try to be
responsive to officers' and other potential
clients' specific requests. As noted above, the
director of the Erie County program found that over
90 percent of the officers she surveyed reported
that they would like to have a stress debriefing
immediately after experiencing a critical incident,
and when union officials in Michigan learned that
many troopers were not comfortable approaching the
department's
psychologists for assistance with alcohol problems,
that program added a recovering alcoholic trooper
to its staff.

Staff may want to prioritize their services to
ensure that the needs of certain clients are met
before the needs of other clients' are addressed.
For example, the director of Tulsa's Psychological
Services gives priority to an officer's need for
counseling over any other kind of service should a
conflict regarding staff availability occur.
Program practitioners and administrators are
increasingly seeing the benefits of focusing their
efforts on proactive preventive services, such as
training and changing organizational sources of
stress, in addition to traditional reactive
services, such as counseling.

Already available services. A number of available
resources--including city or county EAPs, police
chaplains, wellness programs, support groups, and
local private service providers--may already
provide stress-related services to law enforcement
personnel and their families. As discussed above,
program planners need to be sure they do not
duplicate effective existing services or cause
unnecessary "turf" problems with other providers.
Just because a particular service exists, however,
does not mean it is meeting--or can meet--officers'
needs. Respondents contacted for this
publication consistently said that officers do not
use city or county EAPs because these organizations
do not provide sufficient confidentiality and
because their staff do not usually understand law
enforcement. Program staff also need to consider
the extent to which informal support networks, such
as family members, friends, and colleagues, as well
as officers' personal coping methods (e.g.,
listening to music, playing softball), already help
to prevent or relieve stress-related problems. A
needs assessment can help determine the
effectiveness of existing services and personal
coping mechanisms for dealing with stress.

Staff credentials. The training and credentials of
staff may limit the services they can offer in
terms of skills, legal liability, and credibility.
Licensed police mental health practitioners, for
instance, usually can provide in-depth counseling
on a short- or long-term basis, while peer
supporters are limited to listening, assessing, and
referring. Even credentialed mental health
professionals may be limited by their training or
the specialty supervision they receive; few police
practitioners, for instance, are qualified to
provide counseling to children. Chapter 4,
"Choosing Among Staffing Options," discusses the
issue of staff qualifications further.

Program credibility and support. Staff may wish to
start with basic services and then add additional
services on a gradual basis as the program gains
credibility among officers and management. The
director of the Erie County Law Enforcement EAP
initially offered assessment, referral, and short-
term counseling services; as she became better
known and more widely accepted she began to offer
training, counseling to family members, and peer
support services. Only when it was well established
did Michigan's Behavioral Science Section establish
a peer support component. Focusing on basic
services at the outset also helps to ensure that
staff do not overextend themselves but instead
provide high-quality services.

An important element of the service mix of most
programs consists of referrals to sources both
within and outside the agency. Available
departmental resources might include chaplaincy
services or a wellness program, and local
professionals can provide, for example, alcohol and
drug abuse treatment, child counseling, or long-
term adult counseling. Chapter 5, "Establishing a
Referral Network," discusses the selection of
referral sources in more detail.

Subjectivity and a certain amount of guesswork are
inevitable in initially determining a program's
appropriate mix of services. It is important,
however, to inject as much rationality as possible
into the process so that the program offers the
maximum benefit to the greatest number of clients
considering its resources. In addition, it is
important for staff to remain open to modifying
their initial or current service mix based on a
number of
contingencies:

o Some services may prove to require more time than
is warranted relative to the benefits they provide.

o Officers and family members may reveal a need
which program planners did not anticipate.

o Local events, such as a critical incident, may
signal the need for new or more in-depth services.

o It may be possible to expand--or necessary to
curtail--some services depending on funding
changes.

Estimating Funding Needs and Identifying Funding
Sources

At a time when many law enforcement agencies are
already cutting back on staff and other
departmental expenditures, little money may be
available for a stress program. As emphasized in
several other parts of this publication, program
planners must be able to convince administrators
and other funding sources of the benefits and cost-
effectiveness of stress services. Program planners
need to estimate their minimal (but realistic)
funding needs. They may need to look for funding
outside of the department or departments they will
be serving.

Funding requirements will vary depending on program
objectives. Nevertheless, cost estimates can be
developed for all anticipated program services and
materials, even if planners expect that the
department will provide some in-kind assistance in
case these materials or resources are discontinued
and funding for them must be obtained elsewhere.
Chapter 13, "Managing Program Costs and Funding,"
discusses cost elements of a law enforcement stress
program and potential sources of funding.

Establishing and Disseminating Written Policies and
Procedures

Developing detailed written policies and procedures
is important for at least two reasons:

(1) Written policies and procedures can be used as
a marketing tool to make officers and family
members aware of the program, including its
mission, services, methods of referral,
confidentiality guidelines, and other features.
Policies and procedures can help correct any
misconceptions about the program and help ensure
that everyone uses it properly and effectively.

(2) Current staff and consultants can use the
policies and
procedures as a guide for their own behavior, while
new counselors can use them for orientation to
program operations.

As with a program's mission and objectives, it is
best if planners and staff work out the policies
and procedures in collaboration with an advisory
board or, at a minimum, with selected
administrators, union representatives, officers,
and other targeted clients. This helps to ensure
that the policies and procedures meet these
individuals' needs and wishes (and therefore that
they will use the program), that these individuals
and the groups they represent will feel a sense of
ownership in the program, and that there will be
less of a chance of conflict among the parties over
what the program does and how it should be used. In
addition, it is important to consult with an
attorney about the program's potential legal
vulnerability if staff do not follow its policies
and procedures, and about how to write the relevant
guidelines so as to reduce potential liability.

Written policies and procedures can include the
following kinds of information:

o the reasons for setting up the program;

o the program's mission and overall objectives;

o definitions of relevant terms;

o types of services offered;

o eligible clients (including whether some clients
are eligible for fewer or less frequent services
than others);

o types and methods of referrals (be careful when
distinguishing between voluntary and mandatory
referrals, if both are accepted);

o confidentiality guidelines (one of the most
important provisions--see chapter 6);

o record-keeping policies and sample forms;

o staff positions and responsibilities; and

o program organization and location.

In general, the more detailed and organized these
written policies and procedures are, the more
useful they will be. Revisions may be necessary as
a program generates clients and as staff have the
opportunity to see how effective its policies and
procedures really are.

The wider the distribution of written policies and
procedures, the more useful they are likely to be.
Distilling the information onto a single page and
using bullets and other attractive formatting
techniques will help to ensure that officers read
and understand them. Some programs target primarily
administrators and managers for distribution, while
others try to make sure that all eligible clients
receive copies of their policies and procedures:

o The Metro-Dade police department's Health
Services Section policies and procedures were
included in the department's manual of standard
operating procedures.

o The Bureau of Alcohol, Tobacco, and Firearms
distributed a 15-page memo to all bureau
supervisors, and the Drug Enforcement
Administration included its program's policies and
procedures in its personnel manual.

o The policies and procedures of the Michigan
Department of State Police Behavioral Sciences
Section are included in the troopers' association
bargaining agreement with the department.

o The director of the Erie County program has
distributed copies of its policies and procedures
to command staff during meetings, as well as to
recruits and other officers during training
sessions.

As mentioned in the beginning of this chapter,
determining the organizational structure of the
stress program is another crucial step in program
planning. The following chapter addresses this
topic.

Endnotes

1. Goolkasian, G.A., R.W. Geddes, and W. DeJong,
Coping With Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985: 26.

2. Schmuckler, E., "Peer Support and Traumatic
Incident Teams: A Statewide Multiagency Program,"
in Critical Incidents in Policing, revised, ed.
J.T. Reese, J.M. Horn, and C. Dunning, Washington,
D.C.: U.S. Department of Justice, Federal Bureau of
Investigation, 1991: 315-318.

3. Gentz, D., and D. Taylor, "Marital Status and
Attitudes About Divorce Among Law Enforcement
Officers," in Law Enforcement Families: Issues and
Answers, ed. J.T. Reese and E. Scrivner,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1994: 67-71.

4. Gentz, D., "Critical Incident Reactions: A
Comparison of Two Studies Ten Years Apart in the
Same Police Department," Journal of Police and
Criminal Psychology, 2 (1994): 35-37.

5. Unkovic, C.M., and W.R. Brown, "The Drunken
Cop," The Police Chief (April 1978): 19.

6. Schmuckler, "Peer Support and Traumatic Incident
Teams," 316.

7. Goolkasian et al., Coping With Police Stress,
29-30.

Common Precipitating Factors for Establishing 
a Stress Program 

A variety of precipitating factors may spark
development of a stress program. Common motivating
factors include a gradual awareness among law
enforcement administrators of the benefits of
stress services and of the inadequacy of previous
department strategies for dealing with officers'
problems; administrators' concerns about
departmental civil liability; and stress-related
tragedies, such as an officer's suicide.

o The EAP that served all county employees in Erie
County developed a program specifically for law
enforcement officers when several police chiefs
throughout the county, concerned about the
"vicarious liability" of their departments,
contacted the commissioner of central police
services seeking help for officers with stress-
related problems.

o The Centurion Program was established in Rhode
Island shortly after a local police chief committed
suicide in 1978.

o The Tulsa police department's Psychological
Services was formed after a former police officer
of the year committed suicide while on duty.

Sometimes, without any particular precipitating
factors, an enterprising individual is able to
"sell" the idea of a stress program. A psychologist
who became interested in law enforcement offered a
free workshop on deadly force to officers with the
Manatee County (Florida) Sheriff's office, then
convinced the sheriff of the value of psychological
services, and ended up developing a comprehensive
program for the department.

Strategies for Encouraging Responses to a Needs 
Assessment

Officers and other targeted respondents may be
reluctant to complete a needs survey because of the
potentially sensitive nature of the questions.
Program planners can improve the response rate if
they:

o keep the questionnaire short, preferably a single
page;

o have the department and union or association
announce the survey before it is distributed;

o include with the survey an introductory letter
from key
department administrators and labor representatives
encouraging addressees to take the survey
seriously;

o explain in writing or verbally when distributing
the survey that its purpose is to gather
respondents' opinions regarding services for them;
and

o emphasize in writing and verbally when
distributing the
questionnaire that the information is confidential,
and provide self-addressed envelopes for returning
the forms. (The director of the Erie County program
made sure that the return envelope was addressed to
her office, located in an administrative building,
rather than to an office within the police
department.)

Program staff may receive low response rates to
their initial needs assessment because respondents
may still be suspicious of the program. A survey of
the Tulsa Police Department in 1983, just one year
after a stress program was established, elicited a
22 percent response rate, but half of all officers
responded to a similar survey conducted 10 years
later (see the box "Benefits of a Needs Assessment
in a Program's First Year--and 10 Years Later").

Benefits of a Needs Assessment in a Program's 
First Year--and 10 Years Later

In 1982, one year after Tulsa's Psychological
Services was
established, the organization's director worked
with several police officers to develop a survey of
officers' reactions to involvement in shooting
incidents. Questionnaires were distributed to 730
officers; 164 returned the form. In response to the
survey results, the Tulsa Police Department
authorized the formation of a critical incident
response team, a group of officers responsible for
training peers to anticipate possible reactions in
critical incidents and to support officers after
such an incident.

Ten years later, the team readministered the survey
but expanded it to include critical incidents other
than shootings and to achieve three additional
goals: (1) ensure that the team's knowledge
regarding officers' responses to critical incidents
was current and accurate, (2) ascertain the
perceptions and attitudes of officers toward the
critical incident response team, and (3) acquire
information to disseminate to police officers as a
part of
in-service training. Probably due to the expanded
definition of a critical incident and greater
awareness of the trauma related to such incidents,
the survey received twice the response rate as 10
years earlier. In addition to updating information
about officers' reactions to critical incidents and
potential counseling needs, the survey showed that
over three-fourths of the officers wanted to have a
member of the response team present for support as
soon as possible after the incident.[4]

Spelling Out Program Guidelines in a Union or
Association Contract

So far, in most cases the dissemination of
guidelines on program policies and procedures
appears to have been sufficient for obtaining the
support and trust of officers, without
incorporating them fully in contracts between the
union or association and the department. However,
the bargaining agreement between the Michigan State
Police Troopers' Association and the Department of
State Police includes language specifying policies
and procedures of the department's Behavioral
Science Section, particularly with regard to
confidentiality and encouraging officers to use the
section's services, as illustrated in the following
excerpts:

"It is the specific intent of this Section [of the
bargaining agreement] to encourage employees
covered by the terms of this Agreement to freely
and willingly utilize the services of the
departmental psychologist to assist them in
addressing personal and work-related stress
situations. It is recognized that the objective of
voluntarily obtaining assistance will be materially
diminished and curtailed if such highly personal
and subjective information is provided to the
Employer. Though nothing herein is intended to
prevent the departmental psychologist from
compiling statistical records, or making general
reports with reference to the types of problems and
the needs of departmental employees, as long as
copies of said reports are simultaneously provided
to the Association. Said reports and
recommendations shall in no way disclose the
identify of the individual employees seeking
treatment or
consultation. It is recognized by both the
Association and the Employer that violations of the
provisions of this Section may result in liability
to both the Employer and to the departmental
psychologist and are also grievable.

". . . The departmental psychologist may not be
called as a witness in any departmental
disciplinary proceedings or grievance meeting to
testify regarding discussions between the
psychologist and employee, except upon the specific
written request of the employee.

"Nothing herein shall prevent the Employer, after
consultation with the employee, from requiring an
employee to undergo psychiatric or psychological or
medical examination or treatment when there is a
reasonable belief that such examination or
assistance is necessary for the continued
employment of the employee or to assist in
determining if such continued employment is
appropriate. The employee shall be given the
opportunity of conferring with the Association
representative, prior to said examination. However,
such psychiatrist or psychologist or physician will
be an `outsider,' i.e., not Department-
retained/employed personnel. All such costs shall
be paid by the Employer. . . ."

Target Population: The Individual or the
Department?

A potential source of conflict for program staff
concerns whether to consider the program's target
clients to be the officers, nonsworn employees,
family members, and other individuals receiving
services, or the departments for which the
individuals or their relatives work. Program
directors recommend that, to earn the trust of
employees and their family members, staff must
emphasize that the program exists to help
employees, not the department (i.e.,
administrators).

In cases of voluntary referrals, professional staff
are usually obligated by law to consider the
individual as their client and therefore to protect
client/practitioner confidentiality. If program
staff accept mandatory referrals, however, they may
be obligated to consider the department as the
client and release information about the
individual's condition to administrators. (See
chapter 7, "Marketing the Program," and chapter 6,
"Dealing with Confidentiality," for further
discussion of this topic.)

There may be times when staff want to target
department
administrators for certain services. Staff can, for
instance, earn the support of the department by
offering consultation services regarding
organizational change, pre-employment screening,
criminal behavior, and how to handle troublesome
officers or other
employees. Administrators may also want counseling
for their own stress-related problems. Department
administrators may need to be reminded that the
department benefits as a whole if individual
employees receive the help they need.

John Carr, Director of the Rhode Island Centurion
Program, recommends that counseling professionals
implement programs with, not just for, the police
agencies they serve. For example, Carr has written
grants with small police departments addressing
issues of family violence, juvenile delinquency,
and victimization. Currently pending is a $200,000
Federal grant from the Office of Community Oriented
Policing Services (COPS) written by the Pawtucket
police department. The Centurion Program is
identified in the proposal as the lead human
service agency in a consortium providing for crisis
intervention teams, consisting of a police officer
and a counselor, who will provide follow-up support
on all domestic violence incidents referred by
uniform patrol and detective bureaus. These
collaborative ventures improve a department's
capability to serve the community while at the same
time enhancing the credibility of mental health
professionals as collegial relationships are
developed within the teams.

_________________________________________

Chapter 3

Structuring the Program
__________________________________________

Key Points

o There are three basic options for the
organizational relationship between a stress
program and the agency or agencies it serves: in-
house, external, or a mixture of the two. Each has
distinct advantages and disadvantages. Program
planners need to select the option that seems best
suited to their particular needs and resources.

o Advantages of in-house programs, staffed by
agency employees, typically include being
considered by officers as part of the law
enforcement community and culture, being aware of
specific agency stresses, and having high
visibility among officers. Possible disadvantages
include the view of some officers that program
staff are "tools" of management, limitations due to
departmental
supervision, and the expense of such a program to
the agency.

o The advantages of in-house programs (e.g., high
visibility) are typically mirrored by the drawbacks
of external programs
(difficulty gaining recognition), while the
disadvantages (e.g., being perceived as a
management tool) translate into benefits (seen as
independent).

o Program staff of most hybrid programs claim the
advantages of both in-house and external programs
and a minimum of the drawbacks of each; however,
hybrid programs may cause confusion among clients
and create conflict among in-house and external
staff.

o Program services must be delivered in a location
that is accessible and completely private; program
staff generally agree that of these two features,
privacy is the most important. 

Of all the considerations involved in planning a
law enforcement stress program, the program's
organizational structure--including its
relationship to the department or departments it
serves, its staffing mix, and its office location--
has perhaps the most profound effect on how the
program will operate and how effective it will be.
Because program organization is also one of the
least flexible of planning decisions (it is easier,
for example, to adjust program objectives and add
or discard a particular service than to change from
a department-run program to a contracted one), much
forethought needs to be given to what would be the
best arrangement for a particular jurisdiction.
This chapter examines several options for a
program's organizational relationship to the agency
or agencies it serves, along with the advantages
and disadvantages of different office locations.
(Although mentioned briefly in this chapter,
staffing arrangements are covered in more detail in
chapter 4.) The present chapter is written
primarily for planners of new programs, but staff
of existing programs will find the information
useful if they are considering a change in program
organization--or for stimulating consideration
about a change.

Organizational Relationship of the Program to the
Law Enforcement Agency

There are three basic options for organizational
relationships between a stress program and the law
enforcement agency it serves: (1) in-house,
operated by department employees; (2) external,
operated by an individual or group under contract
to the agency; and (3) a hybrid of these two
options, for instance a program that is overseen by
a department employee but that also uses contracted
external sources for some services. None of the
programs contacted for this publication or
described in the research literature consulted are
structured exactly alike, nor do they always fit
neatly into one of these three molds, and, while no
one option stands out as being the most effective
(or as the model for how a program should be set
up), each basic type of organizational relationship
does have advantages and disadvantages. (See the
discussion below and the box, "Advantages and
Disadvantages of Three Basic Organizational
Options.")

In-House Program

An in-house stress program typically exists either
as a separate unit within the law enforcement
agency or as a special operation of an existing
unit, such as the training or personnel division.
The programs described in figure 1 typify this
basic structure--in several variations.

Directors of in-house programs recommend this
arrangement for several reasons. The most commonly
reported advantage is that internal program staff
have an easier time than external
contractors fitting into the law enforcement agency
and culture; they are more likely to be considered
"one of the family" and therefore to be trusted. As
department employees, these individuals typically
know more about law enforcement work and its
stresses (even if they are not, in fact, officers
themselves), especially the problems that are
specific to their agency, and they are more likely
to have a long-term commitment to the department
and its employees. An administrator with the
Michigan State Police noted that there are several
psychologists throughout the State who have police
experience, but he doubts they have the intimate
understanding of the police culture that the
department's own staff psychologists have been able
to develop. Another advantage of an internal
program arrangement is that staff typically have a
high level of visibility and availability within
the department. The director of Michigan's program
is able to provide what he calls "gotta-minute
therapy": because he is around the department so
often, officers frequently approach him for
assistance by asking, "You gotta minute, Doc? I
have a problem. . . ." Finally, internal programs
are more likely than external ones to become
institutionalized and to have secure funding.

The fact that all of the programs described above
are housed in large police departments points to
one of the disadvantages of an in-house stress
program: it can be too expensive for small
departments because of the cost of off-site office
space, employee benefits, and other expenses.
Hiring part-time program staff could help reduce
the cost of an in-house program, but services might
suffer as a result of their limited availability.
Although a significant advantage of an internal
program is said to be the ease with which staff
achieve credibility within the department, such an
arrangement may risk the opposite effect: suspicion
and lack of support among line officers who view
program staff as "tools" of department management.
The director of San Antonio's program, for
instance, said he frequently has to counter rumors
that program files are kept in or are provided to
the chief's office. Directors of in-house programs
report they are not controlled by
administrators, as some officers might think, but
they do sometimes face conflicts between their
professional duties and administrative pressure.
Bureaucratic hassles are an added disadvantage. The
director of Metro-Dade's Health Services Section
said that some managers have badgered him for
information about clients or have tried to mandate
treatment for an officer who did not really need
it; he has also been frustrated with the challenge
of providing immediate services to troubled
officers while also responding to administrators'
emphasis on the completion of necessary
documentation.

External Program

As indicated in figure 2, an external
organizational arrangement usually involves a
written contract between an individual or group of
service providers and one or more law enforcement
agencies. It appears that most departments with
this arrangement contract with a private
psychologist who has developed a specialty in
working with law enforcement officers. In some
cases, one practitioner serves only one agency; in
other cases, several agencies--
frequently very small ones--receive services from a
single
practitioner, organization, or program by setting
up individual contracts or pooling their resources
for a single contract (a "consortium" arrangement).

Usually the contract is negotiated between the
service provider and a high-level police
administrator (or in some cases, a union
representative). In some cases, the contract is
with the city or county personnel department. One
police psychologist recommends that the consultant
report directly to the chief or sheriff in order to
have the best chances of obtaining the support
necessary for providing effective services.[1]

In many respects the operation of most external
programs is similar to that of in-house programs.
However, external programs have several potential
advantages (essentially mirroring the
disadvantages of an in-house program). The most
important benefit from the perspective of the law
enforcement agency is that an external program is
usually less expensive than an internal one, and
encouraging competition among providers for the
contract can further lower costs. In addition,
external providers report having to deal with much
less bureaucracy than in-house practitioners
typically face. The director of the Counseling Team
in San
Bernardino, for example, enjoys being able to offer
a training course without having to obtain top
departmental approval; instead, she can get
permission from lower-ranking administrators.
Finally, contrary to in-house providers' contention
that their arrangement is more conducive to
building trust among clients, external
practitioners point out that officers and other
clients are less likely to be suspicious of a
program that is not a part of their agency.

Drawbacks of having an external program arrangement
typically include having less accessibility and
visibility, and having a greater likelihood of
staff being viewed by department employees as
outsiders. Also, such an arrangement is less stable
than an in-house one for the service provider and
more vulnerable to budget cuts. It can be stressful
and time-consuming to negotiate a new contract
periodically and to compete against other providers
applying for the same contract.

Hybrid Program

The majority of programs contacted for this
publication and described in the literature do not
fit neatly into either of the above two categories.
Instead, as described in figure 3, they combine
elements of both. These hybrid programs fall into
two categories--those that serve a "home"
department on an in-house basis and other
departments on an external basis, and those that
serve one department through a combination of an
in-house and an external component. The first type
of hybrid generally has the typical advantages and
disadvantages of an in-house program for its "home"
department, and the typical advantages and
disadvantages of an external program in relation to
its contracted agencies. According to some program
directors, however, the second type of hybrid
arrangement incorporates in one comprehensive
program the advantages of both the in-house and
external options, while minimizing their
disadvantages. The director of Tulsa's
Psychological Services contends that his original
program arrangement separated the program from
direct inclusion within the police department yet
allowed it to operate for the benefit of the
department's personnel. In this way, the
organization maintained its independence even
though it existed solely to serve the
department.[2]

Finally, there is no empirical evidence, and only
limited anecdotal evidence, suggesting that some
organizational options are better than others.
Program planners and law enforcement administrators
must consider their particular needs and resources,
along with the advantages and disadvantages
described above, and try to select--or convert to--
the option that seems best suited to their
particular conditions.

Location of the Program

The physical location of the program can have a
critical impact on the program's success. Program
services must be delivered in a place that is
accessible and completely private. Officers will
not want--and may not be able--to take the time to
go to an inconvenient location, and they almost
certainly will not go to an office where they thinkother officers or other people they know will see
them. The major question is whether both of these
conditions can be best achieved by locating the
program within or outside a law enforcement agency.
The consensus among program practitioners is that
of the two factors privacy is the more important
and that it is much easier to assure privacy (and
the perception of privacy) by locating the
program's office outside the department.
Nevertheless, both options have their advantages
and disadvantages.

Locating the stress program within the department
increases staff visibility and accessibility among
officers and nonsworn employees. It also helps
build the perception that the program is part of
the law enforcement community. However, some
officers, concerned that colleagues will observe
them coming and going, may be reluctant to seek out
services. If services must be provided in-house,
they need to be located in an obscure part of the
building, away from the offices of the chief and
the divisions of personnel and internal affairs.
The Rochester Police Department's Stress Management
Unit, for example, has its administrative office on
the sixth floor of department headquarters but
maintains a suite of offices for counseling in a
quiet area on another floor; however, because this
location is becoming more heavily trafficked by
officers, the program director is trying to obtain
counseling space outside the department building.

Most program directors prefer an external location
for seeing clients. The Metro-Dade program, an in-
house program directed by a sworn officer,
maintains an office in a corporate center outside
the main police station yet is close enough to be
easily
accessible. Similarly, the Tulsa program is located
in a separate building in the center of the city,
but because it is set up exclusively for the police
and fire departments it is still widely considered
an integral part of the two departments.

The Erie County program is housed in the multi-
story county administration building, which,
according to the director, has so many other
offices that it is not apparent that an officer
entering the building is going to the stress
program; one respondent called the location "quiet
and anonymous." In fact, the director
considered accepting a job as the head of an in-
house program for an individual agency but refused
when administrators requested that it be housed in
the department because she did not think such an
arrangement would be successful.

It is also possible to locate a program's
administrative
headquarters within a department yet offer
counseling services at a different location. Such
an arrangement might be difficult and time-
consuming to administer, but it might also work out
well for programs staffed primarily by peer
supporters but administered by a director.

Simply locating the program outside the department
will not in and of itself ensure that it is
suitable. As mentioned above, the program must be
fairly accessible, and this can be difficult for
programs that serve many departments over a wide
geographic area. The Michigan State Police program,
for example, is two to three hours' driving time
from some posts--12 hours from one--and the Erie
County program is an hour from some departments in
the county. To address barriers of distance, San
Bernardino's Counseling Team can call on five
counselors who live in the most distant
jurisdictions the program serves and who are under
agreements to provide immediate on-site assistance
as needed. Staff can also help to ensure program
visibility and at least some immediate services by
training peers in departments far from the
program's office. The director of the Rhode Island
Centurion Program, which serves several
jurisdictions throughout Rhode Island and
southeastern Massachusetts, recruited peer
supporters from most of the
departments to ensure that officers had immediate
access at least to someone with training in stress
support. However, some officers in Michigan and in
Erie County reported that they did not mind (and in
fact sometimes preferred) driving one or two hours
outside their jurisdiction for services in order to
minimize the chances of being seen by someone they
knew.

The fact that programs with such diverse
organizational features have been effective in
providing stress services hints at the critical
importance of other program features and
activities. Staffing, perhaps the most significant
element in program
effectiveness, is discussed in the following
chapter.

Endnotes

1. Blau, T.H., Psychological Services for Law
Enforcement, New York: John Wiley, 1994: 51.

2. Gentz, D., "A System for the Delivery of
Psychological Services for Police Personnel," in
Psychological Services for Law
Enforcement, ed. J.T. Reese and H.A. Goldstein,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1986: 257-282. 

3. Schmuckler, E., "Peer Support and Traumatic
Incident Teams: A Statewide Multiagency Program,"
in Critical Incidents in Policing, revised, ed.
J.T. Reese, J.M. Horn, and C. Dunning, Washington,
D.C.: U.S. Department of Justice, Federal Bureau of
Investigation, 1991: 315-318.

4. For a detailed description of the Postal
Inspection Service's program, see Shaw, J.H., and
D.R. Hagberg, "A Self-Referred Counseling Program
for Postal Inspectors," in Law Enforcement
Families: Issues and Answers, ed. J.T. Reese and E.
Scrivner, Washington, D.C.: U.S. Department of
Justice, Federal Bureau of Investigation, 1994:
359-374.

5. Fuller, R.A., "An Overview of the Process of
Peer Support Team Development," in Critical
Incidents in Policing, 99-105.

6. Kirschman, E., E. Scrivner, K. Ellison, and C.
Marcy, "Work and Well-Being: Lessons from Law
Enforcement," in Stress and Well-Being at Work:
Assessments and Interventions for Occupational
Mental Health, ed. J.C. Quick, L.R. Murphy, and
J.J. Hurrell, Washington, D.C.: American
Psychological Association, 1992: 178-192.

7. For a detailed description of the Adams County
program, see Fuller, "An Overview of the Process of
Peer Support Team
Development."

8. Shaw and Hagberg, "A Self-Referred Counseling 

Program for Postal Inspectors," 362-363.

____________________________________________

Advantages and Disadvantages of Three Basic 
Organizational Options

In-House Programs

Advantages

o As department employees, staff more likely to
have long-term commitment to agency and law
enforcement community.

o Staff more likely to be viewed by officers and
other clients as part of the law enforcement
community.

o Staff more likely to be knowledgeable about
general law
enforcement stresses, those particular to the
agency, and the structure of the agency
(facilitating efforts to address
organizational sources of stress).

o Staff more likely to become personally familiar
with officers, nonsworn employees, and family
members (prior to any services being rendered) and
have greater visibility and accessibility. 

o Easier to obtain logistical and management
support from the department (e.g., to conduct
training and allow officers to take time to be peer
supporters or go in for counseling).

o Greater chance of institutionalizing the program.

Disadvantages

o Clients more likely to view program as a tool of
management and to be worried about confidentiality,
and hence may be less likely to use program
services.

o Typically a more expensive option because of the
cost of office space, equipment, and staff
benefits.

o Risk of conflict in duties to client and agency.

o Staff's authority may be limited by departmental
supervision.

o Staff may be pressured to conduct activities
outside of what they consider to be their scope of
work.

External Programs

Advantages

o Officers and other clients less likely to view
staff with suspicion, offering a greater chance of
building trust.

o Typically less expensive than an internal
arrangement because of:

--reduced overhead and staff benefits

--competitive bidding, which may lower prices for
program services.

o Greater autonomy in program operations.

o Less chance for dual relationship problems and
pressure to be all things to all people.

Disadvantages

o Greater chance of program being isolated and
officers and other clients viewing staff as
inaccessible, not part of the law
enforcement community, and unfamiliar with law
enforcement work and stress.

o Competitive bidding process causes uncertainty
and can be time-consuming and stressful for both
staff and clients.

o Program less likely to become institutionalized
and therefore more vulnerable to budget cuts.

Hybrid Programs

Most program practitioners with hybrid programs
claim to have the advantages of both the internal
and external options, with few of their
shortcomings. It is possible, however, that some of
the disadvantages will remain. Also, unless well
coordinated, hybrid programs may risk confusion
among clients about how the program operates as
well as conflicts between internal and external
program staff.
___________________________________________

Figure 1

In-House Program Option: Five Variations

Michigan State Police Department (Behavioral
Science Section) 

The Michigan State Police Department has had a
Behavioral Sciences Section since 1978, staffed by
two psychologists who are state police employees
and (since 1993) by a trooper who serves as an
alcohol abuse counselor. The section director (one
of the two psychologists) reports directly to the
state police director. While a separate budget pays
for the psychologists and their off-site offices,
the trooper's salary is paid by the Uniform
Services Bureau.

Metro-Dade (Miami) Police Department (Health
Services Section)

The Metro-Dade Police Department in Miami funds a
Health Services Section which has provided
counseling, training, and other stress services
since 1979. The program director, who had been an
officer with the department for several years, is
considered part of the agency's command staff (for
example, he has access to command staff briefings).
Although the director says he is given a great deal
of latitude over operational aspects of the
program, he receives administrative supervision
from the department's personnel
director.

Los Angeles Police Department (Behavioral Science
Services
Section)

The Los Angeles Police Department's Behavioral
Science Services Section is a unit within the newly
established
Organizational Development Group, which includes a
separate sworn-operated employee assistance unit, a
career development and personnel selection unit,
and a consulting services unit. The section is
staffed by seven police psychologists and two
post-doctoral fellows who provide counseling,
management
consultation, crime-specific consultation,
training, and other services. The section's
supervising police psychologist reports directly to
the director of the Organizational Development
Group, who in turn reports to the assistant chief
of the Office of Administrative Services.

San Antonio Police Department (Psychological
Services)

The San Antonio Police Department hired a
psychologist to direct its Psychological Services
Unit. He is supervised by a deputy chief in charge
of the Human Services Department, with whom the
psychologist meets two or three times a week.
Secretarial help is funded from the city budget.

Georgia Public Safety Training Center 

Georgia established a statewide stress management
program for all public safety personnel, consisting
primarily of training based out of the Georgia
Public Safety Training Center in Forsyth. The
position of stress management supervisor was
created by the State legislature in 1984. A peer
program was set up on a regional basis, based in
the State's 10 emergency health regions.[3]
_______________________________________________

Figure 2

________________________________________________
External Program Option: Five Variations

Stanislaus County, California (11 Police Agencies) 

A single psychologist serves police officers in
five of the 11 police agencies within Stanislaus
County, California, east of San
Francisco. The Modesto Police Department is the
largest agency served, with 215 sworn officers;
other agencies have as few as 15 officers. The
psychologist has contracted with the police
departments to provide counseling services to sworn
officers and their families since the early 1980s.

The Counseling Team, San Bernardino, California
The Counseling Team, a private psychology practice,
has been providing counseling to police officers
and firefighters in over 40 public safety agencies
in the San Bernardino, California, area since 1983.
The group employs seven full-time clinicians and
five part-time counselors at the program's office,
and refers some cases to five independent mental
health professionals who live in jurisdictions some
distance from the office. The Counseling Team has a
separate written contract with each agency and
bills on a fee-for-service basis for individual
counseling, critical incident debriefing, and peer
supporter training.

Palo Alto, California Police Department. 

A police psychologist has been the health resources
coordinator for the Palo Alto, California, Police
Department for 13 years. She works as a contract
employee and maintains an office at the police
station for meeting with clients. She provides
training and counseling eight hours a week for the
department's 100 sworn officers and is available
for emergencies 24 hours a day. The department also
hired an organizational consultant to respond to
the department's organizational sources of stress. 

The Postal Inspection Service Self-Referred
Counseling Program
(12-State Western Region)

The Postal Inspection Service recently established
a Self-Referred Counseling Program for postal
inspectors in the 12 States that make up its
Western Region. Contracts were established with
police psychologists chosen from the region. The
psychologists bill the Inspection Service for
treatment provided to inspectors. A police
psychologist, not an employee of the Inspection
Service, serves as coordinator of the program,
putting inspectors who need services in touch with
a contracted service provider.[4] (See the box,
"Selecting a Stress Program Provider.")

Psychological Services, Tulsa, Oklahoma 

Psychological Services was originally set up as a
private non-profit corporation to provide
counseling services for the Tulsa, Oklahoma, police
and fire departments. The organization was not
completely external, however, because its board of
directors included four high-ranking city employees
(the police and fire chiefs, and the city budget
and personnel directors). When the city attorney
expressed concern about this arrangement,
Psychological Services became an independent for-
profit corporation, still with a contract with both
the police and fire departments. A critical
incident response team consisting of peer
supporters trained by Psychological Services talks
with, refers, and helps train other officers to
deal with critical incidents.

_____________________________________________

Figure 3

Hybrid Option: Seven Variations
_____________________________________________

The first two programs described below serve one
department on an in-house basis and other
departments on an external basis. The remaining
programs are hybrid in a different way: they serve
one department or agency through both in-house and
external components.

Erie County, New York, Law Enforcement Employee
Assistance Program

The director of the Erie County Law Enforcement
Employee Assistance Program in New York originally
served as director of the EAP for all county
employees. As her services for law enforcement
employees grew, county administrators asked her to
focus solely on the needs of law enforcement
officers and hired another counselor to take over
the general county EAP responsibilities. The
director is still a county employee, thus serving
the sheriff's department on an in-house basis, but
to fund her new position as director of the
separate law enforcement EAP, the county
commissioner established subcontracts with other
law enforcement agencies that continued to want
program services. Each agency pays $14 a year per
officer and nonsworn employee in the department (if
the department includes nonsworn employees as
eligible clients).

Rhode Island Centurion Program 

The Rhode Island Centurion Program is operated by a
licensed clinical social worker (who is also a
sworn active-duty reserve officer with the Coventry
Police Department), his wife (also a licensed
counselor and a sworn active reserve officer), and
a network of peer supporters from various law
enforcement and correctional agencies. The director
of the program is the sole contracted provider of
stress or EAP services to eight police agencies,
many of them small, and he furnishes bimonthly
stress training or EAP-related services to 10 other
police agencies every other month to support these
departments' own in-house stress prevention
efforts. Contracts are usually with the
department's management, union, or both. The
Centurion Program acts as an "affiliate" for other
departments that request services on certain
occasions such as critical incidents. The director
serves his own department (consisting of 65 sworn
officers) as the in-house stress program director,
providing direct counseling services to about six
officers a year and training and oversight to the
department's peer police officer.

Drug Enforcement Administration. The Drug
Enforcement
Administration (DEA) has a five-year contract with
one organization to coordinate EAP services to DEA
employees nationwide. However, the agency has a
full-time in-house administrator who directs the
program from DEA headquarters and supervises the
contracted services, which are provided by a
combination of contract support unit personnel and
a subcontracted area clinician network
consisting of practitioners across the country. The
DEA also trains and certifies agents as trauma team
members to respond to critical incidents.

Bureau of Alcohol, Tobacco and Firearms. 

The Bureau of Alcohol, Tobacco, and Firearms
employs a contractor to coordinate professional
stress-related counseling services and also
operates three peer support programs (specializing
in critical incidents, substance abuse, and sexual
assault). The peer support programs are
administered out of the ombudsman's office at the
agency's headquarters in Washington, D.C., while
the contracted EAP services are supervised by the
office of personnel.

Pennsylvania Fraternal Order of Police (FOP)
Officer
Assistance Program (OAP)

The Fraternal Order of Police has established
stress services in several of its lodges across the
country. Through the Pennsylvania FOP Officer
Assistance Program, different lodges throughout the
state designate a lodge liaison officer who
educates members about the program and calls in a
critical incident debriefing team when necessary.
The program also offers confidential access to
professional counselors for members and their
families. Active members pay $3 per month to
receive program benefits, and retired members pay
$2 per month.

Adams County, Colorado Sheriff's Department Stress
Program

The Adams County, Colorado, Sheriff's Department's
stress program consists of an in-house peer support
program that was initially coordinated and now is
also supervised by a contracted
psychologist. The psychologist and a peer support
team coordinator developed guidelines for and
selected members of the peer support team. The
contracted psychologist trains the peers as well as
other officers, and he meets individually with each
team member to review his or her support
contacts.[5]

Rochester, New York, Police Department Stress
Management Unit. 

The Rochester, New York, Police Department's Stress
Management Unit is housed in the Professional
Development Section. An in-house mental health
professional provides counseling services,
coordinates a small group of peer supporters, and
conducts stress training for officers and their
family members. The department also contracts with
the University of Rochester Department of
Psychiatry for additional mental health services as
well as assistance with training program design and
clinical reviews.

Selecting a Stress Program Provider

By some estimates, approximately 90 percent of
police departments in the United States employ
fewer than 10 officers.[6] These and even somewhat
larger departments will probably find that choosing
an external provider is the most economical way to
provide professional stress services. Many options
may be available, including private psychologists
or other mental health practitioners (individual or
group practices), EAPs that already serve other
agencies or organizations in the area, or other
similarly qualified practitioners. An administrator
may choose a provider informally, based on personal
knowledge or recommendations, or identify a
provider more formally, for instance, by requesting
competitive proposals from multiple practitioners.

After the Adams County (Colorado) Sheriff's
Department obtained an annual $26,000 grant from
the 17th Judicial District Victim and Witness
Assistance and Law Enforcement Board to set up its
program (see chapter 13, "Managing Program Costs
and Funding"), it asked several well-known local
psychologists to submit proposals for this amount.
A board consisting of the sheriff and various
department employees then interviewed the
applicants.[7]

Regardless of the approach used, administrators can
consider taking the following precautions in making
a selection (see chapter 5, "Establishing a
Referral Network," for similar recommendations
regarding the selection of referral sources).

o Interview each possible provider.

o Visit each provider's office to ensure that it is
accessible, private, and comfortable.

o Look for staff qualifications such as
professional credentials, license to practice,
years of experience, and experience with law
enforcement agencies.

o Ask for a proposed program budget and explanation
of the costs.

o Ask to see the provider's malpractice insurance
papers.

o Ask for and check on references.

o Ask for a detailed account of

--what services the individual or group will
provide;

--how often clients will be able to use these
services;

--whether the provider or a backup will be
available 24 hours a day and at critical incident
scenes;

-- where services will be provided;

--how program use will be encouraged;

--what referral methods will be used;

--how the provider will protect client
confidentiality;

--how the provider will maintain program records
and assess program effects; and

--how the provider will meet special department
needs.

When a choice has been made, it is important to
develop a detailed written contract. The
department's legal counsel may provide useful
advice on this matter.

In seeking service providers in the 12 States of
its Western Region, the Postal Inspection Service
solicited the names of police psychologists through
state psychological associations, law enforcement
agencies, and police psychologist members of the
Police Psychological Services Section of the
International Association of Chiefs of Police. (See
chapter 14, "Tapping Other Resources.") The Postal
Service sent the psychologists a description of its
newly established program and invited them to
submit a provider
application. After receiving applications
(including copies of each psychologist's state
license and verification of malpractice insurance),
administrators contacted their references and sent
a questionnaire to each applicant's state licensing
board requesting information concerning past
professional disciplinary proceedings. Selected
applicants then were interviewed by the coordinator
of the program and an inspector from the same
geographic area. The interviewing inspector could
veto any applicant about whom he or she had
reservations. Each provider chosen was required to
sign a contract with provisions including absolute
assurance of
confidentiality.[8]

"Outsiders haven't a clue about what the department
does, but staff with the [Michigan State Police
Behavioral Science] Section . . . are `one of us.'"

--Michigan State Trooper

____________________________________________

Chapter 4
Choosing Among Staffing Options
____________________________________________

Key Points

o Programs have very different staffing
configurations.

--Stress programs are staffed primarily by nonsworn
mental health professionals, professionals who are
also law enforcement officers, peer supporters, or
some combination of these groups.

--Nonsworn mental health professionals can be very
effective even though they have no direct law
enforcement experience because many officers and
family members do not find such experience
important in a counselor and because these
therapists can learn about law enforcement work in
other ways.

--Sworn mental health professionals bring instant
credibility to the job with clients who are
officers.

--Some programs also make use of interns,
chaplains, and
volunteers.

o The amount of funding available and the extent of
support for stress programming from police
executives are the most important influences in
determining staff size and mix, but program
directors suggest that

--having at least two mental health professionals
makes it possible for them to cover for one
another, and

--having several staff members enables clients to
"shop" for the right counselor for them and makes
it easier for the program to provide 24-hour
service.

o Qualifications for program staff include an
understanding of law enforcement, flexibility, and
a problem-solving counseling
orientation, among other prerequisites.

o New staff typically receive on-the-job training;
staff
supervision is usually done by meeting with the
program director.

o Peer supporters have become an important
component in many stress programs.

--A peer supporter acts primarily as a listening
ear, but he or she can also assess whether officers
need immediate or professional attention and refer
them to other sources of help.

--Peers offer many significant benefits, including
acting as marketing agents for the program,
providing immediate assistance to troubled
officers, and bringing instant credibility to
critical incident debriefings.

--Peers also have important limitations, including
potential difficulties maintaining confidentiality
because their
nonprofessional status means that what other
officers tell them is not privileged communication.

o Peer supporters require thoughtful recruiting
(using, if
possible, nominations from other officers), careful
screening, and three to five days of training.

o Top management support is essential for a peer
component to be successful.

Stress programs are staffed primarily by one or
more of three types of individuals: nonsworn mental
health professionals, professionals who are also
sworn law enforcement officers, and peer supporters
(individuals with no clinical degrees who volunteer
to assist fellow officers). Some programs also make
use of interns,
chaplains, and civilian volunteers, including
family members. As shown in figure 4, most programs
contacted for this report make use of a mixture of
staff types. The major message program staff and
researchers give about program staffing is the
importance, when feasible, of making a range of
staff of various backgrounds and qualifications
available to officers and their families. Having
nonsworn and sworn mental health professionals on
staff, trained peer supporters in the field, and
ties with chaplains and other service providers
allows officers, civilian employees, and their
family members to choose among them according to
their own preferences and needs. Providing these
options should increase a program's attractiveness
and effectiveness.

The first half of this chapter discusses types of
professional staff and their selection,
recruitment, training, and supervision. Because the
use of peer supporters is increasingly common
within law enforcement stress programs, the second
half of the chapter reviews the advantages and
drawbacks of using peers, the roles they may play,
and their recruitment, screening, training, and
supervision.

Mental Health Professionals

Stress programs can be staffed by professionals
with varying levels of expertise, ranging from
police psychologists to clinical social workers to
marriage or family counselors.

Types of Professionals

As discussed below, there are distinct advantages
and drawbacks to having nonsworn, sworn, or other
types of mental health
professionals on staff.

Nonsworn Mental Health Professionals. Most of the
mental health professionals who staff the programs
contacted for this report or who serve departments
as independent practitioners do not have a law
enforcement background. According to Nancy Bohl,
Director of San Bernardino's Counseling Team, it is
not necessary to become a reserve officer or to
have been a police officer in order to develop
rapport with law enforcement personnel. "Indeed,"
Bohl adds, "many police officers would be
uncomfortable with a therapist who was also a
police officer."[1] According to Theodore Blau,
another police psychologist (but one who did become
a sworn officer), "Some police clients do not want
to be interviewed or questioned by a cop."[2] Blau
also suggests that it is probably easier for the
police psychologist who has not been an officer to
be objective in dealing with clients.

"I want to be able to talk with someone who is
knowledgeable about police work but who isn't one
of them." 

--Police officer

Several police officers interviewed for this report
confirmed these observations. One officer said, "I
want to be able to talk with someone knowledgeable
about police work but who isn't one of them."
Another reported, "I didn't care whether the
counselor understood police work because my problem
wasn't work-related." A 17-year veteran of another
department commented that "other cops don't say,
`What do they [counselors] know about police work.'
Their only concern is with confidentiality."

According to many respondents, there are other
benefits to using nonsworn mental health
professionals:

o Counselors report that even though many of the
problems that bring police officers to seek
professional help are relationship difficulties
that may be caused or influenced by conditions of
work (e.g., shift schedules) or that may impair on-
the-job performance, these problems do not require
an in-depth knowledge of law
enforcement to address. Rather, officers want a
counselor who has the therapeutic skills necessary
to help them resolve these difficulties.

o Some officers, aware of the pervasive grapevine
in every law enforcement agency, express concern
that a counselor who is also an officer may gossip
about them to other personnel.

o Many officers are unlikely to discuss with other
officers problems that are generally unacceptable
in the police culture, such as sexual dysfunction,
fear of getting hurt, or inability to use force
when necessary in the line of duty.

Nevertheless, mental health professionals with no
law enforcement background must make special
efforts--discussed below and in chapter 7,
"Marketing the Program"--to learn about police work
and police culture in order to gain credibility
with officers. At the same time, they must be
careful not to try to act and talk like police
officers as a means of gaining acceptance, or they
may be disparaged as a "copwannabe."  As Richard
Smith, a police
psychologist with the Michigan State Police's
Behavioral Science Section warns, "The closer you
get to the cop role without being a cop, the more
danger you're in of looking like a clown." By
trying to identify too strongly with police
officers, psychologists may also lose their own
professional identity. According to two experts in
police psychology, "Law enforcement agencies do not
hire mental health professional to act like
imitation police officers but to provide
professional mental health services."[3] Warning
signs of overstepping this boundary include asking
for a gun and badge, using police jargon, and
swearing. When one psychologist took to carrying a
knife in his shoe, officers began teasing his
colleague with questions like, "Where's your
knife?"

Sworn Mental Health Professionals. Some stress
program directors and clinical staff consider a law
enforcement background extremely beneficial on the
job. The director of Metro-Dade's Health Services
Section is a law enforcement officer who became
credentialed by earning a master of science degree
in human resources counseling. Conversely, the
director of the Rhode Island Centurion Program is a
licensed clinical social worker who became a sworn
officer and is now, as an active reserve officer, a
member of his local police department's SWAT team.
One of the police psychologists in the Michigan
State Police Department's Behavioral Science
Section attended a police academy for municipal
officers and now serves as a part-time officer in a
small-town law enforcement agency.

These and other clinician-officers believe that
their law
enforcement background enhances their ability to
treat police officers because, with a firsthand
knowledge of police work and resulting ability to
empathize immediately with clients, they have an
easier time gaining a client's trust. Officers
often claim that "it takes a cop to understand a
cop." For this reason, William Garrison, Director
of the Metro-Dade program, feels that a sworn
mental health professional is the ideal choice for
a program: "Sworn licensed professionals have all
the advantages of peer support because they
understand what police work is like, plus they are
qualified to provide competent care and have legal
protection in terms of confidentiality." At the
same time, many police officers--some of whom have
become especially jaundiced after observing
psychologists and psychiatrists providing
contradictory expert testimony in court--tend to
mistrust all members of the mental health
profession regardless of their law enforcement
background.[4]

"Sworn licensed professionals have all the
advantages of peer support because they understand
what police work is like, plus they are qualified
to provide competent care and have legal protection
in terms of confidentiality." 

--William Garrison, Director, 
Metro-Dade Health Services Section

Other Types of Professional Staff. Interns. Some
programs make use of volunteer interns, generally
either last-year graduate students in clinical
psychology or postdoctoral students, who work part-
time for the program over a one-year period,
carrying their own caseload. A stress program
director who has used interns recommends that a
police psychology internship provide a formal
schedule of training, supervision, and evaluation,
and furnish the intern an opportunity for some
degree of police training, ranging from ride-alongs
to attendance at a police academy.[5] Before using
interns, program directors need to consider the
significant amount of time that will be required to
train, supervise, and evaluate them.

Chaplains. Most law enforcement agencies have the
services of one or more volunteer or paid chaplains
for such duties as delivering death notifications,
assisting with funerals, helping police officers'
families deal with personal tragedies, and, in some
cases, teaching in-service classes on stress
management. Chaplains may be especially effective
in helping family members cope with stress.[6] A
chaplain participates in the family orientation at
the Michigan State Police academy and offers to
talk to recruits and their family members about
problems. A corps of 8 to 10 chaplains with the
Michigan State Police are given informal captain
designation and uniforms. A chaplain also
participates when a Behavioral Science Section
psychologist debriefs officers after the death of
an officer to address issues of grief and mourning.
However, no officer or psychologist interviewed for
this report was aware of any occasions on which an
officer had sought counseling for stress-related
issues from a chaplain. Most reported that
chaplains were used infrequently, if at all, for
stress services.

Respondents reported that some officers who are not
religious feel uncomfortable talking with clergy,
while religious officers are sometimes reluctant to
contact a chaplain who appears to have a
denominational bias different from their own. In
addition, one program director thought that
officers see chaplains as focusing only on
spiritual, not psychological, matters. However,
with appropriate training and advertising, in
certain cases chaplains might be brought
successfully into a stress program's
operations.[7]

"The chaplain addresses the needs of the spirit
when, at a time of crisis, the officer is brought
into confrontation with his own mortality. . . . As
one officer wrote recently, `. . . a stress
avalanche occurs because of the guilt the shooter
carries around with him. Believe me when I say
there is guilt . . . guilt rides heavily with the
officer involved with a shooting. "Thou shalt not
kill" is a maxim taught from the crib. Regardless
of the legal definition of justifiable homicide,
there is always, "well, maybe I did screw up," in
the background.'" 

--G.L. Benjestorf[8]

Volunteers. Although it is done infrequently,
stress programs sometimes engage the services of
graduate students who are not clinical mental
health majors. These other student volunteers are
typically brought in to research program
effectiveness. Professors are sometimes interested
in providing their students with real-life
opportunities to conduct research, often as part of
a thesis. Given the sensitive nature of police
stress services, the need for strict
confidentiality, the training and supervision
required, and considerations of legal liability, it
may not be feasible to use nonclinical volunteers
for these purposes.

Selecting and Recruiting Professional Staff

Program planners need to determine what kinds of
staff to hire or contract with, develop criteria
for selecting them, and then recruit them.

Determining Staff Size and Mix. There is no formula
for determining how many staff, or what kind of
staff, a stress program needs in order to meet the
anticipated demand for services. In part, the
number and qualifications of service providers have
to reflect local considerations that are often
unique to each jurisdiction, including

o the amount of available funding;

o the types of services program staff plan to
provide in addition to counseling, such as
training, research, or management consulting (see
the box "Core Functions of Police Psychologists"); 

o the degree of support for stress programming from
top police management;

o the number of sworn officers, civilians, and
family members associated with the law enforcement
agency;

o the expected increase in caseload as the program
gains credibility and becomes known;

o the nature of the department's workforce,
including factors such as average educational level
and number of years on the job, which may influence
officers' willingness to seek services or their
preference for getting help from peers rather than
professional mental health counselors; 

o other features of the workforce that may
influence caseload levels, such as the distance
officers and family members will have to travel to
obtain services and the services that officers'
insurance will cover;

o available alternative sources of services from
employee
assistance programs and other mental health service
providers in the community, and the extent to which
the department plans to rely on referring officers
and family members to these resources rather than
treat them in-house; and

o the amount of time that will be required for
initial and ongoing outreach and marketing.

Comprehensive guidelines for staff size and mix are
also difficult to develop because of the
unpredictable nature of some program services. In a
typical private clinical practice, counseling
sessions last a predictable 50 minutes, occur at
fixed intervals (usually weekly), and continue for
an average of two to six months (for short-term
therapy). However, counseling sessions for law
enforcement officers are often much longer or
shorter than an hour, may require going on-scene
after critical incidents, and may be needed for
only a week or over a year.

Clinicians do offer several reasons for having more
than one, and preferably several, providers on
staff, even if this means forming a consortium of
mental health practitioners who maintain a private
practice and devote only part of their time to
serving a given program's law enforcement clients:

o Having at least two mental health professionals
in the program enables them to cover for each other
during vacations and sick leave. When the chief
psychologist to the San Antonio Police Department
lost his only colleague in the program, he had to
fall back on a pool of local mental health workers
to cover for him, none of whom had the expertise or
ongoing knowledge of cases that his colleague had
possessed. 

o Having several mental health professionals on
staff affords clients the advantage of shopping for
the right therapist for them. Patients do not
always "click" with the first counselor they are
assigned or select. 

o It is difficult for a single practitioner to
serve police clients on a 24-hour basis without
either quickly becoming overworked or making
unpleasant and unpopular decisions about when to
refuse to be on call. 

o With several practitioners in the program, it
becomes possible to hire individuals who are
certified in special areas of expertise, including
alcoholism counseling, marital counseling, sex
therapy, and child counseling. By providing these
services in-house, the program eliminates the need
to refer clients to outside, and less well known,
practitioners.

Program planners rarely have the luxury of
estimating optimal staff size and mix and hiring
accordingly. In most jurisdictions, the
availability of funds and the attitude of top
management toward the value of stress services are
the principal influences that
determine how many and what kinds of staff are
hired. As a result, most programs fall far short of
optimal staffing levels by any criterion. Despite
these staffing obstacles, program administrators
can periodically request funds for additional
counselors, including money to set up or expand a
peer support component. These efforts can sometimes
be successful, especially if program staff can show
that they are providing concrete benefits for the
department or if a change in administration occurs
that brings in managers with more favorable
attitudes toward stress services. (See the box
"Getting Additional Staff Requires Special
Effort.")

Selection Criteria and Recruitment. Program
directors do not seem to distinguish among
different types of certification or academic
degrees in selecting program staff, nor do they see
any difference in ability based on formal
education. As a result, counselors who treat police
officers (and their families) may have certificates
or degrees in alcohol and drug abuse counseling,
clinical social work, or clinical psychology. What
is important is that staff be
licensed, insurable, and good at what they do. In
particular, program directors tend to look for the
following characteristics when hiring staff:

o a desire to work with law enforcement officers
that reflects neither uncritical admiration nor the
wish to "reform" the world of law enforcement;

o some type of experience with law enforcement,
such as having a member of the family who is or was
an officer or having
participated in ride-alongs or worked with jail or
prison inmates;

o an understanding of law enforcement and the
problems and stresses experienced by police
officers;

o enough assertiveness to counter the habit some
law enforcement officers have of acting
intimidating, but also a manner that is warm,
caring, and empathic;

o the flexibility to work in different locations
(e.g., on the streets, at the academy, in an
officer's home), to meet clients off-hours, to go
on duty suddenly at 2:00 a.m., to put in
occasional stints of up to 24 hours straight during
crises, to put in uncompensated overtime, and to
alternate periods of calm paperwork with high-
pressure work in the field;

o the excellent social skills necessary to operate
with a variety of different personalities, ages,
and both sexes in a mixture of interpersonal
situations and in group settings; and

o some political sophistication regarding law
enforcement chains of command and department
protocol.

While there is debate over whether male or female
therapists are more effective with officers and
their families, respondents agree on two points.
First, female counselors can be just as effective
and can have just as much credibility as male
counselors, even with male law enforcement officers
who are seen as hard-nosed (indeed, some male
officers may feel less inhibited revealing their
weaknesses to a woman than to another man). Second,
when possible, programs can hire both male and
female counselors so that clients, including the
increasing number of female officers, may have a
choice in this matter.

Program directors need expert skills not only in
management but also in clinical work because most
will have caseloads in addition to their
administrative responsibilities and because,
whether they see clients or not, they will be
supervising the clinical work of other staff. A
program director also needs to have a keen
political sense, good public relations skills, and
the ability to work simultaneously with several
segments of the police department as well as with
other agencies and professionals in local
government, the community, and the press. One
director reports, "I have to perform a delicate
balancing act in the department, keeping contact
and good relations with both management and line
officers to make sure I never appear to be in one
camp or the other." Other
directors see this balance somewhat differently,
citing the need to always be seen and to be on the
side of their clients--that is, to run an employee
program--but at the same time maintain the good
will and support of management. If their director
cannot keep management's support, command staff
will hamper the program's success or, ultimately,
cut off funding, but, if the program director
cannot run the operation as an employee program,
officers will not trust or use the counselors. 

While many programs are headed by administrators
with doctorates in clinical psychology, a Ph.D. is
not necessary. For example, the directors of the
Rhode Island Centurion and Metro-Dade programs
(both sworn officers) are licensed counselors.

In order to promote organization-wide acceptance of
the program, the Palo Alto, California Police
Department enlisted the
participation of about 50 sworn and civilian
employees from all ranks to design and participate
in a structured, two-day assessment event during
which candidates for the director's position were
evaluated. While this type of participation is not
always feasible, when possible it can help ensure
the selection of a program director whom department
members are likely to trust and like.[10]

Programs that are housed in law enforcement
agencies may be required to follow local government
procedures for recruiting staff. For example,
Metro-Dade's Health Services Section must advertise
for staff first through the police department, then
in the county, and then to the general public.
Program directors in other jurisdictions place
advertisements in the American Psychology
Association's Monitor and other professional
organizations' publications. However, most program
directors report they rely almost entirely on word
of mouth to hire staff. In San Bernardino, Nancy
Bohl has never had to advertise for Counseling Team
staff; instead, she keeps a list of qualified
clinicians who have asked to be considered as
candidates whenever she has an opening. Bohl has
several staff individually interview each new
candidate; then they meet as a group to discuss the
person's suitability.

Staff Training, Case Management, and Supervision of
Professional Staff

Program directors typically spend considerable time
training new staff, making arrangements for in-
service training, assigning cases, and supervising
the quality of the counselors' work. 

Training. Program directors usually train new staff
by requiring them to do ride-alongs and having them
accompany experienced staff during critical
incident debriefings and training events, first as
observers and later as co-leaders. An experienced
staff clinician, often the director, acts as a
"buddy," conferring frequently with new staff after
their first several counseling sessions to identify
and correct any problems and answer questions. It
is particularly important that staff with little or
no experience with law
enforcement learn about law enforcement agency
organization and culture. Nancy Bohl requires all
new staff to attend the Counseling Team's three-day
training session for police peer supporters and all
of the team's academy training sessions for new
recruits. For further training, she sends them to
one of the traveling courses offered by the
International Critical Incident Stress Foundation
(see chapter 14, "Tapping Other Resources"). A
major training focus in every program is the
explanation of confidentiality procedures and the
need to follow them scrupulously (see chapter 6,
"Dealing With Confidentiality").

Depending on their previous experience, new staff
members learn much of what they need to know and do
through on-the-job training. According to William
Garrison, head of Metro-Dade's Health Services
Section, "It takes about three years to fully
develop someone for the unit from the time the
person comes on board. If the new staff person is a
clinician, he or she has to learn about the police
culture; if the person is an officer, he or she has
to learn the clinical skills. There is no way to
speed up this process."

In-service staff training includes attending local
seminars on stress management and taking continuing
education courses. Nancy Bohl makes a practice of
sharing with her staff whatever she learns at the
various training events and conferences she
attends.

Project directors also continue their own training
through
continuing education courses, seminars,
professional conferences, training events, and the
professional literature. Several directors report
that the periodic FBI police psychology conferences
are particularly informative (see chapter 14). Some
learn new skills by going to hostage negotiation
schools and taking courses in clinical specialties
such as hypnosis. They also refine old skills by
enrolling in programs like Roger Solomon's one-week
course in trauma debriefing training (see chapter
14). Funds permitting, directors send their staff
to these courses as well. Finally, some directors,
after many years on the job, still do at least one
ride-along a month to keep abreast of law
enforcement activities and advertise their
program's services.

Case Management. When a program has more than one
clinician, decisions have to be made about who
handles which cases. John Carr of the Rhode Island
Centurion Program holds weekly staff meetings at
which he assigns cases. Large programs often use a
centralized case assignment system. For each new
client, the administrative assistant to the
Counseling Team in San Bernardino consults a
computer program that indicates which counselor is
available to handle the next incoming call. If the
caller asks for a specific counselor, the computer
indicates when that therapist has his or her nextfree hour. Centralized case assignments usually
make it possible to control case intake and ensure
an equitable and appropriate distribution of cases.

More typically, programs adopt an informal case
assignment approach whereby staff members assume
individual responsibility for taking on new cases.
Counselors who are approached individually by
officers and family members seeking services
generally maintain primary responsibility for those
clients. 

In some programs, staff who specialize in certain
types of problems are automatically assigned
officers and family members experiencing those
difficulties. For example, the recovering alcoholic
who serves as a staff member of Michigan's
Behavioral Science Section counsels officers with
drinking problems, while two of the members of San
Bernardino's Counseling Team treat all officers
experiencing traumatic events involving children.
In the Albuquerque Police Department's Personal
Services Unit, one of the two staff members prefers
to handle cases requiring crisis intervention and
short-term counseling, while the other is more
comfortable with cases that involve long-term
counseling.[12]

Staff Supervision. Program directors supervise
staff primarily through regular or ad hoc meetings
to discuss how cases are progressing and how to
deal with problematic clients. The director of San
Bernardino's Counseling Team reviews evaluation
forms filled out by clients in order to identify
any difficulties counselors may be experiencing in
their work. Generally, however, program
directors supervise staff informally as counselors
bring problems to their attention. In programs with
only one staff member, that person typically
consults with two or three close colleagues in the
field whenever a clinical problem arises.

Peer Supporters

An innovative idea in the 1980s, the training of
police officers to provide support to other
officers experiencing stress has become a common
feature of many law enforcement stress programs.
The concept is based on the common observation that
there have always been a few individuals in every
department or post to whom other officers have
turned for help in times of crisis. Stress program
peer support components attempt to capitalize on
this widespread natural phenomenon in two ways:

o by providing training that will increase the
effectiveness of these natural peer helpers, and 

o by deliberately marketing their services so that
as many other officers as possible become aware of
the peers' availability.

In addition, an organized peer support program can
weed out individuals who may do more harm than good
by trying to impose their own morals and behaviors
on other officers seeking help. As one observer
commented, "I have seen on several occasions an
officer who has dealt with his own personal
problems in a certain way . . . and wants to help
others with similar problems. His heart may be in
the right place, and even sometimes his skills are
good, but the personality may not be optimal for
the type of work involved. A distinction needs to
be made between dedication and capability."[12]

Peer supporters serve two major functions in
relation to law enforcement stress programs:

o They provide a source of help for officers who
are unwilling to bring their problems to mental
health professionals because they mistrust
"shrinks," would feel stigmatized for not being
able to handle their problems on their own, or are
afraid that entering therapy might hurt their
careers. While peer supporters, as noted, cannot
provide the level of service professionals can,
they can still be of considerable help.

o Peers can refer receptive officers in need of
professional help to the program's counselors. When
a referral comes from a trusted peer, many officers
are more likely to take advantage of counseling
services than if they have to make an appointment
on their own or follow the suggestion of a family
member or program clinician. As one officer
experiencing problems reported, "When my partner
told me he'd gone to the program and it had helped,
I figured it couldn't be all that bad." In this
regard, peer supporters act as a bridge to the
program--the Rhode Island Centurion Program refers
to them as "liaison officers." (See chapter 7,
"Marketing the Program.")

"Some officers have reported feeling that they are
`going crazy' because of the emotional intensity of
their reactions [to a traumatic event]. He/she
needs to know that what is being
experienced are normal reactions to an abnormal
situation. . . . Who is in the best position to
provide this validation of emotional responses? Who
else but the fellow officer who has `been there'
[and can] . . . say, `After my shooting, I had
nightmares and flashbacks, and I'm not crazy!' "

--Beverly J. Anderson, Clinical Director, and
Officer Jeffrey A. King, Peer Supporter
Coordinator, Metropolitan Police Employee
Assistance Program, Washington, D.C.[14]

Advantages of Peer Support

Like professional counselors who are also sworn
officers, peer supporters offer instant credibility
and the ability to empathize. If there is a large
enough cadre of trained peers, program staff can
heighten the empathy inherent in the peer
relationship by matching them with fellow officers
on the basis of the nature of the particular
incident. A peer support team in the San Antonio
Police Department consisting exclusively of
officers who have been involved in shootings is
available to support other officers as they cope
with that experience. The Bureau of Alcohol,
Tobacco, and Firearms (ATF) operates three peer
programs, each with a separate focus, linking
officers with peers who are themselves incident
survivors, victims of sexual assault, or recovering
alcoholics. The Counseling Team of San Bernardino
tries to match an officer who has experienced the
death of child or who has killed someone with a
peer supporter who has survived the trauma of a
similar event. According to Nancy Bohl, "No one can
empathize with officers undergoing these two crises
unless they have experienced them themselves."
According to John Carr, head of the Rhode Island
Centurion Program, a peer component makes it
possible to have available "a multitude of
personalities for various situations: you can use
quickly a variety of resources on site." Carr's
observation points to another advantage of having
peer supporters available--they are frequently more
accessible than professionals because they are
often already on the scene or at the station.

Another advantage of peer support is that peers are
in a better position, through their daily contact
with fellow officers, to detect incipient problems
before they become full-blown. This "early
intervention can prevent a situational problem from
crystallizing into a chronic maladaptation. As
such, peer . . . programs are assumed to be
proactive and preventative in
nature."[15]

Limitations to Peer Support

Respondents and experts suggest several potential
weaknesses or limitations of peer components.
Several of these drawbacks, however, can be
overcome:

o The use of peer supporters is not a substitute
for the services of mental health professionals.
Because it can be inexpensive to establish a peer
component, some law enforcement agencies may try to
train peers to avoid having to make budget
allocations for professional stress services, but
as the peer guidelines developed by the
International Association of Chiefs of Police
(IACP) make clear, "A peer support program can
augment . . . employee
assistance programs and in-house treatment programs
but not replace them."

o Establishing a peer support component--and
keeping it going--takes time, effort, and patience.
After Michael McMains, Director of the San Antonio
police stress program, lost his second
psychologist in a budget cutback, he no longer had
the time to conduct the recruitment, training, and
supervision necessary to keep the peer support
component going.

o Some trained peers may decide that they are
equipped to do full-scale counseling and, in the
process, harm their fellow officers. However, if
program staff are careful about screening peer
candidates and train them properly (see below), few
peer supporters are likely to overstep their
bounds.

o In some jurisdictions, issues of legal liability
may make it unwise to establish a peer support
component. For this reason, the Metro-Dade program
in Florida has not done so, while New York City
required its peer supporters to become certified
alcoholism counselors. Program directors need to
examine the issue of
liability carefully to determine whether they will
be immune from lawsuits if a peer supporter trained
by their stress program is accused of causing harm
to another officer.

o Officers and nonsworn staff are sometimes
unwilling to talk with peers because they want to
be counseled by a professional or because they are
concerned about lack of confidentiality.

"We made a conscious decision to call them peer
supporters to avoid the impression that they're
offering counseling. We don't want to give troopers
the idea that they can diagnose and treat problems.
They can't."

--Trooper Jeffrey Atkins, Michigan State Police
Behavioral Science Section

Confidentiality, indeed, is perhaps the knottiest
issue related to using peer supporters. Failure by
peers to maintain--and by management to respect--
the confidentiality of what other officers say to a
peer supporter will sabotage the peer component. As
a result, the Bureau of Alcohol, Tobacco, and
Firearms memorandum describing its peer support
program to all special agents in charge emphasizes
that peers "are mandated to maintain total and
complete confidentiality . . . no written reports
are made or maintained." Appendix A, "Peer Support
Counseling Guidelines," includes the
confidentiality guidelines San Bernardino's
Counseling Team expects police departments for
which it establishes a peer support
component to follow. "There is, of course, a
grapevine," according to one peer supporter, "but
if a cop confides in a peer and the information
gets spread around, no one will ever go to that
peer again. Peers want the program to work, so they
do maintain
confidentiality. But the officer being helped may
tell another [third] cop about his problem who does
spread the word, and the peer might then have to
deal with getting blamed for the gossip."

More importantly, communication between peer
supporters and officers is usually not privileged
conversation under the law, regardless of
department rules, because peers are not licensed
mental health professionals. As a result, courts
and police supervisors have the legal right to ask
what was said during these interactions. This lack
of confidentiality under the law can be an
important barrier to peer support during critical
incident
debriefings. (See the box "Potential Legal
Complications from Peer Support.")

Finally, communication between peers and other
officers is never confidential if the officers
being offered support appear to be a danger to
themselves or to others, to have engaged in child
or spouse abuse, or to have committed other crimes.
Chapter 6, "Dealing With Confidentiality,"
discusses these exceptions to privileged
conversation further.

Peer Supporter Responsibilities

Nancy Bohl, whose Counseling Team has trained over
400 peer supporters in 15 law enforcement agencies,
describes their functions as those of listening,
assessing, and referring:

o By listening, peer supporters provide an
opportunity for officers under stress to express
their frustrations, fears, and other emotions to
another person who understands from personal
experience how they are feeling and why they are
upset. As one peer said, "Most of the calls I get
are about work-related anxiety due to department
problems, not street problems. I become a sounding
board, giving them an opportunity to vent."

o By listening, peers can also assess whether the
officer's problem is of a nature or severity that
requires professional--and
immediate--help. Peer supporters can be trained to
note the signs that indicate that an officer may be
suicidal, homicidal, severely depressed, or have
other serious problems.

o If the officer has a serious problem, the peer
can refer 
the person for professional help. "Cops call me,"
one peer
reported, "because they know about the critical
incident I went through, so I often tell them about
the Docs [department police psychologists] and
recommend they make an appointment." Stress
programs provide peers with information about
available referral resources in addition to the
department's own stress services. San Bernardino's
Counseling Team gives peers three pages of
instructions for when and how to make referrals and
a list of over 125 agencies, with telephone
numbers. When a peer supporter in San Bernardino
was asked by another officer whether he could
contract AIDS after cutting himself while subduing
an HIV-positive suspect, the peer arranged for an
expert in HIV exposure from a local hospital to
talk to the officer.

There is considerable agreement that peer
supporters are especially appropriate for assisting
officers with drinking problems and officers
involved in shooting incidents. Many peer
supporters are recovering alcoholics who, if they
can overcome the denial of fellow officers with
drinking problems, can link them with
detoxification programs, inpatient treatment, and
Alcoholics Anonymous groups. These peers may also
attend support group meetings with officers
beginning the process of recovery and, as sponsors,
follow up on their attendance and help them to
avoid or deal with lapses.

Officers who have themselves been involved in
critical incidents can provide effective support to
fellow officers who are involved in a shooting.
Officers who have used their weapons often feel
that no one can understand their turmoil except
another officer who has had a similar experience.
Furthermore, these officers are often equally or
even more disturbed by what they perceive to be
their department's lack of support in these crisis
situations because they are typically relieved of
their weapons, interrogated, and subjected to
internal department investigation as well as
sometimes to a civil suit by the person they shot.
Reflecting the valuable role fellow officers can
play, the Bureau of Alcohol, Firearms, and Tobacco
mandates that all special agents in charge use the
agency's peer supporters after every shooting
resulting in death or injury. While peer supporters
should not provide counseling, they can and do help
other officers realize that the fear, anger, and
other emotions they may be experiencing after a
critical incident are normal under the
circumstances.

Nancy Bohl points out that peers can also perform
two other critical services: be present with
officers and their family members who are under
severe stress and run errands for them:

o When Bohl arrived with another psychologist at
the station house after a sergeant had just killed
himself, 25 peers were already there. Bohl, along
with a captain who was also a peer supporter, gave
them assignments ranging from going to the
officer's home to spend time with his wife, to
picking up the officer's best friends and driving
them to the station, to telephoning other
department employees with the news. Peers in San
Bernardino painted one widow's house and cut
another widow's grass. When a wounded officer was
hospitalized, Bohl arranged for peers to babysit
and feed the officer's cat. Peers brought food for
three months to the recent widow of an officer
because the woman could not cook.

o A peer supporter in the Washington, D.C., Police
Department who had himself been involved in a
shooting on a previous occasion sat with the wife
of another officer for five hours while her husband
was in surgery after he had been shot. "Just being
there a lot of times is enough," he reported.[18]
When an officer is hospitalized after a shooting,
the Counseling Team arranges for peers to make
daily visits. Supervisors in several departments
call on peer supporters to stay with the family
around the clock for a week after an officer is
killed.

Peer support can occur in a variety of settings: 

o A peer supporter in San Bernardino may get a
radio call asking, "Are you clear for an 87?"--a
request to talk that does not reveal the purpose of
the meeting. In the New Haven, Connecticut, Police
Department, officers can beep the peer of their
choice 24 hours a day for help.

o Some peers always wait for other officers to come
to them, but many will approach a fellow officer
when they observe the person is having difficulty.
Usually, however, they do not make a point of
announcing, "I'm a peer supporter, and I'm here to
help you," but simply go over and say something
like, "It seems like you've been late coming on
duty the last few days. What's up?"

o When an officer seeking help calls Cindy Goss in
Erie County, Goss has the option of contacting an
appropriate peer supporter to meet with the
officer. Nancy Bohl in San Bernardino always
carries on her person a list of the names and
experience (e.g., death of a child) of all current
peer supporters so that in an emergency she can
quickly match peers with officers based on the
nature of the problem at hand.

o The chief of the 61-member Norwood,
Massachusetts, Police Department has his peer
supporters carry pagers so that he or his top
administrator can call them at any time to help
with an officer experiencing stress; however, they
are never asked to report back on any aspect of the
encounter.

o Officers who take time off to recover from a
serious injury or illness often feel isolated and
frightened. The Palo Alto,
California, Police Department has sent two peers
and one other officer to be trained in workers'
compensation law so they can visit disabled
officers in their homes to provide support,
information about their rights to workers'
compensation, and assistance in navigating the
complex reimbursement system. Peers in the San
Antonio Police Department prepare officers involved
in a shooting or other critical incident for the
impending change in duties and the legal procedures
that often follow, emphasizing that, while it may
last several months until any litigation has been
resolved, the change is only temporary.

o A great deal of peer support takes place
spontaneously around the water cooler, over coffee,
or wherever an officer and a peer happen to run
into each other. 

Screening and Recruiting Peer Supporters

Screening out inappropriate officers from becoming
peer supporters is essential to an effective peer
program.

Screening. Some stress programs accept applicants
for peer
supporter positions solely on the basis of desire
to help troubled colleagues, but respondents
interviewed for this report suggest that this is a
mistake. Instead, the stress program director needs
to develop selection criteria and institute
recruitment procedures that ensure that only
qualified officers are chosen and accepted. Program
staff suggest that officers be selected based on
some combination of the following criteria:

o reputation as someone whom others already seek
out for informal peer support and who keeps
information confidential,

o nomination by other officers,

o approval or recommendation from the chief or
other command staff,

o quality of social skills and ability to
empathize,

o previous education and training,

o several years of experience on the streets,

o information provided in a letter of interest (see
below), 

o previous use of the program, and

o ability to complete the training program
successfully.

Program staff suggest that, while it is important
that officers be chosen who have experienced
critical incidents and recovered successfully from
them, it is also important to have a variety of
experience represented among peer supporters so
that the group does not become a "shooter's club."
Officers who have experienced the death of a police
partner, been alcoholics, or lived through family
traumas such as the death of a child or spouse can
be of great support to others.

Program staff also recommend that individuals of
all ranks be encouraged to become peer supporters
because officers are usually extremely reluctant to
turn to anyone for peer support who is of a higher
or lower rank. A peer leader who had just become a
sergeant when interviewed for this report talked
about how he was making every effort to continue to
provide peer support to the officers to whom he is
now senior, but he reported that he was not
optimistic that many of them would ever talk with
him again about their personal problems. Indeed,
the IACP's guidelines recommend that peers "should
not develop peer support relationships with
supervisors, subordinates, or relatives." Program
staff often try to train several sergeants and
lieutenants as peer supporters so that senior
officers have someone of their rank they can go to
for assistance--and to increase support for the
peer program among command staff.

It is also important to recruit civilians and
family members as peers, because noncommissioned
personnel feel uncomfortable sharing problems with
officers, while family members may receive
empathetic treatment only from other family
members. (See chapter 11,
"Services for Family Members.")

In the past, some programs have required that
officers have certificates or degrees in counseling
in order to become peer supporters. At one time,
the Dallas Police Department required peer
supporters to be state-licensed counselors, while,
as noted above, the New York City Police Department
required its peers, most of whom worked with other
officers with drinking problems, to have completed
all the requirements leading to State certification
as alcoholism counselors. However, none of the
programs contacted for this report have such
stringent requirements, and none of the staff
interviewed felt such certification was a necessary
prerequisite to becoming an effective peer
supporter (although, as noted before, professional
certification has the advantage in many States of
making conversations between peers and other
officers privileged communication).

Finally, program staff recommend strongly that
officers choose to be peers on a voluntary basis
and that no external rewards be attached, such as
enhanced chances for promotion. Only truly
voluntary participation can ensure that peers are
giving their colleagues support that will be
perceived as genuine and therefore be beneficial.

Recruitment Procedures. Program directors use
different approaches to recruiting peer supporters:

o Some programs announce the position in police
department and association newsletters, in
departmentwide memos, at roll call, and at union or
association meetings. 

o The Erie County program received several
referrals from police associations after the vice
president of the Western New York Police
Association, a network of law enforcement unions in
the region, agreed to send a letter to its member
unions promoting the concept of peer support and
inviting members to apply (see appendix B).

o The Bureau of Alcohol, Tobacco, and Firearms
reviews files to identify agents who are survivors
of critical incidents. Reviews of past alcohol-
related adverse actions are also examined to
identify possible candidates for the bureau's
alcohol peer program.

o Program staff counselors sometimes identify
candidates from among their clients.

Some program directors ask candidates to submit a
letter of interest or to fill out a form explaining
why they want to become peer supporters and what
they hope to accomplish (see the sample form in
appendix C). In other programs, staff interview
each candidate to obtain the same type of
information as well as to get a sense of how
dedicated, skilled, and empathetic the officer will
be. San Bernardino's Counseling Team requires both
procedures.

Peer supporters who have been recommended by fellow
officers--in programs where this is part of the
selection process--are more likely to be accepted
in their new roles than if sworn personnel had no
say in their selection.[22] In very small law
enforcement agencies, recommendations can be made
verbally; in larger departments, officers can be
asked to nominate others more formally (see sample
solicitation memorandum in appendix D). Staff in
the Rochester, New York, program, however, warn
that rejected applicants may become resentful and
then damage the peer support component by
criticizing it to other officers (see the box
"Obtaining Nominations for Peer Supporters").

It is always helpful to obtain management's views
on candidates because, as noted above, if the chief
or other high administrators are opposed to the
officers who are chosen as peers, they will not
encourage their use or make referrals, and may not
even allow peers to spend time supporting other
officers while on duty. John Carr, head of the
Rhode Island Centurion Program, gives presentations
at the small police agencies he serves, asking for
sworn and civilian volunteers; he then asks
management and union officials for their opinions
of the individuals who come forward. The Erie
County program was required to submit the names of
interested officers to the Buffalo Police
Department's inspector, who then made the final
decision about which candidates the program could
train.

Peer Training

Along with management support and careful
screening, training is the third critical
ingredient of an effective peer support
component. Peer candidates generally receive three
to five days of training. The Drug Enforcement
Administration provides 64 hours of initial
training, leading to certification of peer trauma
team members, who must then receive 24 to 40 hours
of additional training every 3 to 4 years to remain
certified.

Training focuses on 

o developing skills for active listening,

o recognizing and assessing officers' problems,

o determining the need for referral to
professionals, and

o selecting the proper resource as a recommendation
for professional assistance.

Training may also cover problem-solving techniques,
dealing with death, and responding to relationship
problems. The San Bernardino Counseling Team's 160-
page peer support training manual covers the
following topics:

o an introduction to peer support,

o peer support issues,

o feelings and emotions,

o listening skills,

o paraphrasing,

o self-disclosure,

o critical incident stress,

o grief and bereavement,

o substance abuse,

o assessment,

o referrals,

o depression, and

o major crisis issues.

Another training curriculum may be found in
Theodore H. Blau's Psychological Services for Law
Enforcement (New York: John Wiley, 1994: see pages
378-387).

Along with management support and careful
screening, training is the third key ingredient of
an effective peer support component.

Training emphasizes the need for peers to avoid
trying to provide therapy, to know their limits
with regard to what they can offer and do, and to
contact program professionals freely and
immediately if they have questions about how to
proceed. Training also stresses the need to
maintain strict confidentiality about what an
officer tells a peer supporter. According to the
IACP's peer support guidelines, "A formal policy
statement should be included in the department
policy manual that gives written assurances that,
within the limits of confidentiality, a PSP [peer
support person] will not be asked to give
information about members they support. The only
information management may require . . . is the
anonymous statistical information regarding the
utilization of a PSP." Exceptions to
confidentiality typically include threats to self
or others and criminal behavior. Peers are trained
to know when to interrupt a conversation with an
officer to explain what information they may not be
able to keep confidential (for example, if the
officer begins to talk about hurting someone else).

Training typically involves lectures,
demonstrations, and role-play exercises. In some
programs, staff videotape simulated support
sessions and critique the interchange. The three-
day training program provided by the Long Beach,
California, Police Department is divided into three
parts: explanation, demonstration, and performance,
following the basic principles of the three-phase
Rogerian model of establishing rapport, active
listening, and taking action. During the training,
psychological principles are presented to the group
and later demonstrated in a simulated counseling
setting by the instructors. The group then breaks
into small groups to practice the skills under the
instructors' supervision.[24] Trainers in the
Rochester Police Department assess trainee
proficiency by using a five-point scale to rate the
officers on such parameters as openness to learning
and
supervision, self-awareness, listening skills,
objectivity, and the ability to maintain
confidentiality. The trainees must exceed a defined
level of proficiency before being allowed to work
as peer supporters.[25]

In San Bernardino, the Counseling Team's program
director, assisted by other program staff, trains
the peers. In the Long Beach program, a clinical
psychologist teams up with a sworn officer with a
clinical degree to provide the training. Other
programs send peers outside the jurisdiction to
attend courses specifically designed for peer
training. The New Haven Police Department's peer
supporters are trained by a variety of community
professionals, including physicians, psychiatrists,
psychologists, and social workers, many of whom are
faculty members at nearby Yale
University.

The San Bernardino program invites staff from the
local employee assistance program to attend at
least part of the training so they will not feel as
though the peers are competing with them. (Staff of
another program encourage peers to meet with
private practitioners to allay fears about taking
away their business.[26]) In addition, according to
Nancy Bohl, "You want the professionals to whom
peers may be referring officers to attend some of
the training" so they understand the nature of the
peers' support. A captain from one law enforcement
agency attended one of Bohl's training sessions,
both reflecting and heightening his motivation to
promote the peer supporters in his agency. Of
course, nonsworn personnel who express interest in
becoming peer supporters need to attend the
training, as well.

Monitoring and Follow-up

Most programs provide some kind of follow-up to the
initial training to reinforce or expand the peers'
skills, enable them to share and learn from their
experiences, and monitor their activity. The Rhode
Island Centurion Program has its peers meet every
two months for two hours of additional training
provided by clinical staff from the inpatient
hospital the program uses when clients need
hospitalization. The training addresses topics that
the peers themselves have expressed interest in
learning about, such as confidentiality and suicide
indicators. Every three months San Bernardino's
Counseling Team asks the peer support coordinators
within each department with which it contracts to
send a letter offering a three-hour free follow-up
training session to all peer supporters, with one
of the agencies taking responsibility for
sponsoring the event and bringing refreshments.
Some chiefs send all of their peers to the training
and give them released time to attend. By inviting
all the peer supporters from several police and
sheriff's departments (several of which are very
small agencies) to each follow-up training session,
both the Centurion Program and the Counseling Team
make it possible to assemble enough peers to make
the training cost-effective. Some of the issues
that continuing training for peers might address
are listed in the box "Possible Topics for
Continuing Peer Support Training."

Staff of San Bernardino's Counseling Team and of
some other programs ask peers to complete contact
sheet logs. The Counseling Team also asks peers to
complete a simple checklist for each support
session. The checklist asks for a case number and
then an indication of whether the person was sworn
or nonsworn, male or female, or a family member or
coworker, and a list of stress-related issues for
which support was given, ranging from problems with
coworkers to financial concerns to substance abuse
(see appendix E). Other peer activity logs, perhaps
more detailed than most peer supporters will be
willing to fill out, may be found in appendix F and
on page 181 of Theodore Blau's Psychological
Services for Law Enforcement.

According to Nancy Bohl, the forms are useful for
determining whether any peers are being overworked;
it was through these forms that she learned that
two of three homicide detectives who were peer
supporters in one agency had been transferred,
leaving the entire responsibility for peer support
to the one remaining detective. By asking peers to
record their current shift
assignment, the forms also enable Bohl to learn
whether too many peers are working the same shift,
leaving the other shifts
uncovered. Finally, the forms may point to
temporary departmentwide problems that may need to
be addressed. For example, Bohl noticed that three-
fourths of all the peer hours in a department were
being devoted to relationship problems; and, upon
calling a peer
supporter in the agency, she learned there had been
19 divorces among its officers within a few months;
as a result, she offered a seminar to the peers on
marriage and family support.

The Counseling Team and other stress programs try
to monitor burnout among peer supporters both in
terms of the ongoing, everyday support peers are
providing and also following
particularly intense incidents. Bohl once had to
call on a local victim/witness assistance program
and a chaplain for additional help with family
members after an officer committed suicide and his
department's peer supporters were becoming
overwhelmed with their caretaking responsibilities.
To help prevent peer burnout, the Drug Enforcement
Administration offers an annual workshop called
"Healing the Healer" for all clinicians and peer
trauma team members who have responded to a
critical incident in the last year.

Marketing Peer Services

As noted, support from police management is
critical to the acceptance of a peer support
component among the rank and file. However, strong
support from the top is not enough: some officers
and civilians in the departments contacted for this
report, even where peer supporters were strongly
encouraged by management, were unaware of the peer
component's existence. Promotion of the component
by union and association officers can be effective,
but often such support has to be facilitated or
encouraged. One association president remarked, "I
should be marketing the peers to my members, but I
haven't had time--I've been remiss." Program staff
can promote the use of peer supporters by
implementing many of the approaches used to
marketing the stress program (discussed in chapter
7, "Marketing the Program").[27]

No program has the staff to provide all the
services police officers and their families will
need--for example, inpatient services and
specialized counseling for children. As a result,
programs need to have arrangements with other
providers to furnish these services. The following
chapter discusses how programs can establish a
network of reliable and competent service
providers.

Endnotes

1. Bohl, N., "Gaining Departmental Acceptance," in
Organizational Issues in Law Enforcement, ed., J.T.
Reese and R. Solomon,
Washington D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1996.

2. Blau, T.H., Psychological Services for Law
Enforcement, New York: John Wiley, 1994: 58.

3. Dietz, P.E., and J.T. Reese, "The Perils of
Police Psychology: 10 Strategies for Minimizing
Role Conflicts When Providing Mental Health
Services and Consultation to Law Enforcement
Agencies," Behavioral Sciences and the Law, 4
(1986): 385-400.

4. Reese, J.T., "A Cop's Best Hopes Are His Family
and His
Colleagues," in  Behavioral Science in Law
Enforcement, ed. J.T. Reese, Washington, D.C.: U.S.
Department of Justice, Federal Bureau of
Investigation, 1987: 65-66.

5. Blau, Psychological Services, 304, 307; and see
page 308 for a sample advertisement for an
internship position.

6. Niederhoffer, A., and E. Niederhoffer, The
Police Family: From Station House to Ranch House,
Lexington, Mass.: D.C. Heath, 1977: 135-137.

7. The library of the International Conference of
Police Chaplains in Livingston, Texas ([409]
327-2332) has a number of publications, available
on loan to chaplain members, which provide guidance
for how chaplains can counsel police officers and
their families, provide critical incident
counseling, and start a chaplaincy program. Also
see, in particular, De Revere, D.W., W.A.
Cunningham, T. Mobley, and J.A. Price, Chaplaincy
in Law Enforcement: What It Is and How To Do It,
Springfield, Illinois: Charles C. Thomas, 1989; the
publisher can be reached at (217) 789-8980.

8. Benjestorf, G.L., "The Chaplain's Role in
Critical Incident Response: An Overview," in
Critical Incidents in Policing, revised, ed. J.T.
Reese, J.M. Horn, and C. Dunning, Washington, D.C.:
U.S. Department of Justice, Federal Bureau of
Investigation, 1991: 17-21.

9.  Ellen Scrivner, The Role of Police Psychology
in Controlling Excessive Force, Research Report,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, April 1994.

10. Kirschman, E., "Organizational Development," in
Police
Managerial Use of Psychology and Psychologists, ed.
H.W. Mor and P.C. Unsinger, Springfield, Illinois:
Charles C. Thomas, 1987: 85-106.

11. Figley, C.R., "Compassion Fatigue Among Law
Enforcement Therapists," in Law Enforcement
Families: Issues and Answers, ed. J.T. Reese and E.
Scrivner, Washington, D.C.: U.S. Department of
Justice, Federal Bureau of Investigation, 1994:
387-400.

12. Goolkasian, G.A., W.R. Geddes, and W. DeJong,
Coping With Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985: 68.

13. Ibid., 57.

14. "On the Front Lines: Police Stress and Family
Well-Being," Testimony by B.J. Anderson and J.A.
King, Hearing Before the Select Committee on
Children, Youth, and Families, House of
Representatives, 102nd Congress, 1st Session, May
20, 1991, Washington, D.C.: U.S. Government
Printing Office, 1991: 68.

15. McMains, M., "The Management and Treatment of
Postshooting Trauma: Administration and Programs,"
in Critical Incidents in Policing, 191-196.

16. International Association of Chiefs of Police,
Peer Support Guidelines, Arlington, Virginia:
International Association of Chiefs of Police,
1993.

17. Gilbert M. Bernard v. The Justices of the
District Court of Cambridge, SJC No. 95-0430.

18. "On the Front Lines," Testimony by J.A. King,
64.

19. For further information about planning a peer
support
component, see, for example, Fuller, R.A., "An
Overview of the Process of Peer Support Team
Development," in Critical Incidents in Policing,
99-105.

20. Schmuckler, E., "Peer Support and Traumatic
Incident Teams: A Statewide Multiagency Program,"
in Critical Incidents in Policing, 315-323.

21. Nielsen, E. "Traumatic Incident Corps: Lessons
Learned," in Critical Incidents in Policing,
221-226.

22. Mullins, W.C., "Peer Support Team Training and
Intervention for the Police Family," in Law
Enforcement Families, 205-212.

23. Ibid.

24. Klein, R., "Police Peer Counseling: Officers
Helping Officers," FBI Law Enforcement Bulletin, 58
(1989): 1-4.

25. Goolkasian et al., Coping With Police Stress,
67.

26. Schmuckler, "Peer Support and Traumatic
Incident Teams," 318.

27. See, in particular, De Revere et al.,
Chaplaincy in Law Enforcement.

Core Functions of Police Psychologists

A survey [9] of 65 police psychologists
representing 50 of the largest police departments
in cities with populations over 100,000 found that
they engaged in the following basic activities:

o 77 percent provided counseling services; 29
percent restricted their activities to providing
only counseling services and none of the other
services listed below.

o 71 percent conducted preemployment screening; 17
percent did only evaluation work, including
preemployment screening and fitness evaluations
(see below).

o 54 percent conducted training classes that
covered a range of topics from hostage negotiations
to handling the mentally ill, but stress management
training was provided with the greatest
frequency.

o 52 percent conducted evaluations of fitness for
duty; an
additional 23 percent referred officers they were
counseling to other psychologists for these
evaluations to avoid the conflict of interest of
treating and evaluating the same individual.

o 42 percent systematically monitored officer
performance for purposes of validating
preemployment screening and for assessing the
success of training and counseling.

By contrast, almost none of the mental health
professionals contacted for this Issues and
Practices report engaged in
preemployment screening, fitness for duty
evaluations, or officer behavior monitoring;
instead, they focused on counseling and training,
primarily in the areas of stress prevention,
management, and treatment. The discrepancy probably
reflects this report's attempt to examine programs
that are devoted almost exclusively to law
enforcement stress, whereas the study summarized
above examined general practice police
psychologists.

Getting Additional Staff Requires Special Effort 

o Michael McMains, psychologist to the San Antonio
Police
Department, lost his second staff psychologist when
the police department went through a budget-cutting
period; however, when a new police chief was hired
in 1995, McMains was able to convince the new
administrator to fund the position again.

o Gary Kaufmann, chief psychologist for the
Michigan State Police's Behavioral Science Section,
helped to convince the department's personnel
department to fund a third program staff person, a
trooper who is a recovering alcoholic, to provide
counseling to other troopers with drinking
problems. The troopers' association president
initiated the request and asked for Kaufmann's
help, because the president kept getting calls from
members with drinking problems who did not feel the
two professional psychologists in the program could
help them. While the association president
documented the need for alcoholism treatment
services for the troopers, Kaufmann explained to
the personnel director that the new staff position
would save money by avoiding the need to put some
troopers with drinking problems on disability leave
or require them to take early retirement. 

o Douglas Gentz, the director of Tulsa's
Psychological Services, which is funded by the city
police and fire departments, arranged for three
outside experts--one police psychologist each from
the Memphis and Dallas police departments, and the
Denver police chief--to make a three-day site visit
to the program to conduct an evaluation. Following
a key recommendation of the evaluation report, the
program's board of directors hired a second
psychologist.

Preventing Burnout

The counseling profession in general, because of
the intense involvement in other people's problems
required of therapists, can easily lead to burnout.
Clinicians in police stress programs may be
especially vulnerable to burnout because much of
the counseling they do revolves around issues of
injury and death and because staff typically work
long hours, often at night and on weekends.
"Sometimes I think I deserve a badge after having
to listen to so many burned-out cops during the
past 10 years. I eat and sleep their worst
experiences. Who listens to me?" asked one stress
program counselor.[11] Program directors recommend
several
techniques to try to prevent burnout:

o Warn staff about the possibility, nature, and
symptoms of burnout, and encourage them to monitor
their own vulnerability.

o Meet regularly with staff to discuss and resolve
problems of work overload.

o Arrange for scheduled staff meetings at which
counselors discuss the impact of their work as
therapists on their own emotions and lives.

o Help staff to set limits on how much time they
will spend on the job and to refuse on occasion to
accept certain assignments, particularly if they
are responding too often to emergencies.

o Help staff understand the limits of what they can
expect to accomplish in their work in terms of
helping clients and promoting organizational
change.

o Assist staff to tolerate some stress through an
awareness that they are doing important work that
affects people's lives.

o Encourage staff to take vacation time--without
their beepers.

o Advise regular physical exercise before, during,
or after the work day (both Michigan Behavioral
Science Section psychologists jog and lift
weights).

o Identify a couple of congenial clinicians who
provide mental health services to other law
enforcement agencies and talk or meet with them, as
needed, to relieve stress.

o Encourage the police department to show
appreciation for what program staff are doing.

Gary Kaufmann and Richard Smith of Michigan's
Behavioral Science Section both used to be on call
for emergencies at all times, alternating
responsibility for the calls as they came in.
"Going on all-night SWAT calls was exciting at
first, but the next day we'd end up canceling our
regular clinical appointments," Kaufmann reported.
"In addition, it became exhausting." As a result,
they decided one of them alone would be on call for
all emergencies for two weeks, after which the
other person would take on emergency duty for two
weeks. That way each of them is assured of at least
two complete weeks of not being rousted from bed at
2:00 a.m. or having to spend 16 straight hours
dealing with a hostage situation.

One Approach to Assigning Emergency Cases

San Bernardino's Counseling Team has five in-house
counselors each of whom works 32 hours a week,
including 25 hours of actual counseling. Each
counselor must schedule one hour every day for
walk-ins, referrals from supervisors, and crises
when an officer or family member needs to be seen
right away. Contract staff choose the hours they
wish to work, so that if, for example, a contracted
clinician says she will devote three hours a day to
program clients, from 10:00 a.m. to noon and from
3:00 p.m. to 4:00 p.m., the computer lets the
program administrative assistant know that these
hours can be filled with emergency call-ins. No
staff may make themselves unavailable every
evening; they must select some evenings to be on
call. Each counselor also picks the weeks he or she
will be on call for emergencies or as backup to the
on-call staff, with the proviso that counselors get
their first choices for on-call evenings and
weekends on the basis of how long they have been
with the program. (The last person on the totem
pole works Christmas evening.) Because there are
eight clinical staff, each one has to be on call
for about seven weeks a year and another seven
weeks as backup. No one is assigned more than one
on-call week per month.

Using Peer Supporters: Benefits and Limitations 

Benefits

o can provide instant credibility and ability to
empathize

o can assist fellow officers who are reluctant to
talk with mental health professional

o can recommend the program to other officers by
attesting credibly to its confidentiality and
concern

o are frequently more accessible than professionals
because they are often already on the scene or at
the station house

o can detect incipient problems because of their
daily contact with fellow officers

o are inexpensive compared with using professionals

Limitations

o cannot provide the professional care that
licensed mental health practitioners can

o may try to offer real counseling that they are
not equipped to provide

o may be rejected by officers who want to talk only
with a
professional counselor

o may be avoided by officers because of fear their
problems will not be kept confidential

o require time, effort, and patience to screen,
train, and
supervise

o may expose themselves and the department to legal
liability

Supporters, not Counselors

Several program directors and researchers emphasize
that officers who become peer supporters are not
trained to provide counseling and, to avoid
misunderstanding about their role, they should be
called "peer supporters" not "peer counselors."
According to Trooper Jeffrey Atkins, a member of
Michigan's Behavioral Science Section, "We made a
conscious decision to call them peer supporters to
avoid the impression that they're offering
counseling. We don't want to give troopers the idea
that they can diagnose and treat problems. They
can't." According to the Peer Support Guidelines
prepared by the International Association of Chiefs
of Police (IACP), "A Peer Support Person . . . ,
sworn or not sworn, is a specifically trained
colleague, not a counselor or a
therapist."[16] To prevent them from engaging in
counseling, John Carr of the Rhode Island Centurion
Program requires his peer supporters to consult
with him if they talk with an officer on three
occasions about the same topic. After that,
according to Carr, "listening isn't enough for that
officer; he or she is stuck with a problem and may
need professional counseling, which we need to
determine and make available."

Potential Legal Complications from Peer Support

As noted in the text, because they are usually not
licensed clinicians, peer supporters are
particularly vulnerable to legal complications. For
example, during stress debriefings after critical
incidents, officers who participate in the incident
sometimes make statements that could be construed
as admissions of wrongdoing, including comments
such as, "I should have . . . ," or "If only I had
. . . ." However, law enforcement departments
cannot offer immunity from civil and criminal
litigation to officers who do not have a clinical
license but who participate in a debriefing to
offer social support and are later asked to testify
at departmental hearings or in civil or criminal
proceedings about what they heard. As a result,
practitioners point out that program staff must be
careful to warn officers who have been involved in
a critical incident (or who obtain counseling for
other reasons) not to say anything that might be
incriminating during a counseling or debriefing
session with other officers, or when speaking
privately with a peer supporter. Peer supporters
also need to be informed of these legal
possibilities and advised not to participate in
group or individual debriefings when use of force
by the officer seeking help was involved. However,
licensed professional program staff who conduct
debriefings and who are protected under
certification law in State statute and by Rule 501
of the Federal Rules of Evidence (see "Subpoenas"
in chapter 6, "Dealing with Confidentiality")
cannot be forced to testify.

Even peer supporters who have considerable training
in counseling--but are still not licensed--may not
be protected by confidentiality laws, depending on
the definitions of various types of counselors in
State statutes. A State trooper in Massachusetts
had received nearly 300 hours of formal training in
stress management,
psychology, and related courses and had several
years of experience providing counseling both at
his department's employee assistance unit and at a
local chemical-dependency treatment center before
being assigned full-time to the unit in 1992.
Although he was not a licensed social worker, he
considered himself a social worker. According to
State Police policy, all counseling provided
through the unit was confidential, and the peer
supporter told other troopers seeking his help that
their communication would be kept in confidence.

In March 1995, a woman filed a complaint against a
trooper whom the peer supporter had assisted,
charging assault and battery and other criminal
behavior. The trooper was suspended from active
duty and criminal charges were brought against him.
The peer supporter subsequently provided additional
help to the trooper on several occasions. The peer
supporter's records were subpoenaed for the
trooper's trial, but the supporter petitioned for a
protective order, alleging that because he was a
social worker employed the State, his conversations
with the trooper were privileged
communication.

Disagreement centered on the State law's definition
of social worker. The law specifies that "all
communications between . . . a social worker
employed in a state, county or municipal
governmental agency, and a client are
confidential," but the court maintained that the
peer supporter was not, in fact, a social worker
because he was not licensed. The peer supporter's
attorney argued in a brief to the Massachusetts
Supreme Judicial Court that the peer supporter
should be considered a social worker according to
the law's provision that "nothing . . . shall
prevent the practice of social work or the use of
the official title . . . social worker . . . by
individuals employed in state, county, or municipal
governmental agencies, provided that such persons
are performing those activities as part of the
duties for which they are employed or solely within
the confines or under the jurisdiction of the
agency in which they are employed." The
Massachusetts Supreme Judicial Court is expected to
rule on the case in late 1996.[17]

To minimize legal complications, program staff
should consult with a local attorney regarding
their State laws and court rulings pertaining to
confidentiality. See the section on "Legal
Assistance" in chapter 6.

Peer Referrals for Financial Problems

The Illinois State Police peer supervisor trains
peer supporters to refer officers with money
management problems to the State's credit bureau
for assistance. If an officer is having problems
with credit card payments, an arrangement can be
worked out through the bureau in which the credit
card issuer will afford the officers an opportunity
to pay the debt. The company prohibits further use
of the card but imposes no interest on the money
owed. According to Jeffrey Atkins, a counselor with
Michigan's Behavioral Science Section, "Money
problems are a sign of or a source of stress for
many officers, so it's entirely appropriate for
peers to link them with organizations that help
them manage their money."

When To Set Up a Peer Support Component: The Need
for Management Support

Gary Kaufmann, Director of the Michigan State
Police Department's Behavioral Science Section,
observes that early establishment of a peer
component may hasten a stress program's ability to
gain credibility among officers while at the same
time serving as a form of outreach to secure
clients. However, Kaufmann, who was just
establishing a peer support component in his
program when research for this publication was
being conducted, warned that a new stress program
should not attempt to set up a peer support
component too soon. According to Kaufmann,

You have to wait until department administrators
are ready to accept peers as a useful adjunct to
the stress program that has already secured
management's respect. Otherwise, you will have a
mini-unit versus management--"cops taking care of
their own," people will say, "because the
department won't take care of them." This may
create a built-in adversarial relationship between
the peer support component and management, with the
stress program seen as supporting the "rebellion."

Other program directors also emphasize that without
strong
management support a peer component will not
succeed. According to an association president,
"Our peer program is a failure because the union
shoved it down the department's throat, and
management just passively went along with it. So,
few cops know there are any trained peers available
to them, those who do don't take them seriously,
and very few officers volunteer to get trained." A
peer supporter pointed out that management support
is crucial because supervisors need to give on-duty
peers time to assist other officers in crisis as
long as the peers are not themselves involved in an
emergency situation.

It may also be important to wait until a stress
program has gained the acceptance of the officers
themselves before setting up a peer component.
Cindy Goss, Director of the Erie County Law
Enforcement EAP, began recruiting and training
peers only after she felt enough officers were
familiar and comfortable with the idea of stress
services as well as the program itself.

Steps in Developing a Peer Support Component[19]

1. Check with legal counsel to determine whether
there are any legal barriers or limitations to
setting up a peer component.

2. Review the literature; consult with other
departments for guidance.

3. Select a peer support coordinator.

4. Conduct a needs assessment.

5. Design the preliminary approach and monitoring
plan.

6. Consult with management.

o e.g., will peers be given on-duty time to attend
training? to do peer support? 

o e.g., will the department pay for the
coordinator?

7. Revise the approach.

8. Develop written procedures and selection 
criteria.

9. Secure funding (may occur earlier).

10. Advertise for candidates.

11. Recruit peers.

12. Screen candidates.

13. Train peers.

14. Market the peer supporters' services.

15. Monitor peer activities.

16. Provide continuing training.

17. Evaluate.

18. Report periodically to management on progress
and problems.

When Using Local Peer Supporters May Not Work

There are some situations in which using officers
to provide peer support to colleagues in the same
agency may not be effective. Below are two examples
in which peer supporters were brought in from
outside the community to support officers and
family members in need.

A Federal Law Enforcement Agency: The ATF

The preference of Bureau of Alcohol, Tobacco, and
Firearms (ATF) officials in critical incidents
involving large numbers of agents is not to use
peer supporters who are serving in the jurisdiction
because they may be too severely affected
personally by the incident to be able to help their
colleagues. For example, after the bombing of the
Federal office building in Oklahoma City in 1995,
the ATF flew in about eight peer supporters who
contacted affected agents, their family members,
and other agents sent into the city to investigate
the explosion (e.g., explosives experts). In the
initial stage, the peers allowed the visiting
agents to continue their work without debriefing
them but tried to remain visible, a task
facilitated by the number of agents who already
knew some of the peers. Peers also stayed with
survivors and their families at hospitals and in
homes.

About three-fourths of the agents' spouses attended
the first voluntary meeting with the peer
supporters in Oklahoma City, at which the peers
informed the spouses about the symptoms of stress
their husbands and wives--and they, themselves--
could expect to experience. A second meeting with
spouses included their children. Next, the peers
approached all the ATF employees, starting with
those who had been in the building at the time of
the explosion. Anticipating that the agents might
be intimidated by mental health professionals, only
peers ran these initial sessions. Individual
contact continued as the peers encouraged agents to
approach them voluntarily. The employee assistance
program mental health
professionals were then integrated into process.

A State Law Enforcement Agency: The Georgia POST

When the governor directed that the Georgia Peace
Officer Standards and Training Council (POST)
establish peer support programs for all State
public safety personnel, POST staff concluded that
some departments in the State were so small that
officers would be reluctant to confide in fellow
officers about their problems because of fear that
confidentiality would not be maintained. As a
result, POST set up peer support teams in each of
the State's 10 emergency health regions. Members of
each region's team are responsible for providing
peer support to the public safety agencies within
its jurisdiction.[20]

Training Can Weed Out Inappropriate Peer Candidates

During the training of peer supporter candidates,
it sometimes becomes obvious that an officer would
be ineffective. Sometimes officers decide on their
own that they are inappropriate for the role
because of the difficulties they experience during
training in opening up themselves to the other
trainees. In addition, certain officers may "become
preoccupied with details of shooting incidents
rather than the emotional impact that the event has
on the individual officer. As a consequence, during
training sessions when specific examples are used,
this group of officers often becomes concerned
about the `rightness' of the shooting or about the
potential of becoming a witness in a civil suit.
Experience has shown that when this is the case,
these officers typically lack empathy or are
largely indifferent to the emotional state of
fellow officers and tend to become preoccupied in
the technical aspects of the police situation:
e.g., conditions for the use of force and/or police
tactics. Obviously, people with this type of
orientation will be largely ineffective in a peer
counseling role and this has been borne out through
subsequent events."[21]

Obtaining Nominations for Peer Supporters

San Bernardino's Counseling Team

When San Bernardino's Counseling Team signs a
contract with a law enforcement agency, the
director gives a memorandum, along with the
criteria for becoming a peer supporter, to the
chief of police and asks the chief to distribute
the memo departmentwide, including to nonsworn
personnel (see appendix D). The memorandum asks
each officer to list the names of up to 20
colleagues who he or she feels best meet the
criteria, listing the most qualified officer first.
The director then has the chief request each of the
individuals who have been most commonly listed and
most highly rated to submit a written request to
become a peer supporter. The chief submits the
requests to the director; staff and two other peer
supporters then interview the candidates.

A Mid-Sized Texas Police Department

A police department in Texas with 48 sworn
personnel and 13 civilians combined several steps
for recruiting peers. First, the agency asked for
officers to volunteer to be peer supporters. Then
it gave all officers in the agency a peer survey
form to complete and return anonymously, on which
they ranked every officer in the department on a 1
to 5 scale (1 = totally unqualified) in terms of
how effective each would be as a peer supporter.
The form provided a brief description of what peer
support was and a brief overview of the activities
peer supporters would conduct. Before analyzing the
responses, a team of three psychologists
interviewed each applicant about why he or she
wanted to be a peer supporter and what skills the
person could bring to the role. The psychologists
also asked a series of situational questions
designed to assess each volunteer's communication
skills, listening skills, ability to solve
problems, and ability to empathize. To qualify as a
peer, each volunteer had to be approved by a
psychologist and be ranked highly by his or her
colleagues. Interestingly, the six persons selected
by the psychologist also had the highest average
ratings among their colleagues.[23]

Do Peers Provide Support On-Duty or Off-Duty?

No department contacted for this report prohibits
peers from providing support on their own time--nor
did any department offer financial remuneration or
compensation time. However, departments vary on
whether they allow peers to provide support while
on duty. For example, in some of the law
enforcement agencies contracted with the San
Bernardino Counseling Team, peers may provide
support while on duty if they first obtain
permission from their
supervisor. When officers call an on-duty peer
supporter to meet, the peer must call the watch
commander for permission so that the peer will be
covered by insurance and workman's compensation if
he or she gets into a traffic accident. But peers
do not say whom they are going to meet. Of course,
most peer support does not require permission
because it occurs informally over coffee or at the
water fountain.

With regard to the question of peers' shortchanging
their work obligations to provide peer support
while on duty, program
directors agree with the position expressed in the
IACP's peer support guidelines: "Sworn peer support
officers are officers first and peer supporters
second. Any conflicts of roles should be resolved
in that context."

The most critical consideration is for departments
to allow officers time to attend peer training
sessions. A few departments contacted for this
report do make provision for officers to attend
training while on duty. For example, all 15 law
enforcement agencies with which Rhode Island's
Centurion Program has contracts to provide stress
services give their peers time off for training as
part of the agencies' agreements with the program.
However, most police departments require officers
to use their days off. When officers must attend
the training on their own time, their
willingness to do so becomes a good litmus test for
assessing their dedication to the role. When told
of the pre-service training requirements, some
officers in the Rochester Police Department decline
the opportunity to qualify because they do not want
to give up their days off to attend the sessions.
By contrast, some Drug Enforcement Administration
agents whom police psychologist Ellen Scrivner of
the U.S. Department of Justice trains to be peers
have told her that some of the peer skills they
learn during the peer training are also useful in
their everyday work as agents in the field, in
particular, interviewing and listening skills (as
opposed to the interrogation skills they already
possess).

Possible Topics for Continuing Peer Support
Training (from the IACP peer support guidelines)

o confidentiality issues

o communication, facilitation, and listening skills

o ethical issues

o problem assessment and problem-solving skills

o alcohol and substance abuse

o cross-cultural issues

o medical conditions often confused with
psychiatric disorders

o stress management

o AIDS information

o suicide assessment

o depression and burnout

o grief management

o domestic violence

o crisis management

o nonverbal communication

o when to seek mental health consultation and
referral information

o trauma intervention

o limits and liability
_____________________________________________

Chapter 5

Establishing a Referral Network
______________________________________________

Key Points

o All stress program staff and independent mental
health
practitioners who consult with law enforcement
agencies need to identify qualified outside service
providers to whom they can refer selected officers
and family members for assistance.

o Program staff and consulting clinicians use
outside providers most frequently for substance
abuse treatment, long-term
counseling, and specialty treatment (e.g., child
therapy).

o Program staff generally base their selection of
outside providers on five considerations:

--professional qualifications, especially
familiarity with police work;

--location and clientele;

--ability to maintain confidentiality;

--third-party insurance coverage; and

--ability to respond quickly.

o Program staff recruit providers in different
ways, but they generally try to visit each facility
and talk personally with each practitioner.

o Formal agreements with providers, while not
always necessary, can help avoid future
misunderstandings.

o Program staff and independent consulting
practitioners may ask the officer in question to
make the appointment with the outside provider, or
they may make the appointment for the officer.

o Most program staff encourage officers and family
members referred to outside providers to call
program staff to report on the quality of the
providers, so that staff can decide whether to
continue to make referrals to those providers.

No stress program, and especially no single mental
health
practitioner who provides stress services to law
enforcement agencies, can provide all the
counseling services police officers and their
family members will need. Program staff and
independent practitioners do not usually have the
time or the expertise to treat every type of client
problem. As a result, program staff need to find
qualified outside counselors and treatment programs
to whom they can refer selected officers and family
members. This chapter discusses how programs and
independent practitioners can establish an
effective referral network.

Selecting Referral Service Providers

Selecting referral service providers involves
identifying the types of expertise that are needed,
developing criteria for
acceptability, recruiting providers, and developing
formal or informal agreements.

Types of Expertise Needed

The most common services for which program staff
and independent practitioners refer officers to
outside resources are inpatient substance abuse
treatment (particularly alcoholism) and long-term
individual or family counseling. John Carr of the
Rhode Island Centurion Program also stresses the
value of having access to a day hospital option.
"This is my inpatient preference of choice," he
says, "because it's not as intimidating to officers
as confining them 24-hours a day in a facility and
because they can still be connected to the
community and their family evenings and weekends."
Most programs refer officers and family members to
specialists when treatment for children is required
or when the client has a serious psychiatric
disorder (e.g., schizophrenia, clinical depression,
anorexia). Program staff can refer officers with
spiritual problems to department-affiliated
chaplains (see chapter 4, "Choosing Among Staffing
Options," for additional information about chaplain
services).

Some programs refer officers and family members to
local self-help support groups. The director of the
San Bernardino Counseling Team, which serves
several small departments, calls on local chapters
of Concerns of Police Survivors (COPS) to help
support surviving spouses or officers and their
spouses who have lost a child. The director also
formed an Alcoholics Anonymous group for officers
that meets at her program after-hours, to which all
program counselors can refer officers with drinking
problems.

Based on the particular types of referral services
the program will need, staff need to compile an
inventory of outside provider names and
organizations, including information about the
specific services each offers, names of key staff,
and hours of
availability. Program staff can then develop
criteria for
evaluating each provider's suitability.

Establishing Selection Criteria

Program staff tend to base their selection of
outside service providers on at least five
considerations:

o Professional qualifications. In general, the same
considerations that are used in the selection of
stress program staff, as
discussed in chapter 4, "Choosing Among Staffing
Options," can be applied to the selection of
referral service providers. In
particular, most program practitioners believe
that, in addition to possessing sound clinical
skills, outside mental health
professionals need to be familiar with the demands
and requirements of police work, organizational
sources of stress, and the law enforcement culture,
as demonstrated by actual law enforcement
experience as an officer or by an existing client
base that includes law enforcement officers.
(Training through ride-alongs, attendance at the
academy, and other methods can help address any
deficiencies in these areas.) One clinician had
taken a course in criminology and had a brother and
an uncle who were police
officers; another had worked with prisoners for her
master's degree and done numerous ride-alongs. In
addition to being knowledgeable about police work,
outside clinicians also need to be able to relate
to officers comfortably. As Cindy Goss, Director of
the Erie County Law Enforcement EAP, says, "An
interest in police work isn't enough."

o Location and clientele. To maintain client
confidentiality, program staff often choose private
practitioners who are not located in areas
frequented by officers and facilities that are
located in other jurisdictions, even other states.
Staff avoid using local outpatient and inpatient
mental health facilities to which officers often
transport offenders or intoxicated or mentally
disturbed individuals.

o Ability to maintain confidentiality. Outside
referral
practitioners need to have the legal authority to
refuse to divulge any information about clients
except under the exceptions listed in chapter 6,
"Dealing With Confidentiality," and the will to
resist inappropriate pressure from department
supervisors for client information.

o Third-party insurance coverage. Some officers are
willing to pay out of pocket for counseling in
order to avoid submitting claims to their health
insurance carrier or being subjected to screening
interviews for eligibility. However, in most cases
outside
practitioners must be accepted by all the officers'
different insurance carriers. As a result, the
director of the Erie County Law Enforcement EAP
sometimes contacts insurance companies to persuade
them that a particular clinician is necessary for
treating police officers and should be approved.

o Ability to respond quickly. Some programs place a
premium on using outside practitioners who will be
available for emergency counseling after critical
incidents. For example, to receive referrals from
San Bernardino's Counseling Team, mental health
professionals have to agree to set aside one week
every month to be available to work with officers
after critical incidents.

Recruiting Providers

The director of the Metro-Dade Health Services
Section keeps a data base of clinicians and clinics
that have sent him marketing information or that
program staff have heard about. These providers are
retained or stricken from the list based on
comments that referred officers share later with
program staff. The director of the San Antonio
Police Department's Psychological Services Unit
sent letters to area mental health professionals
asking about their interests, work experience, and
references. He built a network of providers with
police experience or familiarity with police
culture based on the responses. The director of the
Erie County Law Enforcement EAP telephones would-be
providers and asks them about their police
experience and other qualifications.

The Michigan State Police Behavioral Science
Section identified 25 independent psychologists
from around the state based on
recommendations from clients and colleagues. Staff
then invited them to a one-day program at the
police academy that included meeting department
officials, a tour of the academy, and
discussions about police culture and the special
treatment needs of police officers and their
families. According to a psychologist who attended
the training, "We were also able to share clinical
experiences and how we handle problems." As a
result, when program staff wish to call on one of
these practitioners to accept a referral, they have
more than just a name. (Staff of another program
found that psychologists in the area were too busy
to find a mutually convenient time to meet for
training.)

The Postal Inspection Service, the oldest Federal
law enforcement agency, follows a procedure for
selecting psychologists that State and county law
enforcement agencies with far-flung jurisdictions
may find useful to replicate.[1] To identify mental
health
practitioners in the 12 States that make up its
Western Region, the service

o solicited names of police psychologists through
state
psychological associations, law enforcement
agencies, and police psychologist members of the
Psychological Services Section of the International
Association of Chiefs of Police;

o sent a description of the program to the
recommended psychologists and an application form
that asked for information concerning not only
education and experience but also professional
disciplinary issues, law enforcement work history,
law enforcement references, and ability to abide by
the program's confidentiality requirements; each
applicant was also required to submit a current
copy of his or her State license and verification
of malpractice insurance;

o contacted the applicants' references and sent
questionnaires to the State licensing boards
requesting information concerning past professional
disciplinary proceedings; and

o arranged face-to-face interviews in the
providers' offices not only with the program
coordinator but also with an inspector who had
absolute veto power over any provider if he or she
had any reservations about seeking counseling
personally from the provider should the need arise.

Jeffrey Atkins, a recovering alcoholic trooper who
is a counselor with the Michigan State Police
Behavioral Science Section, interned at a local
alcoholism facility one day a week for two years;
as a result, Atkins developed a good relationship
with an outpatient counselor at the facility who is
a former police officer and an outpatient counselor
who treats law enforcement officers and Vietnam
veterans, and the Michigan program now refers
troopers to this counselor. In addition, when
Richard Smith, one of the program's psychologists,
has some slow time, he visits the
treatment facility to tour the building and talk
with staff to make sure they are competent and good
referral sources. "Making these rounds is part of
my job," Smith says.

Developing a Referral Agreement

Some program directors establish written agreements
with outside agencies and individual practitioners.
The Rochester, New York, Police Department
contracts with the University of Rochester
Department of Psychiatry for mental health services
that the department's stress program cannot
provide, as well as for
assistance with clinical reviews. (Examples of
provisions to include in an agreement can be found
in appendix G, the agreement Tulsa's Psychological
Services uses, and the box "Sample Provisions for a
Service Provider Agreement.")

Formal agreements have the advantage of helping to
avoid future misunderstanding, but many service
providers are reluctant to make such a binding
commitment. Often program staff establish close
professional and even personal relationships with
key providers that make formal agreements
unnecessary. The head of the Rhode Island Centurion
Program has had a 15-year relationship with several
clinicians at a local hospital, including a staff
psychiatrist who is also a member of the Centurion
Program's own staff and mental health providers who
provide periodic in-service training to the
program's peer supporters.

Establishing Referral Procedures

Referral procedures involve linking the officer in
need of services with the outside provider and
monitoring the officer's progress.

Making the Referral

After a program staff member has determined that an
officer or family member needs outside help, the
program counselor can use one of two methods of
linking the client with the provider. Some program
staff provide officers with the name, location, and
telephone number of the agency or clinician and
require the officers to make their own
appointments. One program director has tried to
normalize the mental health process so that
officers feel comfortable calling an outsider
provider without having to go through his program.
However, John Carr of the Rhode Island Centurion
Program warns, "Never refer an officer to a
building; always refer the client to a person at
the facility with whom you have established a
professional relationship so that the officer does
not call or arrive and have to talk with
strangers." Other program staff arrange the initial
appointment for the client and may also discuss
briefly with the outside provider the nature of the
case and review issues of confidentiality, payment
for
services, or paperwork requirements. Of course,
program staff can decide which approach to use
depending on the individual officer's or family
member's preference. Gary Kaufmann, Director of the
Michigan State Police stress program, tells
clients, "Try the person for four to six visits.
You may not click. If you don't, call me and we'll
try someone else. But if you do hit it off, feel
free to call me and tell me that, too."

However, when it comes to referring an officer for
hospitalization, Carr stresses that "hospital-based
care scares the heck out of them. You will lose
them if you just send them; you need to go with
them, introduce them to the staff, keep in regular
touch with them, and see them after they have been
discharged through continued peer support in the
workplace or outpatient follow-up. In other words,
treat the hospital care as an extension of the
program." One way Carr maintains this continuity of
care is by requesting that the officers be treated
in the hospital by the Centurion Program's own
psychiatrist, who is on the facility's staff, and
that the officers be placed on a unit staffed by
one of the in-house clinicians who regularly
provide in-service training to the program's peers.

Program staff may wish to--or have to--consider
other factors in selecting a provider for a given
officer or family member:

o As a government agency, Metro-Dade's program has
to be sure not to show--or be perceived to be
showing--favoritism to certain treatment providers;
as a result, staff provide each officer with the
names of three providers unless a specialist is
needed and practitioners in the field are in short
supply. 

o Cindy Goss, Director of the Erie County Law
Enforcement EAP, tries not to send an officer to
the same inpatient facility while another officer
from the same department is currently being treated
there, even if this means a wait of a few weeks.

Monitoring Treatment

Program staff vary considerably in their ongoing
involvement with officers who have been referred.
In some cases, a program counselor may see the
officer for stress-related problems while the
officer is in treatment elsewhere for a substance
abuse problem. Some staff contact providers
periodically to inquire about the referred
officer's progress. Providers in Erie County tell
the law
enforcement EAP director whether the officer showed
up and what progress the person has made.

Regardless of the nature of any ongoing contacts,
program staff encourage clients to call back to
report their opinions of the practitioner and
facility to which they were referred. These
recommendations or criticisms enable program staff
to eliminate unacceptable service providers and
increase referrals to highly regarded providers. An
independent clinician who came to Erie County in
1992 happened to have a few clients who were police
officers, and these officers told the Law
Enforcement EAP director that he was very good, so
she began to refer officers to him; now half his
caseload consists of police officers and their
family members.

In general, programs vary considerably in the
extent to which they refer officers and family
members to outside service providers, but, because
it will always be necessary to refer some clients,
program staff need to make the effort in advance to
ensure the immediate availability of qualified
outside providers. A program that cannot make
referrals to competent mental health practitioners
is likely to find that officers will reject and
ignore all its offerings, including its in-house
services.

Endnote

1. Shaw, J.H., and D.R. Hagberg, "A Self-Referred
Counseling Program for Postal Inspectors," in Law
Enforcement Families: Issues and Answers, ed. J.T.
Reese and E. Scrivner, Washington, D.C.: U.S.
Department of Justice, Federal Bureau of
Investigation, 1994: 359-365.

Sample Provisions for a Service Provider Agreement

Below is a list of possible provisions program
staff can consider including in an agreement with
an outside agency or individual practitioner to
provide services to officers and family members
referred by the program:

o a list of available services (e.g., drug
detoxification,
psychological testing, outpatient counseling);

o a 24-hour telephone number for emergency
coverage;

o the name of a contact person who will accept
referrals or deal with any problems that may arise;

o what information will be reported to the outside
agency or practitioner with the client's consent at
the time of referral;

o a declaration that the agency or practitioner
will abide by the stress program's confidentiality
guidelines;

o a declaration that program clients will have
priority for bed space, if the agency operates an
inpatient program;

o a declaration that the agency will work in
concert with the program in developing both
treatment and aftercare plans; and

o a stipulation of what the agency's and
practitioner's
responsibilities are with regard to providing
client information to program staff, such as missed
appointments, termination of
treatment, revisions to the treatment plan, and
clinical progress.

Specialized Services for Police Officers

A number of outside treatment organizations serve
only law
enforcement personnel. For example, the On-Site
Academy in Gardner, Massachusetts is a nonprofit
agency for training and treating emergency services
personnel involved in traumatic incidents.
Crossroads, in Delmar, New York, provides complete
outpatient treatment services for law enforcement
officers and their families, addressing alcoholism,
critical incident stress, anger management, and
relationship problems. These providers often feel
that officers are more likely to use services that
are sensitive to the
job-related concerns of law enforcement personnel.

Sometimes officers object to being mixed with
civilians--or with people suffering from different
problems than those they are experiencing. One
program director tried to develop a support group
with law enforcement and corrections officers but
the police officers refused to participate with
corrections staff. Another director sent an officer
with a drinking problem to a facility where he was
housed with mentally ill patients; when he called
up to beseech her, "Get me out of here!" the
director moved him to a facility that segregated
alcoholics from the mentally ill, where he
recovered.

By contrast, some practitioners believe that
segregating officers in treatment reinforces their
belief that their problems are unique and further
insulates them from civilian life. Cindy Goss of
the Erie County Law Enforcement Employee Assistance
Program suggests that "specialized treatment is not
always good for officers; it sets them up to think
they're special, and then they expect that attitude
everywhere. It's best to refer them to a general
program that has a special track for officers."
Taking a middle position, Gray Kaufmann, Director
of the Michigan State Police Behavioral Science
Section, likes the inpatient counselor at a local
alcohol clinic because "he treats cops not as
unique people but as regular people with a unique
job."

"Never refer an officer to a building; always refer
the client to a person at the facility with whom
you have established a
professional relationship so that the officer does
not call or arrive and have to talk with
strangers."

 --John Carr, Director, Rhode Island Centurion
Program

_____________________________________________
Chapter 6

Dealing With Confidentiality
______________________________________________

Key Points

o No program will survive unless (within the limits
of the law) it maintains strict confidentiality--
that is, keeps information about officers and
family members private.

o Because legislation and case law vary from State
to State, clinicians need to obtain legal counsel
regarding their exposure to lawsuits and methods of
reducing this exposure.

o Communication between clients and licensed mental
health
professionals is usually privileged communication
under State statute. However, exceptions to this
rule require counselors to report certain
information clients may reveal to them, such as
homicidal or suicidal intentions.

o Program staff and independent practitioners can
take a number of steps to ensure confidentiality:

--Develop written confidentiality guidelines and
share them with everyone in the department;

--Obtain informed consent to treatment from clients
in writing;

--Learn about the exceptions to confidentiality and
make them known to department administrators, line
officers, family members, and clients;

--Maintain appropriate client records; and

--Try to send mandatory referrals, especially
fitness-for-duty evaluations (which usually require
disclosure of client information to
administrators), to external counselors or at least
clearly separate the treatment of voluntary and
mandatory referrals within the program.

o Programs that accept mandatory referrals need to
limit the amount of feedback given to supervisors
to issues pertinent to the cause of the mandatory
referral and tell the officers or family members
what information about them will be reported to
supervisors.

Police officer: "When I sought private treatment, I
knew about the [department's stress] program, but I
didn't use it because I was afraid other cops and
my supervisors would find out. I had heard comments
from other cops that they wouldn't trust the
program as far as they could spit."

Police officer (different department): "Older cops
still raise questions about confidentiality because
there was a breach many years ago. So it's
important never to break confidentiality or we'll
find you out. One slip of the tongue can undo a lot
of years' work."

Confidentiality in the context of a law enforcement
stress program means guaranteeing that clients can
obtain counseling services without anyone other
than the staff involved in the program knowing
about their participation unless they provide
written consent. As the comments above suggest, the
most significant obstacle to officers using a
stress program is the fear that their
participation may become public knowledge. Beyond
the worry that they will be embarrassed in front of
others, officers fear that they may be reassigned
to less desirable work, not be granted promotions,
and even lose their jobs, perhaps even years after
they have sought program services. This fear is
particularly great in small law enforcement
agencies.

Several officers interviewed for this report were
afraid to seek counseling even though they
understood intellectually that their visits would
be kept secret. "Was I worried about
confidentiality?" one mused. "Yes and no. Yes,
because at the back of my mind I was worried that
the police culture is such that seeing a
psychologist could make me extremely stigmatized.
No, because I knew the counselor very well [both
served on the hostage negotiating team] and knew
that my visit would remain confidential." Another
officer, temporarily assigned to desk duty,
reported, "I had no concerns about confidentiality
because I had asked a friend who had used the
program, `Does word get out?' and my friend said,
`No, there are no leaks.' But when I bad-mouthed my
lieutenant to the counselor, I suddenly became
afraid that if the counselor told him, I'd never
get back on the road again."

Issues surrounding confidentiality are a concern
for counselors as well. In a survey of 49 police
psychologists, maintaining
confidentiality was reported to be the most common
ethical dilemma, with nearly half the counselors
saying they had experienced difficulties in this
area.[1]

This chapter reviews the legal status of
communications between clients and counselors and
discusses methods of keeping client information
private. However, despite some specific precautions
that clinicians can take to help prevent breaches
of
confidentiality, the best source of protection
against clinical and legal problems arising around
the issue of privacy is to provide good clinical
care to officers and family members and to follow
sound ethical and legal practice. Ethical practices
are spelled out in detail in materials available
from the American Psychological Association.
However, program staff need to consult with legal
counsel familiar with mental health issues to learn
what legal practices are required of them in their
State and for their particular licensure.
Confidentiality requirements vary from State to
State depending on local statute and case law;
requirements may also vary by category of mental
health practitioner--for example, clinical
psychologist, licensed clinical social worker, or
substance abuse counselor.

Confidentiality and the Law

As a general rule, information which clients give
to licensed mental health practitioners is
considered by State law to be privileged
communication that the counselor may not share with
anyone else.[2] However, there are conditions under
which State law and department rules may require a
counselor to disclose what an officer or family
member reports:

o Therapists have a positive obligation in statute
and professional ethics to protect clients from
harming themselves or others. For example, a
therapist who determines that a client is suicidal
may have to hospitalize that client against his or
her wishes. Although this will breach
confidentiality because information about the
person will then be available to others, such as
hospital staff, these staff, too, are bound by
obligations to maintain
confidentiality. Counselors need to consider
threats by officers to hurt themselves or others a
particularly grave matter because law enforcement
personnel have immediate access to lethal
weapons.[3]

o Most States require licensed therapists (as well
as
schoolteachers and other adults in regular contact
with children or parents) to report child abuse to
appropriate State authorities. Some States also
require that domestic violence and elder abuse be
reported.

o Many law enforcement agencies require therapists
to report an officer's admission to committing a
felony, or even a gross misdemeanor. In the
agencies' view, by failing to report the
information, a therapist can become an accessory to
the crime.4 Therapists may, of course, continue
treatment or refer the officer to other sources of
help.

Courts have ruled that under certain circumstances
therapists not only must breach confidentiality,
but they also have a positive duty to protect
identifiable individuals whom an officer threatens
to harm.[5] The exact conditions that trigger the
duty to protect, as well as how the duty must be
fulfilled, vary from State to State, depending on
local statute and case law.

Program staff and independent mental health
practitioners need to be aware of special
confidentiality considerations with regard to peer
supporters, because the privileged communication
status conferred on licensed mental health
professionals may not apply to unlicensed peers.
Chapter 4, "Choosing Among Staffing Options,"
addresses confidentiality in relation to peer
supporters.

Steps for Helping To Ensure Confidentiality

Clinicians need to take several steps to ensure
that client communications and records are kept
confidential.

Prepare and Disseminate a Written Confidentiality
Policy

The first line of protection for confidentiality is
to prepare a written statement of what information
program staff intend to keep confidential and how
they will do so. Programs should also have a
written agreement with the law enforcement agency
regarding confidentiality and should include the
agreement in their service contract.[6] For
example, the bargaining agreement between the
Michigan State Police Troopers' Association and the
State Police Department includes the provision,
"The departmental psychologist may not be called as
a witness in any department disciplinary
proceedings or grievance meeting to testify
regarding discussion between the psychologist and
employee, except upon the specific written request
of the employee." The Metro-Dade Police
Department's standard operating procedures
guarantee that "the Department will not request or
require HHS [stress program] staff to furnish
information resulting from voluntary participation.
. . . Information concerning the diagnosis or
treatment of any
voluntary participant shall not be requested by
supervisors."

The program director needs to provide the agency
with a copy of the American Psychological
Association code of ethics and the specific
guidelines program staff plan to follow before
accepting employment or a consulting assignment.[7]

The guidelines should contain descriptions of:

o the types of written records program staff will
maintain and how the records will be stored and
used;

o the circumstances under which exceptions to
strict
confidentiality may be made, and

o the special procedures staff will use regarding
release of information about officers who are
mandated by supervisors to participate.

Appendix H, the confidentiality provisions of the
Rochester Police Department's stress program signed
by the program director and the department,
illustrates the level of detail such guidelines can
provide.

Programs need to distribute their written
guidelines to every member of the law enforcement
agency so that officers can learn how the staff
can--and cannot--protect confidentiality. However,
since few officers will take the time to read or
remember a technical discussion on confidentiality,
program staff need to provide them with a one-page
bulleted summary written in lay language and then
explain the guidelines in person at roll calls and
other
face-to-face occasions.

Secure Informed Consent

At the beginning of the first counseling session,
program
counselors need to give every new client an
informed consent statement, explain it, and ask the
client to sign it. The form should explain both the
program's confidentiality guidelines and the
exceptions to its ability to keep information
private (see the sample consent form in appendix
I).

When a therapist is required to discuss client
information with someone else (see pages 83-85),
the clinician should tell the client what
information will be communicated, to whom, and why.
For example, a therapist may tell an officer who he
or she believes is making serious threats against a
commander that the threats are going to be reported
to the supervisor because
professional ethics, legal requirements, and
department policy require that this information be
shared. Informing the potential victim, however, is
only one of many actions that a clinician may take
to protect that person. For example, the clinician
may include the potential victim in the treatment
sessions to permit
therapeutic discussion of the violent intentions;
in this way, the potential victim is informed by
the client without breaching confidentiality. Other
alternatives include focusing the therapy on the
violent thoughts and threatened behaviors,
evaluating the client for new or different
medication, and psychiatric
hospitalization. Special programs to help people
control anger and violence may also be used.[8]

Maintain Appropriate Client Records

Under certain circumstances, courts may
successfully subpoena a program's or counselor's
written client records (see the discussion on
"Potential Legal Complications," below). As a
result, some stress programs maintain no records at
all. Other counselors report that the only notes
they keep on officers say things like "working on
the problem" or "making progress," without
identifying the officer's problem.

However, recording relevant clinical information is
an important clinical practice because it is
necessary to ensure good client care. According to
the American Psychological Association's Ethical
Principles of Psychologists and Code of Conduct
(section 1.23), "Psychologists appropriately
document their professional and scientific work in
order to facilitate provision of services later by
them or by other professionals, to ensure
accountability, and to meet other requirements of
institutions and the law." For example:

o Counselors need a written record to refresh their
memory, especially if they have many clients or if
more than a week or two passes between counseling
sessions. Records preserve essential information
about patients' medical and mental health
conditions and treatments.

o If the officer or family member needs to be
transferred to another clinician (for example,
because the client has moved) or if the client has
to be hospitalized, good clinical records are
needed to inform the new treatment staff of the
patient's condition and history. 

o Clinical records can provide evidence of a
clinician's thinking and decision making. From a
liability perspective, it is only through the
written record that a clinician can prove that he
or she conducted appropriate treatment and weighed
carefully the pros and cons of a decision (e.g., to
release from the hospital a patient who
subsequently committed suicide).

o Licensing boards in many states require
counselors to keep client notes.

o State law may require record keeping (see the box
"State
Legislation May Require Record Keeping").

The real issue is what to put into the record. On
the one hand, counselors need to anticipate that
because third parties--e.g., insurance companies,
courts, family members--might at some time see the
records, clinically irrelevant information should
be excluded. For example, counselors normally do
not need to record information about clients'
sexual affairs or the negative opinions they voice
about fellow employees. On the other hand, certain
information should be in the record. For example,
client records should record the date of each visit
and contain information about the client's
diagnosis, mental status, and clinical condition,
and in general terms what was discussed during each
session. Information on medical conditions,
medications, drug allergies, effects of treatments,
and emergencies should also be recorded. Of course,
the decision about what is clinically pertinent is
in many cases a matter of judgment. However,
program planners and independent practitioners need
to check their State statutes and case law
concerning the confidentiality of client-counselor
communications for guidance in deciding what kinds
of records to keep.

The specific kinds of information counselors will
be recording should be described in the program's
written confidentiality guidelines and informed
consent form. If counselors will be using a
standard intake form or other data collection form,
copies of these can also be included as part of the
guidelines. Finally, programs typically keep all
client records in a secure place with access
limited to those involved directly in the client's
treatment. For example, records of the Counseling
Team in San Bernardino are kept locked up, and both
the program office and the building have separate
after-hours alarm systems. 

Minimize Mandatory Referrals

Providing counseling to officers who have been
required by their supervisors to seek treatment is
discussed in detail in chapter 10, "Responding to
Stress-Related Problems After They Occur." However,
mandated treatment raises confidentiality issues
for program staff. Most counselors agree that
accepting fitness-for-duty and other types of
mandatory referrals from department command staff
can destroy the program's credibility among line
officers because they will view the staff as
beholden to management and may fear that even
voluntary visits to the program will jeopardize
their career advancement.

In fact, with formally mandated treatment,
supervisors can--and typically do--successfully
demand to be kept apprised of whether the officer
sought assistance, is making progress in treatment,
and is fit to return to duty.[9] For example,
Federal agencies are generally restricted by law
from obtaining information about their employees'
use of counseling services, but in the case of
fitness-for-duty evaluations, administrators can
obtain records from the evaluation.[10] The Metro-
Dade police Department's standard operating
procedures stipulate that "[c]ommunications between
. . . [mandatorily referred] employees and HSS
[stress program] staff or outside consultants, test
results, written opinions and recommendations,
notes, reports, and actions taken are not
privileged and become departmental records."
Records from fitness-for-duty and other kinds of
mandatory referrals may not be protected in some
jurisdictions by statutes that ensure
confidentiality between counselors and their
clients because in such cases the department, not
the officer, may be considered the client.

As a result, most of the programs and independent
practitioners interviewed for this report refuse to
accept mandatary referrals or, if they do, refer
them to outside treatment providers. For example,
the bargaining agreement between the Michigan State
Police Troopers' Association and the department
says that "no employee shall be required to undergo
any psychiatric or psychological examination or be
required to be subjected to psychological
examination by psychologists retained/employed by
the Department, except upon an assertion by the
employee of disability for
psychological reasons."

If a program does choose to accept mandatory
referrals, counselors recommend the following
precautions:

o Include in the written confidentiality guidelines
and informed consent form (1) the exact type of
information the program will report to the
department and (2) the manner in which the
information will be communicated.

o Make clear in the confidentiality guidelines the
differences in the management of mandatory and
voluntary cases.

o To avoid conflict of interest problems, designate
one or more staff members to treat only mandatory
referrals, while all other staff treat only
voluntary referrals.

o Provide supervisors with as little information as
possible about the officers; if possible, tell
supervisors not to expect any written or verbal
report but instead to look for improvement in the
officer's job performance.

Potential Legal Complications

Program staff and independent practitioners may
encounter two legal threats to confidentiality:
subpoenas to provide program records or to testify
and liability suits claiming breach of
confidentiality.

Subpoenas

According to two forensic experts, "The mere fact
that a subpoena has been issued does not compel a
therapist to testify, only to appear. At that
point, it is for the judge to decide whether the
testimony or records in question are subject to a
claim of
privilege. Receipt of a subpoena should be a
stimulus for the therapist to contact the lawyers
involved to determine the
information sought. If the right of a patient to
claim privilege may be at issue, the patient or his
lawyer should be notified, too. Finally, this may
be a good time for the therapist to contact his own
attorney to clarify his rights and responsibilities
in the case at hand. Under no circumstances should
records be altered or destroyed when a subpoena is
received."[11]

A case that the U.S. Supreme Court ruled on
provides some closure regarding the nature of
privileged communication in this area in Federal
cases. The family of an alleged offender shot and
killed by an officer in 1991 in Illinois sued the
officer, contending that the officer violated the
dead person's Federal constitutional right not to
be subjected to unreasonable seizures or deprived
of life without due process of law. The family
directed a subpoena to the licensed clinical social
worker to whom the officer had gone for
professional counseling after the shooting and the
clinician's records and notes pertaining to the
case. The district court denied the officer's
motion to quash the subpoena. After the social
worker was deposed, the family moved the court for
sanctions against her, contending that her
deposition answers relating to her
conversations with the officer were evasive and
incomplete. The court complied, ordering that the
officer would be precluded from testifying at trial
regarding her version of the incident because the
family's attorneys had been prevented from
effective
cross-examination. The court also referred the
matter of the social worker's noncompliance to the
U.S. Attorney's Office for possible criminal
contempt proceedings. Furthermore, at trial, the
court informed the jury that it was entitled to
presume that the contents of the social worker's
notes would be unfavorable to the officer. The jury
awarded $45,000 on the Federal constitutional
violation and $500,000 on the State wrongful death
claim.

On appeal, the Circuit Court of the Seventh
Circuit--which
acknowledged that the communications would be
privileged under State law if it were controlling--
recognized the existence of a
psychotherapist/patient privilege under Rule 501
(the privileges of a witness not to testify) of the
Federal Rules of Evidence. The circuit court held
that the district court had erred in refusing to
recognize that privilege and in requiring
disclosure of the content of any of the counseling
conversations between the officer and the social
workers, and, accordingly, reversed the verdict and
sent the case back for a new trial. The family
appealed the circuit court's decision to the U.S.
Supreme Court. In Jaffe v. Redmond (June 13, 1996,
No. 95-266), the Court in a 7-2 decision for the
first time ruled that "The federal privilege, which
clearly applies to psychiatrists and psychologists,
also extends to confidential communications made to
licensed social workers in the course of
psychotherapy. The reasons for recognizing the
privilege for treatment by psychiatrists and
psychologists apply with equal force to clinical
social workers, and the vast majority of States
explicitly extend a testimonial privilege to them."

Three other examples of subpoenas were identified
during the course of data collection for this
report. Douglas Gentz, Director of Tulsa's
Psychological Services, was subpoenaed to testify
because he was a behavioral consultant in a SWAT
team operation in which team members killed a
mentally ill man after he came out of a house
pointing a rifle at them. Later, the man's family
filed a wrongful death lawsuit against the State of
Oklahoma, the Department of Mental Health, and the
City of Tulsa. Gentz was subpoenaed by the family's
attorney to give a deposition on what he heard and
saw. The suit was later dropped. Records of
Michigan's Behavioral Science Section were
subpoenaed during a divorce proceeding when a wife
wanted to prove that her husband committed
adultery, and on two other occasions when workers'
compensation administrators wanted to verify that
an officer who had filed for early retirement or
disability had suffered a legitimate job-related
injury. Finally, the director of the San Antonio
Police Department's Psychological Services was
required to testify in a criminal case because
under Texas law clinician records are not protected
when the officer is charged with a felony.

Lawsuits

Very few clinicians contacted for this study
reported having been sued. In one case, a counselor
referred an officer to an outside psychologist for
a fitness-for-duty evaluation because of reports
about the officer's behavior from the internal
affairs division. The officer alleged that the
referral itself, because it was demeaning, led to
his developing severe emotional problems. The case
was dismissed by the court.

In a second case, at the request of a police agency
a counselor had undertaken a study of a
dysfunctional police unit. The counselor
recommended to the department that the commander be
replaced because he did not have the interpersonal
skills the position required. When the commander
was transferred, he sued the
department and the counselor. The court dismissed
summarily six of the seven allegations but ordered
that a seventh be explored further--an allegation
that the counselor had violated
confidentiality by providing the department with
information the commander had told him in
confidence and which the department had used
against the officer. Although the counselor did not
have a clinical relationship with the commander,
the department settled the case for an undisclosed
sum. 

Steps Practitioners Have Taken To Reduce Their Risk
of Liability

Program staff and private clinicians follow a
number of steps in the effort to reduce the risk of
legal difficulty around issues of confidentiality:

o They do not overpromise--that is, they do not
guarantee any privacy they cannot ensure--and they
obtain a written sign-off from each client
indicating he or she understands the conditions
under which counselors must report client's words
or behavior.

o They avoid group therapy because there is no way
to control what group members will tell other
people after each session is over. Therapists who
do run groups act to correct misapprehensions that
what the members say will be kept confidential by
warning
participants of this risk. Some therapists will
stop the
conversation if something is being said that could
hurt a
participant or a member of a participant's family.
Unfortunately, by inhibiting communication in the
group, such practices may render the group
ineffective as a treatment modality.

o They train peer supporters to respect the limits
of their role and to avoid presenting themselves as
professional counselors. One chaplain who said he
was a crisis counselor was sued for
misrepresentation and giving dangerous advice.

Legal Assistance

Stress program staff should consult with legal
counsel regarding State and local statutes and case
law, and to clarify their legal responsibility for
maintaining confidentiality. They should ask
attorneys to review program practices, including
record-keeping procedures, to ensure that they meet
acceptable standards. Statutes and case law vary
considerably from State to State, making it
impossible to provide detailed guidance on these
matters in this publication. Furthermore, because
forensic psychology is a highly technical area,
program and independent practitioners who provide
services to police agencies should consult with
attorneys who specialize in legal issues related to
counseling.

Program staff who are in-house employees of a law
enforcement agency may be able to receive free
legal advice from and representation by the agency
or the city or county. The State Attorney General's
Office is a legal resource to the staff of the
Michigan State Police Behavioral Science Unit, and
the San Antonio city attorney's office has always
taken on cases for Michael McMains, Director of
Psychological Services, San Antonio Police
Department. However, even before his program became
completely independent from the police department,
Douglas Gentz, of Psychological Services in Tulsa,
always used his own attorney to make sure he was
represented by someone looking out for his own and
his clients' best interests, not the interests of
the department or the municipality. Counselors in
private practice, whether independent practitioners
or members of a counseling agency contracted by the
police department, need to hire private attorneys
to represent them. Finally, all clinicians should
have professional malpractice insurance. Insurance
carriers commonly provide an attorney if the
practitioner is sued, although there may be
exceptions depending on the nature of the case.

The International Association of Chiefs of Police
is available to provide legal advice to stress
program staff by calling (703) 836-6767, or writing
IACP, 1110 North Glebe Road, Suite 200, Arlington,
VA 22201. Professional associations and schools
that have
continuing education programs often offer risk
management courses, and some malpractice insurance
carriers distribute tapes on risk management.

While they may help, legal advice, courses, and
special precautions are no guarantee against
lawsuits. Rather, the best defense against a suit--
although still not foolproof--is always providing
good clinical care.

Endnotes

1. Zelig, M., "Ethical Dilemmas in Police
Psychology," Professional Psychology: Research and
Practice, 19 (1988): 336-338.

2. "Confidentiality refers to the right of an
individual not to have communications that were
imparted in confidence revealed to third parties.
It is derivative of a broader right to privacy. . .
. Privilege, often called more accurately
`testimonial privilege' . . . [exists] when he has
the right to bar another person from testifying
based on information that person has gained from
contacts with him. Privilege applies only in
judicial or parajudicial settings and its extent is
strictly limited by case law or statute."
Applebaum, P.S., and T.G. Gutheil, Clinical
Handbook of Psychiatry and the Law, second edition,
Baltimore: Williams and Wilkins, 1991: 5.

3. Zelig, "Ethical Dilemmas," 337.

4. Goolkasian, G., R.W. Geddes, and W. DeJong,
Coping with Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985.

5. For example, in Tarasoff v. The Regents of the
University of California (529 P. 2d 553 [Cal. 1974]
[Tarasoff I]; Reargued 551P. 2d 334 [Cal. 976]
[Tarasoff II]), the Supreme Court ruled that when a
therapist determines, or should have determined,
that a patient presents a serious danger of
violence to another person, the therapist must use
reasonable care to protect the intended victim
against the danger by, for example, warning the
victim, warning other people who can warn the
victim, notifying the police, or having the patient
committed to a secure facility. Frequently
misunderstood, Tarasoff held that liability was
imposed not because the therapist failed to predict
the patient was dangerous but because he did not
take sufficient action to protect (and not merely
warn) the victim. In subsequent Federal cases
(e.g., Lipari v. Sears, Roebuck and Co. [497 F.
Supp. 185 (D. Neb. 1980)] and Jablonski v. United
States [712 F. 2d 391 (Ninth Circuit 1983)]),
courts have held that therapists may be liable even
when a specific victim is not known. For a
discussion of Tarasoff and other pertinent cases,
see, for example, Flanagan, C.L., "Legal Issues
between Psychology and Law Enforcement," Behavioral
Sciences & the Law, 4 (1986): 371-384.

6. Zelig, "Ethical Dilemmas," 338.

7. Dietz, P.E., and J.T. Reese, "The Perils of
Police 
Psychology: 10 Strategies for Minimizing Role
Conflicts When Providing Mental Health Services and
Consultation to Law
Enforcement Agencies," Behavioral Science & the
Law, 4 (1986): 385-400.

8. Appelbaum and Gutheil, Clinical Handbook, 12.

9. Ibid., 194-199. 

10. Goolkasian et al., Coping with Police Stress,
36.

11. 42 CFR 2. Also see Public Law 93-282 (42 U.S.C.
4582), sec. 303.

12. Appelbaum and Gutheil, Clinical Handbook.

Word of Mouth Is the Best Method of Publicizing the
Program's Commitment to Confidentiality

While the director can distribute the program's
confidentiality guidelines departmentwide, nothing
convinces officers that their privacy will be
honored better than the recommendation of a fellow
officer. When asked by other officers if the
program keeps its clients secret, a program client
reported he answers, "I've never had anything come
back to bite me about what I've said. And my
counselor has never said anything to me about
another cop, either, even when I've asked." An
officer in another jurisdiction reported that he
came to believe his department's program was
confidential when he discovered that his wife had
been a client for several months, and he did not
even know it until she told him.

State Legislation May Require Record Keeping

Florida statute (chapter 59P-9, Client Records)
states, "A licensed clinical social worker,
marriage and family therapist, or mental health
counselor shall keep current written client records
which . . . at a minimum shall include clear
statements summarizing . . . the service user's
presenting symptoms, what transpired in any therapy
provided, what the service user indicated
concerning sensitive matters such as threats
against other persons, what progress, if any, was
made by the service user, and results obtained."

Additional Strategies for Protecting
Confidentiality

o Chapter 3, "Structuring the Program," discusses
the value of locating the program's office away
from the law enforcement department, preferably in
an area where officers are unlikely to pass by.

o To provide added privacy, program offices in San
Bernardino, Michigan, and Tulsa have a separate
exit for officers so that they do not have to pass
through the waiting room after each session and
chance being recognized. The Tulsa program also
discourages walk-ins in order to further minimize
unwanted encounters among clients in the waiting
room; the program flier states, "To ensure the
utmost in confidential service to our clients,
drop-in visits are strongly discouraged." The
program's general information handed out to clients
also advises that "an individual who is scheduled
for counseling may not wait an extended period of
time in the reception area. We anticipate your
arrival no earlier than 10 minutes prior to you
scheduled appointment."

o The Tulsa client information sheet also notes,
"Since the service is confidential, the staff does
not admit the presence of clients to any inquirer
(for instance--telephone callers), even members of
the client's immediate family. If it is necessary
that you receive a telephone call or message in
this office, please inform the Office Manager."

When Does Confidentiality Go Into Effect?

Communication between a counselor and client is
protected
communication when there has been "a clinical
contact." However, case law is largely silent on
what constitutes a contact, and different
therapists define the term differently. Most
program staff interviewed for this report consider
a clinical contact to have occurred as soon as an
officer or family member says anything about his or
her personal life (including work-related stress).

o "It begins whenever someone starts to tell you
something. For example, if someone on break at the
academy comes over to talk to me, I consider it a
clinical contact." --Nancy Bohl, Director of the
Counseling Team, in San Bernardino

o "Some counselors define a clinical contact as an
hour spent in the office, but I'm not rigid;
spending any amount of time talking to a cop or
family member about a problem is my definition." --
Michael McMains, Director of Psychological
Services, San Antonio Police Department

o "I assume any private conversation with an
officer or officer's family member will be assumed
by them to be privileged." --Douglas Gentz,
Director of Psychological Services, Tulsa

Sources of Additional Information on
Confidentiality

The following materials provide additional
information about confidentiality:

o Richard Rosner. Principles and Practice of
Forensic Psychiatry. New York, Chapman and Hall,
1994.

o Paul S. Appelbaum and T.G. Gutheil. Clinical
Handbook of
Psychiatry and the Law. Second Edition.
Philadelphia: Williams & Wilkins, 1991.

o American Psychological Association. Ethical
Principles of Psychologists and Code of Conduct.
Washington, D.C., n.d.

"The first thing I do with a new client is to have
the officer or family member read and sign the
informed consent form."-- Richard Smith, Michigan
State Police Department Behavioral Science Section

"I would be extremely bothered if the Counseling
Team did
fitness-for-duty evaluations because I'd be afraid
my counselor would tell my department I wasn't fit
for duty."--Police officer client

_____________________________________________

Chapter 7

Marketing the Program
_____________________________________________

Key Points

o To be successful, a stress program must generate
awareness, support, and referrals among four target
groups: administrators and mid-level managers,
union officials, line officers, and, if targeted
for services, family members of all personnel.
Special outreach efforts may be required for other
groups to whom services are available, such as
retired officers, corrections officials, and
nonsworn employees.

o Program planners and staff need to be patient
when trying to gain support and make marketing and
outreach an ongoing program
activity.

o Common obstacles to gaining support and referrals
include the following:

--lack of awareness of the nature or severity of
stress-related problems and the need to address
them;

--lack of awareness of program services;

--the attitude that officers should be able to cope
with their problems on their own or that existing
city or county services are sufficient;

--skepticism about whether the program can prevent
or reduce stress-related problems;

--concern about lack of confidentiality; and

--fear of a stigma attached to using program
services.

o Common strategies for generating awareness,
support, and
referrals among the four key target groups include
the following:

--involvement of the target groups in program
planning;

--training;

-- word of mouth; and

--around-the-clock availability.

o A proven record of maintaining confidentiality is
one of the most important factors in determining
whether programs will gain and maintain support and
referrals.

One of the most important tasks faced by law
enforcement stress program planners and staff, and
by independent mental health practitioners who
consult to police agencies, is promoting the
program among potential clients. Even if a program
has
exceptionally qualified staff and excellent
services, it cannot be effective if officers and
their family members are ignorant, skeptical, or
critical of the program. Depending on its goals and
objectives, a program can be promoted among four
key target groups: administrators and mid-level
managers, union or association officials, line
officers, and family members of all personnel. In
particular, planners and staff must engage in
marketing and outreach strategies to generate

o awareness of stress and its effects on officers'
job performance and personal lives, and of the
program's location, policies, staff, and services;

o support for the program, including trust in the
program's commitment to confidentiality and
confidence in its ability to improve clients' work
and personal lives; and

o referrals of clients, including not only officers
and family members who have been involved in a
critical incident or have reached a personal crisis
but also those who are experiencing less severe
levels of stress but can be helped before more
serious problems arise.

This chapter describes approaches that program
staff serving both large and small departments have
used for marketing their services. Most strategies
are useful, to a greater or lesser extent, for
accomplishing all three of the goals described
above. Some, such as conducting training seminars
and developing brochures, involve a significant
amount of time, effort, and sometimes expense.
Other techniques, often equally effective, can be
as simple as choosing an appealing program name or
taking five minutes at roll call to explain the
program.

Respondents emphasized three points to keep in mind
when marketing stress program services: 

(1) Be patient. The director of the Metro-Dade
Police Department's Health Services Section said it
takes a minimum of three years for program staff to
win the confidence of officers, even if the staff
are officers themselves. The Erie County, New York,
Law Enforcement Employee Assistance Program's
director advised that it takes about one year just
to get a program up and running and several more
years to generate widespread awareness and support;
however, she noted, "We'd rather take longer and do
it right."

(2) Make marketing and outreach efforts an ongoing
program
activity, not a one-time effort, particularly in
large departments. An initial mailing or training
session at the academy is not enough to ensure that
officers will know about, accept, and use program
services. Because many officers may forget what
they have heard or read, staff must continuously
remind them of the availability of program services
and convince them of their value. Also, officers
will not be impressed with a half-hearted effort to
win their support. Marketing and outreach are
usually most important--and most difficult--in the
beginning stages of the program and
gradually become easier as staff build support
among officers. However, even the directors of the
Michigan State Police Behavioral Science Section
and the Metro-Dade Health Services Section, both of
which were established over 17 years ago, said that
promoting awareness of their program remains an
ongoing struggle.

(3) Gain the support of management and labor before
even attempting to win over line officers and their
families. Administrators and union or association
officers are in a position to either provide
enormous help to staff in marketing the program or
make it nearly impossible to win support. Also, a
major selling point among line officers is
agreement between labor and management on the value
of the program.

Marketing the Program to Law Enforcement
Administrators and 

Mid-Level Managers

Program directors consistently report that it is
important to "start at the top" when soliciting
support for stress services. As one program
director said, "Once administrators buy in, it's
easy." However, top-level support must be more than
lip service. Law enforcement administrators can
actively facilitate the development and acceptance
of the program by

o providing funding and office space for the
program;

o facilitating and encouraging the provision of
training to officers;

o allowing officers to take the time to be trained
as peer
supporters and do peer support while on duty;

o providing officers with time to attend counseling
appointments while on duty without asking where
they are going (although this may be difficult to
do with uniformed patrol officers on tight
schedules); and

o making organizational changes suggested by
program staff to reduce officers' stress and
publicizing the program's contribution to these
changes.

Administrators and managers can also set the tone
in a department for whether officers will be looked
down on or disciplined for stress-related problems
and "red-flagged" for excessive monitoring for
signs of stress--or whether they will be encouraged
to obtain assistance out of a genuine concern for
their well-being. Mid-level managers are in an
especially good position to refer officers who are
displaying the effects of stress and to reassure
them of the confidentiality of the referral and
subsequent program services.

Obstacles to Gaining Support and Referrals

Law enforcement administrators and mid-level
managers may be doubtful or cynical about stress
services for a number of reasons. They may believe
that

o stress-related problems are not prevalent or
severe enough among officers and their family
members to warrant a stress program;

o officers should be able to handle their problems
on their own and, that if they cannot, they should
be disciplined or fired;

o a stress program, although well-intentioned,
would not be effective;

o an existing city or county employee assistance
program or other community resources provide
sufficient assistance;

o the program's policy of confidentiality is not
acceptable because it detracts from managers'
ability to supervise effectively;

o the program will divert money from other, more
important, department activities; and

o by trying to assist or refer an officer they will
risk a lawsuit.

In Erie County, the commissioner of Central Police
Services encouraged the development of a program
targeted just toward law enforcement after several
police chiefs throughout the county inquired about
what they could do for officers who needed
assistance for stress-related problems. Even so,
the director of the new Erie County program still
felt she had to make significant efforts to enlist
the support of many of these administrators for the
specific program she was developing.

Even if they support the program, administrators
and managers may be unable to refer personnel to
the program because they are not familiar with the
signs of law enforcement stress.

Strategies for Gaining Support and Referrals

Program planners and staff have found the following
strategies useful for gaining support among
administrators and mid-level managers and
encouraging them to make referrals to the program.

Involve administrators and supervisors in program
planning. Law enforcement administrators and
managers are more likely to support a program that
they had a hand in creating. Their contributions--
and support--can be solicited by inviting them to
serve on a program advisory board or to attend
meetings with program planners and staff. The Erie
County Law Enforcement EAP has an advisory board
which includes the commissioners of Erie County's
Central Police Services and the Buffalo Police
Department, the director of police training, the
sheriff of the Erie County department, a
representative of the Erie County chiefs'
association, and other police administrators from
throughout the county.

Conduct training. Training, ranging from brief
presentations to intensive seminars, while
typically designed primarily to help supervisors
recognize the signs of stress, can also generate
support and referrals among supervisors. Chapter 8,
"Preventing Stress and Stress-Related Problems,"
provides detailed information about program
training.

Provide information on the program's benefits to
the department. Law enforcement management and
command staff are naturally
concerned about the efficiency of their
departments. While stress program staff can appeal
to a humanitarian concern for the
well-being of officers and their families, it is
equally useful to emphasize that the program can
help improve officers' job
performance. Supervisors in the Miami Police
Department, for example, found the case of an
"officer of the month" whose
stress-related problems led to greatly diminished
job performance but whose career was saved after
the program intervened to be a convincing example
of why stress services were needed.[1] San
Bernardino's Counseling Team received a letter from
the sheriff's department reporting that in six
years the program had saved the agency $12 million
in workers' compensation costs. Chapter 13,
"Managing Program Costs and Funding," identifies
other examples of how programs have helped
departments save money. Another useful marketing
strategy for upper management is to explain that a
stress program can help protect a department from
civil suits by reducing the likelihood of officer
mistreatment of citizens. Some programs have also
found it useful to distribute regular program
reports to administrators and managers (see chapter
12, "Monitoring and Evaluating the Program"). These
reports can remind upper management about program
activities and inform them of how officers are
using--and benefiting from--the program.

To counter the perceived image among managers that
the program is staffed by "touchy-feely, liberal,
bleeding hearts," Gary Kaufmann, Director of the
Michigan State Police program, continuously
stresses that his services are designed to improve
the productivity of officers: "Our attitude is, The
employee has to do the job; if he or she doesn't
shape up, the person has to be let go.'" Kaufmann
also promotes the program by reminding management
that when stress forces an officer to leave the
force or retire early, it is extremely expensive to
train a new recruit, and it will still take several
years for the rookie officer to become completely
socialized to respond professionally and safely in
law enforcement situations.

Supervisors may be persuaded of the need for a
stress program, or a new program component, by the
self-reported needs of their officers. Cindy Goss,
Director of the Erie County stress program,
conducted a survey of 254 officers throughout the
county that demonstrated their perceived high level
of stress and their desire for critical incident
debriefing, peer support, and other
stress-related services. The survey results helped
Goss to convince police chiefs throughout the
county of the need for the program. Douglas Gentz,
Director of the Tulsa police stress program,
convinced management to fund a peer support
component by designing and implementing a
departmentwide study on post-shooting trauma. Gentz
presented administrators with the results, which
showed the impact of the shootings on officers'
performance and how strongly officers felt about
the need for support from fellow officers after
such incidents. As a result, the department
encouraged Gentz to organize and train a peer
support team.

Encourage supervisors' participation in program
services. Administrators and command staff can be
encouraged to participate themselves in program
services such as critical incident debriefings and
private counseling. If they have a positive
experience, they are likely to promote the services
to each other and to the officers under their
command:

o In the first year of the Erie County Law
Enforcement EAP, the director helped lead a
critical incident debriefing for county officers
after a deputy sheriff was killed. Part way through
the session, the sheriff of the department--widely
perceived as a tough, imposing man--stood up to
talk about the incident and ended up breaking down
and crying. Although embarrassed afterward, he told
the director that he hadn't realized how much he
had needed the stress debriefing himself. The
director felt that the sheriff's show of emotion
helped generate support among the other officers,
who saw that it was "OK to be human."

o The director of the Behavioral Science Section of
the Manatee County, Florida, Sheriff's Office,
seeing the sheriff looking especially tired one
day, suggested he listen to a relaxation tape that
the director had in his office. The sheriff found
the tapes helpful and became more receptive to the
idea of a comprehensive stress program for the
department.[2]

o When an evaluation showed that many police
supervisors had only a vague notion about his
program's services, over a 20-week period the
director of Tulsa's Psychological Services invited
each member of the command staff for a two- to
three-hour "Friday Afternoon Tour" of the office,
using the time to explain the program as well as to
initiate a personal relationship with each manager.

Be proactive about contacting commanders and chiefs
when an opportunity occurs for the program to be of
service. As the third paragraph in the letter of
commendation reproduced on the following page (see
figure 5) suggests, this strategy can be an
especially useful way for individual mental health
practitioners or programs that serve several small
law enforcement agencies to gain
credibility with these departments.

Marketing the Program to Union and Association
Officials

As the bargaining unit and primary representative
of most officers in the law enforcement agency, the
union or association can be a particularly
important element in the success of a stress
program. For example, in some jurisdictions unions
have stymied any peer support program by demanding
that officers be paid overtime or given
compensatory time whenever they provide peer
support; in others they have jeopardized the entire
program by telling members that the counselors do
not keep visits confidential and are a tool of
management. Conversely, a union can promote the
program to its members and their spouses, refer
officers who need assistance (who often call union
officials on matters related to drinking or
suicide) arrange in some cases for the use of
program services in conjunction with or in place of
disciplinary measures, and either provide resources
itself for the program or influence the
department to invest money or staff in it.

Obstacles to Gaining Support and Referrals

The support of union or association leaders can be
difficult to earn, particularly if the program is
initiated by management. While union and
association officials may be the first to agree
that it is important to address stress-related
problems among officers and their families, they
may be concerned that

o program staff will not keep officers' problems
confidential;

o law enforcement managers will use the program to
target some officers for disciplinary action; and

o program staff, if they are not also officers
themselves, will not be able to understand and
address members' problems adequately.

It is important, therefore, to obtain union or
association support in the planning or early stages
of the establishment of a stress program and to
maintain ongoing efforts to ensure continuation of
this support.

Strategies for Gaining Support and Referrals

Many of the strategies discussed above that are
useful for obtaining management support are equally
effective with union officials.

Involve the union in program planning. As with
administrators and supervisors, union and
association officials will be more likely to
support the program if they have contributed to its
development. Contributions can be solicited by
meeting with representatives on an individual
basis, inviting them to serve on an advisory board,
or both. These methods can also be good ways simply
to get to know and become known by union and
association officials so they can associate a name
and a face with the stress program.[3] One program
director said that despite involving union
officials early on, it took about a year before
they started recommending the program to members.

After the initial planning stages, program staff
can continue to welcome the union's ideas regarding
future development. When the president of the
Michigan State Police union received a number of
calls from members who had drinking problems, or
who knew of other troopers who did, he approached
the director of the stress program about developing
a full-time staff position to be filled by a
trooper with whom alcoholic officers would be more
willing to talk than they were with the
psychologists on staff. Together, the director and
the union president worked with the director of
personnel to fund the position, develop hiring
criteria, and select the trooper--a recovering
alcoholic--for the position.

Sometimes timing--coupled with top-notch service
delivery--will win over a union. The director of
the Counseling Team in San Bernardino had tried
unsuccessfully to convince union officials in one
department to adopt the same contract provision
that is included in all its other contracts--a
requirement that all officers involved in a
shooting attend a group and individual debriefing.
Shortly afterwards, the department had three
shootings. On their own initiative, the police
supervisors on the scene called the program to
provide counseling to the three officers involved.
Afterward, the officers told union officials how
helpful the assistance had been, which resulted in
the union bargaining unit permitting mandatory
counseling to be included in the department's
contract with the Counseling Team.

Collaborate in providing stress services to
officers. Michael McMains, the San Antonio Police
Department's stress psychologist, helped the
officers' association establish a peer support team
of officers who have been involved in shootings to
provide support to other officers who become
involved in the use of deadly force. McMains helped
obtain funding from the union and the police
department for training the peers, but the union
runs the team. Furthermore, while an officer
involved in a shooting is required to meet with
McMains after the incident, the union attorney also
meets with the officer after notifying the peer
team about the incident and arranging for a team
member to stand by for possible support. Informed
of the peer team member's availability by McMains
and the attorney, the officer may meet voluntarily
with the team member for information about the
legal process that will follow the shooting,
preparation for the change in the officer's duties
that will follow, and suggestions for coping with
the emotional trauma of the incident.

Clearly define program guidelines. Because one of
the union's or association's greatest worries is
confidentiality between members and program staff,
it can help to spell out program guidelines clearly
in writing and to emphasize that the program is an
employee program, not a management program (see
chapter 2, "Planning the Program"). The Michigan
State Police union's contract with
management makes clear that the Behavioral Science
Section's services are employee services (see the
box "Spelling Out Program Guidelines in a Union or
Association Contract" in chapter 2.) To assuage the
fears of representatives of the Rochester Police
Department officers' association regarding privacy,
stress program planners involved the association in
drafting its confidentiality guidelines, and
members of the police association approved them in
a formal vote.[4]

Emphasize cost-effectiveness. Just as
administrators are concerned about running an
efficient department, union officials are
concerned about running an efficient union. Program
planners and staff can point out that by assisting
officers who otherwise may have faced disciplinary
action, a stress program can save the union money
that might otherwise be spent on attorney costs.
This is one of the primary reasons that a Teamsters
Union representative for the Erie County Sheriff's
Department gave for supporting the Erie County Law
Enforcement EAP. Usually the union representative
will refer an officer to the EAP when he or she is
going to be disciplined by the department. The
officer, union representative, member of internal
affairs, and director of the stress program meet
before further action is taken; if the officer
agrees to go to the EAP, successful completion of
treatment may mitigate the disciplinary action,
helping the officer and saving the union the
expense of further negotiation. The union
representative said that he prefers to refer
officers on a case-by-case basis, rather than
promote the program through meetings and fliers,
because he does not want officers to view it as a
way to "get off the hook" for disciplinary
problems.

Assist union officials with non-stress-related
issues. The director of the Michigan State Police
Behavioral Science Section has been able to win
support from union officials in part through taking
a role in union conflicts with the police
management. Although some respondents said it is
important for program staff to remain politically
neutral, it may be helpful to take advantage of
opportunities to become involved selectively in
labor-management relations, particularly if the
stress program is part of the department, not an
outside contractor, and risks being seen as
controlled by management (see the box "The Michigan
Program Works with the Union and Management").
These types of activities must be weighed
carefully, however, against the risk of alienating
supervisors who are also essential to program
success.

Marketing the Program to Line Officers

Even with the backing of administrators, managers,
and union officials, several barriers to officers'
use of services may remain.

Obstacles to Gaining Support and Referrals

Respondents consistently described five reasons why
officers might not support or use a stress program:

o Lack of awareness or denial of stress and stress-
related
problems. Officers may not recognize the level or
effects of stress that they or their family members
are experiencing.

o Lack of awareness about the stress program. Many
officers, particularly in a program's early stages,
may be unaware that it exists, or they may confuse
it with other programs, such as a city or county
EAP.

o Lack of perceived need for services or lack of
confidence in their effectiveness. Many officers
will have their own, often very effective, ways of
dealing with stress, including working out,
athletics, fishing, or talking with their police
partners or close family members. Officers may
consider counseling services to be "touchy-feely"
and not really useful for relieving stress. Older
officers who have long worked under a system that
expected them to contain their emotions and work
out problems on their own may be especially
confident that they can deal with stress by
themselves.

o Mistrust of program staff. Fear of lack of
confidentiality is one of the greatest obstacles to
participation in a law enforcement stress program.
This problem and possible solutions are discussed
in chapter 6, "Dealing With Confidentiality."

o Fear of stigma. Many officers either believe that
counseling is for "crazy people" and "wimps" or are
afraid that their colleagues feel this way.

There will always be officers who will not trust
the program or who believe that it is not useful in
spite of staff's best efforts at education and
outreach. Several of the officers interviewed for
this report who had never used their department's
stress services said that there was no way the
program, department, or union could convince them
that staff would keep their problems confidential.
Still, the strategies described below may win over
even some of these officers.

Strategies for Gaining Support and Referrals

Stress program staff and independent practitioners
have found the following strategies (outlined in
the box "Summary of Strategies") to be useful for
gaining support among line officers and
encouraging voluntary referrals.

Ensure that staff are qualified and knowledgeable
about law enforcement work. Important factors that
officers consider when thinking about using program
services are whether they will feel comfortable
with program staff and whether these people are
qualified to help them. Many officers feel that
only someone who has been an officer himself or
herself can understand their problems. The
directors of the Rhode Island Centurion and
Metro-Dade programs point to their law enforcement
experience as a key reason for their success.
Alternatively, some mental health professionals
have obtained police training. A member of
Michigan's Behavioral Science Section went through
the academy for municipal police officers and now
works one or two shifts a week as a sworn officer
in a local police department.

Some law enforcement stress experts, however, claim
that it is not necessary for staff to be, or to act
like, officers; competency as a mental health
professional, an appealing personality, and a good
understanding of the nature of law enforcement work
are the most important qualifications for gaining
acceptance.[5] Chapter 4, "Choosing Among Staffing
Options," examines these issues in detail.

Learn about police work. If program staff are not
police officers, it is important that they learn as
much as possible about law enforcement, including
the idiosyncracies of the departments they serve.
Many officers are impressed when staff volunteer
their time, particularly on the night shift, to
learn more about them and their jobs.[7] Several
program directors suggested riding with officers on
a regular basis.

Many program directors have found using peer
supporters to be one of the most effective methods
of generating support and referrals (see chapter 4,
"Choosing Among Staffing Options"). Peers are
particularly effective at outreach because they are
usually not seen as threatening or as lacking
knowledge about police stress. Peers do not provide
actual counseling but can be the "first line" in
helping officers to understand their problems and
then refer them to the stress program for
professional assistance. Some program directors
consider peers to be the most important single
source of voluntary officer referrals.

Maintain around-the-clock availability. Officers
are likely to be impressed by the dedication of
staff who make themselves available 24 hours a day,
are willing to work long hours, and volunteer their
time. As the director of Michigan's Behavioral
Science Section puts it, "Be there when you're
needed--always." The director of the Metro-Dade
program encourages new staff to prove themselves by
going to crime scenes and being prepared to stay as
long as is needed in critical incident situations.
One staff member stayed with officers for 72
straight hours after a shooting. Most program
directors remain available on call through pager
systems, and even when he was both working and
going to school, the Michigan
program's trooper counselor offered three ways for
officers to reach him. One family member of a
police officer said she was impressed when she
paged the department stress program director on a
Friday evening and the director both called back
within minutes and assured her that she was not
burdening him by calling in the evening. Ellen
Kirschman, Health Resource Coordinator for the Palo
Alto, California, Police Department, offers a
caveat about going on scene because stress program
staff can be seen as being in the way. In addition,
while it is important for mental health
professionals to demonstrate their willingness and
ability to endure the same gruesome sights officers
face, it is also prudent for professionals to do so
with care, as well as to avoid being repeatedly or
gratuitously "tested" in this way.

Prove yourself--and then rely on word of mouth.
Many respondents emphasized that stress programs
live or die by word of mouth among officers. As one
program director said, "One police officer saying
the program worked is worth 50 seminars." Officers
who use a program and are pleased with its services
can be its biggest advocates; officers who are
unhappy with services or derisive about them can be
a program's most potent detractors. To this end,
program staff must prove themselves to officers as
being capable and trustworthy. The benefits of
positive word of mouth are evidenced by such
officers' comments as, "Word is starting to get out
and people are starting to see the stress program
as
professional and productive," and, "It's starting
to get around that you can trust folks in the
program." The directors of several programs believe
that if they slip even once in their dealings with
officers--or are simply perceived to have violated
someone's trust--all their other efforts at winning
support will be futile as word spreads through the
police grapevine.

Another important element in selling the program is
constant and widespread exposure. As a client of
the Michigan stress program observed, "The Docs are
always trying something new and never letting you
forget they exist." As the discussion below
suggests, programs achieve exposure in a variety of
ways.

Involve officers in program planning. Enlisting the
assistance of officers in developing and improving
services not only ensures quality but also makes
the program visible:

o When the director of the Erie County program sent
survey forms to 10 percent of the officers in each
law enforcement agency in the county to solicit
information on their stress levels and on the types
of services they wanted or would use, the survey
not only helped her fashion a responsive program
but also generated awareness and support among many
officers throughout the county.

o The Counseling Team in San Bernardino gains
visibility as well as information by requesting a
department to ask its officers to provide the names
of other officers they feel would be best suited to
be peer supporters.

Simply meeting with officers in group settings or
one-on-one can also be a useful way to solicit
suggestions and gain support. Even those officers
who do not participate may feel more positive about
a program when they discover it consults with
officers.

Offer training and presentations. Conducting
training seminars and making presentations about
stress and the stress program are common and useful
strategies for educating officers and generating
support and referrals. (Training is discussed in
detail in chapter 8, "Preventing Stress and Stress-
Related Problems.")

Many of the officers interviewed for this
publication had heard about their department's
stress program during police academy training.
Program presentations in this setting help officers
become aware of the stressful nature of police work
and the availability of program services before
they even begin work, and a presence at the academy
conveys the perception that the program is an
integral part of the police department fully
supported by top management. However, many police
officers noted that they did not pay much attention
to the academy presentation because they did not
think they would ever need stress services or
because so much other information was being
presented during their training.

To help make a lasting impression on recruits,
program staff can use experienced officers and
charismatic speakers to capture their attention. To
try to convince skeptical recruits about the
usefulness of the program, and to help make sure
that they remember its existence, the Michigan
State Police Behavioral Science Section offers help
that they may need immediately, such as relaxation
techniques to use before especially difficult
phases of academy testing. Staff from San
Bernardino's Counseling Team arrange to give their
first presentation at the end of the academy's
first day, when recruits are particularly stressed.
Reinforcement helps as well: the Counseling Team
provides presentations on six to eight different
occasions during each academy, and its director and
three or four other staff also go to nearly every
academy graduation to cheer on the new recruits and
mingle with them after the ceremony.

Many programs offer stress-related in-service
training to officers and supervisors on a regular
or periodic basis, which serves both to help them
deal with stress and to publicize the program's
services. When an advanced officer survival course
included a session on stress taught by the director
of the Counseling Team in San Bernardino, an
officer in attendance who was still very troubled
by a critical incident was so impressed by the
director's recognition of the stages involved in
going through a critical incident that she
telephoned her that evening to ask to become her
client.

Assist with non-stress-related activities. Program
staff can build trusting relationships with
officers by assisting them with non-stress-related
activities. "By doing some of these activities,"
according to the director of the Michigan
Behavioral Science Section, "officers see program
staff as colleagues trying to catch the bad guy and
not as weird, eccentric `shrinks' who know nothing
about what's going on in the streets."

o The nonsworn directors of some programs have
become familiar to many officers by serving as
consultants (never as the negotiator) on the
hostage negotiating team. They are on call 24 hours
a day, 7 days a week, to respond to hostage
emergencies. Some
officer-clinicians do participate in hostage
negotiations--but only in their capacities as sworn
officers. John Carr and Patricia Carr of the Rhode
Island Centurion Program are their respective
police departments' senior, FBI-trained, hostage
crisis negotiators; similarly, Sergeant William
Garrison, head of the Metro-Dade Police
Department's Health Services Section, is a
negotiator with the department's special response
team of hostage negotiation and suicide
intervention specialists. The negotiator role
provides a valuable asset to the Carrs' and
Garrison's respective departments. This experience
and training also reinforce their credibility in
the provision of critical incident debriefing
support to officers in their own and other
departments.

o Providing conflict management assistance is
another way that program staff can become known
around the department as colleagues, not just a
counselors. The director of the Michigan program
was asked by the State Police union president to
mediate in a conflict between a post commander and
his troopers, and in another between white and
black troopers. In the latter case, the program
director asked the commander to rent a motel
conference room off-site and mandate the 12
troopers involved to meet there for an all-day
session which he moderated.

o Other non-stress-related activities that program
staff may nonetheless be qualified to perform
include training the SWAT team, canine unit, and
underwater team to deal with fear, and helping
investigators with criminal profiling and
investigative strategies. For example, after
viewing a crime scene together, the director of the
Michigan Behavioral Science Section and the
detective sergeant on the case were watching a
video rerun of a news conference at the police
station in which a husband and wife accused of a
crime were asked by the announcer, "Did you do it?"
The wife said, "No, and we'll take a lie detector
test," but the husband said nothing. The program
director suggested that the officers investigating
the case get the husband to a polygrapher (and one
who videotapes all his tests) before he got to his
lawyer. The officers did, and the man confessed to
the polygraph operator. The director of the Rhode
Island Centurion Program has been able to publicize
his stress program by participating with several
local police departments in writing grant proposals
to Federal agencies for funding to work with
victims of crime (who also, of course, experience
considerable stress).

Conduct proactive outreach. Sometimes the best way
to encourage officers to use program services is to
contact them directly, on an individual basis, to
offer assistance. This approach is usually
especially effective shortly after a critical
incident, when it is public knowledge that an
officer has been under a great deal of stress or
has experienced a trauma. Even if immediate contact
is not possible, direct contact as soon as possible
can still be effective. The director of the Metro-
Dade program located an officer to offer him
services a year after the officer had been involved
in a shooting and had left the department, moved to
another city, and then moved back to Miami. When
the recovering alcoholic trooper who became a
counselor in the Michigan stress program receives
calls from captains asking him to speak to troopers
with drinking problems, he will explain to them in
a nonconfrontational manner that people who care
about them are concerned about their behavior and
want them to obtain assistance with their problem.
If the trooper is not responsive immediately, he
leaves his business card and does not push the
matter further at that time, but he may call back
later to offer assistance again.

Many program directors send staff to the scene of
shootings or other critical incidents, if agreed
upon by the department, to provide services
directly to officers who may request them or to let
them know that help is available. Supervisors in
San Bernardino and Michigan are required to call
their respective stress program to send someone to
the scene after every shooting. After the bombing
of the Federal building in Oklahoma City, Bureau of
Alcohol, Tobacco, and Firearms (ATF) peer
supporters contacted affected agents and their
families, as well as agents called in to respond to
the bombing, to inform them of common reactions to
trauma and provide support. Several peers went to
survivors' homes or to the hospital to offer
assistance.

Maintain high visibility around the department. It
is important that officers be able to put a face to
the stress program.
Visibility can be particularly difficult--and
important--for staff of programs located outside
the department, such as individual psychologists
who have contracts with one or more agencies. Many
of the strategies discussed above will help to
personalize a program, however, counselors can
benefit by simply spending time at the department:

o The director of the Michigan program does what he
calls
"management-by-walking-around" or "got-a-minute
therapy." He goes to the State Police headquarters
at 7:30 every morning for mail and to make rounds
with personnel directors, chat with troopers, and
be available for the casual approach: "Do you have
a minute, Doc? I got this thing going. . . ." Ellen
Kirschman, the Health Resource Coordinator for the
Palo Alto Police Department, whose office is in the
police station basement between the locker room and
the briefing room, reports that she counsels people
"in doorways, bathrooms, and in the hall."

o The director of the Metro-Dade program uses his
personal credibility in the department to help new
staff get their foot in the door but requires them
to spend a certain amount of time on their own each
week with officers, observing their work and simply
getting to know them.

o Staff on the San Bernardino Counseling Team
attend officer promotion parties, retirement
parties, weddings, and every funeral.

Making presentations at roll call and at union or
association meetings can also be useful for
generating referrals. Staff must be careful,
however, not to get in the way of officers, be too
pushy, or over-identify with police work (see the
box "Setting Limits on Marketing and Outreach").

Provide written materials and encourage media
publicity. Written program information is an easy
way to reach a large number of officers, and many
officers are more likely to trust a program if they
see its policies, particularly those regarding
confidentiality, in writing. As a former program
director said, "No matter how much bridge-building
a psychologist may do to establish good will and
acceptance within a police department, individual
and family counseling will not be successful unless
a clear-cut policy of confidentiality and privilege
can be established. . . . Without confidentiality
restraints that are very clearly spelled out and
maintained, few requests for service are likely to
be received."[8] (Chapter 2, "Planning the
Program," and chapter 6, "Dealing With
Confidentiality," discuss methods of assuring and
publicizing confidentiality.) One way to emphasize
that the stress program is an employee, not a
management, program is to have policies and
procedures written into the union contract (see the
box "Spelling Out Program Guidelines," in chapter
2.)

Articles and advertisements in union or association
publications also provide visibility. The directors
of the San Antonio and Erie County programs
occasionally write about stress-related topics in
their police departments' union newsletters. The
Michigan program's trooper counselor writes a
periodic column in the union's
newsletter. The monthly union newspaper serving
Metro-Dade police officers regularly prints the
stress program's phone number as a reminder.
Posting the program telephone number on bulletin
boards and other visible locations can also be
useful.

Staff may also want to encourage local media to
write articles about the program. The Erie County
Law Enforcement EAP received an increased number of
calls after a Buffalo newspaper ran a story on the
program. This approach could backfire, however, if
the article is not framed in a positive context.
Also, staff need to be wary of reporters who want
detailed anecdotes about officers. The Erie County
program director has turned down several requests
by reporters for national TV news shows, despite
the publicity the exposure would generate, because
they wanted to talk with an officer who had
attempted suicide, received help from the program,
and remained on the force. The director felt that
even to ask such an officer if he would agree to an
interview would damage her credibility with him--
and, through word of mouth, with other officers.

Distributing brochures, memos, and other program
literature that discuss stress and describe program
services is a good way to reach all officers with
at least basic information to educate them about
stress-related problems and let them know that
assistance is available. These materials, however,
should be eye-catching and easy to skim quickly for
information. (See the sample brochure from the
Michigan State Department of Police Behavioral
Science Section in appendix J.) It may be helpful
to distribute a brochure once a year with officers'
paychecks. Program staff may also want to have
videos on stress, critical incidents, or similar
topics available for officers to check out and view
on their own. Chapter 14, "Tapping Other
Resources," identifies three videos that can be
used for this purpose.

Marketing the Program to Other Law Enforcement
Staff

Some programs offer services to corrections
officers, retired officers, and nonsworn personnel.
Many of the strategies described above can be
useful for generating support and referrals among
these groups, too. Special efforts may be
necessary, however, since these groups may assume
that the stress program is not available to them.
The Michigan State Police Behavioral Science
Section provides a six-hour training seminar on
stress, the program, and its services for civilian
employees at seven or eight posts across the State
each year. In addition, over the years program
staff have

o provided sessions to two mostly civilian
divisions which suffered the premature death of
well-liked coworkers;

o trained the personnel division in how to screen
applicants for nonsworn jobs;

o helped divisions institute performance appraisal
systems to assess supervisor effectiveness; and

o helped a division with team building after it was
forced to adopt a new automated fingerprint system.

Dispatchers are a special focus for some programs.
The Erie County program director periodically helps
train 911 dispatchers on stress and handling
critical incident calls. The San Bernardino
Counseling Team's protocol for responding to
critical incidents requires the on-scene mental
health professional to ask whether the dispatcher
needs help coping with the incident. While many
police officers and civilians wonder why there is a
need to counsel the dispatcher--"She wasn't out
there at the scene!"--the head of the Counseling
Team points out that "dispatchers feel very
responsible for the life or death of the police
officers on their force," and they experience
considerable pressure, stress, and sometimes
feelings of guilt when an officer is hurt or
killed.

Marketing the Program to Family Members

Several program directors said that they delayed
conducting outreach to family members until the
program had established some measure of support
among officers. This approach made it easier to
reach family members because officers were then
more willing to tell their spouses or significant
others about the program's services. Most program
staff find that family members often support the
program once they learn about it. However,
generating awareness in the first place, and then
gaining referrals, can still be difficult.

Obstacles to Gaining Support and Referrals

The most significant barriers to gaining support
and referrals from family members stem not from
ambivalence about the program but either from
ignorance that the program exists or fear that
seeking help will tarnish the officer's image. As
one officer's wife said, "Wives may wonder if they
are being disloyal to their husbands by talking
about them with another man [the counselor]." In
addition, under the impression that their family
members do not and never will need any kind of
assistance, officers may not tell them about the
program, or they may deliberately withhold
information about the program because they do not
want family members to air family problems with
anyone else, especially with someone associated
with the department; they may feel that knowledge
of their personal problems might be used to prevent
promotions, or they may feel embarrassed to have
other personnel learn about their difficulties at
home. Even an officer who acted as a peer supporter
said that his wife knew nothing about the program.

Strategies for Gaining Support and Referrals

Counselors generally promote their services to
family members both through officers and by
approaching family members directly. The strategies
described above for marketing the program to line
officers will go a long way toward generating
awareness and support among family members. Methods
of marketing the program directly to family members
are described below. Because they are also program
services as well as outreach strategies, the first
two approaches below--training and proactive
outreach--are discussed in greater detail in
chapter 11, "Services for Family Members."

Conduct training. One of the most common ways to
educate and generate support among officers' family
members is through
training. This is done most easily during the
academy, by inviting or requiring officers to bring
family members to a special seminar. Family members
may be more receptive to the training, and
subsequently to the stress program, if it includes
presentations by or discussions with spouses of
officers. Staff may attract more family members to
training sessions if they are scheduled at
convenient times, usually in the evening, and if
child care is provided. Finally, it may be helpful
to emphasize that their stress level does not have
to be extreme for family members to visit the
program for counseling; one spouse reported about
her academy experience, "It was very stressful for
me while my husband was in the academy . . . but I
never thought about coming to the program because I
didn't think my problem was that bad."

"When we visit the police station or hospital to
talk with officers after a critical incident, we
always make sure to talk with any spouses and
children who are also there."

--Nancy Bohl, Director, the Counseling Team, San
Bernardino

Conduct proactive outreach. Several program
directors have tried innovative ways of approaching
family members directly. Nancy Bohl, a counselor
from the San Bernardino Counseling Team says, "when
we visit the police station or hospital to talk
with officers after a critical incident, we always
make sure to talk with any spouses and children who
are also there." A program serving a police
department in Texas sent peer officers on home
visits to families of new officers to inform them
about available services within the department and
the community and to hand out a video that explains
police work and associated stress.[9] However, peer
supporters with the Erie County program said that,
while they frequently help officers with marital
and other relationship problems, they are reluctant
to offer or provide assistance directly to family
members for fear that officers would disapprove.

Program staff may want to consider training peer
spouses to provide outreach to officers' family
members. Whenever possible, the Counseling Team
invites spouses to become peers and participate in
the three-day peer supporter training. However,
only a dozen or so spouses have become peer
supporters, partly because departments will not pay
them to attend the required three-day training. In
Modesto, California, wives of officers who had been
involved in shootings formed a spousal support
group that calls the spouse of every married
officer involved in a shooting to offer child care
and other immediate assistance. A week or two
later, someone from the group calls to invite the
spouse to a support group meeting.

Encourage word of mouth. Word-of-mouth promotion of
stress programs is probably not as common among
family members as it is among officers for two
reasons: (1) because some officers are reluctant to
have their spouse or significant other share family
problems with someone associated with the
department, they do not mention the program to
them, and (2) because officers' families do not
necessarily socialize with each other often. Even
if it does not occur frequently, however, word of
mouth is still an effective way to spread
information about the program to family members.
One officer's wife who used the department's
program services to help her cope with her
husband's drinking problem recommended it to other
wives, who expressed surprise that the program was
available to them. In another jurisdiction, an
officer's spouse who had been a client of the
program was in a unique position to promote it
among other spouses because a number of them
patronized the health club she ran--and frequently
shared their frustrations about police work with
her.

A final word-of-mouth approach most programs use is
to encourage officers who come for counseling to
ask their spouses to attend, especially if the
officer's problem is a couples issue or is
affecting his or her spouse. With the officer's
permission, a counselor with the San Bernardino
Counseling Team telephones the spouse directly in
these cases and invites the person to come in for
one session without the officer, to give the
spouse's
perspective of the officer's problem. Only one
spouse has ever refused. Furthermore, the counselor
said, once the spouse has come for that initial
session, "then the officer is more likely to come
back with the spouse."

Mail brochures and other program materials. Several
respondents said that staff cannot rely on officers
to bring home materials that are sent to them at
the department. As a result, both the Erie County
and Michigan programs have mailed brochures or
other program materials to officers' homes as a
means of generating referrals. However, staff
should be prepared to encounter resentment among
officers who may feel that the program sent
information home "behind their back." For instance,
in another jurisdiction, a police department
lieutenant who serves as his agency's stress
officer sent a mailing to "the family of " each
officer describing his services and reported, "I
received a little flak from a few officers asking
me, `Why are you telling my family about your
services? '" Department newsletters can also be a
useful way to reach family members. After reading
articles in the union
newsletter written by the recovering alcoholic
counselor in the Michigan program, several family
members called the program for assistance with
family drinking problems.

As illustrated by the several references in this
chapter to other parts of this publication,
marketing and outreach are tied closely to many
other aspects of stress program development and
operation. The planning process, the organization
and location of the program, program staff, and
referral sources (discussed in previous
chapters) as well as program services and
monitoring procedures (discussed in subsequent
chapters) all have a major impact on whether the
program will be accepted and used. For this reason,
in addition to the direct marketing strategies
described above, planners and staff must be
particularly sensitive to how each feature of the
program will be perceived by its potential clients.
To be sure, a stress program is a difficult sell
among law
enforcement administrators, supervisors, unions,
line officers, family members, and civilian
personnel. However, as emphasized at the beginning
of this chapter, with patience and ongoing
marketing efforts, staff should be able to generate
the awareness, support, and referrals necessary to
make their program a success.

This chapter has explained how training can help
win the trust and support of officers and their
family members. Most importantly, of course,
training provides an opportunity to do what many
program staff and law enforcement administrators
believe is most important in addressing stress:
prevent it from occurring in the first place.
Chapter 8 looks at how stress programs train
officers in stress management and coping
strategies.

Endnotes

1. Goolkasian, G., R.W. Geddes, and W. DeJong,
Coping With Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985.

2. Trotter, R.J., "Psychologist With a Badge,"
Psychology Today, 21 (1987): 26-30.

3. Bohl, N. "Gaining Departmental Acceptance," in
Organizational Issues in Law Enforcement, ed. J.T.
Reese and R. Solomon,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1996.

4. Goolkasian et al., Coping With Police Stress,
34, 43.

5. Chandler, J.T., "The Multi-Department Police
Psychologist," The Police Chief (February 1980):
35.

6. Dietz, P.E., and J.T. Reese, "The Perils of
Police Psychology: 10 Strategies for Minimizing
Role Conflicts When Providing Mental Health
Services and Consultation to Law Enforcement
Agencies," Behavioral Sciences and the Law, 4
(1986): 385-400; Bohl, "Gaining Departmental
Acceptance."

7. Bohl, "Gaining Departmental Acceptance."

8. Blau, T.H., "Individual and Family Counseling
for Police," in Law Enforcement Families: Issues
and Answers, ed. J.T. Reese and E. Scrivner,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1994: 309-327.

9. Bohl, "Gaining Departmental Acceptance"; Dietz
and Reese, "The Perils of Police Psychology,"
398-399.

10. Ricks, P.C., and J.D. Munger, "The Forgotten
Recruit: Training the Police Spouse," The Police
Chief (November 1988): 20-22.

11. Mullins, W.C., "Peer Support Team Training and
Intervention for the Police Family," in Law
Enforcement Families, 205-212.

Program Staff Need to Market to Policymakers, Too

The police department is never the ultimate source
of program funding and, in some cases, not even the
immediate source. The city or county provides its
law enforcement agencies with their money. In some
cases, cities or counties, not the police agency,
also fund the stress program directly. For many
years, the Erie County Law Enforcement EAP stress
program was funded by the county although it served
law enforcement agencies. As a result, program
staff may need to "sell" the program to city
councilors, county
commissioners, town selectpersons, and other
elected and appointed local government officials.
The most effective marketing strategies with these
audiences will be the same approaches identified in
the accompanying text for convincing police
executives to fund--or increase funding for--the
program: pointing out the money the community will
save, the reduced opportunities for lawsuits, and
the reduced impairment that excessive stress
typically has on officer performance and
productivity.

The Michigan Program Works with the Union and
Management

o Originally, Michigan State Police internal
investigators obtained information from officers
involved immediately after every shooting or
critical incident. However, the union president
wanted the department to wait until later to
interview the officers, when they were more likely
to have a clearer recollection of the event. Acting
as an objective police psychologist, the
department's stress program director reported to
management that research suggests that officers do
in fact provide more accurate information about
shootings some time after the event and,
furthermore, that the officers involved experience
less stress if they do not have to confront the
internal investigator immediately after the shock
of the incident. Taking the program director's
information and other factors into account, the
department worked out an arrangement with the union
in which the union president, immediately after a
shooting, obtains a written statement from the
officers involved (one which omits information that
would help the plaintiff's attorneys should there
be a civil suit by the alleged offender or his
family) and provides it to the department to use in
response to media inquiries about the incident. The
department delays its internal investigation.

o Again acting in his capacity as an objective
police psychologist, the stress program director
provided the union president with information on
shift work that the president used in negotiating
with the department to change from mandatory
rotating to optional fixed shifts. (See chapter 9,
"Reducing Organizational Stress.")

o The department was trying to reduce the use of
two-person cruisers between darkness and midnight,
and the union was trying to maintain them. At the
request of the union president, the stress program
director suggested to the department that in his
experience having two officers in each cruiser was
a form of social support that appeared to reduce
trooper stress. Although the department still
reduced its use of double teams, the director's
willingness to state his professional opinion as an
objective third party helped gain support for the
stress program among union
representatives and members.

Summary of Strategies for Gaining Line Officer
Support

1. Hire staff who are well-qualified counselors and
knowledgeable about law enforcement work.

(a) Consider the advantages and disadvantages of
staffing the program with law enforcement officers
who are licensed clinicians.

(b) Learn about police work and consider using peer
supporters.

2. Choose an appropriate name and office location.

3. Maintain around-the-clock availability.

4. Prove that you have something beneficial to
offer and will maintain confidentiality--and then
rely on word of mouth.

5. Expose officers to the program.

(a) Involve officers in program planning.

(b) Offer training and presentations at the academy
and in-service.

(c) Assist with non-stress-related activities.

(d) Conduct proactive outreach.

(e) Maintain high visibility around the department.

(f) Provide written materials and encourage media
publicity, including

o policies and procedures;

o articles and announcements in department and
union publications; and

o brochures and other program materials.

6. Make officers aware of the program's
confidentiality guidelines and then stick to them.

What's in a Name?

The name of the stress program may have a subtle
but powerful impact on officers' attitudes and
acceptance. It is unclear, however, which names are
most effective. The director of San Antonio's
program chose Psychological Services instead of EAP
because he felt the latter would be seen as a
"fuzzy-headed liberal approach." To others,
however, Psychological Services sounds too clinical
and intimidating. The director of the Erie County
Law Enforcement EAP is confident that her program
name is useful because it implies that the
program's goal is to assist employees and is
specialized for law enforcement officers. A
psychologist who developed a stress program for law
enforcement agencies in western Michigan chose the
name Law Enforcement Clarification Center. With
this wording, he felt he included all law
enforcement officers, avoided the term "mental
health" (which he thought had a negative
connotation), implied with "clarification" that
something would be done "with somebody" instead of
"to somebody," and, with the word "center,"
generated a sense that program staff not only
treated clients but were also involved in training,
research, consultation, and other activities.[6] A
psychologist who serves several police departments
in Modesto, California, titled a support group for
officers who had survived shootings Shooters'
Luncheon and later Survivors' Luncheon in an effort
to lessen the stigma that might be attached to
attending support meetings.

Something as simple as how staff answer their
phones can make the difference between conveying a
feeling of collegiality and one of indifference.
Because each of the three counselors has his own
telephone line, the secretary for the Michigan
program answers the phone with, "Dr. Kaufmann's
line," "Dr. Smith's line," or "Trooper Atkins'
line," not "Behavioral Science Section." By titling
a packet of information for agents "Your Employee
Assistance
Services," the EAP for the Federal Drug Enforcement
Administration tries to convey a sense of program
ownership to agents.

Points to Emphasize When Marketing a Stress Program

When making presentations or developing written
materials, program staff may want to highlight the
following:

o Information

--Unique sources of stress and treatment needs of
law enforcement officers

--Available services

--Eligible clients (including retired officers,
nonsworn employees, and family members)

--Confidentiality policies

--Program staffing options (including peer
supporters)

--Program phone number and location

o Themes

--An officer does not have to be referred or feel
out of control to ask for help

--"You have a tough job, and we're here to help
you," not " You're broken and we'll fix you"

--Program is an employee service, not a management
tool

Proactive Outreach Pays Off

o One counselor called an officer three weeks after
she had been in a traffic accident in which her
partner and the driver of the other car were killed
to find out how she was doing and to ask if he
could come see her. The officer wondered, "What can
he say to me that will make this better?" but she
ended up talking to him for two hours on the phone
and came to his office to see him for four
additional 90-minute visits.

o Another police officer called his department
psychologist to ask how to talk to a friend who was
dying of cancer. After providing some suggestions,
the psychologist asked, "And how are you doing?"
"Not so good," the officer answered. The
psychologist drove to the station and talked with
him for two hours.

Setting Limits on Marketing and Outreach

Although marketing and outreach are key to program
success, if staff go overboard in their efforts
they risk alienating officers. For instance,
although it is important for staff to demonstrate
an interest in and familiarity with law enforcement
work, it is equally important to maintain
professional boundaries. In addition, staff should
be careful not to push their services too hard on
officers, for risk of wearing out their welcome.
The director of the Erie County program said that
she tries to be visible in the departments she
serves but does not "show up at everything all the
time." Instead she tries to let officers know she's
there to help them and then backs off and allows
positive word of mouth to generate referrals. She
also is frank about her limitations, saying, "I'm
not here to tell you how to do your job or to
pretend I know a lot about what you do, but I do
think I can help you."

A Newsletter Column Gets Results

A binge drinker whom most considered a model
trooper read an article that Jeffrey Atkins of
Michigan's Behavioral Science Section had written.
After his wife and three children threatened to
walk out, the trooper called Atkins for help.
Atkins lined up a treatment program, but when he
visited the officer the man said that he no longer
needed help because he had been sober for two
weeks--"I've got a handle on the problem." Two
months later, the trooper called Atkins again and
said, "I'm drinking again. What do I do now?"
Atkins drove him to a hospital where the trooper
completed inpatient treatment. The officer is now
back on the job--sober--and still a model trooper.

"We interviewed five providers and found only one
of them willing to be on call 24 hours a day, every
day of the year. Because it offered a member of
their staff always to be available to roll to the
scene of an officer involved in a shooting or other
critical incident, we . . . contracted with the
Counseling Team." 

--Captain Jim Nunn, San Bernardino County Sheriff's
Department "One police officer saying the program
worked is worth 50
seminars."

--Law enforcement stress program director

"I do a lot of management-by-walking and got-a-
minute therapy just by walking around headquarters
every day. Troopers come up to me and say, Do you
have a minute, Doc? I got this thing going. . . . "

--Gary Kaufmann, Director, Behavioral Science
Section, Michigan State Police

________________________________________________

Chapter 8

Preventing Stress and Stress-Related Problems
________________________________________________

Key Points

o The most common method for preventing stress is
to train officers to recognize its sources and
signs and to develop individual strategies for
coping with stress.

o Training also serves to market the program to
officers and nonsworn personnel and to reduce the
stigma frequently associated with obtaining help
for stress-related problems.

o Training regarding sources and manifestations of
stress helps to reduce anxiety and worry over the
unknown, decrease officers' sense of isolation with
regard to their own stress-related difficulties,
and increase officers' motivation to take steps to
combat stress.

o Most of the program administrators and
independent practitioners contacted for this
publication, as well as many of the officers
interviewed for it, said that the academy is the
best time to train officers about stress because
recruits are a captive audience and the information
may remain with them for their entire police
career.

o In addition to training at the academy, it is
useful to provide in-service training not only for
line officers but also for mid-level managers and
command staff, prospective retirees, and nonsworn
personnel. Training can be on general stress-
related issues or can include specialized classes
tailored to specific units, such as the SWAT team.

Program staff contacted for this publication
consistently
emphasized the importance of helping officers to
prevent
stress-related difficulties and to develop
effective ways of coping with inescapable problems
before they require clinical
intervention. In fact, some stress program
practitioners consider prevention efforts, through
training and education, their single most important
activity. The Rochester Police Department's Stress
Management Unit, for example, was developed as a
prevention program, with training as its primary
mission.

Of course, individual and organizational stress are
inextricably linked. As a result, programs that
expect to make a serious dent in reducing stress
among law enforcement officers and their families
need to address both sources of stress
simultaneously, through both prevention and
treatment. However, for discussion purposes, this
report artificially divides the discussion of
stress prevention into two separate chapters, one
on individual stress (the present chapter) and one
on organizational stress (chapter 9), while
treatment of stress--regardless of its source--is
addressed in chapter 10. 

Stress-related problems can be prevented in two
principal ways: (1) by eliminating the sources of
stress themselves, and (2) by learning how to deal
with stressful conditions before they lead to
problems. Of course, there are many strategies that
individuals can use to prevent or reduce stress.
This chapter focuses not so much on the individual
approaches as on the ways that law enforcement
stress programs can teach them to officers. As
discussed below, the most common approach to stress
prevention is providing training on sources of
stress, its manifestations, and coping strategies.
Training for law enforcement employees' family
members, an
increasingly popular program activity, is discussed
in chapter 11.

Why Conduct Training?

There are a number of compelling reasons for
program staff and independent practitioners to
train officers in stress prevention:

(1) to increase officers' awareness about the
nature of stress, the unique stresses associated
with law enforcement work and their personal lives,
and the warning signs that indicate that they,
their colleagues, or their family members are
experiencing
stress-related problems and may need assistance;

(2) to help employees learn specific strategies to
prevent and cope with the stress they, their
colleagues, and their family members experience;

(3) to help market the program by providing
information about its services and other available
resources, introducing officers to program staff,
and beginning to earn the department's trust (see
below and chapter 7, "Marketing the Program"); and

(4) to reduce the stigma associated with stress-
related difficulties by teaching officers that
certain reactions to stress are normal.

Although stress management training requires time
and money, there is widespread agreement among not
only program staff but also law enforcement
executives that the benefits are well worth the
investment. William Garrison, Director of the
Metro-Dade Police Department's Health Services
Section, initially provided only counseling to
officers, but gradually he made training a
significant program activity as he saw the need to
deal with officers' problems before they led to
crises as well as with management issues that were
causing officers stress. The
commissioner of Central Police Services in Erie
County said that training is the most useful and
far-reaching aspect of the county's law enforcement
stress program. By helping law enforcement officers
prevent and reduce stress-related problems,
training can contribute to an organization's
overall efficiency.

Common Training Topics Designed To Prevent Stress 

Reflecting the first three objectives listed above,
training topics typically fall into three
categories: (1) sources and
manifestations of stress; (2) individual coping and
prevention strategies, and (3) information on the
department's stress program and other sources of
assistance.

Sources and Manifestations of Stress

The most fundamental component of stress prevention
training is general awareness. Many officers have
never talked about stress before or have considered
it a problem only for weak individuals. They are
therefore often unaware of how it can affect them.
Simply increasing officers' awareness about stress
may serve to help reduce it. Training in stress
awareness can lessen anxiety about the unknown,
decrease officers' sense of isolation with regard
to their stress-related difficulties, and increase
their motivation to take steps to combat stress.[1]

According to law enforcement stress experts Joseph
Hurrell, Jr., and William H. Kroes, "[W]hen
individuals are unaware of the nature of threats to
their well-being, they are less able to escape,
avoid, or directly confront them. Thus, in order to
successfully cope with stress on an individual or
organizational level, officers need to be made
aware of the nature of job stress and its
consequences."[2]

A number of sources of job stress specific to law
enforcement are typically identified and discussed
in stress trainings, such as physical danger, long
periods of boredom, court rulings and procedures,
public hostility, and characteristics of the
organization such as rotating shift work and
limited opportunities for promotion. Officers are
also usually taught to be aware of personal stress
that arises from family problems, as well as of the
stress that the officer may be causing his or her
family. In addition, training typically explores
the manifestations of stress: physical disorders
such as heart disease, high blood pressure,
fatigue, and headaches; emotional and personal
problems such as anxiety, depression, family
discord, and alcoholism; and inadequate work
performance, such as excessive use of force,
rudeness to citizens, lateness and absenteeism, and
failure to complete reports. Some training topics,
of course, may be tailored to a specific audience.
For instance, program staff and independent
practitioners may teach recruits about the general
sources of stress they can expect to face in their
careers but provide SWAT team members with specific
training on how to cope with critical incidents.
The director of the Erie County Law Enforcement
Employee Assistance Program trains supervisors on
the progression of stress-related problems and the
importance of intervening early with troubled
officers under their command.

Individual Coping and Prevention Strategies

Usually the principal goal of stress management
training is to increase the officer's ability to
prevent or cope with stress by using a wide range
of strategies:

o learning skills to be as effective as possible in
handling what are already stressful situations per
se, such as domestic violence, serious traffic
accidents, shootings, death notification, and
dealing with suicidal and mentally ill individuals;

o understanding human behavior and the
psychological processes relevant to police work so
that officers can recognize when their own
reactions should be seen as normal--or as not
normal;

o maintaining physical health and well-being
through diet and exercise (which may be facilitated
through a department wellness program);

o increasing body awareness and relaxation through
biofeedback, meditation, or yoga;

o managing anger (see the box "Anger Management
Training at the Rochester Police Department");

o learning to communicate effectively with family
members, peers, supervisors, and citizens;

o restructuring attitudes or thoughts that
contribute to stress; and 

o planning his or her career.

Trainers may simply describe or summarize some
strategies, or, in more extensive programs, they
may provide officers an opportunity to practice and
experience certain techniques under supervision. In
addition to these individual coping and prevention
strategies, trainers can teach officers how to help
colleagues who have been involved in critical
incidents or who are experiencing other stress-
related difficulties. Officers can learn, for
instance, what to say (and what not to say) and
when to encourage troubled officers to seek
assistance.

Some programs and independent practitioners offer
training that, while not specifically stress-
related, may still help in reducing stress, such as
seminars in parenting and financial management. If
stress program staff are not qualified to conduct
such training, they can recruit other experts to
lead the sessions or they can make videos and other
instructional materials on the topics available to
department employees.

The Stress Program and Other Resources

The third major training topic consists of
providing information about resources available to
individuals who need counseling or other types of
assistance due to stress-related difficulties.
Training in this area is intended to increase the
following:

o awareness and familiarity with the stress
program--including its location, purpose,
activities, and staff members;

o acceptance of the stress program and willingness
to use its services; and

o knowledge about additional helping agencies and
professionals in the community.

Training is an excellent vehicle for publicizing
services of the stress program. Most officers
interviewed for this publication said that they
learned about the stress program through training
sessions. Beyond that, trainers can try to limit
resistance to using program services by reducing
the stigma often associated with seeking
psychological services from mental health
professionals and by explaining the confidential
nature of the services.

Finally, trainers can provide information on
helpful resources in the community--or within the
officers' own department--that can be called on if
stress program services are not appropriate or are
insufficient, or if officers prefer to seek help
outside the department. In many cases, this may
mean simply providing the names and telephone
numbers of various practitioners (such as clinical
psychologists) who have worked with police clients
in the past and have demonstrated an understanding
and sensitivity to the roles and problems of
officers. Experienced patrol officers are already
familiar with local resources such as local mental
health centers or detoxification centers because
they transport others to these agencies in the
course of their work. However, they may be
unwilling to use these agencies personally because
they are likely to be recognized. As a result,
trainers need to be able to provide the names of
agencies that are located outside the officer's
work jurisdiction and home neighborhood.

Types of Training

Training involving the major topics summarized
above needs to be tailored to the interests and
perspectives of the particular audience being
addressed. Some of the needs and issues that are
most relevant to recruits who are just beginning
their academy training are very different from
those of either seasoned patrol officers or
department command staff. This section examines
training strategies for five distinct audiences:
recruits, line officers (including members of
specialized units, such as the SWAT team),
supervisors and command staff, prospective
retirees, and nonsworn employees. Training for
family members is discussed in chapter 11.

Training for Recruits

Most of the officers, program administrators, and
independent practitioners contacted for this
publication said that the academy is the best time
to train officers about stress because there they
are a captive and relatively receptive audience and
the information will be of use to them for their
entire police careers. However, it is important
that the training capture the attention of the
recruits, who are bombarded with a large amount of
information throughout the academy (see the box
"Training Tips" and chapter 7, "Marketing the
Program").

In the majority of jurisdictions contacted for this
publication, the program director delivers the
stress training, sometimes in conjunction with
other academy instructors and veteran officers. The
director of the Erie County program, for example,
trains recruits with a chaplain from the New York
State Police Department and other officers. 

When time is limited, training for recruits
generally follows a standard lecture format and
provides a brief overview of the topics listed
above. Examples are often provided of (anonymous)
officers whom the program has helped. When more
time is available, films, role playing, and case
studies are often used to supplement the basic
lecture format. Through simulation exercises,
Counseling Team staff in San Bernardino,
California, deliberately create stress for
recruits, to prepare them for domestic violence
calls and other situations when people may be "in
their faces" and they need to control their
reactions and emotions. Trainers may also
distribute written materials such as descriptions
of the stress program or reprints of articles on
stress.

Training delivered to recruits by the Rochester
Police Department focuses not only on police stress
but also on the sources of stress recruits
experience during the academy and in their initial
years on the job. The director of the department's
Stress Management Unit notes that stress from the
highly rigorous recruit training process is far
more salient to recruits than the future stress
they can anticipate as patrol officers. During the
first week of the academy, program staff tell
recruits that although they should become aware of
common sources of police stress before they are
assigned to duty, right now they need to focus on
getting through the academy with a minimum level of
anxiety. Staff instruct recruits in simple
relaxation techniques, for instance, asking them to
turn over the papers in front of them, close their
eyes, and breathe deeply. Michigan State Police
Behavioral Science Section staff help recruits deal
with their anxiety about passing the firing range
test and other skill examinations in an effort to
both relieve their immediate stress and demonstrate
how the program can be of practical benefit.

The timing of stress training during the academy
varies widely from program to program: 

o The Metro-Dade program provides four separate
training sessions for recruits. During the academy
orientation, staff deliver a brief presentation
about the stress program. Later, two separate
courses cover in more detail the program's services
for officers involved in shootings or other
critical incidents. Finally, during a family night,
program staff discuss the changing fears and
concerns of officers and their families during
different stages of the
officer's career.

o Michael McMains, Director of Psychological
Services for the San Antonio Police Department,
provides twelve hours of stress
management training split between the second and
last day of the academy. He also hosts a family
weekend.

Like the two cited above, many programs incorporate
into the academy a family night or other training
session to which officers are encouraged to bring
significant others. (Chapter 11, "Services for
Family Members," discusses this and other types of
academy training for family members.)

In-Service Training for Line Officers

Stress program practitioners emphasize that
training can and should continue after the academy.
Officers will benefit from "refresher" courses, as
well as from instruction on new or specialized
stress-related topics, throughout their careers,
and those who were already with the department
before the program was established or who moved
from other jurisdictions may not have received any
stress training.

Program staff can arrange for special in-service
training sessions, but many program directors have
found it useful to incorporate stress training into
existing, mandatory in-service training sessions.
For example, Michael McMains offers instruction on
stress management to San Antonio officers as part
of the State-mandated 40 hours of in-service
training that line personnel must receive every two
years. In all, he provides approximately four to
eight hours of in-service training each year. The
Erie County Law Enforcement EAP offers a voluntary
all-day course for rank and file officers on a
quarterly basis. Area clinicians contracting with
the Drug
Enforcement Administration EAP conducted 264
training workshops with 4,600 DEA employees and
family members throughout the country in 1994.

While most in-service training is applicable to all
line officers, many program administrators and
individual practitioners have been asked to provide
instruction to special units on the unique
difficulties they experience. The commander of the
Michigan State Police Department's dive team asked
Gary Kaufmann, the Michigan program director, to
develop a training session for officers who were
prone to underwater panic. As a first step,
Kaufmann himself was trained in scuba diving. Even
though he too had difficulty managing his own
fright underwater, he developed a set of training
techniques and selection criteria for the dive team
commander to use. Another counselor with Michigan's
program facilitated a fear management session for
the department's canine unit. Cindy Goss, with the
Erie County program, conducts a "strategic
communication" class, designed for officers who
have received numerous citizen complaints, on how
to deal with the public without becoming angry and
aggressive. She also put together an eight-hour
training session dealing with reactions to critical
incidents for members of the hostage and SWAT
teams.

In-Service Training for Supervisors and Command
Staff

The critical need for training supervisors and
command staff about stress issues is often
overlooked. In some police departments, all sworn
personnel participate in the same in-service stress
training programs. Other departments have designed
training modules exclusively for supervisors and
command staff. The director of the Erie County Law
Enforcement EAP conducts six and a half hours of
training for new supervisors (lieutenants and
sergeants) as part of a four-week course that they
must take within one year of promotion. The
director discusses the nature of stress, warning
signs that officers are under undue pressure,
methods for making referrals, and available program
services and community resources. She emphasizes
that managers are in the best position to help
officers before they fall.

In addition to exploring factors related to their
own stress, stress prevention training for
supervisors and command staff is typically aimed at

o educating supervisors about how their own
behavior and
supervisory styles--and the agency's organization
itself--can contribute to stress-related
difficulties among their subordinates (see chapter
9, "Reducing Organizational Stress"); 

o improving supervisors' skills in detecting
stress-related symptoms in the behavior and
attitudes of officers (e.g., large number of
citizen complaints or sick days); 

o teaching supervisors to assist officers with
stress-related disorders by providing advice,
support, or information about the stress program
and other available resources; and

o encouraging supervisors not to make assumptions
about an
officer's professional capability or mental state
simply because he or she has sought stress
services.

A supervisor who received training on stress
management felt that he benefited twice. First, he
had always been bothered by the fact that his hands
would shake uncontrollably after he had been
involved in a shooting, and the training helped him
to realize that this was a normal reaction. Second,
because he knew about the program's services, he
was able to refer his brother, a fellow officer, to
the program for help with a drinking problem.

Faculty members at the University of Rochester
Medical School's Department of Community Psychiatry
developed and delivered a stress training
curriculum for supervisors and command staff at the
Rochester Police Department (see chapter 14,
"Tapping Other Resources"). This 11-hour curriculum
has been incorporated into the 40-hour State-
sponsored command school that new command officers
throughout New York State must attend. In addition
to discussing supervisors' own experiences with
stress and their responses to subordinates'
difficulties, much of the training is devoted to
facilitating changes in supervisory and management
practices that have been identified as prominent
sources of stress in the department. Topics include
understanding lines of authority, the role of
supervisors, problem-solving techniques, and the
effects of various leadership styles on employee
performance. Participants examine a number of
management concerns, such as rumor control;
confidentiality; competition among officers;
motivation and morale; monitoring, evaluating, and
documenting individual performance; discipline; and
time management. Several types of problem employees
are discussed, including the "burned-out cop," the
officer who resists authority and supervision, the
officer who lacks initiative and performs duties at
a low level of productivity, and the violence-prone
officer. Through small group discussions and role-
playing exercises, participants are taught how to
respond to these personnel concerns either by
addressing the problems in the job setting or
initiating referrals to the department's stress
program. The box "Illustrations of Management
Training" provides additional examples of
management training efforts.

Training for Prospective Retirees

Another important audience for stress management
training consists of officers who will soon retire.
Retirement can be an
exceptionally difficult experience for some
officers.[4] Often they need practical assistance
with financial and other matters as well as help
with stress-related problems. Although most of the
programs contacted for this publication provide
counseling to retired officers, few provide them
with training. However, Douglas Gentz, Director of
Psychological Services for the Tulsa Police
Department, does present a short block of
instruction on the psychological impact of
retirement on police officers that is a part of a
regular in-service retirement program at the police
department. Other police stress experts recommend
that programs prepare officers for dealing with
possible layoffs.[5]

Training for Nonsworn Personnel

Finally, it is important that program
administrators and independent practitioners not
neglect to train nonsworn law enforcement
employees. For general types of training, civilians
can be included with groups of officers. More
specialized training can be directed specifically
at nonsworn employees. 

o The Metro-Dade Health Services Section
periodically provides training for communications
personnel and dispatchers on techniques for dealing
with high-risk callers as well as ways to cope with
the stress these calls create. 

o Psychological Services in Tulsa provides a class
on stress management to new dispatchers and
provides training on the police culture to civilian
volunteers in the police department.

o The director of the Michigan State Police stress
program gave a half-day seminar on stress
management for the department's
accounting staff at the request of the chief
accountant after changes in the accounting system
caused staff a great deal of difficulty. He also
conducted a class for dispatcher supervisors when
he noticed that an unusual number of dispatchers
were
approaching the program for assistance. 

o The director of the Erie County program trains
911 dispatchers on stress management about once a
year. 

o Area clinicians working for the Drug Enforcement
Administration EAP conduct training for support
services program staff together with agents and
other DEA employees.

As mentioned several times throughout this report,
especially in chapter 1, the law enforcement agency
itself is a frequent source of stress for many
officers. Any comprehensive effort to prevent
stress therefore needs to promote organizational
change. The following chapter examines strategies
that stress programs and agencies have used to
reduce organizational sources of stress.

Endnotes

1. Goolkasian, G.A., R.W. Geddes, and W. DeJong,
Coping With Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985: 93.

2. Hurrell, J.J., and W.H. Kroes, "Stress
Awareness," in Job Stress and the Police Officer:
Identifying Stress Reduction Techniques, ed. W.H.
Kroes and J.J. Hurrell, Washington, D.C.:
Government Printing Office, 1975: 234.

3. Garrison, W.E., "Modeling Inoculation Training
for Traumatic Incident Exposure," in Critical
Incidents in Policing, revised, ed. J.T. Reese,
J.M. Horn, and C. Dunning, Washington, D.C.: U.S.
Department of Justice, Federal Bureau of
Investigation, 1991: 107-117.

4. Violanti, J., Police Retirement: The Impact of
Change,
Springfield, Illinois: Charles C. Thomas, 1992.

5. Kirschman, E., E. Scrivner, K. Ellison, and E.
Marcy, "Work and Well-Being: Lessons from Law
Enforcement," in Stress and Well-Being at Work, ed.
J.C. Quick, L.R. Murphy, and J.J. Hurrell,
Hillsdale, New Jersey: Lawrence Erlbaum Associates,
1995: 187.

Anger Management Training at the Rochester Police
Department

The Rochester Police Department's Stress Management
Unit has been providing anger management training
since 1987 in an effort to reduce not only the use
of excessive force on the job but also the health
problems and domestic difficulties that can result
from failure to deal appropriately with anger.
Three full days of training are offered to officers
over a three-week period several times throughout
the year. The classes are interactive, using role
playing, videos, and group discussions, and they
focus on the connection between anger and stress,
the physical and emotional effects of anger, and
ways to acknowledge anger and express and control
it appropriately. Line officers, investigators,
sergeants, and lieutenants are trained in separate
groups.

In addition to the program director and program
counselor, seven trained officers (five of whom are
peer supporters) conduct the anger management
training classes. By the end of 1995, the unit had
provided anger management training to over half of
the officers with the department.

For an evaluation of Rochester's training program,
see Abernethy, A., "Anger Management Training for
Law Enforcement Personnel," Journal of Criminal
Justice, 22 (1994): 459-466.

Training Tips

Law enforcement officers may view stress training
with the same indifference or skepticism with which
they view counseling and other stress services.
Officers report that recruits in particular often
disregard stress training during the academy
because the sources of the stress (e.g., shift
work, dealing with the public) are so remote and
because they are almost totally caught up in the
immediate demands of academy course work and
training. As a result, program staff must make
special efforts such as the following to engage and
retain recruits' and experienced officers'
attention.

o Use concrete examples from police work, not just
dry, technical information. As William Garrison,
Director of the Metro-Dade program, notes, use of
videotape news coverage of actual incidents is
beneficial to break the denial of the officers'
veil of
invincibility in their pragmatic world. Interest is
also heightened by supplying specific details or
little-known facts of a major incident that hits
close to home for the officers. Major incidents
that have little relevance for the officers in
their work
environment will be of little interest to them if
they cannot relate to them. The case studies should
involve a person they can identify with so that
they can apply what they know to be true to the
situation.[3] If time permits, trainers can involve
recruits in role playing.

o Invite veteran officers--especially those
considered to be among the toughest, such as SWAT
team members or command staff--to speak about their
personal experiences in coping with various
stress-related difficulties.

o Present videos on police work and police stress
that will capture officers' attention. The Bureau
of Alcohol, Tobacco, and Firearms (ATF) presents a
video on stress during its roll call training, new
agent training, safety and survival seminars, and
supervisory training (see chapter 14, "Tapping
Other Resources").

o Provide materials that officers can read later
and can give to their family members. The ATF
distributes handouts on symptoms of addiction, the
agency's EAP, and other topics during a one-hour
orientation for new agents. Drug Enforcement
Administration Employee Assistance Program trainers
provide a 46-page workbook to supervisors that
covers such topics as the troubled employee and
provides a list of recommended readings. A workbook
and other handouts are also distributed to agents
and other employees during training.

o Poll the attending officers regarding their own
experiences with stress-related difficulties, such
as critical incidents. If any are willing,
encourage them to describe briefly how they dealt
with their problems.

o Encourage the attending officers to evaluate the
usefulness of the training session and suggest how
it could be improved.

o Write articles on various stress-related topics
for department and union newsletters. This is a
subtle but effective way to provide continuous
training to law enforcement employees and their
families. However, the articles need to be written
in a clear, easy-to-read manner--without academic
jargon--and focus on
practical matters of immediate interest to
officers, not abstract concepts.

o Have written materials, videos, and other
materials on stress and coping strategies available
at the program office for officers to check out and
bring home.

Training Officers from  Several Departments
Together

Nancy Bohl, Director of the Counseling Team in San
Bernardino, California, finds several advantages to
training groups of officers from several
departments together:

o the officers realize that their own department is
not the only one with administrative or
organizational problems;

o training them together helps to reduce
interagency conflict by reminding officers from
different departments of their common goals and
difficulties; and

o the officers provide each other with diverse
views about dealing with the politics and other
sources of stress at difficult
departments.

Illustrations of Management Training

o After about two years of meeting individually
with county law enforcement administrators, the
director of the Erie County Law Enforcement EAP
convened an all-day conference for police chiefs,
the county sheriff, and other upper-level
administrators countywide to discuss the sources
and effects of stress, to inform them of the
availability of program services, and to solicit
their suggestions for improvement. Presentations
were made by the EAP director, the commissioner of
Central Police Services, and officers and
administrators of other departments, who told
stories regarding officers' need for stress-related
assistance.

o Each year, the Michigan Behavioral Science
Section trains sergeants and lieutenants for four
to six hours on how to manage--and how not to
manage--critical incident stress, what to expect of
an officer who has been involved in a critical
incident, signs of alcohol abuse, when to call the
section, and the services offered by the section.
An officer who is a former client of the section
makes a presentation on his personal experience
with critical incident stress.

o The Drug Enforcement Administration (DEA) EAP
developed a workbook for distribution at supervisor
trainings consisting of information about the
program, a checklist of warning signs that an
employee is having problems, expected benefits of
the EAP, referral procedures, and other
information. Trainings are conducted for each field
division, headquarter office, and specialty unit.

o The Counseling Team in San Bernardino is given
one of the five days that police departments in the
county devote to the training of field officer
trainers (FTOs). A team counselor teaches the FTOs
training skills to use with their recruits, along
with instruction on how people react when they are
criticized and how to approach a recruit who is
doing poorly. The counselor encourages the FTOs to
refer recruits who need psychological assistance to
the Counseling Team. (See chapter 9, "Reducing
Organizational Stress.")

Training Officers To Refrain From Use of Excessive
Force

Law enforcement agencies are challenged by the need
to control excessive force by officers--a challenge
that must be met now more than ever if community
policing initiatives are to succeed. Law
enforcement stress programs can play a key role.

In a survey of efforts by police psychologists to
address the use of excessive force, the U.S.
Department of Justice's Ellen Scrivner found that
most psychologists offer training on the issue in
the context of stress management. While this makes
sense on one level, Scrivner argues that "framing
excessive force as a stress issue raises several
questions, among them whether the notion is
supported by research and whether the approach
encourages the perception that stress justifies the
use of excessive force. . . . A more viable
training focus would reflect departmental policy
statements that clarify the tolerance limits for
use of force and perceive excessive force as a
patrol risk that needs to be managed through a
range of specialized skills. . . . Police
departments may need to shift the emphasis in
supervisor training to one that incorporates larger
behavioral issues in order to improve the
management of excessive force. This level of
supervisory training could also incorporate
instruction on early warning behavioral
monitoring."

Scrivner lists several topics psychologists can
address in training officers to avoid excessive
force:

o cultural sensitivity and diversity;

o intervention by fellow officers to stop the use
of excessive force;

o the interaction of human perception and threat
assessment;

o decision-making under highly charged conditions;

o psychological methods of situation control;

o patrol de-escalation and defusing techniques that
not only provide a tactical response but also
respond to the fear stimulated by confrontations;

o anger management programs that use self-
assessment and self-management techniques for
providing individual feedback to officers on how
variable levels of legitimate anger influence
judgment; and

o training in verbal control and communication,
including conflict resolution.

See Scrivner, Ellen, The Role of Police Psychology
in Controlling Excessive Force, Research Report,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, April 1994. To
order, call the National Criminal Justice Reference
Service at (800) 851-3420.
_____________________________________________

Chapter 9

Reducing Organizational Stress
______________________________________________

Key Points

o As discussed in chapter 1, law enforcement
agencies themselves can be a significant source of
stress for officers. As a result, stress program
staff and consulting mental health professionals
can consider working with departments to implement
organizational change.

o Law enforcement managers have many reasons for
not changing their organizations. However,
counselors can help motivate them to implement
change by suggesting how certain innovations can
improve the department's image or save it money,
and by documenting the stress that specific
department procedures or policies are creating for
officers.

o Law enforcement mental health practitioners and
organizational consultants have facilitated
organizational change by 

--training command staff in constructive
supervisory techniques,

--training field training officers (FTOs) to
supervise rookies in a constructive manner, 

--eliminating rotating shift work, and

--improving the match between officers'
capabilities and the needs of specific assignments.

Most police stress programs and consulting mental
health practitioners focus primarily, if not
exclusively, on preventing and treating stress
among individual officers and their family members-
-a person-centered approach. However, as discussed
in chapter 1, law enforcement agencies themselves
may be the single largest source of stress for
many--even most--police officers. Organizational
sources of stress range from rotating work shifts
to inconsistent discipline to lack of opportunity
for career advancement. In addition, many of these
organizational factors can create stress for
officers' families whose lives, for example, may be
disrupted by shift work and who may worry about the
officer's career advancement or even his or her job
security. One expert has suggested that " an
organization-centered approach--that is,
identifying the problems the officers have with
their work, supervisors, and pay, and making
appropriate changes [in these areas]--may well have
a greater influence on improving morale [than
seeking to prevent or treat stress among
officers]."[1] According to Gary Kaufmann, head of
the Michigan State Police's Behavioral Science
Section, the emphasis placed on person-centered
programs by psychologists and police administrators
has overshadowed the importance of addressing
organizational sources of stress.[2]

Unfortunately, program staff and independent
practitioners often lack the time to work with
management to eliminate organizational sources of
stress. Most clinicians may also feel they lack the
knowledge or techniques to work with police
administrators on organizational change. In
addition, many law enforcement
administrators may not accept what they perceive to
be the
intrusion of a mental health professional into the
operation of their department, they may feel they
do not have the time or resources to make the
desired changes, or they may simply not agree that
the proposed changes will reduce officer stress.
Nonetheless, a number of programs contacted for
this study view eliminating or reducing
organizational sources of stress as part of their
mission. For example, the work plan of the Health
Resources Coordinator Program of the Palo Alto
Police Department in California includes the
objective, "To identify sources of organizational
stress and consult with work units and individual
managers to resolve them . . . such as the
promotional process and ways to acknowledge the
contributions of career officers who fail to get
promoted or do not seek promotion."[3] This chapter
suggests how some program staff and independent
consulting clinicians promote organizational
change.

Motivating Management To Implement Change

Many law enforcement managers institute
organizational changes to reduce officer stress
simply because they feel it is the right thing to
do. However, as discussed below, there are several
strategies that stress program staff can use to
increase
management's inclination to make changes.

Offer To Improve the Department's Image

Bad press, public criticism, and legislators' tight
fiscal control are all sources of stress for police
chiefs (appointed at the discretion of the mayor or
selectpersons) and sheriffs (elected by voters).
Stress program directors and independent mental
health professionals can suggest how organizational
change that reduces officer stress can
simultaneously improve the department's image. It
was in part the negative publicity resulting from
eight officer suicides in five years, three of them
in 1994, that prompted the Philadelphia Police
Department to create the agency's first stress
manager position, with (among other assignments)
responsibility for examining department policies
and procedures in order to make them less
stressful.[4] A new police chief in another law
enforcement agency, disturbed by the bad press
caused by his department's negative paramilitary
image, hired an organizational consultant and
implemented several of his recommendations designed
to make the department less autocratic.

Offer To Save the Department Money

Program staff and independent practitioners can
document potential cost savings that may result
from organizational changes by estimating the
impact of the changes on the department's budget or
by citing examples of actual cost savings other law
enforcement agencies have experienced after having
implemented similar changes. For example, the
Mercedes, Texas, Police Department has 25 sworn
officers and serves a city of 14,000 people. In
1986, the
department was reorganized to provide an employee
development program that included establishing high
professional standards, a reward system to promote
superior performance, walking patrol assignments,
and an increase in the annual in-service training
requirement. One result was that, in the 24-month
period following implementation of the changes, the
turnover rate among sworn personnel decreased to 7
percent, compared with an earlier rate of 38
percent. The department estimated that the reduced
turnover saved it at least $53,000 (in 1988
dollars).[5]

The Mercedes, Texas, police department, with 25
sworn officers, was reorganized in 1986 to provide
an employee development program. As a result, the
turnover rate among sworn personnel decreased from
38 percent to 7 percent, and the department saved
an estimated $53,000 from the reduced turnover.

Police administrators report that it is expensive
when an officer takes early retirement or goes on
disability because of the costs associated both
with retirement benefits and also the recruiting,
testing, training, hiring, and equipping of new
officers.
Furthermore, especially in small police agencies,
sudden turnover can result in a serious staff
shortage that requires paying other officers
overtime.[6] If clinicians can document that
organizational changes are likely to reduce the
number of officers who leave prematurely or take
sick time because of stress-related problems--and
quantify the savings in dollar terms--
administrators may be more willing to institute
them.

Offer To Improve the Department's Morale and
Efficiency

Increasing officers' abilities to reduce and cope
with
stress-related difficulties and encouraging the
department to reduce organizational sources of
stress should naturally lead to better morale among
officers, improved productivity, and therefore
enhanced overall department efficiency. Even well-
publicized administrator support for a stress
program by itself demonstrates to officers concern
about their well-being and may induce some good
will, and, as noted in chapter 1, if program staff
can help an officer overcome stress-related
problems, the department might not only retain a
valuable employee but also inspire the officer to
be more motivated and more loyal to the department.
While no concrete information about improved morale
and efficiency was available for this report, the
program practitioners listed at the end of chapter
14 may be able to put other program planners or
practitioners in touch with law enforcement
administrators who can attest to the organizational
benefit of a stress program.

Present Strong Evidence of Organizational Stress in
the Department

While police chiefs may be unwilling or unable to
make many desirable changes, program staff can
usually identify at least one or two sources of
organizational stress which management may be
willing to address (see the list provided in
chapter 1). Staff can identify these sources of
stress by conducting a needs assessment (see
chapter 2) or by presenting administrators with
data
researched by other departments. For example, the
Michigan State Police Department's Behavioral
Science Section provided the police association
with data--and credibility--that helped it to
convince the department to abandon its rotating
shift policy (see below).

Organizational Changes That Stress Programs Have
Facilitated

Staff of four programs contacted for this study
have worked extensively with management to effect
important organizational changes in their police
departments as a way of reducing officer stress. As
described below, these changes fall principally
into three categories: management supervisory
style, shift work, and officer preparation for the
job.

Management Train in Constructive Supervisory Styles

The Palo Alto Police Department, consisting of 100
sworn officers, has undertaken a long-term,
comprehensive attempt to reduce organizationally
generated stress.[9] A series of stress-related
disability retirements prompted the department to
commission a study in 1979 to identify sources of
stress and suggest options for reducing or
eliminating them. The report concluded that
informal and formal organizational structures
inhibited effective communication and created
strained relationships between ranks, divisions,
and individuals. As a result, the department hired
a management consultant and a mental health
clinician to design and implement an 18-month trial
program to alleviate organizational stress. Through
team building and meeting facilitation, the
management consultant taught the department how to
communicate, listen, and solve problems in an
orderly, effective manner. The project, which has
continued long after its trial period, is based on
a 14-point program that is also the basis for the
annually renewed contracts between the two
consultants and the city. The points include the
following:

o "identify sources of organizational stress and
consult with work units and individual managers to
resolve them" (e.g., the management consultant
trained [and retrained because of turnover] all
sergeants in how to prepare for and conduct a
performance appraisal and how to give behavior-
based feedback in a constructive manner);
o "monitor management decisions with regard to
their stress impact, search for implementation
methods which minimize the stressful impact, and
advise management staff" (e.g., when the agency
began to use computer-aided crime analysis to
direct patrol and
investigative resources toward the apprehension of
career
criminals, the organizational consultant designed
ways for the department's sworn and civilian
personnel to influence and shape the change
process);

o "train FTOs [field training officers],
supervisors, and managers in communication, problem
solving, conflict resolution, and supervisory
skills which can minimize stress for employees"
(e.g., at the chief's request, each manager was
surveyed on how the chief himself was creating
stress for them, and recommended changes were
reported along with the findings); and

o "advise individual managers on stress-producing
practices and events within their units" (typically
in response to a manager who requests help in
solving a problem, but sometimes in response to a
large number of complaints from line officers that
suggest a management problem).

Michigan's Behavioral Science Section trains
sergeants every year in how to manage critical
incident stress among officers. Gary Kaufmann, the
program director, brings to the training a trooper
who has been in a critical incident (and has been a
program client) to tell the sergeants, "Here's how
to help a cop after a critical incident and here's
how to mess one up." Kaufmann outlines what to
expect of an officer who has just been in a
critical incident and when to call his program for
assistance with troubled officers. He and another
counselor also conduct two-hour seminars with
executive and command staff, for example during the
all-post commander conference, where they focus on
helping the managers to recognize their own work
styles, understand the impact their work styles
have on subordinates, and learn how to motivate
their personnel to be more productive.

A number of police departments have invited Nancy
Bohl, Director of the Counseling Team in San
Bernardino, to train FTOs. Bohl explains to the
FTOs how people react when they are criticized and
presents the best approaches for criticizing
someone who is performing poorly. She tests the
FTOs on their supervisory style and presents them
with the results so they understand how they need
to improve. According to Jack West, an officer with
the Upland, California, Police Department who
attended the training, "The attitude of FTOs is to
stress the recruit,[5] but Bohl taught us to
recognize that we were stressing them too much. She
also helped us learn how to recognize stress in our
recruits and help them deal with it." 

"The attitude of FTOs [field training officers] is
to stress the recruits, but Bohl [director of San
Bernardino's Counseling Team] taught us to
recognize that we were stressing them too much. She
also helped us to recognize stress in our recruits
and help them deal with it." 

-- Jack West, FTO, Upland, California, Police
Department

West provided examples of how the training changed
his supervisory style:

o "I became more sensitive to signs of stress among
trainees and to the need to confront those
symptoms." He and a trainee went to a child abuse
call and found a severely injured child. Over the
next several days, he noticed that the rookie
devoted extra attention to other children they
encountered but that on other domestic violence
calls she came down very hard on the father,
"obviously bent on taking some husband to jail even
though there was no evidence the men had abused
their children." After the FTO brought her
reactions and feelings to her attention, she
modified her behavior and later told him she had
indeed been headed in the wrong direction--
conducting a sort of vendetta against all fathers. 

o "I learned that seeing an injured child for the
first time and getting extremely upset does not
mean the rookie is unfit to be an officer, it just
means he or she is not prepared to deal with that
scenario right away." Bohl taught West and the
others that an FTO's response should not be to
humiliate trainees for their extreme reactions or
tell them, "Don't be such a wimp." Later, when a
rookie threw up after seeing a dead body, the FTO
told him, "That doesn't mean you're any less of a
cop; you handled the call correctly." Based on
Bohl's training, he also asked, "Have you ever
dealt with a dead body before? Would you like to
take a break?" "Showing a little compassion," the
FTO observed, "goes a long way."

o "I learned that when I was in a position of
authority, I should not demean trainees." In the
past, when a rookie wrote a bad citation or asked a
witness a stupid question, the FTO used to mock him
to the rest of the squad, "Guess what my boot did!
He asked the witness. . . ." The FTO no longer does
that.

Bohl also told the chiefs at the police executives'
meeting that arbitrarily designating officers to
become FTOs often led to personnel who did not want
the assignment feeling they were being punished. As
a result, most of the departments now ask officers
to volunteer as FTOs. Accepting only volunteers and
training them to change their supervisory styles
can be extremely important because these officers
play a tremendous role in acculturating new
officers. For the rest of their careers, rookies
may emulate their FTOs--and use the same harmful or
helpful training techniques if they become training
officers themselves. Indeed, any improvement in how
any police trainers and managers supervise officers
can reduce officer stress:

Good supervision itself is the best stress
management tool. Good supervisory techniques not
only increase efficiency but also help officers
withstand outside pressures. In contrast,
inappropriate supervision can itself be one of the
worst sources of pressure.[10]

Modify Rotating Shift Work Schedule

The Michigan State Police used to rotate shifts
every seven days, causing considerable stress for
many troopers and their families. As a result, the
troopers' association heard constant complaints
from members about fatigue, eating disorders, and
other problems. In an effort to encourage the
department to change to a less stressful shift work
schedule, the association asked the Behavioral
Science Section for any available research
literature that documented the harmful effects of
rotating shifts on employee stress and
productivity. Partly on the basis of the
documentation, the department allowed troopers to
determine the frequency of their shift rotation,
with the option of modifying the shift rotation at
least annually. Employees then select their shifts
by seniority. When additional research suggested
that all rotating shift work might be harmful,
permanent shifts were included as an option. Each
work site now makes its own choice of shift options
by majority vote. Many sites have chosen fixed
shifts.

"You can treat troopers one at a time, but when you
`treat' executives, you're training hundreds of
workers at a time." 

--Captain P. David Charney, Personnel Director,
Michigan State Police

The association was successful in negotiating these
changes partly because of compelling evidence of
the harmful effects of shift work on officer
productivity, but the involvement of the Behavioral
Science Section in providing this research also
helped convince the department. According to
association president Rick Darling, "instead of
seeing me as coming to the table saying, `gimme,
gimme, gimme,' the department learned that by
changing the shift work arrangement it would have
healthier, more productive workers--that is, the
department would benefit, as well." 

Match Officers with Job Requirements

Michael McMains, the psychologist for the San
Antonio Police Department, worked with the
department to improve the match between an
officer's capabilities and the needs of a given
job. According to McMains, when officers are
unsuited to their work, they
experience frustration, disappointment, and self-
blame--that is, considerable stress. To help the
department address this issue, McMains did the
following:

o conducted a functional job analysis of the patrol
officer position by asking a number of officers to
identify the skills that were required to perform
their job effectively (skills the
department now looks for in selecting officers for
patrol);

o conducted a functional job analysis of every job
level so that the department can now base
promotions not only on civil service exams but also
on matching officers' skill levels with the job
requirements of the positions for which they are
applying; and

"Stress management is more than counseling; careful
selection of candidates for the job can reduce
stress that may arise because of a mismatch between
candidate and the job. Performing a person-job fit
analysis before hiring and placing officers can
reduce greatly the need to get mental help later
on. This is preventive mental health rather than
reactive mental health." 

--Michael McMains, Psychology Service, San Antonio
Police
Department

o revised the academic curriculum at the training
academy to include more blocks on problem solving,
critical thinking, and other skills related to
preventing and managing stress, as well as
techniques for identifying areas in which recruits
have skill deficiencies so that instructors can
expand training to improve the recruits' future on-
the-job performance and thereby also reduce their
level of stress.

Promote Change Tactfully and Opportunistically

It is important not to oversell the potential
results of
organizational changes, in order to avoid either
sounding
Pollyannaish or creating disappointment if the
results are modest. In addition, program staff need
to point out that some changes may lead initially
to increased stress or other adverse consequences
before their benefits are fully realized. For
example, changing to a less paramilitary style may
create stress in the short run for officers who are
not used to making their own decisions on certain
matters or are unaccustomed to sharing decision
making with management. Finally staff should not
push for change too hard or too fast but should
instead be sensitive to the many reasons police
managers may resist clinicians' recommendations,
ranging from the perception that chiefs are always
being blamed for every police officer problem to
long-standing mistrust of the mental health
profession.[12]

Finally, programs staff and independent
practitioners should be prepared to take advantage
of unexpected opportunities. Because Gary Kaufmann
had a good working relationship with the Michigan
troopers' association, the association president
approached him personally for help in proving to
the department that shift work was harmful to
officers. Nancy Bohl was addressing a San
Bernardino county police executive meeting when the
issue of field officer trainers came up. She took
the opportunity to suggest to the chiefs that they
were not selecting or training the FTOs correctly,
and, after some discussion and post-meeting
planning, she was invited to work with FTOs in
several departments to improve their supervisory
techniques.

Endnotes

1. Ayers, R.M., Preventing Law Enforcement Stress:
The
Organization's Role, Washington, D.C.: U.S.
Department of Justice, Bureau of Justice
Assistance, 1990: 9.

2. Kaufmann, G., "Law Enforcement Organizational
Health
Consultation," Paper presented at the Consultation
with Police: Problems and Consideration Symposium,
American Psychological Association 93rd Annual
Convention, Los Angeles, California, August 23-27,
1985.

3. Kirschman, E., E. Scrivner, K. Ellison, and C.
Marcy, "Work and Well-Being: Lessons from Law
Enforcement," in Stress & Well-Being at Work:
Assessments and Interventions for Occupational
Mental Health, ed. J.C. Quick, L.R. Murphy, and
J.J. Hurrell, Hillsdale, New Jersey: Lawrence
Erlebaum, 1995: 178-192.

4. "Tired? Stressed? Burned out? Panel Seeks
Answers for
Philadelphia Police Officers," Law Enforcement
News, 22 (1995): 1, 10.

5. Pape, J.L., "Employee Development Programs," FBI
Law Enforcement Bulletin (September 1990): 20-25.

6. Mohandie, K., F.E. Piersol, and N. Klyver, "Law
Enforcement Turmoil and Transitions and the
Evolving Role of the Police Psychologist," in
Organizational Issues in Law Enforcement, ed. J.T.
Reese and R. Solomon, Washington, D.C.: U.S.
Department of Justice, Federal Bureau of
Investigation, 1996: 383-396.

7. Kirschman, et al., 178-192. 

8. Kirschman, E.F., "Organizational Development,"
in Police Managerial Use of Psychology and
Psychologists, ed. H.W. More and P.C. Unsinger,
Springfield, Illinois: Charles C. Thomas, 1987: 85-
106; Walima, S.E., "Organizational Health in Law
Enforcement," in Psychological Services for Law
Enforcement, ed. J.T. Reese and H.A. Goldstein,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1986: 205-214.

9. Ellison, K.W., and J.L. Genz, Stress and the
Police Officer, Springfield, Illinois: Charles C.
Thomas, 1983: 97.

10. See, for example, Glorioso, J., "Understanding
the Reluctant Police Manager," Psychological
Services for Law Enforcement, ed. J.T. Reese and
H.A. Goldstein, Washinton, D.C.: U.S. Department of
Justice, Federal Bureau of Investigation, 1986;
169-172.

11. Pape, "Employee Development Programs," 20.

12. Walima, S.E., and E.F. Kirschman, "Health
Resource
Coordinators: Organizational Consultation
Services," The Police Chief (October 1988): 78-81.

Some Departments Take Systematic Steps To Reduce
Organizational Stress

In trying to reduce organizational stress and give
the issue the attention it deserves, some
departments have taken steps to address the problem
in a systematic fashion departmentwide. After
experiencing significant departmental turmoil due
to several high-profile negative events, Los
Angeles Police Department
administrators recognized the importance of
organizational stress and created the position of
director of organizational development to oversee
the department's already existing Behavioral
Science Services Section and other units related to
officer well-being. In addition, the role of the
section was expanded "to include a greater emphasis
on the involvement of the section in facilitating
the wellness and health of the organization as a
whole via organizational level interventions and
organizational development."[7]

Some departments have hired not just mental health
practitioners but experts in organizational
management to address stress. For example,
following several costly stress-related disability
retirements, the Palo Alto, California, Police
Department hired a consultant to conduct an
organizational analysis of stress in the
department. Based on the consultant's documentation
of several organizational problems, the Palo Alto
City Council then hired both an organizational
consultant and a psychologist to design and
implement a program to address organizational
stress in the police department.[8]

While departments can reduce stress by making
individual
organizational changes such as those described in
this chapter (e.g., eliminating mandatory rotating
shift work), changes may be more effective and far-
reaching if done in the context of a systematic
approach. Approaches such as those described above
demonstrate to officers a commitment to
organizational change and, by soliciting the
expertise of individuals trained specifically in
organizational issues, help to ensure that changes
made are as effective as possible.

Command Support After a Critical Incident

Program staff can easily document the value of the
chief or sheriff (or, in large departments, a
deputy chief or undersheriff), as well as
commanding officers, visiting at the hospital every
officer shot in the line of duty or involved in a
serious traffic accident. Furthermore, this is one
organizational change which police chiefs can
implement quickly and almost effortlessly.
According to a counselor with San Bernardino's
Counseling Team, "The impact of a shooting on the
officers involved depends more on the attitude of
the department toward the officers involved than on
the incident itself. The attitude that `it's no big
deal' is especially stressful. Some chiefs know
this and come to every shooting, 24 hours a day.
But some never show up." Command-level staff can
also offer assurance and support to family members-
-including helping them with paperwork, finding a
baby-sitter, providing phone numbers for follow-up
assistance, and simply spending time with them.
When this happens, word of the commander's concern
typically spreads quickly through the department
grapevine to every officer on the force, improving
morale and reducing stress almost instantly.

Tips for Planning and Implementing Organizational
Change

The management consultant and the mental health
practitioner hired by the Palo Alto Police
Department to reduce personnel stress through
organizational change and counseling provide the
following advice for how to plan and implement any
major effort to change a law enforcement agency's
policies and procedures:[11]

o Involve a sizable and representative cross
section of the agency in (1) the identification of
organizational issues that require attention, (2)
the tentative design of the program, and (3) the
hiring of program staff.

o Secure the support, involvement, and endorsement
of the chief.

o Plan for a trial period of at least 18 months.

o Use the core start-up group for support and
feedback during the initial months of the program.

o Guarantee program access to all agency levels,
work units, and issues.

o Expect and encourage the agency and its personnel
to take risks and accept some discomfort in the
service of growth and positive change.
_________________________________________________

Chapter 10

Responding to Stress-Related Problems After They
Occur
___________________________________________________

Key Points

o Treatment services provided by stress programs
typically include assessment and referral to other
practitioners, critical incident debriefing, other
crisis intervention, short-term counseling (on both
an individual and family basis), and long-term
counseling (including treatment for substance
abuse).

o Most practitioners emphasize the importance of
involving family members, when possible, in each of
these services.

o To varying extents, all stress programs assess
and refer clients to outside sources of assistance;
for some programs with limited resources (e.g.,
those staffed primarily with peer supporters), this
is the primary service offered. 

o Critical incident debriefing, often provided not
only after shootings but after other traumatic
events, is a particularly important service given
the sometimes devastating effects such incidents
can have on officers.

o Stress program practitioners emphasized the
importance of staff being available 24 hours a day
to handle any crisis that an officer may
experience; officers and administrators frequently
cite around-the-clock availability as one of the
most important features of a stress program.

o Most law enforcement stress programs staffed by
licensed mental health practitioners offer short-
term counseling--usually up to about 10 sessions--
for a variety of problems, most commonly marital
and other relationship difficulties, general
anxiety, and
difficulties dealing with past critical incidents. 

o Some programs, particularly those staffed by
police
psychologists, are able to offer long-term
counseling to clients. Most programs, however, due
to limited time and expertise, instead refer
clients needing long-term counseling to outside
sources of assistance.

This chapter focuses on treatment services for
officers and nonsworn employees designed to restore
their well-being and capacity for productive work
after they have experienced
stress-related problems. Detailed guidelines for
providing
counseling services are not included here;
textbooks are available for that purpose, and it is
assumed that readers who are
practitioners have already been trained in
counseling methods or have access to specialized
sources of training. Rather, this chapter reviews
some of the key considerations in providing
counseling to law enforcement officers, with brief
descriptions of how some stress programs are
providing treatment. Finally, the treatment
services discussed here are those that credentialed
mental health practitioners provide. (Because peer
support from fellow officers is such a significant
element of many programs and is a complex
undertaking, the second half of chapter 4 is
devoted to that topic. Strategies for preventing
stress are presented in chapter 8, while approaches
to reducing organizational sources of stress are
discussed in chapter 9.)

For all the reasons discussed in chapter 1, law
enforcement personnel, while essentially healthy
individuals, experience many types of stress-
related problems of varying levels of severity. In
response, most stress programs and independent
practitioners offer five basic services, resources
permitting:

(1) assessment and referral;

(2) critical incident debriefing (on both an
individual and group basis);

(3) crisis intervention;

(4) short-term counseling (usually on an individual
but sometimes on a family basis, including
counseling for problems that result from critical
incidents); and

(5) long-term counseling, including treatment for
substance abuse (usually provided on referral by an
outside treatment center).

Most practitioners stress the importance of
involving family members, when possible, in each of
these treatment services. Chapter 11 describes how
program staff serve family members either
separately or together with the officer or nonsworn
employee.

Assessment and Referral

Assessing the client's needs is a necessary
precursor of most of the treatment options
described below, but it is singled out here as a
separate service because assessment and referral
may be the primary service available in some
programs with limited resources. The Erie County
Law Enforcement Employee Assistance Program, for
example, is staffed by a single licensed counselor,
Cindy Goss, who serves personnel of the nearly 20
law enforcement agencies throughout the county
(and, until recently, served other county
employees, as well). When contacted for assistance,
Goss usually assesses the officer or family
member's condition and then matches the person with
a service provider in the community who seems
appropriate for addressing the problem and is
reimbursable under the client's health insurance.
Goss reports that "many officers consider this a
valuable service in and of itself because they do
not know which service providers are qualified, are
knowledgeable about law enforcement, and have a
good reputation among other officers, but I do."
Along with informal support, assessment and
referral are also the primary services usually
provided by peer supporters. (For a more detailed
discussion of referral procedures, see chapter 5,
"Establishing a Referral Network.")

Critical Incident Debriefing

Much of the stress experienced by law enforcement
personnel is common in other occupations, but
officers, and to some extent nonsworn personnel,
are particularly at risk of being exposed to
disturbing and frightening events and their
sometimes devastating emotional consequences.
Frequently, the stress of the critical incident
itself is compounded by the subsequent
investigation, during which officers may feel that
they are being second-guessed or considered guilty
of wrongdoing by their supervisors, the media, and
the public. This reaction can be exacerbated in
departments where an officer's gun is taken away
after a shooting without being immediately
replaced.

What Is a Critical Incident?

Roger Solomon, a police psychologist in
Massachusetts, defines a critical incident as "any
situation beyond the realm of a person's usual
experience that overwhelms his or her sense of
vulnerability and/or lack of control over the
situation."[1]Jeffrey Mitchell, who has developed a
training curriculum for critical incident
counseling for emergency personnel, defines a
critical incident as "any situation faced by
emergency personnel that causes them to experience
strong emotional reactions which have the potential
to interfere with their ability to function either
at the scene or later."[2]

The type of critical incident most commonly
associated with law enforcement work is a shooting
or other use of deadly force. This includes not
only times when an officer is wounded or killed but
whenever an officer injures or kills another person
or simply witnesses a shooting. One veteran officer
reported that he could not stop shaking after his
partner killed a youth during a
shoot-out. Dispatchers, too, may feel traumatized
after fielding calls involving a critical incident.
One dispatcher required counseling after a hostage
taker with whom she was talking killed the hostage
while still on the phone with her.

In addition to instances of the use of deadly
force, law enforcement personnel may experience
other types of critical incidents, including the
death of a family member or colleague (not
necessarily in the line of duty), participation in
a community disaster (e.g., a hurricane or riot),
and observation or
participation in the investigation of particularly
horrifying crimes.[3] (See the box "Preparing for
and Coping with Major Disasters.")

What Is Critical Incident Debriefing and Why
Provide It?

Although critical incidents may not happen very
often, particularly in small jurisdictions, their
effects can be devastating for the officers
involved, their families, and the department.[4]
Studies suggest that many of the problems suffered
by officers after a critical incident can be
prevented or mitigated if they receive structured
treatment or immediate support.[5] As a result,
critical incident debriefing has become a common
service offered by law enforcement stress programs,
even a mandatory one in some
departments. The International Association of
Chiefs of Police Psychological Services Section
recommends that counseling for officers involved in
on-duty shooting situations be mandatory, partly as
a way to remove the stigma frequently associated
with counseling.[6] (See "Some Departments Mandate
Debriefings in Critical Incidents," as well as
appendixes 10-1 and 10-2, IACP guidelines and a
model policy regarding post-shooting incident
procedures.)

Critical incident debriefing involves a brief,
structured intervention of counseling and support
immediately or shortly after the incident occurs.
Debriefing is meant to offer affected
individuals a chance to express their feelings and
to recognize that their reactions are normal; it is
not meant to take the place of regular counseling,
which could still be needed at a later date.
Critical incident debriefings should always be led
by a licensed mental health practitioner. 

Who Receives Critical Incident Debriefing?

Critical incident debriefing is, of course,
provided to the officer or officers directly
involved the officer who killed a suspect, the SWAT
team members who engaged in a gun battle with drug
dealers, and the officer who investigated the scene
of a fatal-traffic accident or grisly murder.

If the incident is wide-reaching enough (e.g., the
death of an officer), it is also useful to provide
a debriefing for a larger group of personnel who
may not have been directly involved in the incident
but who nonetheless may have been adversely
affected by it, including fellow officers,
dispatchers, and family members and friends. Not
only does this ensure that each affected individual
is offered needed assistance, it may also help to
reinforce the bonds among the "law enforcement
family" and the notion that all of the law
enforcement personnel and their families are on the
same side and support each other.[13] Some program
directors recommend that command officers attend
these group sessions to show their
sensitivity to the difficulties line officers may
be experiencing--and because command staff may need
the debriefing themselves.[14] One sheriff attended
a critical incident debriefing shortly after the
shooting death of a deputy and ended up in tears;
later he told the stress program director that he
hadn't realized how much he also had needed the
intervention.

How Is Critical Incident Debriefing Conducted?

Most practitioners recommend conducting the
debriefing as soon as possible for those directly
involved in the incident and certainly no later
than 48 to 72 hours afterward.[15] At least one
police counselor, however, is cautious about being
the first person to talk to the officer after the
event. Len Wildman, a counselor with the Rochester
Police Department's stress management program, said
he prefers to wait until the officer has had a
chance to talk with a union representative or
lawyer who can discuss the facts of the incident
with the officer; Wildman then talks with the
officer about his feelings regarding what happened
and assesses whether he or she is in a condition to
answer investigators' questions.

A debriefing for other employees not directly
involved in but still troubled by the incident
could be held within one week. Nancy Bohl of the
Counseling Team in San Bernardino, California,
cautions that within this time limit, stress
program staff need to be flexible and sensitive to
the needs of the officers and family members:

The facilitator interviews the officer or officers
immediately after the incident and makes an
assessment about what would be the most beneficial
approach to follow. Frequently, the debriefing is
conducted then. Sometimes, though, it is clear that
an individual is too exhausted or hungry or that
the individual simply feels unable to talk.
Officers may say that they need to exercise, see
their families, or just get away from the scene. If
that is the case, a debriefing is scheduled for
some time within the next few days. If a group is
involved, it is possible for different people to
elect to do different things. Some may stay for an
immediate debriefing, and others may elect to meet
at a later time. The schedule, then, is flexible,
with the paramount concern being how best to meet
the needs of individual officers. The only
limitation is that, if the debriefing is postponed,
the delay period is not allowed to exceed three
days.[16]

The duration of the debriefing can vary, depending
on the number of participants and facilitators, and
the nature of the incident, although it typically
ranges from one to four hours.

Numerous articles have been written describing
critical incident debriefing techniques (see the
box "Sources of Information on Critical Incident
Debriefing"), however, different practitioners have
different ways of facilitating a session. Bohl
suggests the following nine steps:

(1) Introduce the facilitator and the process of
debriefing.

(2) Ask participants to review the facts of the
incident.

(3)Invite participants to describe their thoughts
during the event.

(4) Solicit participants' reactions.

(5)Discuss any symptoms participants may have
experienced or still be experiencing as a result of
the incident.

(6) Ask if participants were reminded by this
incident of other troubling past experiences.

(7) Suggest ways of coping with the incident.

(8) Answer participants' questions. 

(9) Invite participants to add anything else they
wish to say.[17]

Robert Scully, Executive Director of the National
Association of Police Organizations, also
recommends that the debriefing should inform the
participants of what to expect as a result of their
involvement, such as inquiries from the media,
including attempts to contact them or their
families at home; public scrutiny of their
personnel jackets; insensitive reactions from
coworkers who have not been involved in this type
of incident; and possible criminal or civil
litigation, which makes it important not to say
anything to the media that could be used against
them.

Theodore Blau, a police stress expert and former
president of the American Psychological
Association, recommends that, regardless of the
exact process, critical incident debriefing should
have the following features: immediacy (12 to 24
hours after the incident), brevity, privacy (except
for group sharing), respect, and
support.[18] Cindy Goss, of the Erie County
program, adds that it is important that counselors
and other facilitators do not
second-guess, judge, or criticize officers.

Blau also suggests that stress program staff
develop the following standard procedures for
responding to traumatic events: 

o decide what kinds of events qualify as critical
incidents and therefore require a debriefing;

o decide who is to be contacted as soon as a
critical incident occurs (e.g., if there will be a
team leader responsible for selecting and
contacting other team members); and

o decide what each team member's specific
responsibilities will be.[19]

Having these procedures in writing helps to ensure
that program staff (including any peer supporters)
understand their roles and responsibilities and
that the entire process runs smoothly. Cindy Goss
developed a critical incident debriefing policy and
procedural guide and had it reviewed and approved
by the county's commissioner for central police
services.

Crisis Intervention

In addition to critical incidents, law enforcement
personnel and their families may suffer other
crises that require immediate attention. These
crises may be the result of one or more
particularly stressful events or the cumulative
effect of the many minor stresses related to the
individual's life or work that build to a breaking
point. One program director interviewed for this
study recalled the time a sergeant from internal
affairs called to request assistance for a
colleague whose baby had died that morning. The
director of the Erie County program told of being
called to the home of an officer threatening
suicide; she and two peer supporters talked the
officer out of killing himself and then arranged
for him to receive psychological and other help.

The purpose of crisis intervention is to assess the
extent and seriousness of a client's problem;
establish rapport in order to promote a calm,
relaxed atmosphere conducive to the exchange of
sensitive information; offer advice and suggestions
on ways to handle the problem; and, when
appropriate, recommend other service providers in
the community that are better equipped to assist
the client with particular problems.

In most stress programs, at least one program staff
clinician is available 24 hours a day, usually on a
rotating basis so that officers can receive
immediate help whenever a crisis arises. Many
program directors carry a pager at all times. In
some programs, peer supporters are an extremely
important "first line" of support for officers who
are experiencing or appear to be on the brink of a
crisis; officers may be more comfortable contacting
a colleague during an emergency, and if necessary,
the peer can then call program staff for advice or
assistance (see chapter 4, "Choosing among Staffing
Options," for additional information on the role of
peer supporters.)

Short-Term Counseling

Most law enforcement stress programs staffed by
licensed mental health professionals, and most
independent practitioners, offer short-term
counseling--usually up to about 10 sessions--for a
variety of problems, most commonly marital and
other relationship difficulties, general anxiety,
and difficulties dealing with past critical
incidents. Clients whose problems require long-term
counseling are usually referred to an external
treatment provider (see the following section).
Staff sometimes also follow up with officers
referred to outside treatment sources in between
sessions.

Practitioners use a variety of clinical approaches
to address officers' problems, depending on such
factors as the severity of the problem and the
practitioner's training and experience. Several
program directors contacted for this publication
said they use a cognitive restructuring, or
cognitive-behavioral, approach. Some introduce
officers to biofeedback techniques, exercises to
promote relaxation, and hypnosis. In general,
practitioners agree on the importance of addressing
officers' problems quickly, approaching problems in
a very practical manner, and providing officers
with concrete options for managing their personal
lives more
effectively. Several practitioners noted that law
enforcement officers typically have a problem-
solving orientation and want pragmatic alternatives
for coping with their problems.

Most short-term counseling is done on an individual
or family basis, not with groups of officers due to
well-founded concerns about confidentiality.
Sessions can range from brief discussions in
passing (see the box "When Does Confidentiality Go
Into Effect?" in chapter 6) to regularly scheduled
hour-long sessions. Some officers go for
intermittent counseling; others see a counselor
regularly for short period of time. One officer,
for example, used his department's stress program
three times over the course of several years for
different reasons; another officer whose home was
destroyed by a hurricane and whose father was
diagnosed with brain cancer, saw a counselor twice
a week for three months. The same counselor visited
the home of another officer three times in the week
after the officer underwent traumatic surgery and
then once or twice a week for another month.

Some program directors and independent
practitioners limit the number of counseling
sessions an officer can receive, referring them to
external practitioners if long-term care is needed,
even if the officer can afford ongoing treatment.
Employees of the Bureau of Alcohol, Tobacco, and
Firearms, for example, are entitled to only five
free counseling sessions per incident. Drug
Enforcement Administration employees may have up to
six counseling sessions per problem with an EAP
clinician, although additional sessions are
sometimes allowed; twelve months of aftercare at
one contact per month is also provided, during
which time the counselor usually checks with the
client's outside referral source to follow up on
the client's progress. Rochester Police Department
stress program counselors generally limit the
number of sessions per client to "a ballpark figure
of 8 to 12 visits," although they have on occasion
counseled officers for extended periods. Often the
officer's or family member's insurance policy
dictates how many counseling sessions he or she can
attend. However, if a client's insurance runs out,
staff of Rhode Island's Centurion Program and other
programs continue to offer counseling using a
sliding scale or, if necessary, on a pro bono
basis. (See chapter 13, "Managing Program Costs and
Funding," for further discussion of insurance
issues.)

As part of short-term counseling, it is also common
for
practitioners to refer law enforcement employees to
other sources of supplemental assistance, including
in-house health and physical fitness programs,
support groups, and police chaplains. In some
cases, stress program staff may coordinate or work
directly with a department wellness program. In
addition, some programs make stress-reduction
audiotapes and biofeedback equipment available so
officers can learn to control or alter their
physiological
responses to stress.

Long-Term Counseling

Officers and nonsworn law enforcement employees may
need long-term counseling for a number of problems,
including

o alcohol and other substance abuse,

o serious marital or other relationship problems,
and

o depression, suicidal thoughts, post-traumatic
stress disorder resulting from a critical incident,
and other serious psychological problems.

Most program staff and almost all independent
practitioners contacted for this study do not
provide long-term counseling because of limited
time and, frequently, limited expertise with
problems severe enough to require long-term
treatment. Instead, clients are referred for long-
term therapy to other service providers in the
community (see chapter 5, "Establishing a Referral
Network" ). Stress program staff, however, usually
make the initial assessment of the individual and
provide initial short-term treatment as described
above. For instance, the director of the San
Antonio Police Department's Psychological Services
refers clients to outside assistance if they
require more than eight counseling sessions. In
such cases, program staff usually follow up with
the outside practitioner regarding the employee's
condition.

Some programs are able to offer long-term
counseling to clients. Mental health professionals
with San Bernardino's Counseling Team frequently
work long-term with officers on relationship or
critical incident problems. The director of the
Michigan State Police program saw one client for a
year, at first weekly, then every few weeks, and
finally once a month; he has been seeing another
family member twice a month for two years. A
trooper who is a recovering alcoholic joined the
Michigan program's staff and now provides long-term
support to other officers with addiction problems.
While a law enforcement stress program may also
provide long-term support in the form of peer
assistance on an individual or group basis (e.g.,
by organizing a law enforcement Alcoholics
Anonymous group), counselors stress the importance
of providing clients with proper professional
assistance for serious problems.

Providing Services for Mandatory Referrals

Treatment services are usually provided to officers
on a voluntary basis. Some program staff also
counsel or evaluate officers--or refer them to
other service providers--at the request of
department supervisors. However, almost all stress
program staff agree that treating fitness-for-duty
referrals can destroy the program's credibility
among line officers because they will view staff as
tools of management and fear that even voluntary
visits to the program will jeopardize their career
advancement. As the vignettes below suggest,
officers can be encouraged to seek counseling in a
number of other ways that involve different degrees
of coercion.

o The supervisor of an officer who was arrested for
smashing his personal car while drunk recommended
he seek help for his drinking problem. The officer
knew that if he did not enter counseling but never
had another accident, the supervisor would take no
further action. But because he knew the supervisor
would discipline him if he did get into another
drunk driving accident, he sought help from the
stress program. 

o Supervisors with a half dozen police departments
in Rhode Island order officers to the Rhode Island
Centurion Program after a pattern of problems
occurs, such as several citizen complaints or
absences from work. As long as the program director
clears the officer for duty after treatment, the
officer's use of the program does not affect his or
her professional development.

o The Drug Enforcement Administration accepts both
"self-referrals" based on a supervisor's informal
suggestion that an employee obtain assistance, with
no report to the supervisor required, and "formal
referrals" --that is, those made in writing by the
agent's
immediate supervisor specifying work performance
deficiencies and directing the agent to obtain EAP
assistance.

o Many police departments require officers to
attend critical incident debriefings when a firearm
has been used (see the box, "Some Departments
Mandate Debriefings in Critical Incidents").

o The director of the San Bernardino Counseling
Team is writing a proposal to the California Peace
Officers Standards and Training (POST) Division
seeking to obtain certification for a class for law
enforcement officers who are going through marital
separations. She will then try to motivate
departments to require the course, when
appropriate, because the stress officers experience
during a separation often causes them to be
disruptive or distracting to other officers.

o Supervisors with the Metro-Dade police department
may make a "supervisory intervention" when an
employee exhibits a continuing performance problem.
According to the department's standard operating
procedures, a supervisory intervention is a
voluntary counseling session facilitated by the
Health Services Section and is not utilized for
psychological evaluation of the employee. A Health
Services Section staff member facilitates the
supervisory intervention session with the employee
and the supervisor in order to articulate the
performance problems, outline expectations and a
time frame for desired performance change, clarify
other issues that may affect the desired outcome,
and agree on the amount of feedback to be provided
to both the supervisor and the employee on the
employee's progress.

o Most Federal law enforcement counseling programs
have policy statements that allow for the "directed
referral" of officers or agents involved in
critical incidents associated with performing their
duties. The term "directed referral" is sometimes
used to describe programs that utilize a
supervisory referral that is not mandatory in the
traditional sense but is stronger than a
supervisory suggested referral. If an officer does
not follow through with a directed referral, there
is no adverse consequence. The Department of
Justice Employee Assistance Program (EAP) policy
allows for a directed management referral when a
supervisor is able to document a performance or
conduct problem and suspects a personal or family
problem may be the reason. No information is given
to the organization without the officer's written
release. These referrals are "informational" in
nature and not counseling. As previously discussed
in this publication, the Department of Justice,
like most other Federal law enforcement groups,
keeps fitness-for-duty assessments separate from
the counseling service, whether it is an internal
or external model.[21]

Despite this diversity of "mandatory" referrals,
program staff--and officers--often distinguish
among three primary types:

(1) referrals designed exclusively to help the
officer;

(2) referrals designed to help the officer and
accompanied by an explicit or clearly implicit
warning that if the officer's
on-the-job performance remains impaired, he or she
will be disciplined; and

(3) referrals associated with planned disciplinary
action or fitness-for-duty evaluation.

Most supervisor referrals fall into the second
category: more or less mandatory, but with no
request from the supervisor for information from
the program about the officer's condition or
whether the person even received treatment.
However, because treating mandatorily referred
officers may brand the program as unable to keep
information secret about all officers who seek its
services--including officers who are self-referred-
-most of the programs and independent practitioners
contacted for this report accept only those
supervisor referrals that do not require any
feedback from the counselor to the supervisor.
According to Douglas Gentz, Director of Tulsa's
Psychological Services, "Mandatory counseling in a
police department is not really counseling--it is
management consultation, because the true client in
this case is not the officer, it is the
department."[22] Initially, Gentz did conduct
fitness-for-duty evaluations and preemployment
screenings for the Tulsa Police Department but
discontinued them because they presented a conflict
of interest in terms of trying to serve the
department and officers at the same time.

Most stress programs send mandatory referrals to
outside treatment providers for assistance. The
police department in Tulsa sends mandatory
referrals to the citywide EAP rather than to Gentz'
program. The Metro-Dade Police Department's Health
Services Section does accept officers referred for
fitness-for-duty evaluations if their performance
errors are observable and testable, but then sends
them to an outside testing and treatment
psychologist. Program staff keep the referring
commander informed only about whether the officers
are participating in and have completed treatment.
The police union does not object to the Health
Services Section's role with these referrals
because at least officers are given a second chance
to receive help.

As noted above and in previous chapters, an
additional critical clientele for both treatment
services and training consists of family members of
officers and nonsworn personnel. The following
chapter suggests training, treatment, and support
services that programs can offer to family members.

Endnotes

1. Solomon, R., "Critical Incident Trauma for Law
Enforcement Officers," unpublished training
materials, Bureau of Alcohol, Tobacco, and Firearms
Academy.

2. Quoted in Blak, R.A., "Critical Incident
Debriefing for Law Enforcement Personnel: A Model,"
in Critical Incidents in Policing, revised, ed.
J.T. Reese, J.M. Horn, and C. Dunning, Washington,
D.C.: U.S. Department of Justice, Federal Bureau of
Investigation, 1991: 23.

3. Blau, T.H., Psychological Services for Law
Enforcement, New York: John Wiley and Sons, Inc.,
1994: 167-168.

4. Ibid., 168; Horn, J.M., "Critical Incidents for
Law Enforcement Officers," in Critical Incidents in
Policing, 143-148; Bohl, N., "Professionally
Administered Critical Incident Debriefing for
Police Officers," in Police Psychology Into the
21st Century, ed. M.I. Kurke and E.M. Scrivner,
Hillsdale, New Jersey: Lawrence Erlebaum
Associates, 1995: 172-73. 

5. Bohl, N., "The Effectiveness of Brief
Psychological
Interventions in Police Officers after Critical
Incidents," in Critical Incidents in Policing, 34.

6. "Post-Shooting Incident Procedures," Concepts
and Issues Paper, Alexandria, Virginia:
International Association of Chiefs of Police,
National Law Enforcement Policy Center, March 1,
1991.

7. Garrison, W., "Organizational Triage: Restoring
the State of the Organization Altered by Trauma,"
in Organizational Issues in Law Enforcement, ed.
J.T. Reese and R. Solomon, Washington, D.C.: U.S.
Department of Justice, Federal Bureau of
Investigation,
forthcoming, 1996: 193-205.

8. Wee, D., "Disasters: Impact on the Law
Enforcement Family," in Law Enforcement Families:
Issues and Answers, ed. J.T. Reese and E. Scrivner,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1994: 239-250.

9. Allen, S.W., I. Basilio, S.L. Fraser, H.V.
Stock, W.E. Garrison, L.M. Cohen, P.J. Stephens,
and L.M. Cornell, "Proximate Traumatic Sequelae of
Hurricane Andrew on the Police Family," in Law
Enforcement Families, 143-154; Klein, R., "The
Utilization of Police Peer Counselors in Critical
Incidents," Critical Incidents in Policing,"
159-168.

10. Garrison, "Organizational Triage," 198.

11. Wee, "Disasters," 239-250.

12. Reese, J.T., "Justification for Mandating
Critical Incident Aftercare," in Critical Incidents
in Policing, 289-295.

13. Bohl, "Professionally Administered Critical
Incident Debriefing," 175.

14. Blak, "Critical Incident Debriefing for Law
Enforcement Personnel," 25.

15. Ibid., 24; Bohl, "Professionally Administered
Critical Incident Debriefing," 174.

16. Bohl, "Professionally Administered Critical
Incident
Debriefing," 174.

17. Ibid., 176-181. 

18. Blau, Psychological Services for Law
Enforcement, 176.

19. Ibid., 177.

20. Ibid., 179.

21. Elliot, B., "Employee Assistance Programs in
Police
Organizations," in Police Psychology Into the 21st
Century, ed. M.I. Kurke and E.M. Scrivner,
Hillside, New Jersey: Lawrence Erlebaum Associates,
1995, 149-152.

22. Gentz, D., "The Influence of a Primarily
Counseling Oriented Psychological Services Program
on the Law Enforcement
Organization," Paper presented at the FBI Academy
Symposium, Organizational Issues in Law
Enforcement, Quantico, Virginia, January 25-27,
1995.

Preparing For and Coping With Major Disasters

Major disasters such as hurricanes, tornadoes,
floods, and earthquakes have devastating results
and create enormous stress for officers and other
emergency workers, who must take control of an
often chaotic situation while also coping with
their own possible losses from the disaster. The
law enforcement organization as a whole can also
suffer adverse effects as it experiences a major
disruption in patterns of interaction among
personnel and agencies.[7] Finally, the "unique
stresses faced by the law enforcement family
include separation from family members during the
disaster, dual duty to family and community, and
being a victim of the disaster." [8]

Law enforcement agencies need to be prepared to
address the trauma and stress experienced by
officers and their families following a major
disaster.[9] After Hurricane Andrew struck south
Florida in 1992, the Metro-Dade Police Department's
Health Services Section provided emergency
counseling and other assistance to over 1,000
officers and their families from about 25 law
enforcement agencies in the area. William Garrison,
director of the program, set up an emergency
telephone hotline, with officers fielding calls and
categorizing them according to various needs (e.g.,
counseling, shelter). Counselors were available to
provide immediate assistance to callers, and
program staff traveled throughout the area to talk
with officers and provide assistance.

Garrison noted that some law enforcement personnel
did not display anger, depression, or other
emotions stemming from the disaster until after
they had coped with basic needs like finding
shelter and maintaining order." Overwhelming
disaster victims emotionally by flooding them with
the reality of the destruction can easily disrupt
their ability to function on the job or handle
personal business." [10] Garrison therefore did not
limit the provision of critical incident debriefing
to the days immediately following the hurricane but
also offered debriefing to individuals who needed
it long afterward. Later, the Metro-Dade Police
Department created a committee to determine how to
be prepared to cope with a future disaster.

Firestorms in northern California in 1991 caused an
enormous amount of destruction and killed 25
people, including a fire department battalion chief
and a patrol officer. A disaster mental health
program, supported largely by the Federal Emergency
Management Agency, the City of Berkeley, and the
University of California at Berkeley, was set up to
provide psychological and operational support to
emergency workers and other community residents.
Law enforcement officers were trained to provide
crisis intervention and stress management
assistance to their peers, and educational
presentations were offered to all law enforcement
organizations in the area, focusing on
psychological responses to the disaster and
effective intervention techniques.[11]

Garrison suggests that law enforcement agencies
designate a staff member to be trained and prepared
to coordinate activities following a disaster and
have individuals or agencies outside the geographic
area lined up for backup support, if needed. A
triage plan should be developed to assess the needs
of those in distress and to address and follow up
on those needs. In addition, it is important to
have contingency plans for child care for parents
expected to work additional hours. Garrison
suggests that ways to deal with disasters should be
included in management training.

Some Departments Mandate Debriefings 
in Critical Incidents

Based on research and his own experience debriefing
officers, James Reese, former director of the FBI's
Behavioral Science Services Section, recommends
that debriefings be mandatory following a critical
incident. In fact, he says, law enforcement
agencies have an obligation to provide debriefings:
"Critical incident care is a nonnegotiable
responsibility for law enforcement agencies, not
only to the participants and the observers of the
incident(s), but to their support systems, as well
. . . . Mandatory aftercare is a way of protecting
and serving those who `serve and protect.'"[12]

Most of the contracts the San Bernardino Counseling
Team has signed with local law enforcement
agencies--many of them small agencies--require that
someone at the scene of a critical incident (for
example, a person from the civil liability unit)
call the stress program to send a counselor to the
station or hospital to debrief all officers
involved in the incident--usually first as a group
and then individually. Different departments make
the debriefings mandatory for different types of
incidents. All departments require debriefings when
a firearm has been used, but some also require them
for the death of a child, death of a coworker
(including traffic accidents), or whenever an
officer is taken to a hospital for exposure to
hepatitis or HIV. 

The departments have learned to mandate the
debriefings because some officers mistakenly feel
they can handle any fear, guilt, anger, or other
emotions stemming from the incident on their own
when in fact they need support--and will benefit
from it if they are forced to participate. To avoid
stigmatizing particular officers, everyone involved
in the incident, including dispatchers, is required
to be debriefed. A deputy chief reported
overhearing officers gripe initially about having
to talk with the counselors but afterwards heard
some of them report,"I feel 100 percent better;"
other officers, who appeared indifferent to the
requirement were still talking to the counselor an
hour later; a union leader reported that some of
the debriefed officers made follow-up appointments
with program counselors on their own. Some of the
departments also mandate that officers involved in
a critical incident return for a follow-up group
debriefing with the Counseling Team at least once
during the year following the event. Of course, the
counselors report nothing of these meetings to
anyone not in attendance.

Sources of Information on Critical Incident
Debriefing

Since the mid-1980s, when critical incident
debriefing rapidly became more common among law
enforcement departments, much has been written on
the topic. The following are a few sources of
information (see chapter 14, Tapping Other
Resources, for
information on how to obtain these and other
materials):

o Critical Incidents in Policing is a collection of
papers
presented at a 1991 conference sponsored by the
Federal Bureau of Investigation, Behavioral Science
Services Section. The papers address the nature of
critical incident trauma, efforts by stress
programs to address the emotional effects of
critical incidents, and approaches to providing
debriefings and counseling.

o Psychological Services for Law Enforcement
(1986), also developed by the FBI's Behavioral
Science Services Section, includes an entire
section (16 articles) on critical incident
reactions.

o Professionally Administered Critical Incident
Debriefing for Police Officers, by Nancy Bohl,
appears in Police Psychology Into the 21st Century
(1995), edited by Martin I. Kurke and Ellen
Scrivner, and published by Lawrence Erlebaum
Associates. The article details the approach Bohl
has used to provide debriefings for officers in the
San Bernardino, California, area.

o Psychological Services for Law Enforcement
(1994), a book written by police psychologist
Theodore H. Blau and published by John Wiley and
Sons, Inc., has a chapter devoted to critical
incident counseling. The chapter discusses the
types and effects of critical incidents,
individuals who are in a position to intervene in
incidents, and intervention and counseling
techniques.

o The International Association of Chiefs of Police
has developed guidelines and a model policy
regarding post-shooting incident procedures (see
appendixes 10-1 and 10-2).

o Concerns of Police Survivors (COPS), a national
organization of survivors of officers killed in the
line of duty, can provide information and training
on how to deal with an officer's death. 

o Chevron Publishing Corporation, a publisher
associated with the International Critical Incident
Stress Foundation, Inc. (ICISF), offers a number of
training guides, books, videotapes, and other
materials.

Supportive Departmental Responses to Shootings

In addition to providing critical incident
debriefing, program staff can encourage department
administrators, managers, and other officers to
respond in a supportive manner to officers involved
in the incident. A 1986 FBI study of post-traumatic
shooting reactions recommended the following
treatment components for an officer involved in a
line-of-duty shooting:[20]

(1) Give a compassionate response to involved
officers at the scene.

(2) Avoid judgmental remarks.

(3) Provide physical and mental first aid.

(4) Remove the officer from the crime scene.

(5) Replace the officer's weapon.

(6) Arrange contact with the officer's family and
provide support.

(7) Provide a psychological break for the officer
before the detailed interview.

(8) Place the officer on administrative leave (not
suspension).

(9) Provide mandatory counseling within one to two
days.

--Screen incoming telephone calls to the officer.

--Advise other employees of the basic facts of the
incident.

--Screen department personnel for vicarious thrill
seekers.

--Provide independent legal counsel for the
officer.

--Allow a paced return to duty.

--Consider the officer's interests in media
releases.

--Expedite the completion of administrative and
criminal
investigations and inform the officer of the
outcomes.

In addition, program staff or peers can run errands
for the officer and his or her family, arrange for
child care, and help deal with the media.

An officer asked his wife to call a program
director in the middle of the night after he awoke
with flashbacks to the stabbing attack he suffered
while at work at a corrections facility. The
director met the officer and his wife at the
emergency room and provided immediate crisis
intervention.

Jeffrey Mitchell, who has developed a training
curriculum for critical incident counseling for
emergency personnel, defines a critical incident as
"any situation faced by emergency personnel that
causes them to experience strong emotional
reactions which have the potential to interfere
with their ability to function either at the scene
or later." 

Mandatory counseling in a police department is not
really counseling--it is management consultation,
because the true client in this case is not the
officer, it is the department. 

--Douglas Gentz, Director, Psycho-logical Services,
Tulsa

______________________________________________

Chapter 11
Services for Family Members: Treatment and Training
______________________________________________

Key Points

o An increasing number of stress programs are
providing treatment services and training to
officers' family members--usually broadly defined
as a relative or anyone else with whom the officer
has a close relationship.

o Providing services to families of officers can
help to prevent and reduce the stress-related
difficulties family members may experience, limit
the stress that family members may cause the
officer in the family, and help family members
become a source of support for the officer.

o Many programs offer the same services to family
members that they provide to officers, but usually
on a more limited basis. These services include
assessment and referral, critical incident
debriefing, crisis intervention, and short- and
long-term
counseling.

o Three services in particular are typically
tailored for family members' needs: family
counseling, critical incident debriefing (provided
by professional program staff and sometimes by peer
officers and family members), and other peer
support (e.g., spouse support groups).

o In addition to the topics that stress training
addresses with officers, family members can benefit
from information about the law enforcement agency,
duties involved in a law enforcement career, and
general family issues such as financial planning,
housing-related problems, parenting, illness, and
dual careers.

o Training for family members is usually offered
during the academy. Periodic family training
sessions throughout the year, conducted with the
officers, are also an important way to provide
information about stress management and program
services.

Each year, families of law enforcement officers who
have been slain in the line of duty are honored
during Police Memorial Week. As police psychologist
Ellen Scrivner pointed out during congressional
hearings held in 1991 on law enforcement stress,
the needs of these bereaved families "remain
substantial [but so] do those of other police
families who, though not having lost a member of
their family, still contend with the rather unique
stressors attributed to the influence of the law
enforcement occupation." The needs of all family
members of officers, Scrivner emphasized, must be
addressed not only for one week each year but
throughout the officers' careers.

Chapter 1 reviews some common sources and effects
of stress that family members experience and points
out that most programs define "family" very broadly
to include not only spouses and children but also
parents, significant others, and anyone else with
whom the officer has a close relationship. Chapter
7, "Marketing the Program," discusses how to secure
referrals of family members. The present chapter
discusses strategies for preventing and treating
family members' stress-related problems.

Why Serve Family Members?

All of the law enforcement stress programs
contacted for this publication offer at least some
services to officers' family members. Program
counselors gave three reasons for serving this
group:

1) As described in chapter 1, certain aspects of
law enforcement work, such as fear for the
officer's safety and the odd and changing hours
that officers must work, can take a tremendous toll
on family members, causing difficulties that
require counseling or other assistance. 

2) Stress-related difficulties experienced by
family members can also create problems for the
officer, resulting in impaired job performance. In
fact, several counselors reported that family
problems are the most common reason for which
officers seek help. As a result, serving family
members--usually together with
officers--can help reduce officers' stress.

3) Family members are in the best position to
support officers, recognize early when the officers
are experiencing stress-related difficulties, and
refer them to professional help. Family members can
probably provide this kind of assistance better if
they are familiar with law enforcement work and its
stresses.

The International Association of Chiefs of Police
(IACP) suggests that law enforcement agencies offer
several services for family members, including
individual and family counseling, post-shooting
incident support and debriefing, group discussions
among officers and their spouses, orientation
programs, and frequent family events. An IACP
training document on law enforcement stress and the
family states, "The financial cost of implementing
these programs is not large, but the return
benefits to the officer, the family, the department
and the community can be immense in stimulating
positive public relations, reducing stress,
promoting marital harmony, and improving job
performance."[1]

Most of the family members interviewed for this
publication who had used law enforcement stress
programs found the services helpful. One officer's
wife who received marital counseling with her
husband said that "no one was there for us except
the stress team." Even family members who had not
used the program said they were glad it was
available and would use it if they felt the need.
Family members who had participated in stress
training sessions
particularly appreciated learning about law
enforcement work and hearing from other family
members who had similar experiences and
difficulties. Like officers, family members said
they wanted services that were readily accessible
and, in the case of
counseling, confidential.

A survey of police officers' wives conducted in the
late 1970s found that, when asked what type of
services the department should be providing, over
half wanted family or marital counseling, one-third
hoped for an orientation to law enforcement, and
about one-tenth wanted social activities, financial
and medical assistance, and information services
(such as notification about emergencies and
injuries). Twenty percent of the respondents wanted
no services at all, but this was apparently due
primarily to fear of departmental intrusion rather
than to lack of need.[2] In deciding whether to
offer assistance to family members, one law
enforcement stress expert suggested that, when in
doubt, ask: "An offer of support to the spouse and
family from the officer's department is rarely
inappropriate and may be deeply appreciated, even
if declined by the family. What seems to hurt
spouses very deeply is the impression that their
needs are being ignored, resulting in a feeling of
isolation from the rest of the
department."[3] Reflecting this view, Counseling
Team clinicians in San Bernardino, California, try
to talk with family members who are present after a
critical incident.

As with law enforcement personnel, treatment
services and training are the two main services
that stress programs provide to family members.

Treatment Services

Depending on available time and expertise, law
enforcement stress programs and independent
practitioners generally offer the same services to
family members as they furnish to officers:
assessment and referral, crisis intervention,
critical incident debriefing, and short- and long-
term counseling. The discussions of these services
in chapter 10 apply equally to family members. The
services are typically provided, however, on a more
limited basis to family members. As they do for law
enforcement personnel, most law enforcement mental
health professionals commonly refer family members
to other providers for long-term counseling.
Because they do not have the specialized training
to work with children, most counselors--even police
psychologists--usually also refer
children's cases to other practitioners.

Family members typically seek stress program
services for problems related to the officer's
work, such as marital problems due to shift work
rotation or trauma after a critical incident. Some
family members use the programs for other reasons.
After being involved in a terrible traffic
accident, one officer's wife developed a phobia of
being on the freeway and found herself taking
alternate routes. She sought counseling from the
police psychologist who ran the stress program in
her husband's department. Another family member who
received individual counseling from the
department's stress program for a problem unrelated
to police work was pleased that the program treated
her problems "as seriously as they treat the cops'
problems."

This section focuses on three treatment services
tailored specifically for family members: (1)
family counseling, (2) critical incident
debriefing, and (3) peer support.

Family Counseling

Stress program practitioners report that the most
common problem for which officers seek treatment is
marital or other relationship difficulties. Both
Philip Trompetter, a psychologist who serves
several small departments near Modesto, California,
and Gary Kaufmann, Director of the Michigan State
Police Department's Behavioral Science Section,
report that over half of their clients come to them
because of family difficulties. John Carr, Director
of the Rhode Island Centurion Program, says that 75
percent of his cases involve "a broken heart, not a
broken head," and the director of the Washington,
D.C., Metropolitan Police Department EAP calls
family and marital difficulties "our number-one
problem."[4]

Although counselors often treat only the officer
for a relationship problem, many mental health
practitioners recommend joint
counseling.[5] When an officer comes to discuss
marital
difficulties with Nancy Bohl, Director of the
Counseling Team in San Bernardino, she encourages
the person to bring his or her spouse to the next
session, because she feels this is the best way to
mediate the confusion and discord between them. The
Washington, D.C., Metropolitan Police Department
EAP provides marital
counseling and coordinates couples' groups and
retreats.[6]

Not all family counseling focuses on relationship
problems. William Garrison, Director of the Metro-
Dade (Florida) Police Department's Health Services
Section, not only counseled an officer whose father
was suffering from brain cancer, he also went to
the home of the officer's parents to talk with
them, to counsel the officer's mother, and to
advise the family on how to care for the father and
themselves during the difficult time. Garrison
later attended the funeral for the officer's
father. Garrison counseled another couple who
needed assistance after the husband, an officer,
was involved in a shooting and the family's house
was destroyed by a hurricane. In another
jurisdiction, an officer and his wife regularly see
a substance abuse counselor as a couple to help
them work through the officer's alcohol problem,
which was prompted by his flashbacks of a critical
incident.

Although most law enforcement counselors do not
have the training to work with children, they can
sometimes provide general assistance along with
referrals. Garrison went to one home to talk with
an officer's two young children who were frightened
by their father's involvement in a shooting.
Members of the Bureau of Alcohol, Tobacco, and
Firearm's peer support team visited schools
attended by many of the children of agents and
other Federal employees who were killed or injured
in the Oklahoma City bombing in 1995 to talk about
the youngsters' fears and other negative reactions.
Beverly J. Anderson, Clinical Director and Program
Administrator of the Washington, D.C., Metropolitan
Police EAP, who started her career as a child
specialist and is married to a police officer,
coordinates an adult children of trauma group and
an adolescent therapy group for children of
officers, who, she said, frequently act out, are
depressed, or are either violent or extremely
sensitive to violence. Anderson also evaluates
children and confers with their teachers regarding
problems related to their parents' law enforcement
work.[12]

Critical Incident Debriefing

Critical incidents can traumatize the relatives and
partners of the officers involved just as severely
as the officers themselves. Family members' fear
and shock are compounded by their ignorance of the
event since they were not on the scene. According
to one observer, "Recognizing that families are
negatively impacted by traumatic events and that
significant others have a key role to play in the
recovery of the distressed [officer] is not
sufficient. It is also important to recognize that
families may at times be so seriously overwhelmed
by the stress response of their loved ones that
they are unable to assume their appropriate roles
in
facilitating the recovery of the hurting
[officer]."[15] As critical incident debriefing has
become more common (even mandatory) among law
enforcement agencies, attention is now turning to
the needs of family members after an incident.

Program staff and independent law enforcement
clinicians provide critical incident debriefing for
family members by including them in the debriefing
provided to officers involved in the incident, by
providing a separate debriefing attended only by
family members, and by coordinating peer support.
In Modesto, California, services for spouses of
officers involved in a critical incident used to
amount only to the sensitive delivery of the news
of the incident. After the creation in the early
1990s of a support group for officers involved in
shootings, several spouses of these officers began
meeting informally to address their common concerns
and needs. The group eventually encouraged Philip
Trompetter, a police psychologist serving several
small departments in the area, to contact them
after a critical incident so that they could
provide support to the spouse of the officer
involved. Now, after a critical incident,
Trompetter encourages the officers involved to
invite their spouses to the stress debriefing.
Trompetter writes, "The presence of the spouses
during this initial debriefing has been extremely
helpful in providing practical coping strategies
for potential conflicts, misunderstandings, or
other disruptive variables that could impair the
familial relationship. One of the factors thought
to contribute to the success of initially involving
spouses is that such debriefings facilitate a sense
of having shared a stressful experience."[16] The
spousal support group helps arrange for child care
for the officer and his or her spouse and invites
the spouse to the group's next support meeting.
Spouses of other officers not directly involved in-
-yet still adversely affected by--the incident are
invited to a second, larger
debriefing.

Although some clinicians report that peer support
for families is a beneficial service after a
critical incident, one observer offers a warning:

In group process meetings with spouses, care should
be given as to the composition of the group. It may
be extremely upsetting for the spouses of officers
who have just died to meet in an intense group
process with spouses whose husbands and wives are
still living. The sensitivities of the situation
and the judgment of responsible professionals and
command officers are much more reliable
indicators about what should be done than the
prescriptions of any general model for critical
incident debriefing     . . . . At the time of the
critical incident, one of the most sensitive things
that a department may do is to activate the natural
support system surrounding an officer and his or
her family.[17] 

In addition to debriefing family members, program
staff can arrange for practical assistance that can
do much to alleviate the family's difficulties.
After one critical incident, Counseling Team
director Nancy Bohl arranged for peer supporters to
bring food to the hospital and the officer's home,
and to look after the officer's children.

Peer support may be most helpful after the
immediate crisis is over and the family is learning
to adjust to the aftermath of the incident. One
family member of an ATF agent involved in both the
burning of the Branch Davidian compound in Waco,
Texas, and the bombing of the Federal building in
Oklahoma City said the family never talked about
Waco at home until they experienced peer
intervention in Oklahoma City. "Until then it was
not okay to talk about or even feel anything about
these incidents," she said.

Other Peer Support

Peer support can be a valuable service for law
enforcement family members not only after critical
incidents but also for dealing with general
problems and providing camaraderie. Both officer
and spouse peers can provide these services. Six
officers in a medium-sized department in Texas were
trained as peer supporters with special instruction
on work-related and general family problems. The
peers have helped family members cope with divorce,
alcoholism, child care difficulties, long-term
illnesses, financial planning, the death of a
relative, spouse abuse, and crime victimization.
Peers accompany the family to an outside expert if
a referral has been made.[18]

Some stress program staff warn that setting up and
maintaining a support group for family members can
be difficult because of the limited time that
spouses may have for meeting together or that staff
may have for coordinating the group. Family
members'
different expectations and the tendency for some
group meetings to turn into gossip sessions may
also limit a group's value. One wife, for example,
joined an informal group of spouses from her
husband's department but was dissatisfied with
their traditional viewpoints and lack of interest
in addressing difficult questions faced by her
generation of spouses. In fact, officers may be the
largest source of resistance to family peer support
groups because they fear their "dirty laundry" will
be aired in public. One officer told his wife to
avoid the spouse support group that department
wives had formed "because all they do is gossip."
Although the group arranged for invited speakers,
the wife found her husband's criticism to be valid.

According to Suzanne Sawyer, Executive Director of
Concerns for Police Survivors:

Some officers have actually forbidden their spouses
to become involved in support organization work.
They label these support groups as `hen parties',
`coffee-clatches'. And as long as spouse support
groups are willing to serve cookies at police
department and police organization functions, these
spouse groups are
acceptable, bearable. Family support groups know
the issues--substance abuse within law enforcement,
spouse and child abuse, extramarital affairs, the
need for the family to know what their officers
confront on the streets--and we know they need to
be addressed. But we are kept from addressing these
issues because mere mention of them will only bring
more criticism to bear on our organizations.[19]

Stress program staff recommend that if a peer
support group is established, it is essential to

o inform officers about the group and its goals and
activities (that is, that it will not be a forum
for gripes and gossip);

o advertise the group effectively to family
members; and

o for each meeting, establish an agenda of issues
to cover within a specific time period to eliminate
gossiping and griping.

Training

Law enforcement stress experts agree that training
for family members can help prevent and reduce
stress-related difficulties. Anecdotal information
from family members interviewed or surveyed for
this and other publications indicates that most
family members who receive stress-related training
find it extremely worthwhile.[20] Participants in a
separate academy for spouses coordinated by the
Colorado Springs Police Department made such
comments as, "Listening to stories told by
officers' wives who had `been there' had a calming
effect," and, "It was very reassuring to know that
someone was concerned about us wives. I don't think
any of us realized what kind of job our husbands
were getting into."[21]

Training Topics

Training for family members usually covers the same
three general topics as does training for law
enforcement officers: sources and manifestations of
stress, individual prevention and coping
strategies, and the department's stress program and
other sources of assistance. (See chapter 8,
"Preventing Stress and Stress-Related Problems,"
for a review of these training topics.) Some
information, of course, is tailored to the unique
circumstances of being a family member of an
officer. These circumstances can vary from officer
to officer (e.g., the family of a female officer
may face some different sources of stress than the
family of a male officer). Besides educating family
members about how to recognize and cope with their
own individual problems, program staff can teach
them how to recognize and understand the effects of
stress on the officer, and how best to offer help
and encourage the officer to seek help.

Family members, along with their officers, also can
benefit from training and assistance with general
family issues, such as financial planning, housing-
related problems, parenting, illness, and dual
careers. As one police psychologist noted, "Police
departments have virtually ignored these general
family issues, which are more frequent and can be
more detrimental to marital and family harmony than
officer-instigated issues." Yet, an
"examination of spouse training programs and peer
support team training curricula reveals a
noticeable absence of training to deal with general
family issues. Even comprehensive employee
assistance programs do not cover these issues."[22]
Stress program staff and independent practitioners
may feel that given their typically limited
training time they need to focus on topics more
directly related to stress. However, they can still
encourage officers and family members to talk about
general family issues, provide helpful literature
that discusses them, and make referrals to other
sources of information and assistance. 

Stress prevention training usually includes an
introduction to the law enforcement organization
and the stages and duties of a law enforcement
career. Many family members find that the most
useful benefit of training is simply learning about
what law enforcement work involves. As a captain
and the chief of the Colorado Springs Police
Department observed:

Historically, the police wife [or significant
other] has been left to fend for herself when it
comes to understanding just what it is her husband
does when he puts on his uniform and goes out the
door at midnight or 4 p.m. This has been especially
true of the recruit wife. All too often, she is
left to her own devices to figure out this strange
new "profession" in which she now finds herself
enmeshed. These devices usually include television
shows (a poor source at best), news broadcasts
(focusing on the unusual), or her own
imagination.[23]

Training at the Academy

Training for family members is most commonly
provided during the academy. While family training
is not new--the Los Angeles County sheriff's office
established an eight-week program for spouses of
recruits in 1975[24]--it is becoming increasingly
common and far-reaching, targeting not only
officers' wives and husbands but also children,
parents, and other individuals with whom officers
have close relationships. As mentioned in chapter
8, training at the academy offers perhaps the best
opportunity to introduce family members to the
program and other available resources and to begin
to inoculate them against--or at least prepare them
for--
stress-related difficulties during the officer's
law enforcement career and even during the academy
itself. At the very least, academy training can
increase family members' awareness and
understanding of the job the recruit is about to
undertake.

Training at the academy ranges from a brief
orientation to the stress program, to a "family
night" consisting of speakers and socializing, to a
"spousal academy" consisting typically of several
weeks of courses on police work and stress
management and involving ride-alongs and weapons
practice. A minimal effort to involve family
members may be inadequate and even
counterproductive: 

[A spouse orientation] may be as superficial as
holding a reception for the wives with a tour of
the academy and perhaps showing a film (that is
usually shown to grade school students) entitled,
What Is a Policeman? In other cases, the
orientation is a formal briefing by personnel
representatives giving the spouse an overview of
the pay system, benefits and so forth--often after
the new officer has had to make choices about
insurance plans and other benefits--as well as a
lecture from a psychologist on police stress.
Although well meaning, such programs often tend to
exacerbate the problem rather than alleviate it by
further frustrating the spouse."[25]

. . . [A] police department may provide a one- or
two-hour evening orientation session for recruit
officers' wives which is loaded with informational
material about insurance programs, retirement
benefits, and some caveats from more experienced
wives. However, feedback from many women at
discussion groups suggests that they clearly view
this level of programming as inadequate.[26]

Departments that provide a comprehensive stress
program for family members usually recruit a
variety of instructors, including an expert in each
field being addressed. The Rochester Police
Department's Stress Management Unit arranges for
the recruits' firearms instructor to give family
members a tour of the firearm range and to let them
fire a service revolver under close
supervision. A New York State Police chaplain
counsels recruits and their spouses for three and a
half hours about police officer relationships,
interpersonal communication, domestic violence, and
other stress- and family-related topics. Veteran
officers and their family members can be
indispensable co-trainers because they can speak
from personal experience and are therefore likely
to be credible and capture family members'
attention. According to one law enforcement stress
expert, "Wives tell us that they want much more
than a lecture by a veteran police academy
instructor, who from his position of authority
talks down to them. Many would prefer to
participate in panel discussions with older police
wives, who from their years of experience in coping
with the job could communicate their strategies of
adjustment and disseminate their practical guide
for survival as a police wife."[27]

Even before the academy, the Michigan State Police
Department trains family members. Some department
recruiters ask applicants to bring their partners
or spouses to the orientation program before even
taking the tests or completing the application. One
recruiter has on occasion talked with a wife alone
because he could tell she was afraid to talk freely
around her husband.

Michael McMains, Director of Psychological Services
for the San Antonio Police Department, conducts a
Saturday workshop for recruits and their
significant others. In the morning, different
police couples who are at different stages of their
careers spend time with the group, with the police
officer member of each couple first talking about
the problems of policing from his or her
perspective and then the spouse talking from her or
his
perspective. In the afternoon, the recruits and
their partners split into work groups to plan
social activities for the first six months of
recruit school. The program also maintains an
ongoing voluntary group for partners at the academy
that meets weekly and typically attracts about a
dozen of the 40 recruits' spouses.

The Rochester Police Department's Stress Management
Unit
coordinates seven training sessions for significant
others during the academy. On the first night of
the academy, the director of the program usually
presents an overview of law enforcement work,
introduces program and training staff, and asks
family members to introduce themselves and discuss
their concerns and expectations. Two weeks later,
the director uses prepared overheads outlining
these expectations to stimulate discussion about
stress, life changes, and family support. At the
third session, family members observe
demonstrations of unarmed defense techniques and
use of firearms. The fourth and fifth sessions
review aspects of officer training, law enforcement
work and career progression, and
emotional issues to be aware of at different stages
of a career in policing. The sixth session consists
of a full day of discussions with the family
members and officers together. At the final
session, other department personnel provide
information about the union and department
benefits.

Training Throughout the Officer's Career

As long ago as 1978, Martin Reiser, former director
of Behavioral Science Services for the Los Angeles
Police Department, was recommending that
departments provide stress training for officers
and family members together six months, two years,
and four years after the academy, and then "at
other significant developmental points at which
conflicts can be predicted." Reiser also suggested
an initial psychological "checkup" for the couple
and then another one regularly every three years to
determine if any underlying problems require
attention.[28] Although not as common as training
during the academy, some stress programs offer
periodic training for families of experienced
officers throughout the year.

o After noticing that a large majority of the
police cases she was handling involved marital or
other relationship problems, a counselor serving
law enforcement agencies in Colorado developed
officer/spouse workshops in late 1992. The
workshops were offered at various times and days,
including evenings, to accommodate the different
schedules of officers and their family members.
Some officers brought their children. The counselor
and other presenters provided a handout on law
enforcement as an occupation and
"high-risk" relationships. During the workshop,
presenters reviewed job stresses, relationship
difficulties, and ways of preventing and resolving
them. The presenters tried to use lighthearted and
humorous examples and to provide practical--not
"touchy-feely"--advice.[29]

o On a quarterly basis throughout the year, the
Denver Police Department's stress program conducts
a one-night marital and family stress class for
officers and their spouses. Presenters discuss
types of stresses, why police marriages can be
high-risk
relationships, personality changes often
experienced by officers, and related issues.
Officers and spouses are informed of the class
through a notice sent to their homes.

As mentioned at the beginning of this chapter, many
programs are able to provide only limited services
to officers' families because of limited time and
expertise. By referring family members to other
mental health professionals and service providers
in the community, however, program staff can ensure
that they receive needed
assistance (see chapter 5, "Establishing a Referral
Network").

Endnotes

1. International Association of Chiefs of Police
National Law Enforcement Policy Center, "Police
Work and Family Life," Training Key Number 339,
Alexandria, Virginia. See also the IACP's 1991
Concepts and Issues Paper, "Post Shooting Incident
Procedures." These materials are available from the
IACP at (800) THE-IACP.

2. Niederhoffer, N., and E. Niederhoffer, The
Police Family: From Station House to Ranch House,
Lexington, Massachusetts: Lexington Books, 1978:
130-131. 

3. Hartsough, D.M., "Stresses, Spouses, and Law
Enforcement: A Step Beyond," in Critical Incidents
in Policing, revised, ed. J.T. Reese, J.M. Horn,
and C. Dunning, Washington, D.C.: U.S. Department
of Justice, Federal Bureau of Investigation, 1991:
134.

4. "On the Front Lines: Police Stress and Family
Well-Being," Testimony by B.J. Anderson, Hearing
Before the Select Committee on Children, Youth, and
Families, House of Representatives, 102nd Congress,
1st Session, May 20, 1991, Washington, D.C., U.S.
Government Printing Office: 1991: 61-63.

5. Borum, R. and C. Philpot, "Therapy With Law
Enforcement Couples: Clinical Management of the
`High-Risk Lifestyle,'" American Journal of Family
Therapy, 21 (1993): 122-135.

6. "On the Front Lines," Testimony by B.J.
Anderson, 61-63.

7. "On The Front Lines," Testimony by B.J.
Anderson, 61-63.

8. Mitchell, J.T., "Critical Incident Stress
Interventions with Families and Significant
Others," in Law Enforcement Families: Issues and
Answers, ed. J.T. Reese and E. Serivner,
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1994: 195-203.

9. See, for example, Swann, M.A., and C.A.
D'Agostino,
"Post-Shooting Trauma and Domestic Violence:
Clinical Observations and Preliminary Data, in Law
Enforcement Families, 227-229; Neidig, H., H.E.
Russell, and A.F. Seng, "Observations and
Recommendations Concerning the Prevention and
Treatment of Interspousal Aggression in Law
Enforcement Families," ibid., 353-358.

10. Honig, A.L., and E.K. White, "Violence and the
Law Enforcement Family," in Law Enforcement
Families, 101-109.

11. Clark, J.R., "Policing's Dirty Little Secret?
Spouse Abuse by Police Sparks Concern--and a
Federal Lawsuit," Law Enforcement News (April 15,
1991): 1.

12. Neidig, Russell, and Seng, "Observations and
Recommendations Concerning the Prevention and
Treatment of Interspousal
Aggression," 355.

13. Ibid., 357.

14. Stillman, F.A., "Line-of-Duty Deaths: Survivor
and Departmental Responses," Research in Brief,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, January 1987.

15.Ibid.

16. Trompetter, P.S., "Conjoint Critical Incident
Debriefings," in Law Enforcement Families, 233-238.

17. Hartsough, "Stresses, Spouses, and Law
Enforcement," 134.

18. Mullins, W.C., "Peer Support Team Training and
Intervention for the Police Family," in Law
Enforcement Families, 205-215.

19. "On The Front Lines," Testimony by S. Sawyer,
105-108.

20. A study by Stratton et al. in the late 1970s
and early 1980s found that the spouse academy
presented by the Los Angeles County Sheriff's
Office did not impact officers' divorce rates five
years later. However, most of the officers and
spouses reported that the program was beneficial
and said they would encourage others to attend. See
J.G. Stratton, B. Tracy-Stratton, and G. Alldredge,
"The Effects of a Spouses' Training Program: A
Longitudinal Study," Journal of Police Science and
Administration, 10 (1982): 297-301.

21. Ricks, P.C., and J.D. Munger, "The Forgotten
Recruit: Training the Police Spouse," The Police
Chief (November 1988): 20.

22. Mullins, "Peer Support Team Training," 205-215.

23. Ricks and Munger, "The Forgotten Recruit," 20. 

24. Stratton et al., "The Effects of a Spouses'
Training Program," 297-301.

25. Ricks and Munger, "The Forgotten Recruit," 21.

26. Reiser, M., "The Problems of Police Officers'
Wives," The Police Chief (April 1978): 42.

27. Niederhoffer and Niederhoffer, The Police
Family, 130.

28. Reiser, "The Problems of Police Officers'
Wives," 42.

29. Flater, L., "Officer/Spouse Workshops: A
Prevention and Intervention Technique," in Law
Enforcement Families, 329-335.

Preventing and Treating Domestic Violence

A relatively large percentage of law enforcement
officers may be involved in domestic violence, to
some extent because of the nature of their work and
the organizational stresses they face.[7] In the
past, officers who battered their partners were
often ignored by fellow officers who knew them
personally or felt the behavior was acceptable.
This tolerance is disappearing in many
departments,[8] in part, perhaps, because of
lawsuits that battered spouses have brought against
law enforcement agencies for allegedly violating
their civil rights by failing to discipline,
supervise, and monitor officers who abuse their
spouses.[9]

o According to police psychologist Claire
D'Agostino, the Atlanta Police Department's written
policy covering domestic violence committed by
members of the department requires the internal
affairs unit to suggest to an offending officer's
deputy chief that he send the officer a letter
requiring the person to meet with D'Agostino at the
city's Bureau of Employee Assistance Services.
D'Agostino then sends a written evaluation to the
officer and the deputy chief that includes
recommended actions. The deputy chief usually
accepts the clinician's recommendations and directs
the officer in writing to comply with them.
Recommendations may include attendance at group
counseling sessions with the city's contracted
employee assistance program or individual
counseling with the EAP, with a Bureau of Employee
Assistance Services clinician, or with an
independent therapist. Internal affairs learns
about officers with problems either after an arrest
or through an early warning system used to identify
officers who appear to be having personal or
professional problems that need intervention.

o According to Sergeant Mark Wynn, the Nashville,
Tennessee, Police Department's policy is to
investigate criminally every act of domestic
violence committed by an officer. Furthermore, to
avoid having officers who are friends with the
offender conduct the investigation, the
department's 34-person Domestic Violence Division,
headed by Wynn, takes responsibility for doing so.
A Domestic Violence Division supervisor then
notifies the department's internal affairs division
and the officer's bureau commander and sergeant so
that the information does not remain buried at the
precinct level. If there is probable cause, the
officer is arrested at the Domestic Violence
Division's precinct house. At that time, the
officer meets with a social worker to consider
counseling, something in which the division
encourages arrested officers to participate. The
officer is then booked, relieved of his or her
service revolver, and placed on
administrative leave or desk duty until the case
has been
adjudicated. The department's internal affairs
department conducts its own parallel investigation
at the same time that the Domestic Violence
Division conducts its criminal investigation. Wynn
estimates that the division investigates about 20
officers a year for domestic violence.

o According to Michael McMains, police psychologist
to the San Antonio Police Department, commanders
send each officer arrested for domestic violence a
letter discussing the stress associated with police
work and the risk that family violence may escalate
unless they receive help. The letter suggests that
the officer visit the department's Psychological
Services program and warns the officer to
anticipate a follow-up telephone call in a week
checking on whether he or she has done so. A letter
encouraging counseling is sent to the officer's
spouse.

With early detection, it may be possible for stress
programs to intervene through individual
counseling, family counseling, and training
programs in time to reduce the likelihood of
continued violence. However, because batterers
rarely volunteer to accept counseling, it may be
necessary to mandate participation[10] as, for
example, the San Antonio Police Department attempts
to do. Stress programs can also try to prevent
domestic violence by addressing the "conditions and
coping skill deficits that put officers at risk . .
. in mandatory training incorporated into existing
schooling and in-service training programs."[11]

Families of Officers Killed in the Line of Duty:
Services Immediately after the Incident--and Beyond

The death of an officer in the line of duty does
not happen often, and is especially rare in small
departments, but law enforcement counselors
emphasize that program staff need to be prepared--
and train other department personnel to be
prepared--to assist the officer's family after this
tragedy. According to a 1987 report from the
National Institute of Justice (NIJ):

Many departments have no formal procedures for
completing required paperwork and assisting family
members with funeral plans and requests for
benefits. Most departments do not consider the
emotional and psychological needs of survivors to
be a part of their responsibility . . . .
[Furthermore], relatives of slain police officers
often endure psychological distress for long
periods of time and do not seek help or discuss
their problems because they feel embarrassed or
wish to avoid seeming weak. They may refuse
existing community services because they believe
that only other members of the `police culture' can
understand their problems.[13]

In an NIJ-sponsored survey of survivors, many
reported feeling abandoned by the police
departments: "The spouses wanted some type of
formal and informal contact to continue. Most
reported that contact ended soon after the
funeral."[14] Stress program staff can assist
survivors in a number of ways, including

o providing crisis intervention and critical
incident debriefing immediately after the incident
and assisting with practical matters, such as
funeral arrangements;

o encouraging officers and their families to talk
about the possibility of the officer's death and to
make practical plans in case death occurs (e.g.,
prepare wills, organize personal
documents);

o encouraging the agency to implement policies
concerning notification procedures, provision of
long-term emotional support and informal contact,
and provision of benefits and compensation;

o providing counseling for survivors (including
parents, siblings, and children) even after the
crisis period is over, when they still may be
suffering the effects of post-traumatic stress
disorder or other emotional problems, and, if the
department will not pay for such services,
encouraging the department to change its policies;
and

o referring the survivors to support groups and
other local service providers.

Local chapters of Concerns of Police Survivors
(COPS), a national support group, provide peer
support for survivors, national counseling and
training programs, psychological counseling for
children of slain officers, assistance to agencies
in the
development of procedures for line-of-duty deaths,
and educational grants for spouses and children.
Call COPS at (314) 346-4911 in Camdenton, Missouri.

Tips on Training Officers' Family Members

Law enforcement stress program staff and officers'
family members offer the following tips for
training family members. (Some of these tips are
similar to those presented in the box in chapter 8
concerning training for officers; others are unique
to family training.)

o Use other spouses and significant others as
instructors or facilitators of discussion.

o Allow time for questions and answers.

o Have an agenda so the session does not turn into
a gripe session.

o Arrange for actual participation in or
observation of basic law enforcement activities,
such as ride-alongs.

o Do not glorify the job; instead focus on its
realities and potential difficulties. 

o Conduct training at night so that working spouses
can attend, and arrange for child care. 

o Make attendance "mandatory" or as close to
mandatory as possible--one program has the academy
commander issue a formal invitation to family
members and tell recruits they have to bring a
significant other to the training--otherwise wives
might never find out about the training or might be
too intimidated to come.

o Use instructors who are genuinely concerned about
helping spouses. 

o Distribute or mail an evaluation form.

o Conduct a "graduation" ceremony for family
members who complete the training.

Often neglected are those men and women who marry
or become seriously involved with an officer after
he or she has gone through the academy. Program
staff should consider reaching out to new spouses,
for instance by offering periodic trainings and
get-togethers.

_____________________________________________

Chapter 12

Monitoring and Evaluating the Program
______________________________________________

Key Points

o Many program administrators and independent
practitioners have a variety of concerns about
monitoring and evaluating service delivery, from
finding time to maintaining confidentiality.
However, program assessment is critical to maintain
or increase funding and to improve program
operations and effectiveness.

o Programs typically use three record-keeping
forms:

--a client intake form,

--a case control card, and

--a treatment record form.

These forms will be most useful if they are kept
simple, formatted as checklists, and result in the
data clinicians need to assess their services.

o A process evaluation, which involves measuring
how well a program functions, requires

--establishing program operations objectives,

--assessing client satisfaction with program
services,

--analyzing the data, and

--reporting the results.

o An impact evaluation, which involves measuring a
program's effectiveness, requires

--establishing outcome measures,

--securing the data from personnel records and
specially designed questionnaires,

--selecting a research design,

--analyzing the data, and

--reporting the results.

o It may also be useful, and enhance the
credibility of the evaluation, to obtain the
assistance of someone experienced in conducting
evaluations, such as a local professor or graduate
student.

o An impact evaluation needs to be designed to
establish that it is the program, not other events,
that is responsible for improvements in officer
performance.

Many program administrators and consulting mental
health
practitioners consider monitoring and evaluating
program activities a low priority. This chapter
suggests how administrators and independent
counselors can benefit from both activities and how
they can perform them with the least amount of
work.

Concerns and Responses

Administrators of every type of program, as well as
independent practitioners, are often reluctant to
monitor or evaluate their efforts. There are a
number of understandable reasons for this aversion,
but there are even more compelling reasons to keep
certain records and assess program performance.

Finding Time

Most administrators, and most independent
practitioners who consult to law enforcement
agencies, have little time to design and implement
monitoring and evaluation procedures. Frequently--
and understandably--they would rather devote their
limited energies to direct service delivery.
However, administrators sometimes
overestimate the amount of time required to design
record-keeping forms, ensure their proper use, and
aggregate and analyze the information. More
importantly, administrators need information about
program activities in order to identify flaws in
program design, implementation, and operations and
then to correct these deficiencies. And, of course,
they are likely to need objective documentation of
program activities and effectiveness to convince
police departments to continue or expand program
funding. Finally, in addition to being concerned
about the well-being of their officers, most law
enforcement administrators will want concrete proof
that the program will contribute, or is
contributing, in a cost-effective way to a
productive police force. 

o It was only after outside consultants evaluated
Tulsa's
Psychological Services and recommended that a
second psychologist be hired that the police and
fire departments increased the budget to support
the position. The Tucson Police Department's stress
program was threatened at one point because its
lack of records rendered it unaccountable to the
department; the department could not determine
whether one officer or 100 officers had used the
program during the previous year.[1]

o When city officials began to consider shutting
off funds for one police department's stress
program, staff had to scramble to hire an outside
evaluator to assess and document the program's
effectiveness because no other assessments had been
conducted that could be brought to the officials'
attention.

Lack of Expertise

Some administrators feel they can assess their
program's
effectiveness accurately by relying on their
experience, common sense, and intuition, or by
using anecdotal evidence and testimonials. However,
while sometimes accurate, subjective impressions
are often wrong, and general impressions are
unlikely to impress most police administrators, who
are interested in knowing what they are getting for
their money.

Administrators and independent practitioners may
also feel they do not have the research experience
necessary to implement formal monitoring and
assessment procedures. As one program director
commented, "I haven't done any evaluation; I just
monitor numbers of clients. I'm not a research
person." However, as in the case of the Tulsa
police and fire departments, outside consultants
can be hired to evaluate   an agency's stress
program, and, in some jurisdictions, program
directors have found clinicians, college
professors, or graduate students who are willing to
provide free or low-cost assistance.

The recommendations in the remainder of this
chapter, along with materials in the appendixes and
from other cited publications and programs, may be
all a program director or independent practitioner
needs in order to implement basic monitoring and
assessment procedures.

Concerns About Confidentiality 

Some program administrators and clinicians refuse
to maintain any written program records, or keep
only the barest of records, because they fear that
collection of any type of data will
reinforce officers' concerns that the program will
not ensure confidentiality. Counselors are also
usually concerned that written records may be
subpoenaed in a court case. However, as discussed
in chapter 6, "Dealing with Confidentiality,"
program administrators and independent
practitioners can address this concern by
maintaining anonymous records only, publishing data
from records only in aggregate form, and describing
the program's
confidentiality guidelines to officers and clients
both in writing and verbally. 

The director of Tulsa's Psychological Services
observes that maintaining records and then using
them to evaluate the program can confirm, rather
than cast doubts on, the program's commitment to
confidentiality:

The evaluation process can send a very positive
message to the police department about the degree
of openness to scrutiny, as well as confirming the
limits of confidentiality. A well-thought out
evaluation can say very clearly, "We want you to
examine the amount of time and energy spent [by
program staff] . . . , our priorities, and our
goals, and you may not have access to confidential
material."[2]

Given these considerations, some kind of monitoring
and evaluation involving formal procedures for
collecting and analyzing information needs to be an
integral part of the activity of every stress
program and individual clinician. The sections
below discuss monitoring and evaluation under three
headings: developing record-keeping forms,
conducting a process evaluation, and performing an
impact evaluation.

Developing and Maintaining Record-Keeping Forms

Police stress programs vary in the types of
services they offer, the professional backgrounds
of their staff, and the information their
departments or other funding sources expect. As a
result, it is not possible to develop forms for
recording client information that can meet the
needs of every program. Instead, this section
suggests the types of information that can be
included in
record-keeping forms. However, most programs
normally use three forms: a client intake form, a
case control card, and a treatment record form.

In designing these forms, three points can be kept
in mind:

(1) The forms may be used by different counselors.
To make sure every counselor records similar
information, the forms must be simple to use. Even
so, a senior counselor or the program
administrator needs periodically to review selected
completed forms to make sure that they are being
thoroughly and accurately filled out.

(2) The forms should make use of checklists (either
alone or to supplement open-ended questions) so
that information for several clients can be
aggregated quickly and accurately. Using checklists
also minimizes the record-keeping burden for
counselors and expedites assessment interviews.
Police officers often find it difficult to seek
counseling in the first place. They are unlikely to
see the value of lengthy intake procedures.

(3) The forms should be designed to collect the
information that program staff will need in order
to answer the questions posed in their process and
impact evaluations.

Forms can be filled in as hard copy or on computer.
However, unauthorized persons may be able to gain
access to computer records. As a result, program
administrators need to pay close attention to
preventing unauthorized access to computer records
by devising access passwords or keeping computer
records only on diskettes under lock and key.

Client Intake Form

A client intake form is used to record information
offered by referral sources and by officers and
family members themselves during the initial
assessment interview. Information on this form not
only refreshes the counselor's memory but also
documents the types of clients the program is
serving. The box "Possible Intake Information to
Collect" lists the information a client intake form
might include.

Appendix M consists of the intake form the Erie
County Law
Enforcement Employee Assistance Program uses.
Although this sample form requests the officer or
family member's name, address, and phone number,
most program directors recommend that the client's
name not appear anywhere on the form, in order to
ensure
confidentiality. Instead, identification numbers
are used and a record matching client names and ID
numbers is kept in another, secure file.

Case Control Card

A case control card helps protect client
confidentiality. As noted above, to afford extra
protection, neither the client's name nor the names
of the client's immediate supervisor or the
referral source should be listed on the intake
form. A case control card, kept in a secure file as
hard copy or on computer diskette, can be used to
record this information and to match the client's
name with a case identification number.

Treatment Record

Treatment records are intended to document the
client's treatment plan, compliance with the plan,
and final case disposition. The following treatment
options can be included on the checklist:

o referral outside for:

--medical examination 

--psychological testing 

--psychiatric evaluation

--alcohol/drug detoxification

--hospitalization

--other inpatient treatment (specify)

o referral outside for outpatient treatment:

--Alcoholics Anonymous

--Al-Anon

--counseling (individual, group, family, marital)

o referral outside for social, legal, or health
services

o in-house counseling or clinical services

o special in-house services:

--physical fitness program

--post-shooting trauma program

--chaplaincy services.

The checklist can include space to record
information about the prescribed treatment (e.g.,
name of outside facility or service, total length
of stay, number of sessions per week, total number
of sessions, special conditions). The form needs to
provide space to list the name, address, phone
number, and other information about outside
services to which the client has been referred. The
client should be identified only by an assigned
number.

The second part of the treatment record form
documents the
officer's or family member's compliance with the
treatment plan. The first column can list the
specifics of the treatment regimen (e.g., outside
marital counselor, one session per week for eight
weeks; physical fitness program, two sessions per
week for 12 weeks). Subsequent columns can indicate
the client's compliance or noncompliance with
certain aspects of the treatment regimen at weekly
or monthly intervals. If the client is referred
outside the department, the counselor needs to
follow up to determine his or her level of
compliance. At the end of treatment, tabulations
can be made of all services used by that client.
Program staff can then aggregate this information
across all clients for inclusion in any reports
describing service delivery.

The third part of this form can provide space to
indicate final case disposition. A narrative
description of the disposition can be accompanied
by a checklist (e.g., officer refused further
assistance, treatment successfully completed,
officer retired or resigned, officer terminated
from force, officer given disability pension).

The treatment record form is not used to record
case notes a program counselor makes during the
course of treatment. Counselors, if they keep
progress notes at all on the treatment record form,
typically record innocuous information, such as
"making progress," in case the notes are ever
subpoenaed. Chapter 6, "Dealing With
Confidentiality," provides additional guidelines
for keeping progress notes in a manner that
maintains maximum confidentiality.

Program staff can also develop treatment record
forms for peer supporters to use in tracking
contacts with other officers. Chapter 4, "Choosing
Among Staffing Options," provides additional
information for monitoring the activities of peer
supporters. In addition, many programs have
monitoring forms which they may be willing to share
with new or established programs.[4]

Monitoring Performance: Conducting a Process
Evaluation

When information gathered by program monitoring is
used to judge the quality, adequacy, or
appropriateness of program operations, the
assessment is referred to as a process evaluation.
The focus of a process assessment is the
implementation and operation of the program, not
program impact. By developing well-specified,
quantified process objectives (e.g., to deliver
well-received stress management training sessions
for 75 sworn personnel every 6 months), a process
evaluation can compare program expectations with
actual performance. Furthermore, if the program
director has listed specific tasks for each staff
member under each process objective (e.g., 80
percent of officers attending counselor A's
training sessions report satisfaction with the
training), a process evaluation can easily lead
into a review of staff work performance, the
distribution of program resources, and possible
corrective actions.

Process Objectives

When program staff or independent practitioners
undertake to monitor and evaluate their services,
the first step is to describe what they hope to
accomplish. As noted in chapter 2, a needs
assessment is usually extremely helpful in
establishing program objectives because the
findings suggest where staff need to concentrate
their efforts. For illustrative purposes, a variety
of process objectives are listed in the box "Sample
Process
Objectives." The objectives have been divided
according to the principal components of a typical
stress program: 

o program administration,

o marketing program services,

o treatment,

o training, and

o program assessment.

Once staff have established their objectives, they
need to develop appropriate indicators of
performance. For process objectives, the indicators
are simply the documented performance of specified
levels of program activity (e.g., 60 officers and
18 family members received individual counseling in
the past 6 months). Ideally, these program
objectives are spelled out when the program is
first organized, but it is never too late to
develop objectives. It is also important that
command staff, union leaders, and program
administrators agree on the program's objectives
and how to measure their achievement.

Client Satisfaction Surveys

In addition to collecting data associated with the
process objectives listed in the box, clinicians
can ask clients to rate their overall satisfaction
with the program's services and the impact of
treatment, if any, on a number of areas of their
lives, including their physical health, emotional
health, job performance, job enjoyment, drinking
behavior, and marital satisfaction. Client surveys
can also request opinions about the contribution of
individual service providers, including both
program counselors and outside agencies, in terms
of the quality of services delivered and staff
availability and accessibility, sensitivity to the
demands of police work, trustworthiness, ability to
maintain client privacy, and follow-up. San
Bernardino's Counseling Team hands out "consumer
satisfaction" forms to clients once or twice a
year, covering a period of a few months at a time,
to be mailed back anonymously. About 25 percent of
the officers and family members who have used the
program return the forms.

Analyzing the Data

The data collected on monitoring forms and the
program
documentation related to the process objectives
(see the "Sample Process Objectives") can be
reported "raw"--that is, as simple tabulations--or
with inferences drawn from the data about program
effectiveness and needed program change.

Simple tabulations. Most programs contacted for
this study assemble compilations of their
monitoring data. 

o The Michigan State Police Department's Behavioral
Science Section prepares statistics every year that
include total number of new patients for the year
and for each year since the program began, along
with a breakdown of patients by rank and other
characteristics (see appendix N).

o Periodically, Tulsa's Psychological Services
collects and tabulates data on officers' and family
members' satisfaction with its counseling services
using a one-to-ten rating scale (see the box
"Sample Client Satisfaction Survey Form and
Results"). The program's annual report provides bar
graphs that show, for each year of program
operation, the number of staff hours spent on each
program activity (direct counseling, management
consultation, research, education and training) and
on new cases and active cases (see appendix O for
an example).

o Each enforcement agency within the U.S.
Department of Justice (e.g., Drug Enforcement
Administration) provides the EAP program director
with data on program costs, number of program
staff, and number of supervisory training hours
offered, as well as number of clients by problem
category, current status, and referral source
(e.g., manager versus self). The Department of
Justice then reports total agency data to the
Office of Personnel Management.

Process Evaluation. At a simple level, if the data
tabulations show that very few family members are
appearing for treatment, or almost no female
officers report satisfaction with program services,
program staff know they need to improve their
outreach or treatment services to these
populations. Even better, staff can compare the
number of family members who have used the program
with the number the program expected to serve to
determine whether there is a program deficiency in
this area that needs fixing.

At a more complex level, program staff or an
outside consultant can examine the data
systematically (ideally in conjunction with staff
and client interviews) and report on the entire
range of program strengths and weaknesses. For
example, in 1985 the director of Tulsa's
Psychological Services arranged for three outside
experts--one police psychologist each from the
Memphis and Dallas police departments, and the
Denver police chief--to conduct an on-site process
evaluation. In advance of the visit, the program
director mailed anonymous satisfaction surveys to
all clients seen the previous year (to be returned
by mail in a pre-stamped,
pre-addressed envelope to the Dallas psychologist
for tabulation), distributed assessment forms to
academy recruits (where the program ran some
sessions), and sent an assessment survey to police
department administrators. The evaluators spent
three days
interviewing police officials, academy staff,
officers, and other pertinent individuals, and
reviewing the data from the client satisfaction
surveys. The evaluators' report to the program's
board of directors made five principal
recommendations:

(1) The program should become an in-house
operation.

(2) The board of directors should hire a second
psychologist.

(3) The program should no longer carry out fitness-
for-duty evaluations because they conflict with its
role as an employee service.

(4) Better efforts were needed to make command
staff aware of the services that the program could
offer.

(5) The program needed a clearly written statement
of purpose for the organization.

The board carried out all the recommendations,
except for the first one. "In looking back over all
the varied activities of our program," Douglas
Gentz, the program director, later wrote, "I can
find no single project which did our organization
more good than the evaluation. I strongly recommend
it as a way to (1) increase the effectiveness of a
. . . program; (2) increase the credibility and
good working relationship between the department
and the program; (3) clarify and refine the program
goals; (4) enhance the general well-being of the
service delivery and clerical staff; and (5)
provide a benchmark for future evaluations."[5]

Reporting the Data

Distributing copies of the report to key commanders
(e.g., of the SWAT team) and agency units (e.g.,
personnel) can help develop or increase awareness
of the program and its services. The Palo Alto
Police Department posts its stress program's
quarterly reports for the entire department to
read.[6] The reports provide monthly tallies for,
among other program activities, consultations to
line staff, supervisors, and management (and
whether the consultation was work-related or dealt
with personal matters); meetings, including
debriefings, staff meetings, and watch meetings;
ride-alongs; and field training officer contacts.
The bargaining agreement between the Michigan State
Police troopers' association and the department
includes the following sentence: "[N]othing herein
is intended to prevent the departmental
psychologist from compiling statistical records, or
making general reports with reference to the types
of problems and the needs of departmental
employees, as long as copies of said reports are
simultaneously provided to the Association." By
contrast, Miami's Metro-Dade program deliberately
does not publish its monitoring reports to avoid
giving the media an opportunity to misuse the data
to criticize the department.

Evaluating Effectiveness: Conducting an Impact
Evaluation

An impact evaluation (sometimes also called outcome
or summative evaluation) is designed to show what
effects a program has had on its clients and the
department as a whole. Program staff should not
conduct an impact evaluation until the program has
been properly implemented and appears to be on its
way to achieving its process objectives. It takes
time for a program to get started, for deficiencies
to become apparent, and for corrective actions to
be put in place. As a result, an impact evaluation
can normally begin during a program's second or
third year and then be updated every few years
thereafter.

Implementing an impact evaluation requires the
development of outcome measures and the design of
an evaluation methodology, which usually require
considerable expertise. While program staff are
often qualified to conduct process evaluations,
this may not be the case with impact evaluations.
Outside help is likely to be
essential.

Outcome Measures

For impact objectives, the indicators measure a
result or outcome that the program is designed to
accomplish (e.g., decrease in the number of days
that personnel are absent this year compared with
the number for the previous year). Staff also need
to identify where the needed data may be found and
negotiate obtaining them (e.g., gain access to the
department's personnel records for data on
absenteeism). Listed below are several outcome
measures that staff can use to assess the program's
impact on clients. The measures are divided into
two sets according to where the data will come
from: (1) personnel records and (2) specially
designed survey questionnaires. Both types of
outcome measures have their
limitations. Personnel records, for example, may be
incomplete or inconsistently filled out, while
specially designed surveys can be ignored by the
people who need to fill them out, questions that
are phrased improperly can yield inaccurate data,
and baseline data are needed for before-and-after
comparisons (see the box "Writing Evaluation
Questions"). As a result, the most useful
evaluations employ both types of measures.

Data from Personnel Records

When available, personnel records can provide
valuable information about program effectiveness,
such as data for

o absenteeism and tardiness (e.g., total number of
days on sick leave, total number of unexplained
absences from detail, tardiness to roll call or
detail),

o number of on-the-job accidents,

o job performance (e.g., failure to respond,
failure to use good police procedure, violation of
department rules and regulations),

o civilian grievances or complaints (e.g.,
inappropriate
brandishing of weapons, excessive force, civil
rights violations),

o disciplinary actions (e.g., suspensions, fines,
job
terminations), and

o premature retirements or disability pensions.

Specially Designed Questionnaires

While treatment records already in use can provide
some information that can indicate program
effectiveness, program staff must often develop and
administer questionnaires to obtain truly useful
information, such as data on

o medical examination results (e.g., height,
weight, body fat, blood pressure, heart rate, and
number and type of physical complaints),

o present levels of alcohol and drug use,

o reported level of job satisfaction (including
morale and
satisfaction with supervision and hierarchical and
cross-functional communication),

o reported level of job-related stress and
frustration (e.g., ratings of stress generated by
certain types of situations
encountered on and off the job),

o supervisor ratings of job performance, and 

o reported level of family-related stress.

Questions devised for these instruments must be
phrased in a balanced way that permits accurate
measurement of respondents' true opinions (see the
box "Writing Evaluation Questions").

Selecting a Research Design

A useful impact evaluation involves much more than
recording changes in clients' work performance, job
satisfaction, or general health. Knowing that
changes occurred is important, but
insufficient. Beyond that, there must be a
demonstration that the program was the cause of
those changes. Such a demonstration requires a
comparison between those clients and another sample
of similar police officers who did not receive
program services.

With limited staff, time, money, and expertise, few
programs can conduct the type of experiment that
can unequivocally prove program impact--randomly
assigning some officers and family members in need
of counseling to a "control" group that is refused
program services so that this group can be compared
with clients who did receive services. Furthermore,
most program staff would consider it unethical to
deny services to any officer or family member who
seeks help. In addition, many of the individuals
assigned to the control group might seek counseling
elsewhere, with the result that they could no
longer be considered "controls."

As a result, most program directors settle for what
are called "quasi-experimental" research designs
(see the box "Two Acceptable Research Designs").
While not perfect, quasi-experimental research
designs can still yield extremely useful
information if their findings are approached and
evaluated with caution. The studies reviewed below
are examples of this type of research. 

o Nancy Bohl, Director of San Bernardino's
Counseling Team, compared a group of 40 male
officers from several police
departments who had received a 1-1/2-hour group
debriefing after a critical incident with a group
of 31 officers in departments that received no
debriefing. Written data were collected from the 71
officers three months after their critical
incidents. The results showed no difference between
the groups in terms of the measure of anxiety.
However, the officers who participated in the
debriefing were significantly (statistically) less
depressed and angry, and had significantly fewer
stress-related symptoms, than the untreated
officers.[7]

o A study of a Philadelphia Police Department
program for alcoholic officers found that the
typical officer in inpatient treatment cut his or
her sick leave days from nearly 21 to under 10 days
per year, reduced injury days from just over 4 to
just over 2 days per year, and reduced suspension
days from over 2 to just over 1 day per year.[8]
This study cannot prove with certainty that it was
the program that produced the favorable results;
perhaps many of these officers would have improved
without inpatient care. Nevertheless, the
evaluation illustrates how three key measures of
program effectiveness (sick leave, injury, and
suspension days) can be used to suggest strongly
that a program is effective. The results also
illustrate another important feature of doing a
process or impact evaluation: the desirability of
converting the benefits into dollars so that
department administrators see that their
expenditure of agency funds for the stress program
pays off--literally.

Perhaps the most useful information an impact
evaluation can yield, in addition to suggesting the
need for program improvements, is that the program
is cost-effective. This means that the program
saves the department more money than it costs to
run it. 

o The Philadelphia study described above enabled
the department to conclude that it had more than
recovered the costs of running the program in the
three years of the program's operation. The
department expected to save over $50,000 per year
in the future because of the program's activities.

o Two of 27 inspectors in the Postal Inspection
Service who had sought counseling in 1993 with
police psychologists under contract to the agency
reported that the program was an alternative to
their taking disability leave. The average salary
and benefits for an inspector total about $85,000
per year. Typically, disability leaves are taken
for at least a year, and it is not uncommon for
inspectors to resign or take disability retirement.
The total cost to the Inspection Service for paying
psychologists to counsel the 27 inspectors was
$13,070. Had even one inspector taken disability
leave (let alone early retirement), there would
have been additional medical bills associated with
the disability. Based on these data alone, the
counseling program appears to have been very cost-
effective.

The checklist on the following page summarizes the
steps involved in implementing an impact or process
evaluation regardless of the design chosen. For
additional information about different
evaluation designs and the evaluation process,
program staff can consult two standard works in the
field:

o T.D., Cook, and D.T., Campbell, Quasi-
Experimental Design and Analysis: Issues for Field
Settings. Rand McNally, 1979.

o P.H., Rossi, and H.E., Freeman, Evaluation: A
Systematic
Approach. Third Edition. Beverly Hills, California:
Sage, 1985.

However, even with these aids as guides, most
programs should engage the help of outside research
specialists in conducting any type of impact
evaluation both to ensure objectivity in the
findings (and, equally important, the appearance of
objectivity in the findings) and to bring the
necessary expertise to bear on the technical issues
involved in this type of assessment.

Endnotes

1. Goolkasian, G.A., R.W. Geddes, and W. DeJong,
Coping with Police Stress, Issues and Practices,
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985.

2. Gentz, D., "Benefits of Program Evaluation for
Law Enforcement Psychological Services,"
Unpublished paper presented to the Consortium of
Policy Psychologists, Miami, Florida, 1986.

3. Hurrell, J.J. Jr., and W.H. Kroes, "Stress
Awareness," in Job Stress and the Police Officer:
Identifying Stress Reduction Techniques, ed. W.H.
Kroes and J.J, Hurrell, Washington, D.C.:
Government Printing Office, 1975: 234.

4. See, for example, the forms provided in Gentz,
D., "A System for the Delivery of Psychological
Services for Police Personnel," in Psychological
Services for Law Enforcement, ed. J.T. Reese and
H.A. Goldstein, Washington, D.C.: U.S. Department
of Justice, Federal Bureau of Investigation, 1986:
257-282.

5. Gentz, "Benefits of Program Evaluation."

6. Kirschman, E., E. Scrivner, K. Ellison, and C.
Marcy, "Work and Well-Being: Lessons from Law
Enforcement," in Stress and
Well-Being: Assessments and Interventions for
Occupational Mental Health, ed. J.C. Quick, L.R.
Murphy, and J.J. Hurrell, Hillsdale, New Jersey:
Lawrence Erlebaum, 1995: 178-192.

7. Bohl, N. "The Effectiveness of Brief
Psychological Interventions in Police Officers
after Critical Incidents," in Critical Incidents in
Policing, revised, ed. J.T. Reese, J.M. Horn, and
C. Dunning, Washington, D.C.: Department of
Justice, Federal Bureau of
Investigation, 1991: 31-38. See also, Bohl, N.,
"Professionally Administered Critical Incident
Debriefing for Police Officers," in Police
Psychology Into the 21st Century, ed. M.I. Kurke
and E.M. Scrivner, Hillsdale, New Jersey: Lawrence
Erlebaum, 1996: 169-188.

8. Unkovic, C.M., and W.R. Brown, "The Drunken
Cop," The Police Chief, 45 (1978): 18-20.

Checklist of Steps for Evaluating a Program or a
Program Activity

1. Decide on the evaluation's goals--why it is
being conducted*

2. Identify the evaluation's audience(s)

o program staff

o department

o union or association

o general public

o other

3. Decide who will conduct the evaluation

o program staff?

o outside consultant?

o both collaborate?

4. Decide on type of evaluation*

o process evaluation?

o impact evaluation?

o select research design (e.g., quasi-experimental)

5. Select measures of program performance and
effectiveness, based on program goals and
objectives*

o direct observation of behavior?

o objective indicators of behavior change?

o both?

o quantitative?

o qualitative?

6. Select types of respondents

o line officers

o administrators and managers

o civilian staff

o family members

7. Select measurement methods*

o survey?

o records analysis?

o interviews?

8. Develop data collection instruments and
establish methods of administration*

9. Decide how many respondents to contact or events
to observe

o all eligible respondents (universe)

o random sample

o non-random sample

10. Decide when to collect the data*

o collect data prior to program participation
(baseline)?

o collect data after program participation (post-
intervention)?

11. Collect the data

o take steps to obtain a high response rate

o ensure respondents anonymity

o use trained data collectors

12. Analyze the data*

o use descriptive statistics (e.g., what percent of
eligible officers participated in the program?)

o use inferential statistics (e.g., were officers
who participated in program training less likely to
require disability leave due to stress-related
problems?)

13. Interpret and report the results

o clarify the evaluation's limitations

o tailor the report or reports to the intended
readership

o conclude with recommendations

*See text for more detailed information about these
steps.

Possible Intake Information To Collect

o Client identification number.

o Client's rank, number of years in the department
and in law enforcement, and present duties or
assignment (e.g., field, dispatch, administration).

o Demographic information, including, at a minimum,
age, sex, marital status, and number of children. 

o Date of referral, source of referral (e.g., self-
referral, top command staff, immediate supervisor,
union president, spouse, other family member), and
description of presenting problem according to the
referral source. To protect the client, the name of
the referral source should not be listed on this
form.

o Client's description of presenting problem. A
checklist of typical presenting complaints can be
developed (e.g., work-related stress, post-shooting
trauma, marital or family problems, problem
drinking, drug use, financial trouble, gambling,
legal difficulty). The counselor may wish to add a
brief narrative description for each complaint.

o Job performance record (e.g., absenteeism,
tardiness, on-the-job accidents, citizen
complaints, disciplinary actions). Important
changes over time can be highlighted.

o Present physical condition (e.g., rating of
overall health, height, weight, blood pressure,
list of physical complaints), present use of
medication, and very brief medical history. 

o Present level of alcohol use. The Michigan
Alcoholism Screening Test (MAST) is designed to
provide a simple, quick, and effective means of
identifying alcoholics.[3] While the MAST has only
25 yes/no questions, a briefer version with 10
questions has also been developed.

o Clinical assessment. The intake counselor's final
diagnosis should be indicated. Again, to supplement
a narrative description, a checklist could be used
to allow easy data aggregation.

Sample Process Objectives

Administration

(1) Develop job descriptions for all program staff.

(2) Develop activity reporting system for staff to
record how much time they spend on various tasks.

(3) Develop policy statement, rules, and procedures
to cover all aspects of program operations.

(4) Develop and distribute confidentiality
guidelines to all department employees. Develop
consent-to-treatment forms for clients.

(5) Enlist support of top command staff and union
officials (see chapter 7, "Marketing the Program").

Marketing Program Services

(1) Distribute memorandums from the chief on
department policies and procedures regarding the
stress program.

(2) Produce information brochures and flyers on the
program and distribute them to members of the
department.

(3) Present information on stress issues and the
stress program during roll calls.

(4) Conduct regularly scheduled meetings with
supervisors to answer questions and review case
findings and program policy.

Treatment

(1) Deliver program services. As described above,
the treatment record can be used to document the
actual execution of a prescribed plan. Compliance
with each aspect of the treatment regimen can be
noted.

(2) Develop formal agreements with outside agencies
to accept client referrals from the stress program
(see chapter 5,
"Establishing a Referral Network").

(3) Develop a procedure for monitoring the quality
and cost of treatment services. One important index
of treatment quality is the percentage of clients
who successfully complete their treatment regimens.
The costs of using outside resources should be
monitored; treatment agencies vary tremendously in
the cost of their services.

Training

(1) Develop curriculums for recruit, in-service,
and supervisor stress training (including detailed
outlines of covered material) in consultation with
subject matter experts. If a program uses peer
counselors, a curriculum for training those
counselors is also needed.

(2) Deliver training. A list of participants can be
used for documentation. A record of questions asked
during the sessions can be kept to help revise the
curriculum.

(3) Determine the quality of delivered training.
Ask participants to indicate their overall
satisfaction with the training and the extent to
which their expectations for the training were met.
Further ratings can be made on

o satisfaction with each of the training modules;

o the quality of instruction provided by each
trainer;

o the usefulness of films, other visual aids, and
handouts; and

o the effectiveness of the training in increasing
awareness of stress issues, promoting use of the
stress program, promoting use of techniques for
stress reduction (e.g., exercise), and improving
supervisors' case finding skills.

Open-ended questions can include: What aspect of
the training was the most informative? What aspect
was least informative? Of everything learned, what
was of greatest value? How can the training be
improved to better meet trainee needs? The trainees
can also be given a brief test to assess what they
learned.

Assessment

(1) Conduct intake interviews.

(2) Devise individual treatment plans. The first
portion of the treatment record, described above,
can be used to document
prescribed treatments.

Information from both the intake form and treatment
record can also be aggregated to provide a
description of the types of clients handled, their
presenting problems, and recommended treatments.
Certain cross-tabulations will also be of interest.
For example, a table could be constructed to show
the types of problems presented by officers with
varying lengths of police experience. Such
information could be used in revising the
curriculum for awareness training sessions or to
refine case finding strategies.

Anecdotal Evidence Can Sometimes Be Useful

While always suspect, some types of anecdotal
evidence can be suggestive of program impact,
especially when they involve a pre/post comparison
or a matched group comparison. For example, a
Bureau of Alcohol, Tobacco, and Firearms (ATF)
agent involved with both the Waco conflagration and
the Oklahoma City bombing told of how his family
never talked about the Waco events at home until
after they had participated with an ATF peer
support group in Oklahoma City. Until that time, he
reported, "It was not okay to talk about or even
feel anything about these incidents."
Furthermore, the peer support group visited the
school this agent's children attended. As a result,
the children, who previously had considerable
anxiety about going back to school, became more
comfortable returning. This anecdote is indicative
of the program's effectiveness because it suggests
that the improvements in the agent's family were
probably due to the intervention of the peer
supporters (although something else in the family's
life could conceivably have been the cause). By
contrast, when officers credit the program with
having enabled them to remain on the job, there is
no way of knowing whether they would have actually
quit had they not participated.

Writing Evaluation Questions

The manner in which a question is worded may affect
how the respondent uses the rating scale. Consider
this example: "To what extent do you find the
department's handling of officers involved in a
critical incident to be a source of stress?"
Clearly, this phrasing strongly suggests that the
respondent should agree that the typical handing of
a critical incident is a stressful
experience. This alternative wording would be
better: "Do you find the way your department
handles officers involved in a critical incident to
be stressful?"

The response alternatives provided on a rating
scale must be balanced, as well. This example fails
to achieve that balance: "On the whole, how would
you rate your satisfaction with your job--very
satisfied, satisfied, not at all satisfied?" This
set of response alternatives would be better: "very
satisfied, mostly satisfied, neither satisfied or
dissatisfied, mostly dissatisfied, very
dissatisfied."

Questions must also be worded in a way that avoids
potential "social desirability" effects.
Respondents are often motivated to avoid looking
foolish and will give what they think are socially
desirable responses. Consider this example: "Have
you made a sincere effort in the past several
months to improve your relationship with your
immediate supervisor?" Regardless of what effort
they have in fact made, some officers will indicate
that they have done so. Similarly, even if ironclad
confidentiality can be guaranteed, many officers
will be reluctant to admit to
wrongdoing (e.g., alcohol abuse, violation of
department regulations).

Respondents may also provide answers they think the
questioner wants or expects to hear. Consider the
following question: "Since your involvement with
the stress program began, has your level of job
satisfaction increased, decreased, or stayed the
same?" If the questioner is on the stress program
staff, some respondents may be reluctant to admit
that their satisfaction has actually decreased or
remained the same, not increased. To avoid this
bias, questions must be phrased in a way that does
not betray the questioner's real motivation in
posing them.

Since these kinds of biases can be introduced in
subtle ways, project staff inexperienced in
designing and administering
questionnaires may want to ask a professional
researcher to review both the phrasing of all
questions and the project's plans for their
administration.

Two Acceptable Research Designs

One Group Pre-Test/Post-Test Design

With this design for measuring the impact of a
stress program, outcome measures are taken for
program participants both before and after
treatment, but there is no comparison group.
Because it can be implemented easily at low cost,
this design is the most commonly used--the
Philadelphia Police Department study reviewed in
the text is an example of this type of research
design. The objection to this design is that other
events that occur while the officers are in
treatment may be the actual causes of any observed
changes, rather than the program itself. For
example, department rules and regulations or their
enforcement may change; a supervisor who has never
been liked or respected by line officers may
retire;
labor-management relations may improve. Without
information from a comparison group, the
contribution of these other factors cannot be
completely excluded.

Nonequivalent Control Group Design

This design involves choosing a group of officers
or family members who, for whatever reason, did not
participate in counseling or training sessions and
comparing their experiences with those of officers
and family members who did receive these services.
The San Bernardino study summarized in the text is
an example of this type of research design. This
design makes it easier to determine whether some
external change is responsible for improvement in
the treated officers and family members (such as a
change in command staff) because, if so, the
matched group should show improvement, too. The
limitation of this design is that the officers or
family members who do not seek counseling may
differ in some important respects from those who
do. The problem of noncomparable groups can be
reduced if it is possible to select officers and
family members for the matched comparison group who
are as similar as possible to the counseled group,
for example, in terms of years of service, gender,
marital status, rank, and type of stress-related
problem. The only way to eliminate this problem
completely, however, would be to assign officers
and family members seeking counseling or training
randomly to one group that gets counseling and one
that does not, which programs obviously cannot do. 

"I can find no single project which did our
organization more good than the evaluation. I
strongly recommend it as a way to . . . increase
the effectiveness of a . . . program . . . [and]
increase the credibility and good working
relationship between the
department and the program." 

--Douglas Gentz, Director, Psychological Services,
Tulsa

San Bernardino's Counseling Team hands out
"consumer satisfaction" forms to clients once or
twice a year covering a period of a few months at a
time, to be mailed back anonymously. About 25
percent of the officers and family members who have
used the program return the forms.

The Palo Alto Police Department posts the quarterly
reports prepared by its stress program for the
entire department to read.
________________________________________________

Chapter 13

Managing Program Costs and Funding
_________________________________________________

Key Points

o Stress programs and consulting mental health
professionals need to estimate the costs of their
services. This estimation involves identifying cost
elements, such as personnel and rent, and
calculating unit costs, such as cost per client or
counseling hour.

o Clinicians have found a variety of ways of saving
money, including

--securing in-kind contributions,

--increasing their use of relatively inexpensive
staff,

--referring some clients to outside sources of
help,

--devoting less time to high-cost services,

--serving other agencies, such as correctional
departments,

--putting in uncompensated overtime.

o Programs and independent consultants have been
able to tap a variety of funding sources besides
the law enforcement agency, including

--officer unions and associations,

--State and local governments,

--private funding sources.

o Program staff increase their chances of securing
or increasing funding from the department if they
increase police chiefs' motivation to provide funds
by

--offering to improve the department's image,

--showing how the department can save money,

--offering to improve the department's efficiency
and morale,

--documenting stress among department personnel.

o Managed care plans may limit programs' and
individual counselors' ability to provide services
because of screening requirements and restrictions
in mental health coverage.

Due to fiscal constraints, law enforcement
executives are reluctant to fund department
activities, especially non-line law enforcement
services such as stress programs, that lack
visibility in the community. For this and other
reasons, new law enforcement stress programs tend
to have difficulty obtaining funding, while
existing programs usually remain underfunded. These
realities heighten the need for programs to keep
costs to a minimum and for program staff and
independent mental health professionals to present
strong justification for initial and continued
funding. This chapter discusses the basic elements
of program costs, options for reducing or
containing costs, possible outside sources of
supplemental funding, and strategies for convincing
management to support the program adequately.

Estimating Program Costs

Most programs have incomplete cost information
because of the difficulty of estimating their
expenses. Separate budget line items for the
operation of in-house programs generally do not
exist; staff, office space, and equipment may be
shared with other department units; and in-kind
contributions of space, supplies, and personnel are
often used.

Identifying Cost Elements

Many programs, however, share certain cost
elements:

o personnel, including staff salaries and benefits,
which account for the bulk of total costs in
programs with paid staff;

o consultants, who may be used in addition to or in
place of in-house staff;

o rent and utilities;

o vehicles (or mileage reimbursement if personal
cars are used) for responding to emergencies and
meeting clients away from the program's offices;

o equipment and supplies, such as beepers, paper,
books and periodicals, business cards, program
brochures, training materials, and coffee;

o telephone, fax, and postage; and

o travel, for example to conferences and training
seminars.

In addition, programs that are just starting will
incur some one-time start-up costs that staff of
established programs typically need not consider,
such as the purchase of office furniture,
computers, and duplicating machines, and possibly
the development of a peer support component.

Independent mental health professionals who consult
to law enforcement agencies may also have
difficulty estimating their costs because officers
may constitute only a part of their
practice, reimbursement will vary according a given
officer's insurance coverage, and the practitioners
may provide significant pro bono services to the
departments they serve in the way of free
counseling, crisis intervention, and training.

Calculating Unit Costs

Calculating unit costs can be useful for monitoring
costs over time, identifying increases or decreases
in program or individual counselor efficiency, and
showing funding sources how inexpensive the program
is on the basis of some unit of service delivered.
The most common measures are likely to be cost per
officer or family member counseled, cost per
counseling session, and cost per participant in
training sessions. These figures can be calculated
easily by dividing total program costs by the total
number of clients, counseling hours, or training
participants. Of course, this calculation cannot be
validly made by programs or counselors that perform
several activities--for example, counseling,
supervision of a peer support component, and stress
management training--unless staff keep track of the
number of hours they devote to each activity. If
they do keep such a record, they can determine the
percentage of time they spend on each activity,
multiply that percentage by their total expenses,
and divide the resulting figure by the per-unit
measure. For example, assume a counselor spends 40
percent of her time counseling officers and has
bottom-line expenses of $100,000 per year for all
the services she provides the department. This
means that approximately 40 percent of her $100,000
in expenses, or $40,000, are devoted to client
counseling. If she treats 20 officers and family
members in the year, her cost per client is $2,000.

By estimating the number of officers and family
members likely to need counseling, and the number
of sessions they could be expected to need on
average, the director of Erie County's Law
Enforcement Employee Assistance Program negotiated
contracts with each participating agency according
to which the agency pays $14 per officer or
nonsworn employee in its department per year. Of
course, this amount of money could be inadequate or
excessive depending on actual program utilization.
Furthermore, the harder program staff work to
recruit clients, the lower the program's per-client
reimbursement will be. The director of Tulsa's
Psychological Services tries to solve this dilemma
by negotiating a total budget with the police and
fire departments that slightly exceeds
anticipated program usage and then reverting any
unused funds to the city. As a result, between
$4,074 and $22,273 has reverted to the city each
year, or between 2 and 15 percent of the program's
budgeted amount.

Ways of Saving Money

Program staff and independent practitioners have
found a variety of strategies for minimizing costs.

Secure In-Kind Contributions

Some programs receive in-kind contributions of
space or supplies, such as rent-free or less-than-
market-rate office space. In Boston, the police
stress program at one time occupied offices rent-
free on city-owned hospital grounds. For over a
decade, the Catholic Archdiocese has provided the
San Francisco Police Department's stress unit with
free office space at a seaman's mission owned by
the church.

Devise Alternative Staffing Configurations

There is the potential for considerable cost
savings in the area of program staff, since
salaries and fringe benefits typically account for
most program costs. The use of consultants,
volunteers, student interns, and peer supporters,
instead of regular paid staff, can sharply reduce
program costs. "It is assumed that mental injuries
require the services of highly paid mental health
professionals," one observer writes, but the same
observer concludes that "in the few studies that
exist regarding effective coping skills, peer
support appears to provide the treatment of choice
for traumatic sequelae [aftereffects]."[1] However,
staff need to weigh carefully the savings gained by
this approach against the benefits of hiring
licensed professionals and in-house staff. See
chapter 4, "Choosing Among Staffing Options," for a
discussion of the benefits of hiring licensed
professionals as well as the advantages and
disadvantages of using volunteers, interns, and
peer supporters.

Network

Programs may be able to save money by referring
some or even all officers and family members to
independent mental health professionals, group
practices, and agencies, and by limiting the number
served by in-house clinicians. Another option, used
by several programs, is for program staff to
conduct only short-term counseling (for example,
for up to a year) and to refer long-term clients to
outside practitioners. Chapter 5, "Establishing a
Referral Network," discusses the advantages and
drawbacks to using consultants to provide some
program services.

Change Services Mix

Program directors and independent practitioners who
are considering or are already providing different
types of services can consider reducing or
eliminating one or more of these activities in
order to save money or to devote additional
resources to the remaining types of services. For
example, Tulsa's Psychological Services, which
provides counseling, consultation to department
supervisors, education and training, and research
and development, has steadily reduced the
percentage of staff hours devoted to providing
consultation to police managers and has increased
the percentage of hours devoted to counseling
officers and family members. Whereas 7 percent of
staff time was spent on consultative services in
1987 and 79 percent on counseling, by 1994 the
percentages were 1 and 86 percent, respectively.

Serve Other Agencies

Programs can sometimes achieve economies of scale
if they increase the number of agencies they serve.
For example, Tulsa's
Psychological Services serves the city's fire
department as well as its police department. The
Rhode Island Centurion Program and San Bernardino's
Counseling Team contract with correctional
facilities as well as law enforcement agencies.

Put In Overtime

Staff in most programs contribute uncompensated
overtime in order to get the job done, conducting
trainings or treating some clients for free or at
reduced rates. The director of the Counseling Team
in San Bernardino is able to make up partly for the
way her pro bono treatment of clients lowers her
average hourly counseling fee by requiring full
compensation for the training she conducts around
the country.

Sources of Funding

Many programs are funded entirely by a single law
enforcement agency. However, even if the department
provides complete or core program funding,
supplemental funding from other sources may still
be needed. In addition, small law enforcement
agencies, which constitute the vast majority of
police and sheriffs' departments in the country,
can rarely afford in-house stress programs. Mental
health professionals who serve these departments
have to supplement their income with some
combination of private clients, teaching, or
contracts with a number of law enforcement or
correctional
agencies.

The following are funding sources that programs,
group practices, and independent practitioners can
try to tap:

o Unions and associations. For many years, the San
Francisco police officers' association contributed
as much as $2,000 each year (obtained from
membership dues) to the department's stress unit.
The association still pays the unit's telephone
bills. The
Teamsters Union, which represents Erie County
sheriff's deputies, covers the cost of the beeper
used by the director of the Erie County Law
Enforcement EAP. The Metro-Dade police officers'
association sometimes provides financial assistance
to officers who do not have insurance coverage that
covers mental health treatment. The Dade County
Chiefs of Police Association established a Police
Officers Assistance Trust to help defray the costs
of counseling and other needs associated with
catastrophic events such as an officer's or family
member's death. Money is raised through fundraising
events like golf tournaments and stock car races.
Fraternal Order of Police fundraisers provide
modest support for the Rhode Island Centurion
Program; however, John Carr, the program director,
warns that "because taking union money may lead
management to regard the program as being in bed
with labor, it is best to try to secure financial
or administrative support, with clear policy
guidelines, from both labor and management."

o State and local governments. The county provides
the Metro-Dade program with second-dollar funding
through the Law Enforcement Trust Fund, made up of
money and proceeds from the sale of goods
confiscated during drug seizures. The Psychological
Services Division of the Prince Georges County
(Maryland) Police Department, established in 1979,
was maintained until 1988 with grants from the
Governor's Commission on Law Enforcement.[2] Some
departments obtain funds from their State's Peace
Officer Standards and Training (POST) agency, for
example, by securing reimbursement to pay POST-
certified instructors for providing stress-related
training to personnel or peer supporters. The Adams
County, Colorado, Sheriff's Department secured a
$26,000 annual grant from a local victim/witness
assistance and law enforcement board to hire a
psychologist. The department won the grant by
explaining that officers and nonsworn personnel,
because of the stressful nature of their work, were
themselves "victims" of crime.[3]

o Private funding sources, such as community-based
organizations and foundations. As noted, the local
Catholic Archdiocese provides the San Francisco
stress unit with free office space. Such sources
can be useful not only for underwriting program
costs but also for helping to pay for treatment for
officers who require outside assistance that their
insurance does not cover. For example, the director
of the Erie County program was able to convince an
inpatient facility to treat an alcoholic officer
for free.
Interphase 911, a treatment center for law
enforcement officers in Florida, has also
occasionally offered "scholarships" for officers
who lack financial resources. (Such a strategy can
work to the advantage of the treatment center if it
later obtains referrals of insured officers.)

Program staff who have secured grants stress the
importance of writing detailed, comprehensive
proposals that include a statement of objectives,
an explanation of the specific ways the money will
be used, and a detailed line-item budget.

Strategies for Securing Funds

Chapter 9, "Reducing Organizational Stress,"
suggests a number of approaches to motivating top
administrators to change the way their department
is run in order to reduce stress among personnel.
As discussed below, with slight variations several
of these strategies can also be used to obtain
funding, or additional funding, for the stress
program.

Offer To Improve the Department's Image

Program staff and independent practitioners can
suggest how establishing or expanding services
designed to reduce officer stress can
simultaneously improve the department's image. It
was eight officer suicides in five years, three of
them in 1994, that prompted the Philadelphia police
department to create the agency's first stress
manager position.[4] 

Show How the Department Can Save Money

Early identification of critical incident stress
and prompt intervention can result in significant
department savings in reduced disability and early
retirement claims, absenteeism, trauma-related
medical costs, and litigation when officers
mistreat citizens.

o The Barrington Psychiatric Center in Los Angeles
estimated that the average cost of intervention and
relief with cases in which post-traumatic stress
disorder was detected soon after the event totaled
$8,300 per victim, whereas the average cost of
cases in which detection and treatment were delayed
amounted to almost $46,000. In addition, employees
who received prompt treatment averaged 12 weeks of
recovery before returning to work compared with 46
weeks in the delayed treatment group. "Clearly, the
expense of a few sessions for all involved,
especially if conducted as a group, would be
significantly less than long-term treatment and/or
disability leave of a significantly involved
few."[5]

o There were fewer stress-related disability claims
by San Diego officers after the San Ysidro
McDonald's massacre in 1988, when immediate
intervention programs were implemented, than
stress-related retirements following the Pacific
Southwest Airline crash in 1978.[6]

o A cost-benefit study of a program for alcoholic
officers in the Philadelphia Police Department
found that by cutting down on the officers' sick
leave days, injury days, and suspension days, the
department more than recovered its costs three
years after the program began. The department
estimated that it would save $50,094 each
subsequent year.[7]

o The police psychologist for the Palo Alto Police
Department estimates that the stress program cost
is absorbed many times over with the prevention of
one stress-related disability retirement.[8] Before
the Palo Alto stress program began in 1980, there
had been a dozen recent stress-related retirements;
between 1980 and 1996 there was only one.

o The San Bernardino Sheriff's Department estimated
that over a six-year period it reduced its
psychological stress retirements from eight to zero
at a saving of $1,500,000 for each officer, or $12
million total, in retirement funds alone.[9]

Quantifying the benefits of a stress program can
serve as a convincing tool for budget planning and
justification. Approaches for conducting program
evaluations that can yield
cost-effectiveness data are discussed in chapter
12, "Monitoring and Evaluating the Program."

Document Stress Among Department Personnel

Program planners and independent practitioners can
summarize the literature cited in chapter 1 of this
report to use as evidence to help convince police
administrators of the need for establishing or
expanding stress services. Chapter 2, "Planning the
Program," suggests how program planners and staff
can conduct a needs assessment that will document
the particular stresses and their severity in an
individual law enforcement agency. These
agency-specific findings may be more persuasive
than the results of studies reported in the
literature about other jurisdictions.

Medical Insurance Issues

The nature of mental health services coverage
available in the medical insurance policies of law
enforcement officers and nonsworn personnel, and
their families, can have an enormous impact on the
extent to which these individuals use stress
programs. At one extreme, Michigan State Police
officers and family members pay nothing and need no
insurance coverage to receive treatment with the
department's Behavioral Science Section. At the
other extreme are officers in hundreds of small law
enforcement agencies that have no in-house stress
program and whose medical insurance--if they have
any at all--provides no outpatient mental health
benefits. Most plans offer something in between
these extremes. One preferred provider organization
(PPO) allows seven free visits without prior
approval if the counselor is on the organization's
list of approved providers, and then a total of 20
visits after case manager approval. Another PPO
reimburses only three visits and only for group
therapy. After one free session, if an officer's or
family member's insurance does not cover treatment
or runs out, Rhode Island's Centurion Program
accepts direct payment or, if necessary, offers a
sliding scale of payment or even free service. 

Before authorizing payments for mental health
services, many managed care plans require insured
individuals to have an
independent screening to determine eligibility.
Some health maintenance organizations (HMOs) and
PPOs require two screenings: first by an internist
and then by a case manager. Counselors and officers
alike report that many potential clients are
unwilling to be screened because of the
inconvenience and their concerns about
confidentiality. One counselor talked about an
unnamed officer who paid out of pocket for several
visits rather than go through an assessment screen;
the officer would have--and, according to the
counselor, should have--remained in treatment but
had to stop coming because of the expense. Another
counselor treated an officer who remained in
therapy for many months, paying $90 a session out
of pocket rather than accept screening that would
allow the hundreds of employees at his insurance
company--and perhaps his supervisor--to find out he
was in therapy.

In addition, managed care providers may not cover
certain
conditions for which officers need counseling.
Because one
officer's preferred provider organization did not
provide benefits for marriage counseling, he came
for counseling by himself for depression for two
sessions but then stopped coming because continued
treatment seemed pointless if his wife could not
join him.

Finally, HMOs and PPOs limit the officer's options
for choosing a counselor because the therapist has
to be a member of the provider organization. As a
result, many officers are prevented from selecting
a therapist with an understanding of law
enforcement and its stresses, since few mental
health workers associated with HMOs and PPOs have
this type of background.

When collective bargaining is not involved in
selecting health insurance coverage, the
department, or the county or city budget director,
may seek to purchase the least expensive policy.
However, if insurance is a bargaining issue, unions
can negotiate for policies that provide good mental
health coverage, perhaps even reallocating some
coverage (e.g., for eyeglasses or dental care) to
psychological services. In addition, unions can try
to obtain an indemnity plan, not a managed care
plan.

Despite increasing retrenchments among city and
county funding sources and greater restrictions in
insurance coverage for mental health conditions,
stress program staff and individual mental health
practitioners are finding ways to begin, maintain,
or even increase services to law enforcement
agencies. Doing so, however, requires constant
vigilance, good record keeping and program
assessment, and periodic knocking on doors to
solicit additional money.

Endnotes

1. Dunning, C., "Mitigating the Impact of Work
Trauma:
Administrative Issues Concerning Intervention," in 
Critical Incidents in Policing, revised, ed. J.T.
Reese, J.M. Horn, and C. Dunning, Washington, D.C.:
U.S. Department of Justice, Federal Bureau of
Investigation, 1991: 73-82.

2. Kirschman, E., E. Scrivner, K. Ellison, and C.
Marcy, "Work and Well-Being: Lessons from Law
Enforcement," in Stress and Well-Being at Work:
Assessments and interventions for Occupational
Mental Health, ed. J.C. Quick, L.R. Murphy, and
J.J. Hurrell, Hillsdale, New Jersey: Lawrence
Erlebaum, 1995: 178-192.

3. Fuller, R.A., "An Overview of the Process of
Peer Support Team Development," Critical Incidents
in Policing, 99-104.

4. "Tired? Stressed? Burned Out? Panel Seeks
Answers for
Philadelphia Police Officers," Law Enforcement
News, 22 (1995): 1, 10.

5. Dunning, "Mitigating the Impact of Work Trauma,"
78.

6. Ibid.

7. Unkovic, C.M., and W.R. Brown, "The Drunken
Cop," The Police Chief, 45 (1978): 18-20.

8. Kirschman et al., "Work and Well-Being," 190.

9. Nunn, J., "One Department's Experience,"
Unpublished Report, San Bernardino County Sheriff's
Department and Seventh Member, Board of Retirement
for San Bernardino County. 

10. Dunning, "Mitigating the Impact of Work
Trauma," 79.

11. Ibid., 78.

12. "On the Front Lines: Police Stress and Family
Well-Being," Testimony by B.J. Anderson and J.A.
King, Hearing Before the Select Committee on
Children, Youth, and Families, House of
Representatives, 102nd Congress, 1st Session, May
20, 1991, Washington, D.C.: U.S. Government
Printing Office, 1991: 66.

Other Ways To Motivate Police Executives To Provide
Funding

o Alter the planned or existing program's service
mix to include more visible types of services, such
as training and critical incident debriefings that,
unlike individual counseling, which goes largely
unseen, may help the chief conclude that the
program is doing something tangible.

o Work with legislators to have dedicated funding
or added funding introduced into the law
enforcement budget.

o Obtain a professional legal opinion regarding the
possibility that administrators who ignore the
psychological aftereffects of critical incidents
among their personnel risk suits alleging negligent
officer supervision, retention, or training if
mental injuries contribute to work actions that
injure citizens.[10]

Insurance Limitations Can Change a Program's Plans

Washington, D.C.'s, Metropolitan Police Employee
Assistance Program (MPEAP) "provides short-term
supportive counseling/crisis intervention. Most
clients' needs fall into this category.
Sometimes, such as in the case of death, divorce,
critical incidents, post-shooting stress or other
situational life crises, long-term therapy is not
needed. However, in some cases
individuals' problems are very deep-rooted, as in
cases of child abuse/neglect, childhood trauma,
clinical depression, etc. These situations may
interfere so greatly with an individual's ability
to function that long-term therapy is necessary. In
these extreme cases, referrals are made to an
outside therapist."

"Although our initial plan for counseling was less
than or up to six months, that plan has been
abandoned. In fact, many of our clients have been
with us for over a year. Why the change? The cost
for counseling nowadays averages $80.00 per
session. The
recommended treatment is usually one session per
week.
Unfortunately, most police officers do not have
insurance coverage to pick up this cost or they
have HMOs that may pay little or nothing towards
the cost of treatment. Therefore, the chances that
an officer/family member will follow up on a
referral are very poor due to the financial burden
posed by weekly therapy on the
outside." 

--Beverly J. Anderson, Clinical Director/Program
Administrator, and Officer Jeffrey A. King, Peer
Counselor Coordinator, Washington, D.C.,
Metropolitan Police Employee Assistance
Program.[12]

The Adams County, Colorado, Sheriff's Department
secured a $26,000 annual grant from a local
victim/witness assistance and law enforcement board
to hire a psychologist in part by explaining that
the stressful nature of the work makes police
personnel "victims" of crime.

"A dollar in psychological services now can save us
hundreds of thousands down the road." 

--Robert Peppler, Assistant Sheriff, 

San Bernardino Sheriff's Department

"Clearly, the expense of a few [critical incident
debriefing] sessions for all involved, especially
if conducted as a group, would be significantly
less than long-term treatment and/or disability
leave of a significantly involved few." [11]

______________________________________________

Chapter 14

Tapping Other Resources
______________________________________________

Key Points

Information regarding law enforcement stress and
stress programs is available from

o agencies and organizations,

o publications and videos,

o program materials, and

o individuals with experience in law enforcement
stress
programming.

This chapter presents several resources for
information about law enforcement stress
programming. The list is based on a limited search
and is therefore not comprehensive.

Agencies and Organizations

American Psychological Association (APA)
Division of Psychology and Public Services
Police and Public Safety Section
750 First Street, NE
Washington, DC 20002
(202) 336-5500 or (800) 374-2721
(202) 336-5502 (fax for order department)

The APA's Police and Public Safety Section consists
of
approximately 300 psychologists who can provide
expertise on a variety of police psychology issues.
Also, at the APA's national convention each year,
the section sponsors a one-day
"mini-convention" on police psychology. Audiotapes
of presentations made at the conventions are
available. Call the APA's 800 number and ask the
Continuing Education Department for an audiotape
catalog.

Scott W. Allen, chair of the section, can be
contacted at:
Health Services Section
Metro-Dade Police Department
8525 Northwest 53rd Terrace
Suite 215
Miami, FL 33166
(305) 591-1106

Concerns of Police Survivors (COPS)
P.O. Box 3199
North Highway 5
Camdenton, MO 65020
(314) 346-4911
(314) 346-1414 (fax)

COPS is a national support organization, with many
local chapters, for families of law enforcement
officers who have died in the line of duty. Members
provide peer support and practical assistance to
newly bereaved surviving families, conduct national
counseling and training programs for survivors, and
help law enforcement agencies develop a plan for
dealing effectively with line-of-duty deaths. The
organization distributes a number of free
publications on support for surviving families.

Federal Bureau of Investigation (FBI)
Behavioral Science Services Unit
FBI Academy
Quantico, VA 22135
(703) 640-6131
(703) 640-1354 (fax)

The FBI Behavioral Science Services Unit has
sponsored a number of conferences on law
enforcement stress and police psychology, several
of which have been compiled into publications (see
"Publications and Videos," below). For additional
information about the unit or to inquire about the
opportunity for attending the next FBI police
psychology conference, contact Tony Pinizzotto,
Program Manager for Police Psychology, at the above
address, or call (703) 640-1710.

International Association of Chiefs of Police
(IACP)
Police Psychological Services Section 
515 North Washington Street
Alexandria, VA 22314-2357
(703) 836-6767 or (800) THE-IACP
(703) 836-4543 (fax)

The Police Psychological Services Section,
established in 1985, is made up of approximately 70
police psychologists who contribute articles to the
IACP's The Police Chief magazine, present training
programs at the annual conferences, and schedule
in-service training for police psychologists at
each annual conference. The section has also been
instrumental in the development of guidelines
regarding peer support, fitness-for-duty
evaluations, dealing with officers involved in on-
duty shooting situations, and preemployment
psychological evaluation services. Membership in
the section is open to any active or associate
member of the IACP. 

In addition to the section's activities, the IACP
has developed "model policies" related to post-
shooting incident procedures and employee mental
health services, as well as brief "training keys"
on job stress in police work, frustrations with and
adjustment to police work, coping with stress,
alcoholism in law enforcement, post-shooting
service, police work and family life, and
post-traumatic stress disorder. The training keys
provide an overview of the topic, a discussion
guide, and suggested readings. The organization
also offers training courses to law enforcement
agencies on critical incident management.
Descriptions of these and other training courses,
as well as where and when the courses are offered,
are presented in the IACP's annual training
catalog. Agencies can also contract with the IACP
to have instructors come to their jurisdictions to
provide training.

Stephen F. Curran, chair of the section, can be
contacted at: Greenside Psychological Associates 
660 Kenilworth Drive
Suite 101
Towson, MD 21204
(410) 823-0555
(410) 823-2677 (fax)

International Critical Incident Stress Foundation,
Inc.
5018 Dorsey Hall Drive
Suite 104
Ellicott City, MD 21042
(410) 730-4311
(410) 730-4313 (fax)

Foundation staff travel around the country offering
an intensive course on emotional trauma and how to
respond effectively to individuals who have
experienced a critical incident. One- to two-day
courses cover such topics as "Peer Counseling
Techniques," "Advanced Critical Incident Stress,"
"The Family Factor," and "Traumatic Stress
Management." Chevron Publishing Corporation, a
publisher affiliated with the foundation, offers a
number of training guides, books, videotapes, and
other materials about preventing and treating
stress among emergency services personnel.

National Association of Police Organizations (NAPO)
750 First Street, N.E.
Suite 1020
Washington, D.C. 20002-4241
(202) 842-4420
(202) 842-4396 (fax)

NAPO is a coalition of 3,500 police unions and
associations from across the United States
organized for the purpose of advancing the interest
of America's law enforcement officers through
legislative advocacy, political action, and
education. Police Research
Education Project (PREP), NAPO'S research and
educational arm, is currently conducting a research
study on support programs for law enforcement
officers. The National Law Enforcement Officers
Rights Center was established under PREP to protect
officers' legal and constitutional rights. The
Rights Center filed an amicus curiae brief in the
U.S. Supreme Court supporting the confidentiality
of statements made by a police officer to a
licensed mental health practitioner (see chapter 6,
"Dealing With Confidentiality," for a discussion of
the case).

National Criminal Justice Reference Service (NCJRS)
Box 6000
Rockville, MD 20849-6000
(800) 851-3420
(301) 251-5212 (fax)
askncjrs@ncjrs.aspensys.com

NCJRS is a reference service provided by the
National Institute of Justice, the research arm of
the U.S. Department of Justice. Information
specialists conduct literature searches on subjects
related to law enforcement, including law
enforcement stress. The reference service
distributes many Federal Government documents free
of charge and sells or obtains others through
interlibrary loan.

Publications and Videos

Ayres, R. M. Preventing Law Enforcement Stress: The
Organization's Role. Washington, D.C.: U.S.
Department of Justice, Bureau of Justice
Assistance, 1990.

In contrast to the "person-centered" approach to
occupational stress, this book examines law
enforcement stress using the "organizational health
model." It reviews organizational sources of
stress, the implications of higher education on law
enforcement stress, and management strategies for
developing a healthy law enforcement workplace.

Contact the National Criminal Justice Reference
Service, described above in "Agencies and
Organizations."

Blau, T. Psychological Services for Law
Enforcement. New York: John Wiley and Sons, Inc.,
1994.

Written by a police psychologist and former
president of the American Psychological
Association, this book provides a
comprehensive review of police psychological
services, including crisis intervention, critical
incident counseling, the prevention of stress,
individual and family counseling, management
consultation, and training. An extensive
bibliography is included.

Contact John Wiley and Sons, Inc., in New York
City, at (212) 850-6000.

Goolkasian, G.A., Geddes, R.W., and DeJong, W.
Coping with Police Stress. Issues and Practices.
Washington, D.C.: U.S. Department of Justice,
National Institute of Justice, June 1985.

This book is part of the Issues and Practices in
Criminal Justice publication series of the National
Institute of Justice. Based on a review of the
literature and interviews with law enforcement
stress program staff, the book provides an overview
of law
enforcement stress and guidance on the development
of a stress program, including planning,
organization, services, training, and monitoring
and evaluation.

Contact the National Criminal Justice Reference
Service, described above in "Agencies and
Organizations."

Niederhoffer, A., and Niederhoffer, E. The Police
Family: From Station House to Ranch House.
Lexington, Massachusetts: Lexington Books, 1978.

This book's examination of the law enforcement
family contains information still relevant today.
The book includes a discussion of sources of stress
for officers and their family members, including
children, and descriptions of some departments'
efforts to address stress-related problems among
officers and their families. The book is out of
print but may be available in a local library.

On the Front Lines: Police Stress and Family Well-
Being. Hearing Before the Select Committee on
Children, Youth, and Families, House of
Representatives, 102nd Congress, 1st Session,
Washington, D.C., May 20, 1991. Washington, D.C.:
U.S. Government Printing Office, 1991.

This publication provides transcripts of testimony
presented to a congressional hearing on law
enforcement stress for officers and their families.
The statements of psychologists, other experts, and
officers and family members are included.

The publication can be purchased on microfiche for
$15.80 or on paper for $35.10 from the
Congressional Information Service in Bethesda,
Maryland, at (800) 227-2477. The publication's
order number is 1992-H961-7. The publication also
may be available through interlibrary loan.

Reese, J.T., and Goldstein, H.A., eds.
Psychological Services for Law Enforcement.
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1986.

This is a 543-page collection of papers presented
at the FBI's 1984 National Symposium on Police
Psychological Services. The papers are grouped
into: (1) police officer selection and assessment;
(2) counseling: issues and practices; (3)
organizational issues; (4) psychological services;
(5) critical incident reactions; and (6) stress and
stress management.

Contact the FBI Employee Assistance Unit at the
address and phone number below or the National
Criminal Justice Reference Service, described below
in "Agencies and Organizations."

Reese, J.T.; Horn, J.M.; and Dunning, C., eds.
Critical Incidents in Policing. Revised.
Washington, D.C.: U.S. Department of Justice,
Federal Bureau of Investigation, 1991.

This is a collection of papers presented at a
conference sponsored by the FBI Behavioral Science
Services Unit. Papers address the nature of
critical incident trauma, efforts by stress
programs to address the emotional effects of
critical incidents, and approaches to providing
debriefings and counseling.

Contact the FBI Employee Assistance Unit
J. Edgar Hoover Building
10th and Pennsylvania Avenue, NW
Washington, DC 20535
(202) 324-5244

Reese, J.T., and Scrivner, E., eds. Law Enforcement
Families: Issues and Answers. Washington, D.C.:
U.S. Department of Justice, Federal Bureau of
Investigation, 1994.

This publication consists of papers presented at an
FBI conference, grouped into the following
categories: (1) law enforcement's impact on
families, (2) family problems, (3) factors unique
to law enforcement and their effect on families,
(4) trauma in the law enforcement family, (5)
organizational culture and the family, (6)
counseling issues, and (7) professional issues.

Contact the FBI Employee Assistance Unit at the
address and phone number above or the National
Criminal Justice Reference Service, described above
in "Agencies and Organizations." 

Scrivner, E. and Kurke, M., eds. Police Psychology
Into the 21st Century. Hillsdale, New Jersey:
Lawrence Erlbaum, Inc., 1995.

This book includes chapters on "Employee Assistance
Programs in Police Organizations," "Professionally
Administered Critical Incident Debriefing for
Police Officers," "Law Enforcement
Families," "Counseling Issues and Police
Diversity," and
"Organizational Management of Stress and Human
Reliability."

Contact Lawrence Erlbaum, Inc.
20 Industrial Avenue
Mahwah, NJ 07430
(201) 236-9500

Stress Management for the Law Enforcement Family
California Peace Officers Standards and Training
(POST)

This 90-minute video provides comprehensive
information on law enforcement stress for both
officers and their families. Police psychologists,
officers, spouses, and children are interviewed.

Available for $79.95 from the California Commission
on POST 1601 Alhambra Boulevard
Sacramento, CA 95816-7083
(916) 227-4889

By Their Own Hand: Suicide and the Police Officer:
Getting Help Before It's Too Late

New York City Police Department and the New York
City Police Foundation

This package, consisting of a 40-minute video and
accompanying 23-page trainer's guide, requires one-
and-one-half hours to present. Through interviews
with officers and family members, the video
presents the histories of three New York City
police
officers, two of whom seriously considered
committing suicide, and one who of whom did commit
suicide. The trainer's guide presents lecture
material and discussion topics, as well as reviews
the key points in the video. The package's
objectives are to enable officers to identify
common risk factors and warning signs that indicate
someone may be thinking about suicide, get help
when having life problems, recognize when other
officers may be having life problems and intervene
to help get them assistance, and identify community
and departmental resources available to the officerwho needs help with both major and minor emotional
problems. A before-and-after evaluation of the
package conducted by the Columbia University
Graduate School of Social Work with over 4,000 New
York City police officers found that six months
after the session there were increases in use of
the department's
Psychological Services and Counseling, the
likelihood of officers seeking help for themselves
and others, and awareness of their own and others'
major and minor emotional problems.

Available for $75 from the New York City Police
Foundation
345 Park Avenue
New York, NY 10154
(212) 751-8170

Program Materials
"Dynamics of Fear"

Michigan State Police Department Behavioral 

Science Section

In this 35-minute video, produced by the Michigan
State Police Department's Behavioral Science
Section, six officers describe critical incidents
in which they were involved, illustrating six
separate phases of fear that police psychologist
Roger Solomon has found officers often pass through
during the incident. The video suggests how
officers can prepare for dealing with fear. A
training manual accompanies the video. Available
for $15.

Michigan State Police Behavioral Science Section
2510 Kerry Street
Suite 106
Lansing, MI 48912
(517) 334-7745

Peer Support Training Manual
The Counseling Team

Prepared by The Counseling Team in San Bernardino,
California, this 160-page manual provides extensive
information on peer supporter services, basic
support methods, listening skills, critical
incident stress, grief and bereavement, assessment
and referral, and suicide. The Counseling Team
distributes the manual free of charge.

The Counseling Team
1881 Business Center Drive
Suite 11
San Bernardino, CA 92408
(909) 884-0133

"Stress Management for Supervisors" Training
Curriculum
Rochester Police Department Stress Management Unit 

This 11-hour training curriculum has been used and
revised for 20 years at the Rochester Police
Department and other police
departments in New York State. It reviews topics
such as drug and alcohol use, dealing with problem
employees, stress and managers, and post traumatic
stress syndrome.

Available from the Rochester Police Department
Stress Management Unit
Civic Center Plaza
150 South Plymouth Avenue
Rochester, NY 14614
(716) 428-7540

___________________________________________________

Appendix A

Peer Support Counseling Guidelines San Bernadino
County Sheriff's Department Program Guidelines
__________________________________________________
___

Introduction

Almost everyone has experienced, or will
experience, a stressful situation in his/her
lifetime. It is during these times that family and
friends come to the rescue. They are able to
provide needed support and understanding that help
overcome life's problems. The Peer Support Program
is one of those "friends" who is available to every
San Bernardino County Sheriff's Department
employee.

This handbook has three specific objectives:

o It provides a background for understanding the
department's Peer Support Program. 

o It provides practical guidelines for management
of the program.

o It provides the peer supporters with guidelines
for assisting their peers.

This handbook is divided into two sections. Section
One contains a description of the program,
including the roles of the
organizational components. In addition, it contains
an outline of the information and a listing of
procedures for practical
administrations of the program.

Section Two describes the skills and techniques
that may be used by a Peer Supporter to assist
persons who are faced with stressful situations.
Each Peer Supporter must comply with the policies
and procedures outlined in this handbook.

As the Peer Support Program matures, policy and
procedure changes are inevitable. The program
coordinator, advisory board and the peer supporters
shall be required to keep open lines of
communication to facilitate this maturation
process. Effective, honest communication in a
caring environment, balanced by the program
protocol, will greatly enhance the opportunity for
a successful program.

Section I 

Peer Support Program

Unit 1

Definition

The Peer Support Program is a program that offers
assistance and appropriate support resources to
employees when personal or professional problems
negatively affect their work performance, family
unit or self. This assistance is confidential,
providing it does not violate any law or department
regulation.

This program is designed to:

o Provide emotional support during and after times
of personal or professional crisis to other
employees who express a need for assistance.

o Promote trust, allow appropriate anonymity, and
preserve
confidentiality for persons using Peer Supporters
within the guidelines of the program.

o Develop peer supporters who can identify personal
conflicts and provide guidance or referral to
professional\alternate resources as required.

o Maintain an effective peer supporter training and
response program.

o Support those who have had family tragedies.

o Check on status of illnesses and IOD's and
provide support where desired and needed.

Mission Statement

The San Bernardino County Sheriff's Department has
recognized the value of providing a way for their
employees and their family members to deal with
personal and\or professional problems. A successful
approach to this problem has been to provide a
program which offers a non-professional (peer)
support program in addition to The Counseling Team.
The peer support program is composed of a group of
peers who have volunteered to make themselves
available to any member of the department. This
will provide a way for the San Bernardino County
Sheriff's Department employees to talk out personal
and\or professional problems confidentially with
someone who understands and cares.

The San Bernardino County Sheriff's Department's
most valuable resource is its employees. The peer
support program's goal is to assist peers with
stresses caused by personal and\or professional
problems and help them continue to be a productive
member of the San Bernardino County Sheriff's
Department.

Unit 2

Duties and Responsibilities

Role of peer supporters. The peer supporter
provides support and assistance to employees in
time of stress and crisis. Peer
supporters responsibilities are as follows:

o Convey trust, anonymity, and assure
confidentiality within guidelines to employees who
seek assistance from the Peer Support Program.

o Attend the Peer Support 3-Day Training Seminar:
"Listening and Helping Techniques." Additional
training will be required during the maturation of
this program.

o Provide assistance and support on a voluntary
basis.

o Assist the employee by referring him\her to the
appropriate outside resource when necessary.

o Be available to the individual for additional
follow-up support.

o Maintain contact with the Program Coordinator
regarding program activities.

o Peer Supporter will agree to be contacted and, if
practical, respond at any hour.

o Attend annual 8 hours of updated Peer Support
Program training provided by The Counseling Team,
and attend bi-annual meetings.

The peer supporter is not exempt from Federal,
State, local laws, or the rules and regulations of
the Department. When necessary, contact the Peer
Support Program Coordinator for assistance and
guidance.

Role of the peer support advisory committee. The
Peer Support Advisory Committee acts as the policy
setting board for the program's operation and
future direction, subject to review and approval by
the Sheriff. The committee also participates in the
selection process of peer supporters.

Members are selected by current peer supporters,
except those from The Counseling Team. Three Peer
Support Advisory Committee members will be selected
by the Peer Supporters. The Peer Support Advisory
Committee will be peer supporters who will answer
directly to the coordinator who is appointed by the
Sheriff.

Membership consists of representatives from:

o The Counseling Team

o Peer Supporters from the San Bernardino County
Sheriff's
Department

o Program Coordinator who is appointed by the
Sheriff

Role of program coordinator. The Peer Support
Program Coordinator acts as the primary liaison
between the peer supporters, Peer Support Advisory
Committee, resource persons, and the department.
The Program Coordinator serves as the link to
ensure that the Peer Support Program is being
managed by the peer supporters in
accordance with the goals and objectives
established for the program.

Major duties of the Program Coordinator's include:

o Supervising the Program on a daily basis.

o Serving as a member of the Peer Support Advisory
Committee.

o Recruiting and coordinating the screening of the
Peer Support applicants.

o Coordinating training of peer supporters.

o Developing resources to assist individuals when
problem areas are identified.

o Maintaining only statistical data of reported
contacts by peer supporters.

o Offering guidance to peer supporters when
problems occur.

o Coordinating follow-up response of peer
supporters when referrals are made to The
Counseling Team.

o Off duty emergencies must be approved through the
Program Coordinator or his designee in order to be
compensated.

Role of San Bernardino County Sheriff's Department
psychological services in the peer support program.
The Counseling Team shall:

o Provide a permanent member on the Peer Support
Advisory
Committee.

o Design peer support training curriculum and teach
peer supporters basic and continuing (updated)
curriculum.

o Be on-call and available to supervise peer
supporters if
necessary.

Unit 3

Peer Support Selection Process

All interested employees who choose to volunteer as
a peer
supporter must submit their request through their
chain-of-command to the Peer Support Program
Coordinator.

Any member of the San Bernardino County Sheriff's
Department may also submit the name of a peer to
their chain-of-command or to the Peer Support
Program Coordinator for consideration as a peer
supporter.

Prospective peer supporters must be willing to meet
the following criteria:

o Agree to maintain confidentiality within the
guidelines provided in this handbook.

o Be empathetic and possess interpersonal and
communication skills.

o Be motivated and willing to manage time
effectively. This will allow minimal impact on
their normal duties.

o Must successfully complete the selection process.

o Must attend and successfully complete the 3-day
training program.

o On-going training.

The Peer Support Advisory Committee will recommend
candidates suited for appointment as a peer
supporter to the Sheriff for final approval.

Any employee may seek support from any of the named
supporters and do not have to stay within their
work groups.

Peer Support Training Program

The peer support training program will be
coordinated by The Counseling Team. The major
emphasis will focus on skill development for
conducting peer assistance. The main areas covered
include:

o Effective listening

o General assessment skills

o Problem-solving skills

o Relationship termination (death, divorce, etc.)

o Referral and follow-up.

Follow-up training and workshops will be scheduled
to enhance problem solving skills, provide group
sharing, and allow an exchange of experiences. The
mandatory 8 hours of updated Peer Support training
will be offered 3 times per year and all Peer
Supporters will be required to attend one of the
eight hour courses.

Rules and Regulations 

Service assignment:

o Peer supporters may voluntarily withdraw from
participation at any time. They are, however,
required to notify the Program Coordinator.

o Peer supporters will be removed from
participation in the program for conduct
inconsistent with program policy and objectives.

o All peer supporters serve at the direction and
pleasure of the Advisory Committee and can be
removed at any time for any cause.

o Peer supporters will be removed from
participation in the program if up-dated training
is not attended (annual) at least once per year.

Organization resources. The following guidelines
provide the peer supporter's formal authority to
obtain certain organizational resources and support
he\she needs to assist peer employees:

o Lodging and per diem expenses may be provided for
training, workshop attendance, and assignment
referrals to a work location outside the peer
supporter's currently assigned location. All such
activity is subject to prior authorization by the
commander.

o The peer supporter is authorized to use
department facilities to meet with employees, with
appropriate prior approval as necessary.

o The peer supporter is permitted to consult with
employees off duty with advance notice to the
Program Coordinator and\or Advisory Committee
Members and approval from the peer supporter's
immediate supervisor. No names or personal
identifiers will be given to the supervisor.

Unit 4

Confidentiality

The acceptance and success of the San Bernardino
County Sheriff's Department Peer Support Program
will be determined, in part, by observance of
confidentiality. It is imperative that each peer
supporter maintain strict confidentiality of all
information learned about an individual within the
guidelines of this program.

The policy of the San Bernardino County Sheriff's
Department Peer Support Program is to maintain the
confidentiality. Communication between the peer
supporter and a person is considered confidential
except for matters which involve the following:

o Danger to self.

o Danger to others.

o Suspected child abuse.

o Narcotic offenses.

o Domestic violence.

o Factual elderly abuse.

o In cases where law requires divulgence.

o Where divulgence is requested by the peer.

A general principle for peer supporters to follow
is inform the person, prior to discussion, what the
limitations and exceptions are regarding the
information revealed. In those cases where a
question or any question regarding confidentiality
arises, the peer supporter must immediately contact
a member of the Peer Support Advisory Committee
and\or The Counseling Team who will take
appropriate action or contact the Program
Coordinator.

Section II
Field Management of the Peer Support Program

Unit 5

Discipline

Internal investigations. It may occur that a peer
supporter is assisting an individual who is or
becomes the subject of a
disciplinary investigation. The peer supporter
should be guided by the confidentiality policy of
the Peer Support Program. He should not volunteer
any information received in confidence; however,
peer supporters may not hamper or impede the actual
investigation nor may they attempt to shelter the
individual from the department's investigation.

The peer supporter's role in disciplinary
situations should be one of support and assisting
individuals through the stress they may face during
the disciplinary process. If peer supporters have
any questions or concerns regarding these
situations, they should consult with the Program
Coordinator for guidelines and assistance.

Unit 6
Peer Support Program Skills and Techniques

The purpose of this section is to provide the peer
supporter with a summary of the guidelines to be
followed when dealing with situations under field
conditions. These guidelines are the basic tools
for providing assistance. Used properly, they will
help boost peer supporter confidence and will
reduce the risks of mismanaging emotional problems.
For more detailed guidelines, the peer
supporter should refer to the material contained in
the Peer Support Training Manual provided by The
Counseling Team.

o Listening--Listening techniques are fundamental
to the use of all other interviewing skills. The
purpose of effective listening include:

o Encouraging self-expression.

o Allowing peer opportunity to direct the
interview.

o Giving peers a sense of responsibility for what
happens.

o Helping peers relax and be comfortable in the
interview.

o Fostering trust of the peer supporter and a sense
of security.

o Enabling the peer supporter to draw more accurate
inferences about the peer.

o Assessment--The process of making a judgement
about the
information gathered during the interview. Several
factors must be considered. They are:

o Assess whether the problem is one with which you
can assist the peer or one that should be referred
to professional resources.

o Assess whether the problem needs urgent
attention.

o Referral--The process of directing the peer to
the appropriate professional service(s) available.

New Policy Regarding the Peer Support Program

Peer support program. The Department recognizes the
need for a Peer Support Program. This is a self-
help program designed to assist employees who
desire advice or support from a peer. It is
designed to assist employees during times of grief,
stress or other personal problems.

Scope of the peer support program. Members seeking
peer support and peer supporters are not exempt
from laws, rules, regulations, directives or orders
that govern them. Peer support is, however,
intended to be a support system for department
personnel and family members seeking their help.
The assistance provided and the dialogue between
supporter and peer is deemed confidential
providing it meets the requirements of this
section.

Duties/Responsibilities of the Peer Supporter:

o Advise peers seeking assistance that peer
supporters are not exempt from laws, rules,
regulations, directives or orders; but any exchange
of information not in violation of this statement
will be confidential.

o Provide all assistance and support on a volunteer
basis.

o Convey trust, anonymity and assure
confidentiality to peers who seek assistance from
the Peer Support Program.

o Assist peers by referring them to appropriate and
viable referral resources when necessary; i.e.,
Alcoholics Anonymous, The
Counseling Team, etc.

o Be available for follow-up support.

o Maintain contact with the program coordinator
(Errol Bechtel assigned by the Sheriff) regarding
the program and report
statistical information.

Duties of the Program Coordinator and Peer Support
Advisory Committee. The Peer Support Advisory
Committee acts as the policy setting board for the
program. It directs the program's operation and
provides direction for the future. The program
coordinator is responsible for the policy and
direction offered by the committee. The program
coordinator is Errol Bechtel and the Peer Support
Advisory Committee members are Doug Williams, Ed
Ripley, Greg Kyritsis, Nancy Bohl and Bonnie
Spitzer approved by the Sheriff from volunteers
within the Department.
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