After keeping an eye on victims of the Hyatt disaster, KC shrinks have bad news for the grief-counseling industry 

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To put it in nonacademic terms, Gist uses an example from landscape architects who design college campuses: "You don't put down sidewalks. You leave raw grass for a semester or two, and then you look at where the students have worn a path and you pave it. You assume people already know where they're going, and then you just try to make it possible for them to get there. Unfortunately, in contemporary pop psychology, we got to a place where we figured people didn't know where they were going, and we started leading them places they didn't need to be."

Gist edited two books on community disaster responses, one published in 1989 and the other in 1999. He thought that would be the end of it.

"Reality has a way of catching up with you," he says. "Following September 11, myself and many other researchers were just getting inundated with reporters. All of a sudden, all this minor academic debate became a huge concern to a lot of people."

It turns out that, from his work on the Hyatt, Gist had helped create a singular way of dealing with community disasters.


In the wake of disasters like 9/11 and hurricanes Katrina and Andrew, the long-term effects of post-traumatic stress disorder have been scrutinized at an unprecedented level. With the rest of the country catching up to lessons already learned from the Hyatt, mental-health providers are now less likely to bombard people with intrusive help.

Betsy Vander Velde is president and CEO of the Family Conservancy in Kansas City, Kansas, which represents mental-health workers across the metro's counties. She calls Gist's work "an amazing evolution of not just what post-traumatic stress really is, but how to be helpful and how to intervene and how not to intervene."

The country's firefighters now seem poised to move away from surveys and strangers asking them about their feelings. The National Fallen Firefighters Foundation — an organization for creating standards and requirements for fire prevention and suppression, training, equipment, codes and standards — removed any recommendation for using CISM from its 2009 standards.

Even with the official protocol turning away from CISM, it may take awhile for fire departments that have used it for decades to adopt a new model.

"There was just a suicide in Texas [this October], and the first thing that fire department did was run a debriefing," Bledsoe says. "A lot of police departments are still into it, and I think most of the debriefers are moving into the public-school setting. Guys like this just move to a different market. You see it all the time. There's a school disaster, and counselors are on hand."

Now, the National Center for Post Traumatic Stress Disorder is trying to provide a better option.

"We're developing combat and operation stress aid for the military, Marine Corps and Navy that's informed by research that came from Kansas City, among other places," says Patricia Watson, an educational specialist with the center, which is part of the U.S. Department of Veterans Affairs.

"We're also creating a model with the same basis for the National Fallen Firefighters Foundation. The first responders have started saying they don't want to sit and talk with this stranger about how they feel, and there've been red flags raised."

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