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Watson's mode is based at least partially on the idea that nothing can be mandatory or coercive, so the challenge becomes how to make sure people get the help they need without getting in their way. That means not intervening with any kind of psychological first aid unless a person shows problems functioning.
The center's guide, still in preliminary drafts, establishes a framework for early interventions that rely on a person's peers rather than outside agencies and counselors; peers would help connect traumatized colleagues to outside agencies if necessary. The loose structure will be tested over the next year at 14 military bases.
"I'm very cautious now about what we do," Watson says. "You look back 100 years, and it's like, 'Oh my God, they're drilling holes in people's heads!' But that's what they thought was best. We want this to be a living model that'll keep improving over time."
In Kansas City, the silver lining to the Hyatt has been that the mental-health sector learned the benefits of allowing people to heal in their own ways.
In May 2008, when tornados swept through the Northland, grief counselors — some trained in CISM, others just self-made specialists from disparate religious groups — reacted in typical fashion. Workers on-site took their information but didn't give them direct access to the people involved.
"What's unique here is that we've developed a very controlled system," Betsy Vander Velde says. "There's a mechanism in place to be sure that people who aren't supposed to be in these recovery areas aren't there being counterproductive."
As Vander Velde helped with the tornado recovery effort, she regularly saw people who she expected would need ongoing counseling. She recalls one elderly couple who was isolated from nearby neighbors and had little family. They refused to leave their home because it was all they had, and they wanted to start repairing damage as soon as possible. As it turned out, they were fine.
"We've learned we can't assume everyone is going to be horribly hurt for the rest of their lives," she says. "It seems now like the best predictor we might have of how you'll do in a crisis is how you handled the bad things that happened in your life before, on your own."
Gist suggests that counselors stop trying to be saviors.
"I tell students, if you want to be the messiah, you don't understand the story," Gist says.
"Messiah looks like a great job on Palm Sunday, but working conditions deteriorate remarkably over the week, and by Friday they suck." Instead, he tells students, "Be the Maytag repairman. Build a system that doesn't break down, and if it does, it can be fixed easily. Build something that can sustain itself and look for ways to help people where they are, without you getting in the way."
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