Introduction

Children are sometimes affected by ‘critical incidents’ (CIs), such as human or natural disasters or acts of aggression, which may have negative psychological effects upon them. Such CIs, whilst not being exhaustively defined, are identified as being acutely time-limited, involving a sense of helplessness and the perception of threat (Schulberg, 1974). Beeke (2011) reviewed policy and literature in the area and provided a comprehensive definition of CIs:

“a sudden and unexpected event that has the potential to overwhelm the coping mechanisms of a whole school or members of the school community. A serious and significant event, it is likely to be outside the range of normal human experience and would be markedly distressing to anyone in or directly involved with the school community” (Beeke, 2011, p.13).

Ray (1985) suggested that school staff are often the most available adults when a child or young person faces a crisis, and therefore they need to be aware of, and able to support, appropriate intervention.

An extensive review of literature, summarised below, has explored chronologically the development of school-based responses to CIs. The development towards contemporary Critical Incident Response Teams (CIRTs) made available through education services can be seen to have started in the US over thirty years ago. Arena, Hermann and Hoffman (1984) described how a model of consultation was developed as an intervention in cooperation with significant members of the community following the death of a student. The aims of this intervention were to widen understanding of the situation, to encourage the expression of feelings, and to identify ways to cope. Similarly, Blom (1986) looked at aspects of group, community and individual interventions which followed a school disaster. At a strategic level, Purvis, Porter, Authement and Boren (1991) described school intervention teams which were led by headteachers within individual schools, highlighting a key role for the school psychologist1.

Poland (1994) however suggested that school psychologists lacked training in crisis intervention but that the increased frequency and severity of school crises presented an opportunity, and indeed a mandate, for school psychologists to become involved in leading an organised response to CIs (cf. Young, Poland & Griffin, 1996). In the 1990s, there appeared an increasing number of published reports of school psychological services organising services in response to specific crisis situations. For example, in the UK, O’Hara, Taylor and Simpson (1994) and Mallon and Best (1995) described and evaluated ad hoc service responses at whole school levels following a specific CI in a school. Both evaluations identified a distinctive role for educational psychologists (EPs) in direct support and in consultation across the school community. Accordingly, Cameron, Gersch, M’Gadzah and Moyse

1 The terms ‘educational psychologist’ and ‘school psychologist’ are used interchangeably to indicate the role of a practitioner psychologist qualified to work primarily in school settings. Whilst the term ‘school psychologist’ is the more commonly used term, the term ‘educational psychologist’ statutorily applies in England which is the site of the reported research.

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(1995) and Carroll, Frew, Futcher, Ladkin, Morey, Price and Smith (1997) described the development of a psychological service strategy and guidelines to support schools and their communities in the aftermath of a CI, identifying a variety of role options. Such strategic developments identify organizational principles to support an effective service response to CI, including specific staff training in CI response work, agreed re-allocation/ re-prioritization of other work to facilitate rapid response, and identification of a service co-ordinator for inter-agency liaison and maintenance.

With the development of strategic CI interventions comes the need for practitioners, as part of evidence-based practice requirements, to evaluate research on the most effective approaches. During the 2000s debate centred around the most appropriate ways to deliver ‘psychological debriefing’ (PD) in the immediate aftermath of an incident, in particular the use of Critical Incident Stress Debriefing (CISD) (Mitchell, 1983). From a meta-analysis, Van Emmerik, Kamphuis, Hulsbosch and Emmelkamp (2002) found that many reported interventions did not report a faithful implementation of CISD and the National Institute for Health and Clinical Excellence (NICE) (2006) highlighted flaws in negative evaluation studies of CISD. However, there is also evidence that single session CISD may be ineffective or detrimental (Aucott & Soni, 2016; Stallard, Velleman, Salter, Howse, Yule & Taylor, 2006; Van Emmerik et al., 2002). Practitioner research has highlighted school- and community-based group support for CIs (e.g.La Greca, 2007; Litz, Gray, Bryant & Alder, 2002; Peake, 2001), though Dyregrov (2004) found different levels of long term distress following CIs and recommended more specialised and intensive intervention for those most severely affected, for example, by the development of Post-Traumatic Stress Disorder (PTSD) (cf. Kelly, 2005; Vickers, 2005;).

The UK Department for Education (DfE, 2013) has published guidance to outline the broad responsibilities of local authorities (LAs) and other agencies in responding to CIs and emergencies. However, the level and focus of involvement of educational/ school psychologists in this work (e.g. through provision of CISD) is less clear as there has been no published survey of practice in the area since Houghton (1996). From a grey literature search of UK psychological service portfolios through search engines and LA websites, the present researchers identified detailed information on direct involvement of EPs in CI work in several services2. Most psychological service information specifies the availability of telephone advice, individual or group support, signposting to other specialist services, consultation with staff, and verbal and written advice on trauma, bereavement and PTSD issues. Three services identified the need for schools to develop their own CI policy and procedures and four services offered training by EPs to schools in preparing for CIs.

Notably, there is little indication within the existing academic and practitioner literature about the processes of inception and maintenance of psychologists’ CI support work, which are essential considerations within complex and high-stakes work that is embedded across multiple agencies within the LA (e.g. police, medical services). Carroll et al. (1997) provide some description of the development of a psychological service CI support service, indicating decision points about services to be provided and training undertaken. However, discussions of options and rationale for such decision-making, as well as organizational or strategic issues such as governance, resource management, or intra- or inter- departmental negotiations, are not provided. Brock (2000) described the inception and development of a school district crisis policy in the USA, identifying inter-

2 Grey literature refers to written materials produced by organizations, outside of traditional commercial or academic publishing and distribution channels.

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departmental processes, change management issues and factors specific to the subject of CIs. Brock (2000) is less clear about how developed processes should be maintained through periods of personnel change, resource deficits and the long time periods between CI occurrences.

Rationale and Context for the Present Study

Given the high stakes, high intensity yet low frequency nature of CI support work, considerations of effective organizational work are essential for EPs in developing and maintaining their work as part of a CIRT. Notably, EPs’ strategic role across multi-disciplinary organizations is acknowledged to be complicated and potentially challenging (cf. Fox, 2009; Pellegrini, 2009; Stoker, 2000; Woods, Stothard, Lydon & Reason, 2013). Against this background, the aim of the present research was to explore with EPs the functioning of effective CIRTs to include details of the processes and context of CIRT inception, identification of support to be offered, and most importantly, the processes for maintenance of the CIRT.

The research was carried out in order to inform a UK commissioning Educational Psychology Service (EPS) about the elements and processes for establishing and maintaining an effective multi-agency CIRT across their LA area. The LA had previously initiated a CIRT but this had proved to be unsustainable despite a clear need for such a service within the large and diverse LA. The research aimed to make an original knowledge contribution about how CIRTs are incepted and maintained in a complex multi-agency context, which in turn would inform practical developments within the commissioning EPS which was seeking to effectively set up a sustainable CIRT.

Method of the Present Study

Theoretical framework, research design and questions.

The research adopted an open social systems theoretical framework in which CIRTs are viewed as discrete organizational entities with their own internal workings but with permeable boundaries to other proximal environmental organizational systems (e.g. the LA) (Owens, 2001). Following a review of relevant international literature, a preliminary content analysis was made of CI documentation that was available from LA EPSs within the United Kingdom. The purpose of this analysis was to sensitize the researchers in advance of an exploratory survey (Cohen, Manion & Morrison, 2007) relating to the study research questions:

How have local authorities developed critical incident support in terms of inception, support offered and response protocols?

How do local authorities maintain and evaluate a critical incident approach?

Participant recruitment.

LA CIRT recruitment site inclusion criteria were:

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CIRT in operation for at least five years

CIRT had been activated within the last 12 months

CIRT had involvement of EPs

Given the possible practical and ethical challenges to client outcome evaluations from CIRT intervention, and the focus in this study upon sustainability of a CIRT embedded within a LA, these criteria were selected as credible proxy indicators of an effective CIRT. An attempt at representative sampling through regional CIRT networks was unsuccessful and so LAs were recruited using a snowball sampling strategy, through which seven LA recruitment sites were identified. The researcher was alerted to three CIRTs during the preliminary fieldwork orientation that she subsequently contacted. Members of these CIRTS suggested other LAs that are currently involved in the work Furthermore members of the home LA and the university suggested LAs which could be contacted. The researcher had to snowball and filter as the study progressed, for example, if she found out that a recommended CIRT was not accessible, she went back and moved to looking at another LA. The researcher carried out semi-structured interviews in seven LAs which contrasted along relevant dimensions. Information gained through the literature search suggested that important dimensions were the people involved in the CIRT and the rationale/procedures for involvement. Examples of the relevant dimensions which created contrast in this study were the size of the LA, size of the CIRT and team membership (e.g. all EPs/multi-agency), thresholds for involvement, and whether work was viewed as part of generic EP role. At each of the seven recruitment sites, contact was made with the educational psychologist(s) who were centrally involved in the CIRT. From this, the lead professional for each CIRT was identified, who was, at six of the seven sites, also an EP.

Data gathering.

At each of the seven LA CIRT sites, a combination of individual and pair interviews with CIRT team members was arranged. Pair interviews were employed as an alternative to focus groups for which there were insufficient participant numbers. Across the seven CIRT sites, 16 participants were interviewed in total, 14 of whom were EPs, one of whom was a clinical psychologist, and one of whom was a senior teacher (median participant number per CIRT site was 2).

A semi-structured interview schedule was used allowing a combination of a degree of focused information gathering with flexibility for exploration (Robson, 2002; Smith, 1995) (See Appendix 1 for interview schedules). Additional questions were devised for those interviewees who were CIRT team members and had also been involved in the initial development of the CIRT (see Appendix 1). Previous review of CI documentation across other LAs had referenced a range of features relating to CIRT aims, communication protocols, and support/ advice provided, which facilitated the researchers’ best utilization of the semi-structured interview schedule with participants. The demographics of the LAs who

participated and details of the interviews are outlined in Table 1 below.

Table 1 here

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Data analysis.

Since the researchers were working across different information technology systems, interview transcript data analysis used a manual process (rather than qualitative data analysis software); organisation and security of dataset was ensured at all times.

For research question 1, a three-category directed content analysis (Hsieh & Shannon, 2005) was employed, since the researchers were specifically searching for data relevant to the three categories of CIRT inception, support and protocol(s). The first researcher transcribed the recorded interviews and, through multiple readings, familiarised herself fully with the data. She then coded all text features relevant to the three elements of research question 1, i.e. CIRT inception, support and protocol(s), including a little of the surrounding text to ensure that the context was not lost; data from each research question element and from each LA was differentiated and coded accordingly. Two steps were taken to reduce interpretive bias and to support trustworthiness and credibility within the process of analysis (Savi-Baden & Howell-Major, 2013): first, the first researcher consulted with the second researcher in relation to query codings, e.g. whether a text section was likely to be relevant to one particular content category or another; second, the second researcher independently checked all of the text codings and their categorisation then met with the first researcher to resolve any discrepancies or coding queries. No discrepancies between first and second researcher codings were evident.

For research question 2, Braun and Clarke’s (2006) six-stage thematic analysis was used for analysis of the remaining data items in the interview data, since it provides a method for identifying key patterns or themes within a large data set. A combined inductive-deductive approach to the thematic analysis was used since, whilst acknowledging a degree of factual and theoretical knowledge, the researchers did not have a priori assumptions about the nature of the data that would be elicited with relevance to research question 2. Interview extracts were grouped by the first researcher into similar content areas, e.g. ‘training’, ‘group work’, ‘future’. Once all the data had been grouped, the first researcher revisited each group, re-read the interview data to identify codes; some data extracts were coded more than once. Coded data were then arranged by the first researcher into potential themes. To reduce interpretive bias and to support credibility of the analysis, the first and second researchers then met and considered the emerging themes relating to all of the coded data; this led to movement of some codes from an original broad theme to two or more focused themes. The first and second researchers then re-read all data extracts under each code to reach agreement that they were coherent and internally consistent. Finally, the first researcher proposed organising the 26 themes identified into three superordinate themes, namely, ‘Context’, ‘People’ and ‘Process’; this superordinate organisation was checked independently by the second researcher who agreed with the suggested organisation of themes. To support trustworthiness of the process of thematic analysis, Braun and Clarke’s (2006) 15-point quality checklist for thematic analysis was adhered to, with code identification and naming cross-checked by both researchers.

Both researchers are registered practitioner educational psychologists and through this have some direct experience of working at organisational level within English LAs and of offering CI support. This relevant background experience, together with a rigorous process of analytic cross-checking, lend

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support to the credibility of the interpretive analysis presented (Savi-Baden & Howell-Major, 2013; Forrester, 2010).

Ethical considerations.

The research process paid due regard to the Health and Care Professions Council (HCPC) Standards of Conduct, Performance and Ethics (HCPC, 2012) and British Psychological Society’s (BPS) Code of Human Research Ethics (BPS, 2011). Approval for the research was granted by a University Research Ethics Committee prior to commencement of any formal communication with participants. Specifically in this research, where the interview process was a recursive and developmental process, it was important to maintain anonymity between research sites. Also, consideration was made that in pair interviews, colleagues were participating alongside other colleagues, one of whom may be a line manager, to which an interviewer must be sensitive in relation to information that may be emerging during the interview (e.g. negative organisational evaluation).

Findings

Research question 1: How have local authorities developed critical incident support in terms of inception, support offered and response protocols?

Data which described specific manifest details about the inception, support offered and protocol of each individual CIRT were separately identified and coded.

Inception. In four of the seven LAs a local CI occurrence had provided the catalyst for inception of the CIRT. In two LAs, CIRT inception had been influenced by a senior EP with a specific interest in CI support work and in one LA the inception was prompted by service review identifying a gap in expected provision. An initial step for four LAs was to seek training and in one LA a specific post, with a one day per week time allocation, had been created to support the development of the work. In another LA, a senior psychologist had been tasked with leading the CIRT development by the principal educational psychologist. Unusually, in one LA it was EPs based within a health service setting, rather than an educational setting, who had led on the CIRT development. Two LAs identified having set up a CIRT development working group, one of which set the objective of evaluating research relating to CIRT approaches. In one LA, the working group had moved on to train members of a wider CIRT team and to write the CIRT support materials.

Support. Main elements of CIRT psychological service support are shown in Table 2 below.

Table 2 here

All seven LAs identified that there was an initial telephone call/visit to gather further information and problem solve. All seven LAs also identified having being involved in debriefing or another form

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of group work. Of the support noted less frequently, in only two LAs, ‘letter templates for writing to parents/carers’ was important to look at in the context of the more general support for parents, which was identified in four LAs. Only two LAs noted that they would inform safeguarding officers if necessary, however, this is likely to have been assumed in other LAs. Support to work with the media was only referred to in two LAs and is likely to be dependent on the scale of the CIs the team has been responding to. It is interesting that of the two LAs which identified ‘24 hour support’, one had a generic response where it is an expectation that everyone within the EPS should be involved and the other had a more specific CIRT. It might be assumed that with a generic response, 24-hour support would be more feasible.

Protocol.

Though CIRT teams varied in composition, common protocol elements included telephone call from school to CIRT team leader; CIRT team leader contact to appropriate CIRT team member(s) who in turn contacts the appropriate EP; EP then contacts school to arrange/ offer support. One LA had a different approach as school advisors carry out the initial first day response with CIRT involvement only if PD is carried out and for follow-up monitoring. One LA CIRT reported keeping senior LA personnel informed about the response being delivered.

Research question 2: How do local authorities maintain and evaluate a critical incident approach?

From the seven CIRT sites, 110 codes were produced and organised into 26 basic themes, which were then grouped into three superordinate themes, namely: ‘Context’ encapsulating basic themes relating to elements, factors or processes outside the direct parameters and control of the CIRT (e.g. LA priorities; media); ‘People’ representing basic themes concerned primarily with personnel factors within the CIRT (e.g. working together; personal impact of the work); and ‘Process’ encompassing actions and interactions between CIRT structures, elements and clients (e.g. training; communicating CIRT role). All of the seven CIRT sites evidenced initial codings which were represented in all three of the superordinate themes, confirming the coherence of the analysis. However, whilst being equally significant to the final analysis, the superordinate themes are variably evident within the data and presentation of findings, which may in part be a reflection of the specific questions or sensitivity during interview, or indeed a reflection of inherent complexity or function. A summary of themes and their pervasiveness across the dataset is shown in Table 3 below:

Table 3 here

Basic theme findings are presented below in relation to each of the three superordinate themes.

Context.All of the CIRTs in this study involved the EPS and in four of the seven LAs it was solely EPs who were involved; four LAs identified that CI work specifically suits the EP role. However, there was a perceived reluctance of EPs and other services within the LA to take part in CI work: “People gradually realised that if there is a team that can be relied upon to do that then in whatever weird and wonderful financial way they will try to sustain that” (Participant 5c). In LA5 the strategic responsibility for the CIRT operation became disproportionally allocated to the psychological service, and particularly the lead EP. Employees’ lack of confidence, the perceived challenging nature of the

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work, and difficulty committing time, were suggested reasons for the perceived reluctance to take part.

The CIRT position within LA pointed to the significance of having LA senior management support: “we have been very fortunate that our managers have seen the need and supported us in doing that work” (Participant 5c). It was suggested that having support and connection with management raises the profile of the CIRT. In addition to being high profile it was important that CI work was seen as a LA priority – “there is an expectation that if something comes up it takes priority over everything” (Participant 6c) – which was identified as being easier in a large LA where CI incidents are more frequent.

Four LAs identified outside pressure for CIRT to respond in a particular way, for example, to offer counselling to staff and children: “someone from safeguarding board thinks it’s the LA’s responsibility to discharge a particular role and that compromises your position” (Participant 5a) – with the related influence of media ‘hype’: “I think we finally got it through to the local press after several years not to say that the counsellors are going in” (Participant 5c); “the media involvement determines whether it is critical or not” (Participant 6b). Four LAs reported confusion about the role of counselling within CI support offered and the need for clear communication about the potential contribution of a CIRT: “There is a place for counselling but not in initial response” (Participant 2a).

Factors affecting multi-agency ability include existing agency links, the ‘size’ of the incident (since the majority of incidents did not warrant a multi-agency response), and some schools’ initial scattergun response: “Historically, the senior EP, who was involved in that work, had managed that behaviour team at the time, so [she] included some of those people in that work” (participant 2c). In LA5 it was suggested that personal contacts with other agencies are needed in order to have success in developing a multi-agency response. Providing a range of perspectives and facilitating referrals to other agencies were identified benefits of multi-agency working.

Wider links such as sharing information with other LAs, attending regional groups, school-specific links (e.g. school chaplain) and denominational affiliation, were seen as part of a context supportive of CIRT. Smaller LAs such as LA1 and LA3 reported that their CIRTs share training and pull together their personnel resources if they do not have capacity to cover a CI; LA6 forged cross-bordering working. Two LAs reported the use of an external consultant role. At the same time, the established links provide a resource: “I always think in a small way that we are spreading the word to a huge number of people” (Participant 5c).

There was variation in clarity surrounding the CIRTs role within local emergency planning procedures. Three LAs reported being part of the emergency planning team, but others referred to lack of clarity: “We all went off to do the joint training but when asked what are we all going to do together, how do we fit in ... it wasn’t a set plan” (Participant 6a).

People.

Acknowledging a gap in provision, prior involvement in CI work, and having an interest in the area were identified as motivations for EP CIRT involvement: “you wouldn’t stick at it if you weren’t interested in keeping it going” (Participant 6b). Personnel issues included low numbers of people in the CIRT and also whether CIRT involvement was seen as a specialist role within the psychological

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service: “The team does feel very much under threat” (Participant 1a); advantages of being a CIRT member included building good working relationships and expertise.

Working together in pairs was noted as essential across all LAs, affording advantages of mutual debriefing, learning a specialist role by working alongside a partner, and maintaining responsiveness by avoiding set patterns of working; four LAs noted the advantage of similarity of background and approach as colleagues: “for that latest suicide you had to think on the spot, how can we adjust this and it would take people from different backgrounds a long time to try and get there” (Participant 6a). Six LAs identified the personal emotional impact as challenging regardless of experience, as incidents are infrequent and unique: “we would certainly be wary of people who had suffered a bereavement in their own lives getting directly involved” (Participant 4b).

Process.Communicating and operating the role of the CIRT consistently at all phases was seen as important: “...often telephone calls go to a level above and they cascade it down, but what they say is not always that helpful because they give an impression that we will do things” (Participant 6b). It was reported that, in practice, school staff most often use a system that they think and know of rather than follow the procedure set out by a CIRT: “people just think of the psychologist and ring them” (Participant 1a).

Thinking and reflecting before responding was thought to help gauge the priority and type of support needed: “It is easy to say you will rush in but what you really need to do is to get facts, get the information and step back from it.” (Participant 4b). Effectively gauging priority, talking to colleagues, and encouraging schools to think and reflect, was thought to prevent CIRT members attending crises unnecessarily. Participants extensively described the notion of a threshold in relation to involvement.

It was proposed that hypothesising and joint problem solving, having a relationship, understanding of school systems, and applying a scientific approach are some of the process benefits of psychologists being involved: “only a few people will perhaps be able to work in the joint problem solving approach rather than just telling them what to do.” (Participant 6a). Also, the process of watching and assessing the children and/or staff was another identified process element: “a key part of what we try and offer is an audit of needs” (Participant 4c).

Some schools were reported to be able to be self-sufficient following a CI, for example, sharing the news and supporting other staff members: participant 4b noted that some school staff report “actually we are doing just fine, we are prepared, we don’t think there is any cause for you to become involved”; “some local special schools work with children who have terminal illnesses and they have to deal with that on a fairly regular basis and they have skills” (Participant 2b). The decision as to whether an incident is ‘critical’ was pertinent: “who are we to say what is sad, so it is again about contact with the school and finding out where they are at” (Participant 6b). Partnership between the CIRT and the school staff was seen to balance mobilization of school capacity with providing direct and specialist support: “[The CIRT aims to] make schools more self-sufficient, self supporting…[but] they will always need support, depending on the incident.” (Participant 6b).

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Ongoing training was sourced externally, in-house, and via CIRT team case discussions (group supervision). The question of whether all CIRT members need to be trained in all CI support methods, or whether different specialisms could be developed, was raised: “...have groups of people who can do things with a lot of confidence and they can be moved around within the service and the whole organisation as they are needed” (Participant 4c); in LA5 specialisms were developed from the outset.

In all of the LAs a version of debriefing type group work was reported to be offered if deemed appropriate. However, issues related to the delivery of post-CI debriefing included its time consuming training, infrequent use/ practice of debriefing, duplication by other agencies, uncertainty around timing of delivery, appropriate group size, and agreed identification of contra-indication: “we went in and did debriefing using the model and there was some dissent amongst us about whether it was appropriate” (Participant 6a). A range of examples of widening support offered by CIRTs included consultation and training working with special schools, pre-schools, and hospices, raising staff awareness of the impact of bereavement, though such aspirations are often limited by available resources.

In three LAs, skills transfer (succession planning) within the CIRT was identified as crucial: “Frankly you and your colleagues are the future of this and I think we need to make sure we have got to a point where we have transferred that confidence and skills over” (Participant 4b). One LA had developed a specific strategy (‘first contact group’) to empower other colleagues within the EPS to get involved in CIRT work3.

Structural changes in LAs were reported as creating particular challenges for maintaining the integrity of CIRT processes: “They [the LA] have been restructured so much and I think the key people who were involved have gone to do other things” (Participant 2b); “...organisational changes around us have been a challenge.” (Participant 7a).

Several issues arose regarding CIRT evaluation, including: timing of evaluation – “because it was some time later I went back, it was strong enough in minds to remember, but far enough away not to be too painful” (Participant 6a); variety of approaches (e.g. review meetings, self-evaluation, evaluation forms, incidents logs, commissioned research, anecdotal feedback); linking evaluation to development; ethical sensitivity of service evaluation around CI.

Discussion

The present study offers a unique insight to the development of CIRTs within LAs, and the role of EPs within that. CIRTs pose particular challenges in respect of inception, the structuring of support, and maintenance on account of their intermittent operation. However, two limitations obtain within the reported research: first, data were gathered primarily through EPs themselves, which potentially limits the comprehensiveness of the dataset; second, the context for CIRT work within LAs has possibly developed rapidly since the present data were gathered, against the wider background of government concern relating to possible civil security threats and the associated CIs that may arise

3 EPs come together to talk about the support offered to schools, using scenarios to model possible responses and language used; CI involvement opportunities are offered out to non-CIRT team members as they arise.

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(HM Government, 2015). Nonetheless, EPs could be considered to be very reliable informants on CIRT processes by dint of their primary involvement, and whilst the context for CIRT operation may have developed, the core features likely remain the same. Accordingly, from the analysis and synthesis of findings, a theoretical pre-model was generated (see Figure 1 below) focusing on the development and sustainability of CIRTs.

Figure 1 here

The pre-model is designed to integrate superordinate themes of Context, People and Process, and their associated subthemes, which have emerged from this analysis as being significant to developing or maintaining a CI response. The pre-model can be used as a tool to guide decision-making on key questions for those involved with CIRT development and maintenance. Having an existing relationship with a school, understanding of the school system, and the practice of hypothesising and joint problem solving, are suggested as benefits of involving psychologists within the CIRT. Findings revealed a confidence in psychologists’ scientific approach and use of psychological theories to support researching ideas, creating resources, and training. Cameron (2006) notes that CIs are one of the complex problem situations that occur where applied psychologists have to use psychology in an innovative and creative way in order to provide both a coherent and integrated perspective. Cameron (2006) proposes five distinctive factors which make the EP’s perspective different from that of other professional groups. Two of these apply particularly to CIs: Using research and theory in psychology to recommend evidence-based strategies for change; promoting innovations informed by psychological research and theory, which can enable clients to identify opportunities for positive change. Interestingly, monitoring and evaluation as key components of the scientific method would need to take account of capacities developed through CIRT involvement, which then enable schools and communities to become self-sufficient in the context of future CIs. However, given a perceived reluctance to take part in CIRT work and some ambivalence about the appropriateness of EPs’ involvement, there is potentially a risk that a lead CIRT psychologist (or other LA worker) assumes sole strategic responsibility. To support stability of the CIRT, a practice of shared, or distributed, leadership, could be established, either through the use of a deputy CIRT leader, or a working group where roles are linked to specific agencies. Shared leadership may also mitigate consequences from the challenging nature of CI work.

Both advantages and disadvantages of multi-agency approaches have been raised within the analysis and so a strategic decision therefore needs to be made as to where a multi-agency response should be made and by which agencies. Notably, in scoping post-CI psychosocial support, Posada (2006) reports a large amount of data gathering on the services already provided within a borough. Farrell, Woods, Lewis, Rooney, Squires, and O’Connor (2006) report that EPs are well placed to map provisions across a LA and to ‘oil the wheels’ of joint working and decision-making. Similarly, the findings highlighted the significance of school staff’s existing wider links which potentially highlights provision gaps to focus the mapping of CIRT support from across the agencies. Furthermore, the present research signals the use of regional networks in providing benefits to CIRT capacity and range through cross-authority sharing of information and resources, including personnel.

Posada (2006) recommends that, when developing a LA response, multi-agency training needs to be set up “to ensure that agencies have information about each other’s roles and responsibilities, a

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collective awareness of trauma, the needs of those affected, and how best to support them” (p.210). This is supported by the present research which identified confusion about the appropriateness of providing counselling and/ or debriefing, and the importance of communicating the CIRT role accurately and consistently. EPs, as scientist-practitioners, would need to evaluate practice in relation to research evidence (Lane & Corrie, 2006; NICE, 2006).

The findings also raise the issue of when a CIRT should provide support, whether there should be a ‘threshold’ for intervention, or whether it should be dependent on a school community’s ability to cope and manage. Adopting an objective threshold may help a CIRT to manage resources and structure responses, particularly when there is high demand. Also, if the CIRT aim is to build capacity in schools for post-CI coping, then resources may need to be focused on assessing capacity, pre-CI training and preparation, though one view is that some basic level of direct support would always be needed. Alternatively, a more socially constructed view about the needs of a school community would indicate a move away from any preconceived notion of ‘thresholds’ for support. In any event, communicating the role of a CIRT may be better seen as an ongoing process, rather than a one off event, due to the restructures and changes in personnel which occur in LAs.

School staff tendency to make initial post-CI contact with existing contacts, rather than follow defined CI response protocols, raises a question about the positioning and structuring of the CI response work as generic or specialist. The authors would predict a simple/ flatter structure, with the flexibility to cope with a variety of ways of seeking support, to be more effective for service users. Therefore a generic support approach, in which all EPs act as a first point of contact and lead on CI response within their area, may be supported by specialized training, and can avoid the loss of valuable expertise from a team where that is vested within one individual. In addition, Conversely, the embedding of specialist skills and protocols (e.g. PD, Cognitive Behaviour Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR)) may be more difficult when spread more thinly across a team of psychologists for reasons such as cost and practice opportunity. A further issue to consider in skills development and maintenance concerns the ethicality and feasibility of effective ‘learning on the job’ as CIRT work is infrequent and often high stakes; Posada (2006) proposes simulations as a way of developing and researching the effectiveness of CIRT support. However, with the growth in traded services, within UK LAs the low incidence, but high maintenance, work of CIRTs may be threatened. Traded services’ refers to a common EPS service delivery model within England. In this model, schools directly buy in EP services using funds delegated from local authorities. Potential effects of this is seen as increased scaling of service to demand, increased choice of schools in accessing children’s services, reduced child/ family choice in access to services, and decreased EPS capacity to engage in strategic or maintenance activities (Lee & Woods, submitted; Woods, 2016). Within the climate of traded services strategic and development work may be seen as more difficult as operations may be driven by the immediacy of contextual factors in the environment (Lee & Woods, 2016; Woods, 2016).

Notwithstanding any claim to a degree of analytical generalizability of the presented pre-model, its detailed definitions, internal mechanisms, and wider theoretical generalizability should be tested through data from a broader range of sources, for example, through the study of ‘unsuccessful’ or now defunct CIRTs to identify the extent to which the converse of the pre-model elements apply in such contexts (Yin, 2013). The pre-model could also be tested with different kinds of successful CIRTs. These could be other non-mandatory, professional, low incidence, rapid response type work

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teams where members have to work with a range of different people. It could be within other disciplines or voluntary services. Future research in this area would inform the extent to which the pre-model can be used by LAs and be developed into a more detailed general model incorporating dynamics and outcomes.

Conclusion

The present research highlights the importance of LA senior management support for, and connection to, the work of the CIRT. The research findings predict greater stability where CIRTs are integral to the wider emergency planning and support offered following community disasters (DfE, 2013). At the same time, a generic EP role within CIRT, with some support provided at targeted or universal levels, may contribute to embedding of CIRT services. At whole profession level, initial professional training could evaluate the preparedness of newly qualified EPs to contribute to CIRT work within LA and other service delivery settings.

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Appendix 1

Semi-structured interview schedule for CIRT members

[Note that additional question and prompts for those interviewees who had been involved in the initial development of the CIRT are in italicized font.]

1) When did the EPS or LA first become involved in critical incident support?

2) Can you explain the process by which you implemented it?

Prompts

- A team of professionals (working group), which ones and why? Example of recent management activity and operational activity, what goes on to organise it?

- Did people go off and research things?

- Impetus and experience of similar, previous knowledge of CIRT ,what if they are not the initiator but the inheritor, more about maintenance and development

- In liaison with schools?

- Involving management within children’s services?

- Are you part of the emergency plan?

- Can you explain how decisions were made?

- Were there any barriers?

- Were there any drop out/capacity issues?

- Were modifications needed?

- CIRT structure

- What is your theory of its sustainability?

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3) Can you talk through a recent example of its operation?

Prompts

- Is that the way it always works?

- Are those the people who are normally involved?

- A team of professionals (which ones, why)?

- Just the EPS?

- Are you part of the emergency plan?

- What support is offered (consultation, training, CISD)?

- Long/short-term support?

- Documentation distributed?

4) How would you like to develop in the future?

Prompts

- Any areas that you think need further research?

- Working in special provision?

5) How is the service evaluated?

Prompts

Questionnaires/simulations/anecdotal

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