What track would CISM fall in?

[Eclipse]

I have a new member who is a professional counselor and very interested in CSIM.  What track would best fit that?

ES, I suppose, but that seems a stretch as the ES track is more about managing ES programs then being an operator.

I don't want to hamstring her today with a track she is unlikely to be able to complete to the master level down the road.

[JeffDG]

As a professional counselor, maybe Health Services?  Just a stab in the dark on my part.

[Eclipse]

As a professional counselor, maybe Health Services?  Just a stab in the dark on my part.

A good stab, but there's very little if any mention regarding mental health professionals, and
no specialty track to speak of - same potential problem.  Members get an initial click for their
degree and then are stuck because there's no way to actually do anything, not to mention
there's no real "job" for this beyond CISM, which is where she can be valuable.

I know she wants to come up organically and that CISM is just one thing on here list.

[JeffDG]

As a professional counselor, maybe Health Services?  Just a stab in the dark on my part.

A good stab, but there's very little if any mention regarding mental health professionals, and
no specialty track to speak of - same potential problem.  Members get an initial click for their
degree and then are stuck because there's no way to actually do anything, not to mention
there's no real "job" for this beyond CISM, which is where she can be valuable.

I know she wants to come up organically and that CISM is just one thing on here list.

However, HSOs are exempt from PD requirements for promotion, so they can take their rating and promote normally.

[lordmonar]

Try Character Development or Health Services.

As for no job for this.....it is no different then being a Mission Pilot.  They may or may not be in the ES specialty track.
So.....steer here towards the CISM tract and get her spun up in some other PD track that suits your units need, her needs if CD or HSO is not the best fit.

[KASSRCrashResearch]

Members get an initial click for their degree and then are stuck because there's no way to actually do anything, not to mention there's no real "job" for this

Agreed.  Is there are a less useful track in CAP than health services?  That's not entirely sarcasm.  I'm actually kind of curious as to everyone's opinions. 

[Chaplaindon]

As the former Deputy Director for CISM at National, and co-author of the current CAPR 60-5, I can tell you that, the CISM program was always intended to be an Operations program, as evidenced by the regulation being a 60-series one.

Unfortunately, in an apparent moment of command myopia, in late 2007 or early 2008 the then-CAP/CC moved the functions of CISM from operations to the dead-end "backwaters" of Health Services, where it languishes today, in spite of officially being an Operations program (per 60-5).

The move destroyed many years of work and devastated a nationwide CAP CISM Team infrastructure that had begun to be truly effective. I know of -at least- one (1) life DIRECTLY SAVED by the program and its founder Lt. Col. (now Dr.) Sherry Jones.

As a former Flight Paramedic who'd been the recipient of civilian CISM interventions long prior to my involvement in the CAP CISM program, and as (then) a CAP SAR/DR IC (long before becoming a Chaplain), I can vouch for the efficacy of CISM and the irreparable damage done by a past National Commander.

For the record, I retired from CAP as a direct result of the move of CISM to HS (and the concurrent removal of Col. Jones).

With that history as a sort of preface, let me suggest that a Professional Counselor who wishes to participate in the CISM program focus their PD (even if they CAN be exempted by choosing to be a "Health Services Officer") in either Operations or Emergency Services.

The most useful "Mental Health Professionals" (MHPs) and/or "Clinical Directors" (CD) for CAP CISM, in my personal and professional experience, are those who share ES or Ops experience with those they are seeking to assist. Engagement with the ES/Ops side of CAP will be an invaluable asset to any CAP CISM MHP or CD  ... see CAPR 60-5, 4 (a) 1-2 for those definitions.

So a "Professional Counselor" who aspires to serve with CAP's CISM program as a MHP or CD would best serve the program's intentions, the efficacy of CISM, and ultimately the membership by actively immersing themselves into the Operations and/or ES PD program. CISM is not clinical medicine, it is operational support. It's hard to support something if one is unfamiliar with, or functionally detached from, it.

Likewise the membership would be best served by the current CAP/CC removing CISM from HS and returning it -functionally- to Ops (where the regulation mandates it to reside).

My $0.02 worth.

[KASSRCrashResearch]

As a former Flight Paramedic who'd been the recipient of civilian CISM interventions long prior to my involvement in the CAP CISM program, and as (then) a CAP SAR/DR IC (long before becoming a Chaplain), I can vouch for the efficacy of CISM

Ah....nice anecdote.  Now here's mine followed by a crap ton of actual data.

As a former EMS provider I was fed the same "CISM/CISD is a great tool for preventing PTSD/posttraumatic depression/nightmares/halitosis/gout/accidental death and dismemberment/emasculation via chainsaw.  It's a godsend for emergency services!" indoctrination.  You know....just like we were taught that spine boards, MAST pants, universal large volume fluid resuscitation for trauma and hyperventilating all head trauma patients were great ideas (for all of you not of a medical background all of these are things that have been proven not to work like they were once thought to or have been found to only be useful in a very narrow set of circumstances).  Then I paid attention to the science  but first, I got to experience CISM/CISD firsthand

I've been on the receiving end of quite a few debriefs in the name of avoiding PTSD in several states (Indiana, Maryland, Illinois, Ohio, Kentucky...) with quite a few different providers handling the 'organization' of it.  I have to say that it wasn't all it was cracked up to be and in one very, very bad case it made my recovery far worse because I basically had to listen to my colleagues describe the pediatric gunshot wound case we had just worked a few hours before. 

That case messed me up enough as it were.  I went into the debrief feeling really unsure of myself and hurting.  I came out of it feeling like I had worked it a dozen times over and like I was a worthless excuse for a provider to the point that I was ready to turn in my badge and resign my certification.  Basically I was left emotionally shattered and raw because I didn't feel like I was allowed to leave.  Whenever I tried to, I was more or less guilt tripped into staying by statements about how I needed to "stay for the team" and "Don't you care about your colleagues?".  The same sort of tactics I encountered in every CISM/CISD event I took part in.  The last time I was involved in an event that had one mandated- after a burn case involving a child on Christmas morning- I literally told my boss that he had two choices: fire me/let me quit or make the CISM guru get out of the doorway so that I could leave.  She was standing there blocking it as she tried to convince me to take part with the same "for the team" crap.

Without the debriefing which was led by one of the leading proponents of CISM/CISD in the Midwest and a guy who had been trained by Mitchell himself (as he told us repeatedly during the briefing), I probably would have taken a couple of days off of work, gone fishing and drank a few beers.  With it, I was off work for almost three weeks and back and forth off the 911 truck for another two because I kept having issues with anxiety every time we'd get a call. 17 years on and I still tend the kid's grave.  Now, I freely admit that it's not definite that the CISM worsened my condition but it sure as heck didn't help.  But saying that "It worked for me so it has efficacy as a concept in a broader application" isn't anymore of a valid argument than saying that being born on Friday means you'll be wealthier.  It might work for some but it doesn't seem to pan out on a large scale.

If one starts looking at the hard facts, most of the claims don't hold up to scrutiny or are based only on very tenuous science.  Independent review- the hallmark of medical science or any science for that matter- has been less than glowing in it.  See:
Van Emmerik AAP, Kamphuis JH, Hulsbosch AM, Emmelkamp PMG. Single-session debriefing after psychological trauma: A meta-analysis.  Lancet 360:766–771, 2002  AND
Rose R, Bisson J, Wessley S. Psychological debriefing for preventing  post traumatic stress disorder (PTSD). Cochrane Review, The Cochrane  Library, 2002

The proponents tried to put together counterpoint analyses but these were ripped apart by Robert Ursano (who probably has more knowledge and clinical experience with the reactions to death, warfare and disasters than just about anyone on the planet) and his colleagues.  See: Fullerton CS, Ursano RJ, Vance K, Lemming W. Debriefing following trauma. Psychiatric Quarterly 71:259–276, 2000  The takeaway point says it all:

Reports cited in a meta-analysis by Everly, Boyle and Lating; and Everly and Boyle, are not representative outcome studies.

Basically, Everly, Boyle and Lating pretty much used random anecdotes and tried to pass it off as hard data.  Not smart when you're facing people who know how to read a statistical analysis.  You might fool a bunch of cops, firefighters and paramedics but it's much harder to pull a fast one on someone who has a substantial amount of statistics education under their belt.

But you know...maybe those folks weren't independent or had their own model to sell.  So let's look at the three year study FEMA did on it involving like 600+ firefighters including part of the group that worked the Oklahoma City bombing.  SEE: Harris MB, Stacks JS. A three-year five-state study on the  relationships between critical incident stress debriefings,  firefighters' disposition, and stress reactions. USFA-FEMA CISM  Research Project. Commerce, TX: Texas A&M University, 1998.

Harris MB, Balolu M, Stacks JR. Mental health of trauma-exposed  firefighters and critical incident stress debriefing. J Loss Trauma  7:223–238, 2002.

The takeaway?  People generally felt WORSE after the debriefs but had a somewhat better picture of the world and their roles and status in it.  Sounds good right....except for that this was a very weak positive correlation so it's arguable that it might have been caused by something else that wasn't measured directly that had nothing to do with the debriefings.   But what about the bread and butter, the thing that CISM is supposed to be the key in the fight against: PTSD.  No correlation, positive or negative, was found.  Aww shucks.  Better luck next time right?  Let's try a different continent.  Maybe Americans are just tough nuts to crack (no pun intended).

Carlier IVE, Voerman AE, Gersons BPR. The influence of occupational  debriefing on post-traumatic stress symptomatology in traumatized  police officers. British J Med Psych 73:87–98, 2000.   243 cops were randomized and studied.  While there were no significant differences in the baseline, at 24 hours post-trauma or six month post trauma....you read for this?  At one week post-trauma, the debriefed subjects has HIGHER rates of PTSD symptoms than their non-briefed counterparts.  So....no long term benefit and in the short term the odds are that you'll worsen the symptoms.

An earlier study by the same group, also involving police officers as subjects found no difference early on but at 18 months the debriefed group had a higher rate of stress-related symptoms (what is technical known as hyperarousal).  See: Carlier IVE, Lamberts RD, van Ulchelen AJ, Gersons BPR.  Disaster-related post-traumatic stress in police officers: A field  study of the impact of debriefing. Stress Medicine 14:143–148, 1998.

Back to this side of the Pond.....British Columbia and an air ambulance crash.  Looking at docs, nurses and medics involved in the case they found no evidence that CISM did anything for stress symptoms either in frequency or severity.  There was an important finding here that might actually be useful Those who had pre-established routines or methods for coping with stress in healthy ways had fewer and less severe symptoms at six months post-event.  Hmmmm...having moved from full-time EMS to forensics, allow me to point out that we call this a "clue".    SEE: Macnab AJ, Russel JA, Lowe JP, Gagnon F. Critical incident stress  intervention after loss of an air ambulance: Two-year follow-up. Prehosp Dis Med 14(1):8–12, 1999

In another study, this time looking at persons injured in car accidents,  debriefing increased the levels of hostility and psychiatric symptoms four months out in patients while levels of anxiety and physical symptoms (what's called somatization) declined more significantly in the non-debriefed control group.  SEE: Hobbs M, Mayou R, Harrelson B, Worlock P. A randomized controlled  trial of psychological debriefing for victims of road traffic  accidents. Br Med J 313:1,438–1,439, 1996

Same group, three years post-event the long term followup from a psychiatric standpoint was worse for the debriefed group although only slightly so.  The really important findings here though were that the debriefed group had recovered less quickly, had greater degrees of impaired functioning (even when accounting for the differences in physical injury severity) and had higher degrees of personal and financial issues.  SEE: Mayou RA, Ehlers A, Hobbs M. Psychological debriefing for road  traffic accident victims: Three-year follow-up of a randomized
controlled trial. Br J Psych 176:589–593, 2000.

Over a year out, burn victims reported worse anxiety, depression and PTSD if they had been debriefed versus similarly injured persons who had not been debriefed.  (Rose S, Brewin CR, Andrews B, Lirk M. A randomized controlled trial of individual psychological debriefing for victims of violent crime.  Psych Med 29:793–799, 1999)

Back to looking at responders, this time Norwegian firefighters who had been exposed to what almost half of them described as the worst fire they had ever seen.   This was a very early and very informal form of CISD/CISM with everyone just talking to their colleagues.  No difference was noted between the study group and the control group.  The important takeaway point in this one was that despite this being described as a landmark for many of the subjects and it involving a high degree of stress, the rate of significant psychiatric symptoms was surprisingly low.  There may be a reason for this and how it contrasts with the other studies: there is a tendency with CISM/CISD to "pathologize" what may well be normal and even healthy reactions to stress.  If you treat a person like they are broken or are really invasive in seeking symptoms, especially when they are already vulnerable- because, well, if you aren't having symptoms to some degree by seeing a dead kid or a horribly mutilated colleague (or in my case holding a friend's brains in your hands at autopsy after a medical helicopter crash; I do crash survivability research....it's part of the job)  then you are either lying, not paying attention or you're a sociopath- then they start to think "Maybe I am broken?".  Not all grief or stress is pathological.  We shouldn't treat it as such and unfortunately, just like the old saying "If you see yourself as a hammer, all you'll find is nails", if you're trained to be aggressive and see a person who is still processing what happened as having a major psychiatric illness, guess how you're going to treat that person.

SEE: Hytten K, Hasle A. Fire fighters: A study of stress and coping. Acta Psychiatr Scand 80:50–56, 1989

Welcome to why in recent years the original model (and CISM to a large degree) has been abandoned- to the point that Mitchell and his disciples basically started their own journal because it was so much easier when you didn't have critical peer review getting in the way- for methods that are more grounded in science rather than the "Eh....this should work.  I think it works.  Let's do it" approach of Mitchell and his disciples.  I mean what can you expect from a psychological treatment that wasn't first tested before being tossed out into the emergency services community in a trade magazine.  No, seriously....that's how it was done. (See: Mitchell JT. When disaster strikes...the critical incident debriefing process. JEMS 8:36–39, 1983)

Now, don't get me wrong.  Being there for each other and knowing how to handle a person who is going through a tough time is important and I am currently parked up the rears of some fire officers about getting the department set up with a functional system so that we don't lose good people to either suicide or just having to walk away from the field to save themselves.  It's really, really, really important but the CISM approach has so many holes in it scientifically that it simply doesn't hold water no matter how much we want it to. 

The better approach seems to be a less formal approach with more emphasis on allowing the individual to come forward for one-on-one peer counseling (with referral to professionals if necessary) rather than the model that was common from the mid-1980s through the early 2000s where grief counselors basically circled like buzzards anytime there was a mass casualty incident.  I've experienced both ends and des


As one of the studies I mentioned pointed out, folks who had well developed stress management skills BEFORE the event tended to have better outcomes.  Maybe instead of worrying about having a little group therapy session post hoc the more professional approach is getting everyone trained to recognize the signs and symptoms in themselves and each other and how to deal with it.  Why not prevent the fire instead of trying to put it out after it starts?

the irreparable damage done by a past National Commander.

It's nice to have that one person to scapegoat but it's not "irreparable damage" done by someone with an agenda....unless the CAP National Commander happens to be in cahoots with:
-the National Institutes of Mental Health, Department of Health and Human Services, Department of Defense, Department of Veterans Affairs, Department of Justice and the American Red Cross: they held a consensus meeting that after an obscenely anal retentive review of every bit of literature they could get their hands on said that CISM nor any other form of routine psychological debriefing could be recommended as a standard early-intervention practice.  SEE: National Institute of Mental Health. Mental Health and Mass  Violence: Evidence-Based Early Psychological Intervention for  Victims/Survivors of Mass Violence—A Workshop to Reach Consensus on  Best Practices. NIH Publication No. 02-5138, Washington, DC: U.S.  Government Printing Office, 2002, 

-The World Health Organization: "Because of the possible negative effects, it is not advised to organize forms of single-session psychological debriefing that pushes  persons to share their personal experiences beyond what they would normally share."  SEE: World Health Organization. Mental Health in Emergencies: Mental and  Social Aspects of Populations Exposed to Extreme Stressors. Geneva:
World Health Organization

-The British National Health Service: "Review of the best-designed studies  suggests that routine debriefing (a single-session intervention soon after the traumatic event) is not helpful in preventing post-traumatic  disorders."  SEE: Parry G, Chair, Development Group. Evidence-Based Treatment  Guidelines in Psychological Therapies and Counselling. Department of
Health, National Health Service, United Kingdom

-NATO *AND* the Russians working together: "There is still no  consensus on the role, if any, of very acute interventions. CISD can no  longer be recommended." SEE: North Atlantic Treaty Organization. North Atlantic Treaty  Organization (NATO)-Russia Advanced Research Workshop on Social and Psychological Consequences of Chemical, Biological, and Radiological Terrorism


-The New South Wales Department of Health during the run-up to the Sydney Olympics: "There is no evidence that [CISD] prevents PTSD or other psychological morbidity,  and it may make some people worse."  SEE:  New South Wales Health Department. Disaster Mental Health Response  Handbook: An educational resource for mental health professionals  involved in disaster management. NSW Health Department, Sydney, NSW,  2000
   
-AND A FREAKING CRITICAL INCIDENT STRESS PROFESSIONAL GROUP (Australasian Critical Incident Stress Association):
"Experience and systematic  investigations have revealed a marked discrepancy between outcomes once  presumed to be achievable (Mitchell, 1983; Mitchell and Everly, 1995)  and those that can be reliably delivered (Rose and Bisson, 1998)."  SEE: Australasian Critical Incident Stress Association. Guidelines for  Good Practice for Emergency Responder Groups in Relation to Early Intervention after Trauma and Critical Incidents (Glenelg Declaration),  1999

-The British Royal Navy and Royal Marines: "Psychological debriefing cannot be considered safe, and thus it should
not be routinely used."  SEE:  Greenburg N. A critical review of psychological debriefing: The  management of psychological health after traumatic experiences. J Royal Naval Med Serv 87(3):158–161, 2001

===================
Your sacred cow wasn't sacrificed over politics.  It was taken out and mercifully put down when it became clear that it wasn't able to pull the plow like it was supposed to do.

By the way, there's seriously no offense intended.  I just have a tendency to be a very aggressive debater especially when someone is advocating something that has been largely discredited for at least 15 years.  Usually this sort of stuff still has advocates because of a lack of exposure to the evidence and because we tend to associate with folks who validate our beliefs ("Dr. SoAndSo has an actual CAP save because of this" as an example) and we will see efficacy in what we do even if it's not able to be validated when someone looks at it.  That's just natural human thinking.  It's also why research- actual hard, statistical research- is so vitally important.  If you were really "truly effective" then you should have the records to back it up and CAP could have been the landmark study that salvages CISM.  No offense, but given all of the very well publicized debunkings of CISM- even if you just read JEMS or EMS Magazine you should have noticed it- if I had a stake in it and saw someone saying "no evidence, no evidence, inconclusive, harmful, harmful", I would have gotten the data together, blinded it and published it.  The joke we use in the field I work in is "citation or GTFO".  The same applies here. If you really had an effective team and structure, then you should have more to show for it than just a couple of off the cuff anecdotes.  The days of such things dictating a standard of care are thankfully vanishing in the rearview mirror of emergency and prehospital medicine.

[Chaplaindon]

Well, I guess you put me in my place.  :clap:

[Spaceman3750]

The best CISM I've ever found is a cold beer with friends, but that's just me... My limited experience with real world finds has told me that peer to peer discussions did provide more than what the CISM people were able to.

That said, CAP does still have a duty to provide help to those who have been exposed to potentially traumatic situations "in the line of duty" when needed, and that doesn't go away just because we say CISM debriefings don't work.

[EMT-83]

I'm certainly no expert, but I've always thought that tailboard debriefings were more beneficial than structured CISM sessions. They both probably have pros and cons.

[KASSRCrashResearch]

The best CISM I've ever found is a cold beer with friends, but that's just me... My limited experience with real world finds has told me that peer to peer discussions did provide more than what the CISM people were able to.

That said, CAP does still have a duty to provide help to those who have been exposed to potentially traumatic situations "in the line of duty" when needed, and that doesn't go away just because we say CISM debriefings don't work.

Agreed on both parts.  I think a more evidence based approach is in order and even though I'm not a mental health practitioner, I am happy to help try to arrange that. 

I'm certainly no expert, but I've always thought that tailboard debriefings were more beneficial than structured CISM sessions. They both probably have pros and cons.

Tailboard debriefs/AARs should be viewed as essential for even successful, routine operations from a "how did we do and how do we do better next time?" standpoint.  If you're not answering five fairly basic questions, you're missing out on a lot of opportunities for improvement and to pick up on near misses that could eventually lead to disaster.  They are:
-What was the intention/goal?
-What went well?
-What could have gone better?
-What should have been done differently?
-Who needs to know about this information? (immediate team, squadron, group, wing, national, beyond?)

I will also put forth that in a technical discussion it's often best to discuss the situation in as detached a manner as possible.  It's not so much a matter of "who shot whom".  Doing discussion in the third person also helps to get at the root issues in many cases and to avoid angering people because of ego issues.  The same goes for keeping anyone who wasn't part of the event or doesn't have a regulatory/legal requirement to be there the heck out.

Sorry....even though I am not a CAP safety officer (yet), this is kind of my thing.

Implicitly using tailboard debriefs for mental health issues- beyond a very general "If anyone needs to talk, you can always come to me" or something along those lines- it becomes a little more tenuous.  It can cross the line into putting pressure on someone to talk that doesn't want to and that's where it becomes possible to cause harm.   You (or your unit) put a lot of time, effort and expense into training a person so doing something that could, at worst, really harm someone or cause them to quit the team or, at best, ruin any trust they have in you is something not to be taken lightly.

[Chaplaindon]

This thread has run so far afield from the original question so as to not only miss the parallel runway but perhaps the majority of the surrounding continent.

The original question focused on what would be the proper PD track for a Mental Health Professional, who wished to become involved with the CISM program, to proceed with.

I stand by my answer that an Operations and/or Emergency Services PD track would be best.

That said, I feel the need to remind everyone that, regardless of one's personal opinion(s) (and/or annotated bibliography) that CISM is a mandated program. It is required by CAPR 60-5.

For those who need footnotes, or those new to CAP (or its Ops/ES missions), or anyone otherwise insufficiently informed, the regulation may be viewed here: http://members.gocivilairpatrol.com/media/cms/u_082503073826.pdf

Again, it is a mandatory operations program.

While one's personal opinions about any mandatory action (or CAPR) in CAP, from disliking BDUs, limiting the use of member-owned aircraft for most missions, to limiting the pilot seat on our aircraft on SAR/DR missions to those over 18 years of age, or the differentiation of AFAM and Corporate Missions, etc., are fine and excellent fodder for CAPTalk debate and/or dead equine punting ... BUT we must never lose sight of, nor compliance with, the REGULATIONS.

We must follow the CAPRs ... something that's taught from Level-1 (or the 1st cadet achievement) forth.

Familiarity with the pertinent Operations/ES CAPRs in an essential part of ES qualification.

To others here, who've seemed to pillory CISM, how about reading the original question and trying to answer Eclipse's original question ...

Also, if you wish to eliminate CISM from CAP, CAPTalk diatribes, alone, won't do it anymore than it'll change the CAP field uniform to the USAF ACU with 2-tone Saddle Oxfords.

An opinion in CAP (with or without footnotes) and $8.50 will just about buy you a cup of coffee at TooManyBucks. That's about it.

I speak from decades of CAP experience on that one.

There is a chain of command that suggestions may be sent through seeking a change, or redress (or elimination) of CAPR 60-5; give it a try ... who knows maybe Saddle Oxfords will make a comeback too?

Best of luck.

[KASSRCrashResearch]

Again, it is a mandatory operations program.

Guess it's time to get the "mandatory" in line with the standard of care as of 15 years ago.

Otherwise, it's more than just a bad joke it's practically gross negligence if one wishes to apply the definition of it that the New York Court of Appeals used in Sommer: because it has the "smack of intentional wrongdoing" which "evinces a reckless indifference to the rights of others".  You know (or reasonably should know given your position, education, training or experience) that it doesn't perform as you claim yet you do it anyhow. To wit, one who insists on standing by a  is toeing perilously close to the line that was described in another legal decision: 'want of even scant care' or 'an extreme departure from the ordinary standard of conduct.'  No matter how much you want to believe or an out of date regulation states that something is "mandatory", the organization is still liable if it violates a standard of care and harm results.  It's probably best that they pulled the brake on this before someone decided to sue.  Even if it gets thrown out, that's not a cheap process to go through. 

It's not "pillory" when you simply say "Hey....it doesn't work" nor is it one person unless I missed the bit where I am a dozen or so international agencies personified.  Which, if that's the case, I am way underpaid. 

It's no different than looking at the guy trying to taxi a plane where the engine keeps sputtering and dying and pointing out there's a problem.  I don't think any of us would not go "What are you doing?" no matter how convinced the pilot was that he's right.  The same applies here. 

[Eclipse]

This pretty much confirmed my understanding and experience with CISM and its place in the CAP universe.

Like a lot of things in CAP, there are anecdotal successes, but poor implementation, members with agendas, lack of a clear vision, and
politics, not to mention a shortage of manpower, has turned something which can be a benefit in some circumstances
into a checkbox in most cases.

I agree that ES is probably the way to go, with the caveat that the member would struggle above Technician unless they
are fully invested in actual ES operations - that's my primary concern.  I don't want to handcuff an otherwise active
member into 3-5 years of strong activity only to find they are stymied because Master in "whatever" requires participation
at a level either generally unattainable, or that they would not be interested in.

At some point CAP needs to take a hard look at the ancillary areas and make difficult choices about whether they
are still, assuming they ever were, appropriate to today's CAP.  CAP wastes so much time, manpower, initiative
and benevolence making promises it cannot possibly keep, or setting new members up with ideas about operations
that are simply not practical in reality.

[lordmonar]

Well......that's sort of the way it should be.

One should not be getting a senior or master rating in any specialty with out getting invested in that specialty.

I think that it is too easy for CAP members to get master ratings....and the rank that it opens up....with out actually doing the job at the master level.

If a member wants to do CISM.....good on them.   CISM is mostly an operations/ES sort of job and so ES would be the closest match.   That means they can only advance to the senior rating with out moving up to the wing/region ES positions.  Which is, IMHO, as it should be.  Same should be true with any specialty.   Only want to do CS at the squadron level.....or just be a GTM or Just be an MP......then your specialty level (and your rank) should reflect that.

Want to be a Master Level Lt Col......then you should be ready and able to move beyond just squadron level operations.

YMMV.

[Eclipse]

I actually agree with that, and then you have HSO...

And your points about being an operator and staying at company grade too, the trouble is that isn't how things are actually
done in CAP, and the expectation is that most members can get to an oak leaf if they are reasonably active, and only realize
they have to restart at zero when they are 3-5 years into the deal.

It's on them for lack of understanding, but as a CC it's my responsibility to make sure they don't get left behind because
of my apathy or negligence.

In this case I thought I might be missing something CISM-wise in terms of an appropriate track.

[KASSRCrashResearch]

I think that it is too easy for CAP members to get master ratings....and the rank that it opens up....with out actually doing the job at the master level.

I have no formal opinion on that- since I am not entitled to one at this point- but I was kind of surprised at the level of requirements listed in the regs when I looked at them.  My wife reacted the same way but then again, we both have backgrounds in EMS where promotion tends to be rather....what's right word?  Random and arbitrary?  So I guess we're kind of used to that. 

[Chappie]

Currently, there is a moratorium on all our regs and publications as there is a re-engineering process underway.  So I see a re-write of the aforementioned reg in the near future since it has an '06 date of issue.

NHQ recently released a strategic plan from 2016-2020.  Part of the plan is Goal 5.2 "Take Care of Our Members".  From both official and non-official conversations, it appears that CAP is gravitating away from CISM and adopting/adapting the USAF (and other service branches) usage of "resiliency" (psychological "first aid"/chaplain side of the house: spiritual first aid).

http://www.capmembers.com/media/cms/CAP_Strategic_Plan__Annex_2016_Appr_E8DFF56CE806A.pdf (and repeated in each subsequent year's annex)

http://www.af.mil/News/ArticleDisplay/tabid/223/Article/494434/comprehensive-airman-fitness-a-lifestyle-and-culture.aspx