On a daily basis, EMS providers experience some of life's most tragic and difficult events. Critical Incident Stress Management (CISM) is a vital component of mitigating the effects of traumatic stress ensuring providers have a safe place to process through those tough calls. Click the links below to contact local CISM teams or learn about how to become an accredited CISM - Peer Support Team.
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Virginia CISM and Peer Support Accreditation Program FAQs
The following questions represent some of the most frequently asked topics related to the Virginia CISM and Peer Support Accreditation Program. They are intended to assist public safety personnel, agency leaders, and team coordinators in understanding how the program works and what is required for participation. Topics include the differences between CISM and Peer Support, who the services are intended for, how to request or join a team, legal protections, training requirements, and how to maintain accreditation.
If you have additional questions not addressed here, please contact the CISM and Peer Support Accreditation Program Manager at the Virginia Office of EMS.
What is the difference between CISM and Peer Support? CISM and Peer Support are both designed to support the mental health and well-being of public safety personnel, but they serve different purposes.
CISM is typically activated after a specific critical incident, such as a traumatic call, a line-of-duty death, or a mass casualty event. It follows a structured process led by a trained team and may include group defusings, debriefings, or one-on-one support.
Peer Support is more flexible and ongoing. It allows trained peers to offer support through a wide range of personal and professional challenges. This may include stress, grief, burnout, family issues, or emotional struggles that affect daily life and job performance.
Many Virginia teams use a blended model, integrating both approaches to meet the diverse needs of public safety personnel.
Download our CISM vs. Peer Support Overview (PDF)
Who are CISM and Peer Support services for, and can they be used during a crisis? CISM and Peer Support services are intended only for public safety professionals. This includes EMS providers, firefighters, law enforcement officers, dispatchers, and others working in emergency services. These services are not available to the general public.
They are also not emergency or crisis response services. If you are in immediate danger or experiencing thoughts of suicide, self-harm, or harming others, call or text 988 to reach the Suicide & Crisis Lifeline, or dial 911. You can also contact your primary care or mental health provider or go to the nearest hospital emergency department.
If you are a responder seeking support after a critical incident or during a difficult time, reach out to your agency’s Peer Support contact or your regional CISM/Peer Support team.
List of Accredited Teams in Virginia
How can I request CISM or Peer Support services? The process for requesting CISM or Peer Support services can vary depending on your agency and region. Some teams are activated internally through department leadership, peer coordinators, or wellness officers. Others may be requested through regional or multi-agency networks.
We recommend that responders and agency leaders become familiar with their local team's services, activation process, and guidelines for deployment or dispatch. If your agency does not have its own team or is unsure how to access support, you can view the list of accredited teams in Virginia to identify available resources in your region.
List of Accredited Teams in Virginia
If you need further assistance connecting with a team, contact the Virginia Office of EMS.
What do I have to do to join a CISM or Peer Support team in Virginia? To join a CISM or Peer Support team in Virginia, you must complete the International Critical Incident Stress Foundation (ICISF) Group Crisis Intervention course and meet any additional requirements set by the specific accredited team you are applying to.
At a minimum, all accredited teams require members to complete training in Group Crisis Intervention, Assisting Individuals in Crisis, and Suicide Prevention or Awareness. These trainings may be completed before or after joining, depending on the team’s internal policies. Some teams may also require interviews, agency affiliation, mentoring, or continuing education.
Team members are expected to follow the guidelines and expectations of their accredited team. For more details on minimum training requirements and participation standards, refer to the Accreditation Program Application or contact your local accredited team.
Will the team respond to personal or family issues, like domestic violence or substance use? CISM and Peer Support teams are designed to support public safety professionals only, not members of the general public.
CISM services are typically provided after a critical duty-related incident, such as a traumatic call, line-of-duty death, or mass casualty event. These services are not intended for personal or family-related situations.
Peer Support, however, may be available to help responders with personal challenges such as family stress, addiction, grief, or emotional concerns. Support may be provided when those issues are affecting the responder’s well-being or job performance. The availability of these services depends on the team’s structure, training, and policies.
If you are a public safety professional in need of help, contact your agency’s Peer Support team or a local accredited team to learn what support options may be available.
What types of incidents qualify for a CISM response? CISM services are typically activated after critical incidents that may cause significant emotional stress for responders. These include events such as line-of-duty deaths, pediatric fatalities, suicides, mass casualty incidents, or any situation that has an unusual emotional impact or disrupts normal operations.
Each request is evaluated on a case-by-case basis by the team leadership. Accredited teams are required to have an affiliated clinician who provides oversight and guidance on response appropriateness and team activation. Some teams may also follow agency-specific or regional activation criteria.
In certain situations, a Peer Support response may be more appropriate or may occur alongside CISM services depending on team structure and responder needs. If you are unsure whether a response is appropriate, contact your local team coordinator or regional point of contact for assistance.
Are CISM and Peer Support services confidential and protected? Yes. CISM and Peer Support teams are expected to operate in a confidential and professional manner. However, it is important to understand the difference between confidential and privileged communication.
Confidential means that team members are trained to protect the privacy of what is shared during support interactions. They are expected to treat all information with professionalism and discretion.
Privileged communication is protected under Virginia Code § 19.2-271.4. This law provides legal protection for communications between EMS and public safety personnel and members of a CISM or Peer Support team when those services are provided in response to a critical incident. Team members cannot be compelled to testify in court, and the information is exempt from the Virginia Freedom of Information Act (FOIA). The individual who shared the information may choose to waive the privilege.
These legal protections apply only to accredited teams recognized under the Virginia CISM and Peer Support Accreditation Program.
Why are there more CISM and Peer Support teams in Northern Virginia? CISM and Peer Support services in Virginia began to take shape after the 1982 Air Florida crash in Washington, D.C. That incident led to the formation of early CISM teams in Northern Virginia, particularly in Alexandria and Arlington. Because of that history, the region still has a higher number of long-established, agency-based teams.
In other parts of the state, most teams were formed later through EMS Regional Councils or as multi-agency programs. Many of these are multi-disciplinary and include members from EMS, fire, law enforcement, dispatch, and other public safety sectors.
The Virginia Office of EMS continues to support the growth of accredited teams across all regions of the Commonwealth to improve access to support for all responders.
What is the Virginia CISM and Peer Support Accreditation Program? The Virginia CISM and Peer Support Accreditation Program is a statewide initiative managed by the Virginia Office of EMS. It is designed to recognize and support CISM and Peer Support teams that meet established standards for training, structure, clinical oversight, and operations.
The goal of the program is to improve consistency, accountability, and quality of care provided to EMS and public safety personnel across the Commonwealth. Accreditation ensures that teams are properly trained, supported by qualified clinicians, and operating with clear procedures for response, confidentiality, and documentation.
Participation in the program is voluntary, but teams must be accredited in order to receive legal protections under Virginia law. Accredited teams are also eligible to participate in the Virginia CISM and Peer Support Accreditation Network (VCPSAN), which promotes collaboration and resource sharing across teams.
How do we maintain accreditation once approved? To maintain accreditation, teams must continue to meet the minimum standards outlined in the Virginia CISM and Peer Support Accreditation Program. This includes maintaining proper team structure, ensuring all members complete the required training, documenting responses, and keeping current records of participation, continuing education, and clinical oversight.
Teams are also required to notify the Office of EMS if there are any changes to team leadership or the affiliated clinician during the accreditation period. Contact and deployment information must remain current, and teams are expected to remain active and responsive.
OEMS may request periodic updates or documentation to verify compliance as part of ongoing program oversight. For full details, refer to the Accreditation Program Application.
How do we apply for accreditation? To apply for accreditation, teams must complete and submit the Virginia CISM and Peer Support Accreditation Program application. The application includes information about team structure, training records, clinical oversight, and deployment policies. Teams must demonstrate that they meet the program’s minimum requirements and agree to follow the standards outlined in the accreditation policy.
The application is available on the Virginia CISM and Peer Support Accreditation Program webpage. If you have questions about eligibility or need assistance getting started, contact the CISM and Peer Support Accreditation Program Manager at OEMS.
What happens if a team becomes inactive or no longer meets the requirements? Accredited teams are expected to remain active and in compliance with the program requirements. If a team becomes inactive, fails to maintain required training or documentation, or no longer meets the minimum standards, the Office of EMS may place the team on inactive status or revoke accreditation.
Teams may also choose to voluntarily withdraw from the program if they no longer wish to maintain accredited status. In either case, teams are expected to notify OEMS promptly and provide updated documentation as requested.