On the ground in New York City, the response to the attacks of September 11 was stunning for its speed, breadth, and depth. There were, of course, firefighters, police officers, and emergency-service workers who literally sacrificed their lives. But the destruction of the World Trade Center inspired extraordinary, if less physically heroic, responses from other organizations as well.
In the immediate aftermath of the attacks, Crisis Management International Inc. (CMI), a tiny Atlanta-based firm, was called on by the giants of the U.S. economy to supply a critical recovery resource. CMI has just nine full-time employees, but dozens of companies with thousands more flooded the firm with requests for specialists from CMI's carefully prepared nationwide network. Even as founder Bruce Blythe and his two lieutenants scrambled to mobilize resources, CMI was able to start delivering for its customers on September 12.
Pamela Porter, CMI's director of response services, drove all night September 11 in her pickup truck, which was loaded with equipment and supplies, to set up a command center. Without sleeping, she began dispatching people to clients on the morning after the attacks from a Best Western hotel just outside the city. The next day, she started operating out of a hotel in downtown Manhattan, where CMI commandeered every available room — housing dozens of specialists who had dropped their lives in places as far away as Milwaukee, Seattle, and Tulsa to respond to the company's emergency summons.
The urgency and instantaneous demand for CMI was all the more remarkable because of the service the firm provides: It delivers crisis counseling in the workplace. Its network consists of 1,402 therapists and psychologists, all specially trained by CMI in "critical-incident stress debriefing." Crisis debriefing is a kind of psychological first-aid kit designed to help people understand and cope with their reactions to stress or disaster.
Betsy Leavitt called CMI sometime between 11 AM and noon on the day of the attacks. Leavitt is the manager of Mellon Financial Corp.'s in-house employee-assistance program, which has been providing stress debriefings, among other services, for years. As Leavitt watched the attacks and their aftermath unfold, she knew that Mellon's staff of seven counselors would be overwhelmed just handling its 5,000 New York employees. "We've maintained contact with CMI over the past couple of years," says Leavitt. "They are known as the best in the business."
Starting that first week, CMI supplied up to 25 people a day for dispatch to different Mellon locations, where each counselor conducted two or three group debriefings each day, along with individual sessions. Even after two weeks, Mellon was still using between 10 and 20 CMI counselors a day.
Although viewed skeptically by academic and research psychologists, crisis debriefing has been embraced during the past 10 years for employees involved in incidents ranging from attempted bank robberies to workplace killings and natural disasters. Founded in 1988, CMI worked with companies after both the Oklahoma City bombing and the earlier attack on the World Trade Center. Crisis debriefing is seen as a way to demonstrate corporate compassion and a way to give psychological-recovery efforts some structure. The goal is to help employees return as quickly and comfortably as possible to normal work — and normal productivity — and to try to prevent more serious problems later on, including post-traumatic stress disorder.
"We focus on the human side of crisis," Blythe says. "We bring order out of chaos. We want to keep people out of psychiatrists' offices and drug stores. That's our mandate."
The National Guard of Therapists
CMI — set up as a virtual company, with its small staff and its almost infinitely and instantly expandable response network — is a kind of National Guard of therapists. It is composed of people who work day jobs in a range of mental-health professions until they are called upon by CMI. The terrorist attacks were an unprecedented test of its operating strategy. Were the crisis experts themselves ready for crisis on a scale that even they could not have imagined?
During the first two weeks following the attacks, close to 150 counselors from CMI's network did six months' worth of work, according to Mary Cardin, vice president of operations. Although most CMI clients don't want to be identified, the list of assignments posted on the walls of the firm's Manhattan command center is a who's who of recognizable organizations: banks, phone companies, mutual-fund companies, airlines — even a branch of the U.S. military.
And CMI is not cheap. The company charges $250 an hour per counselor and pays its therapists between $640 and $800 a day. One client company contracted for 24 CMI counselors a day for two weeks, spending upwards of $35,000 daily on debriefing services.
According to Blythe, CMI's largest previous response was in August 1992, during Hurricane Andrew in Florida. At that time, CMI offered services to 28 companies simultaneously. According to Cardin, CMI counselors visited 136 companies during the first two weeks after the September 11 attacks, including 14 that had been tenants of the World Trade Center.
One source of referrals in the wake of the attacks was mental-health employee-assistance programs (EAPs) that companies already had in place. The EAPs, in turn, contracted with CMI for counseling. Chuck Taylor is executive vice president of workplace services for ValueOptions Inc., a large behavioral-health managed-care company that tapped CMI. In the first week, ValueOptions used 50 CMI counselors a day for its client companies. In the first three weeks, Taylor says, ValueOptions held five years' worth of "critical-incident debriefings," many of which were staffed by CMI. "I reviewed the feedback from those first weeks, and our clients and their employees reported a 99.6% satisfaction rate," says Taylor. "To get those kinds of ratings, it not only means that people liked what CMI did — it means that they didn't have one person who was an hour late to one session. That level of customer service — it's fantastic."
Three-Step Recovery Program
In hundreds of debriefing sessions, CMI's counselors heard stories that were too unsettling or graphic for newspaper or television. They heard individuals describe images, sounds, and smells that can haunt people's sleep for weeks, rattle their waking concentration, reorder the priorities of their lives.
Lynn Friedman, a PhD from New Orleans, was sent to Long Island to debrief the staff of an insurance company that had offices in the World Trade Center. "These were ground-zero survivors," says Friedman, "people who walked down more than 50 flights of stairs to get out. They saw people in wheelchairs with no way out, people staying with those in the wheelchairs. They saw bodies falling to the ground. One person got pushed out of the way of a falling body — that's why he survived."
The theory of crisis debriefing, which has its roots in World War II and Vietnam battlefield counseling, is that, as Friedman puts it, "just telling the story is important. It's important for people to put all of the puzzle pieces together, to be validated in their feelings, and to get information." In sessions of 15 to 20 people, lasting between one and two hours, participants are guided through three steps: venting stories and feelings; "normalization," in which the counselor reassures participants that the range of their reactions is normal; and education about the typical course of the stress reactions, the healing power of time and routine, and what signs to look for that might indicate the need for more counseling.
CMI's counselors quietly do a couple of other things. They constantly assess debriefing-group members, watching for people who even early on are not coping well and need follow-up help. They also function as a corporate-crisis feedback loop, listening for unhappiness about a company's security or response, gauging things such as anger and blame. CMI counselors not only file a written report — they also sit down with managers at day's end to provide a sense of mood and morale.
"This is really a blend of therapy and consulting," says Porter, who maintains a small private practice that specializes in combat veterans. "We use the word 'consultant,' not 'therapist.' Being debriefed is therapeutic — but it is not therapy. For one thing, there is no implied confidentiality in the process" — although CMI claims to be protective of the names of those who receive counseling — "and we do give advice. We have a real emphasis on the here and now, on how to move forward."
Some firms who contracted with CMI were deep into planning layoffs before the World Trade Center attacks and wanted to know what to do about that. "We said, Deal with what's in front of your face," says Porter. "Take care of your people first. Then, after a few weeks have gone by, you can turn and look at the downsizing question again."
The Business of Psychology
Bruce Blythe is a psychologist-turned-executive who left private practice to cofound an early EAP. He founded CMI when he realized, after working on the aftermath of a plane crash, that companies had no idea what to do for employees after a crisis.
Blythe's style is a sometimes jarring mix of salesman and therapist. "I've always known that I was into psychology," he says. "But talking to one person at a time? Not for me. I'm a consultant, an entrepreneur — and my product is mental health."
In the thick of CMI's response to the attacks, Blythe is one minute on the phone negotiating with a financial-services firm over fees — "we're slammed; if I have to talk to our people about accepting discounted fees, I have to chuckle" — and the next, he is quietly advising an insurance company to cater lunch on the first day back at its offices near ground zero. "That's a nice touch," he says, "then you could use the cafeteria for debriefings."
Blythe has a penchant for overstatement. His estimate, quietly adjusted by Mary Cardin, was that CMI had 300 client companies after the attack, including 80 World Trade Center tenants. But his network of therapists is compassionate, his customers effusive, and he knows how to talk to executives: "If you are not ready to help your employees at the most difficult moment in your business, when will you be ready to help them?"
In the academic world, it is the lack of scientific support for debriefing, more than the mixture of motives, that troubles psychologists. "It's outrageous that billions of dollars are going into providing people with psychological services without any knowledge of whether it's cost-effective," says Edna Foa, a professor of psychology at the University of Pennsylvania and director of its Center for the Treatment and Study of Anxiety. Foa has been impressed with the impulse of companies to address their employees' mental health but says that there is no peer-reviewed research supporting the benefits of crisis debriefing. Foa is particularly troubled by the emphasis of companies such as CMI on making sessions mandatory and the use of single rather than multiple sessions.
But for those in the midst of crisis, there is enthusiasm, relief, and a sense that the counseling allows them to reconnect. The corporate response to the events of September 11 may ultimately be a watershed for the importance of mental-health services in the workplace.
When asked how Mellon Financial will assess the cost-benefit ratio of CMI counseling, Mellon's HR managers were at first silent. "I don't think we're thinking in those terms at all," says Diane Doyle-Love, a senior Mellon manager for work-life programs. "This counseling is the right thing to do. One counselor called to tell me that an employee said, 'If this is what the corporation does in situations like this, you've got an employee for life.' These are priceless kinds of activities."
Charles Fishman (email@example.com) is a Fast Company senior editor based in Raleigh, North Carolina. Contact Pamela Porter (firstname.lastname@example.org) by email, or learn more about CMI on the Web (www.cmiatl.com).
A version of this article appeared in the December 2001 issue of Fast Company magazine.