The first U.S. casualty of the war on terrorism in Afghanistan was a Central Intelligence Agency (CIA) officer. Johnny Micheal "Mike" Spann was killed Nov. 25 during an uprising of Taliban prisoners. Within 24 hours of his death, CIA psychologists offered support to all those who needed help in coping with the tragedy, from his family to his co-workers, domestically and overseas.

That's just one example of the many critical roles CIA psychologists play in support of America's national security. In an interview with the Monitor, psychologist Terrence W. DeMay, EdD, offers a glimpse of the important work of Agency psychologists. DeMay is chief of the Mental Health Division, Office of Medical Services, at the CIA.

Q: What is the psychologist's role at the CIA?

A: One of our primary roles is to help CIA employees with the unique challenges they are required to cope with: security requirements, intense training, unconventional tasking, unfamiliar working conditions, unexpected and time-sensitive challenges, multiple and competing requirements, and the burden of a secretive, silent and sometimes misunderstood mission.

CIA employees and their families find themselves living in unfamiliar, unpredictable, unfriendly, unhealthy or potentially dangerous surroundings. Some are asked to endure hardships and inconveniences never experienced by most people. Some are placed directly in harm's way in service of their country, living and working in areas of the world affected by natural disasters, manmade disasters, crime, terrorism and war.

They are not asked to take on these challenges alone. Within the CIA, Office of Medical Services (OMS) psychologists, psychiatrists and other support personnel care for their mental and physical well-being from the onset of employment. The Mental Health Division of OMS develops and implements worldwide response capabilities that address both the needs of the individual and unique organizational requirements. The work of CIA psychologists is grounded firmly in traditional clinical psychology and accepted professional practices. Screening, evaluation, selection, consultation, crisis intervention, short-term counseling, follow-up and training are the cornerstones of a program that enjoys widespread acceptance and has experienced consistent growth during the last decade.

Q: Screening potential employees must also be an important part of your job.

A: Psychologists evaluate all candidates for CIA employment to determine their suitability for a position of trust. Pre-employment evaluations focus on clinical disorders, risk factors and vulnerabilities that might impact adversely on the ability of the individual to protect classified information. Reliability, responsibility, impulse control and good judgment are required of all employees. We use structured interviews, developmental histories, psychological testing and collateral data to determine suitability for employment. We make recommendations in the context of a broader applicant-processing system that includes input from security professionals, human resources specialists and substantive experts.

Some candidates for unusually sensitive positions--those requiring labor-intensive or expensive training, or positions involving safety issues--complete additional psychological testing and interviews. We conduct job analyses to determine the specific requirements of each position. These analyses are updated on the basis of changing requirements and manager, trainer and incumbent input.

CIA psychologists also participate directly in many training activities that enhance their first-hand knowledge of Agency requirements. We develop testing and interview protocols to address the strengths and weaknesses of each candidate in relationship to the current requirements of the anticipated position.

Q: How do most employees fare under what can be challenging work environments?

A: Our pre-employment screening and evaluation appear to contribute to a relatively healthy and resilient work force capable of supporting the Agency's unique mission. Base rates of diagnosable mental health problems are significantly lower for Agency employees than they are for comparable age groups in the general population. Agency employees also tend to experience fewer severe or disabling conditions and fewer life-threatening conditions. Rates of relapse are lower than what would usually be expected.

Agency employees are not immune to psychological disorders, however, and in some cases are at greater-than-average risk because of the unique stressors they are asked to endure routinely. CIA psychologists attempt to understand the potential impact of these stressors, develop relevant preventive interventions, monitor individual and systemic impact, and ensure the availability of consultation, treatment and follow-up. Thousands of employees also attend mental health workshops, seminars and briefings conducted by Agency psychologists each year. Coping with conflict, coping with organizational change, time management and stress management are just a few of the topics covered in these popular presentations.

Q: Do psychologists play a role in the assignment of employees and their families overseas?

A: CIA psychologists and psychiatrists screen employees and their families. We consider the needs of the individuals involved in the context of the demands of the anticipated assignment, support and resources available, and types of problems encountered in the past. We interview employees and sometimes their spouses and review the developmental histories of their children, and pay particular attention to their psychoeducational needs. We seek second opinions from specialists when doubts regarding assignability remain. Candidates for particularly unpleasant, inconvenient or dangerous assignments receive additional attention from CIA psychologists who are knowledgeable about the living and working conditions they will encounter. These individuals participate in additional interviews and complete additional psychological testing. Psychologists are often asked to participate in multidisciplinary assignment panels to assist management in making informed decisions that can affect the career of the individual and the Agency's mission.

Q: What happens when a CIA employee needs psychological services?

A: Psychological problems that occur in the context of an overseas assignment can be disruptive and costly. The success of CIA personnel is determined at least in part by their ability to maintain a low profile and function with relative anonymity. Employees in distress can draw unwanted attention to themselves and to their parent organization.

In the worst-case scenario, untreated problems can result in the exposure of clandestine activities and possibly even the loss of life. In the best-case scenario, mission-critical activities are unaffected but the individual must be returned home for appropriate treatment that often is not available overseas. Bringing an employee home can result in lost productivity, disruption of spousal employment, disruption of the education of children and a significant financial burden for the individual and the organization.

CIA psychologists are prepared to assist in the prevention and remediation of mental health problems wherever they occur. They travel extensively, providing routine consultations and responding to crises. Although travel in some parts of the world is difficult, CIA psychologists and psychiatrists can generally get to any employee in less than 24 hours. Pre-employment screening, pre-assignment screening and rapid response capabilities combine to minimize the number of employees and family members that must be returned home short of tour for mental health reasons.

Q: Do you feel that your role is well-integrated into the Agency's overall goals?

A: The success and professional effectiveness of CIA psychologists depend on their ability to understand individual needs in the context of the unique mission they support. Throughout their careers, they participate in the same kind of specialized training afforded employees outside of the mental health arena--experiencing the same stressors, enduring the same long hours and developing some of the same knowledge, skills and abilities. Understanding of organizational dynamics is fostered through participation on interdisciplinary panels that focus on recruitment, hiring, training, risk management and emergency response readiness.

Psychologists have become welcome partners in a wide range of forums impacting on both the individual and the Agency. Some components within the Agency have psychologists assigned to their area of responsibility on a full-time basis, giving them immediate and ongoing access to a behavioral scientist who becomes intimately familiar with their requirements.

Q: Are you able to engage with psychology colleagues outside the Agency?

A: Yes. There is a great deal of emphasis on multidisciplinary service delivery and on the continuing education needed to sustain and enhance clinical competencies. CIA psychologists work closely with staff psychiatrists, staff physicians and other medical specialists. Continuing education needs are surveyed yearly and outside speakers with substantive expertise are invited to share their knowledge. Psychologists from other government organizations with similar missions are often invited to attend, creating additional opportunities for professional interactions and development. Agency psychologists also attend continuing education programs sponsored by other organizations.

In addition, Agency psychologists are encouraged to participate in other professional activities that encourage interactions and exchanges of ideas with their non-Agency peers. Some have part-time private practices in the evenings that broaden their perspective on current practice issues.

Q: What do you like best about your job at the CIA?

A: The challenges of providing mental health services within the intelligence community are many and varied--but so are the rewards. When earthquakes erupt, planes crash, assaults occur, buildings are bombed or people are wounded or killed by acts of war, CIA psychologists are there to minimize the impact of the traumatic event, formulate appropriate intervention strategies and coordinate follow-up plans. When a Headquarters employee seeks help for clinical symptoms, problems related to job satisfaction or more common problems of daily living, CIA psychologists are there to assess the nature and extent of the problem and facilitate its resolution. And when the impact of a traumatic event, clinical disorder or situational stressor extends beyond the affected employee, support is available for spouses, children and other family members.

Thousands of miles from home or across the hallway at CIA Headquarters, CIA psychologists address the mental health needs of all employees.