Critical Incident Stress Debriefing (CISD) is a form of psychological intervention originally done after a critical incident in which people are killed or severely injured. It was originally developed to help prevent traumatic stress in emergency service and recovery personnel who were faced with disasters that were beyond what they are prepared to deal with. Fire departments, Ambulance Service, Police Force, Hospitals and other public emergency service personnel have done this as a standard procedure. It has been found to be helpful with any population including children.
Critical Incident Debriefing or Psychological Debriefing, (the terms are used interchangeably) is ideally carried out a few days after an incident, but within one month. Anecdotal evidence suggests however that a debrief such as this can be beneficial even many years after an event.
The most common model employed by debriefing consultants is the Mitchell and Dyregrove model. This consists of a seven-stage process which people are guided through by the debriefing consultants. The intention is to allow people the opportunity to talk, express their feelings, discuss any concerns arising from the incident and most essentially to prevent them from ‘bottling up’ their feelings and emotions. It is when this happens that psychological distress becomes a concern. The debriefing process is described by Dyregrove as: "a group meeting to review the impressions and reactions that survivors, bereaved or helpers experience during or following critical incidents, accidents or disasters. The meeting aims at reducing unnecessary psychological after-effects." Although Dyregrove refers to a group meeting, debriefing can also be successfully used on individuals.
In both cases debriefing consultants need to be properly trained and experienced. In general, cost prevents most organisations from maintaining their own teams and these are generally sourced through outside agencies.
When used to help individuals to resolve life traumas such as bereavement, abuse, or any traumatic experience, sometimes refered to as 'Post Traumatic Stress Disorder', then a slightly modified version of CISD is used and this therapy is often called Trauma Resolution.
The aim of CID is to minimise unnecessary psychological distress or responses in the aftermath of a traumatic event by:
Introduction to debriefing:
It is useful for a traumatised person to understand that this method of debriefing has been developed specifically for normal people who are experiencing normal reactions to an abnormal situation.
Allowing the ventilation of:
· Impressions, Feelings, Reactions
Helping people to make sense of their experience by:
· Creating a better understanding of the nature of traumatic incidents
· Explaining the normalcy and predictability of reactions
· Allowing feelings to be shared and reversing a natural tendency to 'bottle thing up'
Harnessing group dynamics to:
· Reduce tension and stress
· Reinforce normalcy and reduce feelings of isolation and being "different"
· Share experiences with people who were there, who helped during or after, and who 'understand'
Discovering and raising awareness of resources by:
· Raising awareness of personal resources (coping skills)
· Raising awareness of group or organisational resources (Avenues of assistance available via employer for example)
· Raising awareness of other resources (Charity and support groups)
Preparing for the possibility of future reactions by:
· Education
· Making general information available
· Providing information on resources
Examining future needs for
· The individual
· Their family
· The peer group
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