"There is no current evidence that psychological
debriefing is a useful treatment for the prevention of post traumatic stress disorder
after traumatic incidents. Compulsory debriefing of victims of trauma should cease."
(from the Cochrane Report).
Thanks to our colleagues through the Academy of Cognitive Therapy (ListServ), the
following list of references addresses the empirical outcomes of Critical Incident Stress
Debriefing (CISD) research.
CISD References
Alexander, D. A., & Wells, A. (1991). Reactions of police officers to body
handling after a major disaster: A before and after comparison. British Journal of
Psychiatry, 159, 547-555.
Avery, A., & Orner, R. (1998). First report of psychological debriefing
abandoned-the end of an era? Traumatic Stress Points, 12(3).
Avery, A., King, S., & Orner, R. (1999). Deconstructing psychological debriefing
and the emergence of calls for evidence-based practice. Traumatic Stress Points, 13(2).
Bisson, J. I., & Deahl, M. P. (1994). Psychological debriefing and prevention of
post traumatic stress: More research is needed. British Journal of Psychiatry, 165,
717-720.
Bisson, J. I., Jenkins, P. L., Alexander, J., & Bannister, C. (1997). A randomised
controlled trial of psychological debriefing for victims of acute harm. British Journal of
Psychiatry, 171, 78-81.
Carlier, I. V. E., Lamberts, R. G., van Uchlen, A. J., & Gersons, B. P. R. (1998).
Disaster related post-traumatic stress in police officers: A field study of the impact of
debriefing. Stress Medicine, 14, 143-148.
Deahl, M. P., & Bisson, J. I. (1995). Dealing with disasters: Does psychological
debriefing work? Journal of Accident and Emergency Medicine, 12, 255-258.
Deahl, M. P., Gillham, A. B., Thomas, J., Dearle, M. M., & Strinivasan, M. (1994).
Psychological sequelae following the Gulf war: Factors associated with subsequent
morbidity and the effectiveness of psychological debriefing. British Journal of
Psychiatry, 165, 60-65.
Dishion, T. J., McCord, J., & Poulin, F. (1999). When interventions harm: Peer
groups and problem behavior. American Psychologist, 54(9), 755-764.
Foa, E. B., & Meadows, E. A. (1997). Psychosocial treatments
for posttraumatic stress disorder: A critical review. Annual Review of Psychology, 48,
935-938.
Gist, R. (1990, August). Debriefing and related activities. In G. A. Jacobs (Chair),
Flight 232: Case study of psychology's response to air disasters. Symposium conducted at
the 98th annual convention of the American Psychological Association, Boston, MA.
Gist, R. (1996a). Is CISD built on a foundation of sand? Fire Chief, 40(8), 38-42.
Gist, R. (1996b). Dr. Gist responds (Letter to the editor). Fire Chief, 40(11), 19-24.
Gist, R., Lohr, J. M., Kenardy, J. A., Bergmann, L., Meldrum, L., Redburn, B. G.,
Paton, D., Bisson, J. I., Woodall, S. J., & Rosen, G. M. (1997). Researchers speak on
CISM. Journal of Emergency Medical Services, 22(5), 27-28.
Gist, R., Lubin, B., & Redburn, B. G. (1998). Psychosocial, ecological, and
community perspectives on disaster response. Journal of Personal & Interpersonal Loss,
3, 25-51.
Gist, R., & Woodall, S. J. (1995). Occupational stress in contemporary fire
service. Occupational Medicine: State of the Art Reviews, 10, 763-787.
Gist, R., & Woodall, S. J. (1998). Social science versus social movements: The
origins and natural history of debriefing. Austalasian Journal of Disaster and Trauma
Studies, 1998-1 Online serial at
http://www.massey.ac.nz/~trauma
Gist, R., & Woodall, S. J. (1999). There are no simple solutions to
complex problems: The rise and fall of Critical Incident Stress Debriefing as a response
to occupational stress in the fire service. In R. Gist & B. Lubin (Eds.), Response to
disaster: Psychosocial, community, and ecological approaches (pp. 211-235). Philadelphia,
PA: Brunner/Mazel.
Gist, R., Woodall, S. J., & Magenheimer, L. K. (1999). And then you do the
Hokey-Pokey and you turn yourself about . . . In R. Gist & B. Lubin (Eds.), Response
to disaster: Psychosocial, community, and ecological approaches (pp. 269-290).
Philadelphia, PA: Brunner/Mazel.
Griffiths, J., & Watts, R. (1992). The Kempsey and Grafton bus crashes: The
aftermath. East Linsmore, Australia: Instructional Design Solutions.
Hobbs, M., Mayou, R., Harrison, B., & Worlock, P. (1996). A randomised controlled
trial of psychological debriefing for victims of road traffic accidents. British Medical
Journal, 313, 1438-1439.
Hytten, K., & Hasle, A. (1989). Firefighters: A study of stress and coping. Acta
Psychiatrica Scandinavia, 355(supp.), 50-55.
Kenardy, J. A. (2000). The current status of psychological debriefing: It may do more
harm than good. British Medical Journal, 321, 1032-1033.
http://www.bmj.com/cgi/content/full/321/7268/1032
Kenardy, J. A. (1998). Psychological (stress) debriefing: Where are we
now? Austalasian Journal of Disaster and Trauma Studies, 1998-1. Online serial at http://www.massey.ac.nz/~trauma
Kenardy, J. A., & Carr, V. (1996). Imbalance in the debriefing
debate: What we don't know far outweighs what we do. Bulletin of the Australian
Psychological Society, 18(2), 4-6.
Kenardy, J. A., Webster, R. A., Lewin, T. J., Carr, V. J., Hazell, P. L., &
Carter, G. L. (1996). Stress debriefing and patterns of recovery following a natural
disaster. Journal of Traumatic Stress, 9, 37-49.
Lee, C., Slade, P., & Lygo, V. (1996). The influence of psychological debriefing
on emotional adaptation in women following early miscarriage: A preliminary study. British
Journal of Medical Psychology, 69, 47-58.
Mayou, R. A., Ehlers, A., & Hobbs, M. (2000). Psychological debriefing for road
traffic accident victims. British Journal of Psychiatry, 176, 589-593.
McFarlane, A. C. (1988). The longitudinal course of posttraumatic morbidity: The range
of outcomes and their predictors. Journal of Nervous and Mental Disease, 176, 30-39.
Macnab, A. J., Russell, J. A., Lowe, J. P., & Gagnon, F. (1998). Critical incident
stress intervention afetr loss of an air ambulance: two-year follow up. Prehospital and
Disaster Medicine, 14, 8-12.
Ostrow, L. S. (1996). Critical incident stress management: Is it worth it? Journal of
Emergency Medical Services, 21(8), 28-36.
Raphael, B., Meldrum, L., & McFarlane, A. C. (1995). Does debriefing after
psychological trauma work? Time for randomised controlled trials. British Journal of
Psychiatry, 310, 1479-1480.
Redburn, B. G. (1992). Disaster and rescue: Worker effects and coping strategies.
Doctoral dissertation (community psychology), University of Missouri-Kansas City
[University Microfilms No. AAD93-12267; Dissertation Abstracts International, 54(01-B),
447].
Rose, S.,& Bisson, J. (1999). Brief early psychological interventions following
trauma: A systematic review of the literature. Journal of Traumatic Stress, 11, 679-710.
Small, R., Lumley, J., Donohue, L., Potter, A., Waldenström, U. (2000). Randomised
controlled trial of midwife led debriefing to reduce maternal depression after operative
childbirth. British Medical Journal, 321, 1043-1047.
Stephens, C. (1997). Debriefing, social support, and PTSD in the New Zealand police:
Testing a multidimensional model of organizational traumatic stress. Australasian Journal
of Disaster and Trauma Studies, 1. Electronic journal accessible at http://www.massey.ac.nz/~trauma
Stuhlmiller, C., & Dunning, C. (2000). Challenging the mainstream: From pathogenic
to salutogenic models of psttrauma intervention. In J. M. Violanti, D. Paton, & C.
Dunning (Eds.), Posttraumatic stress intervention: Challenges, issues, and perspectives
(pp. 10-42). Springfield, IL: Charles C. Thomas.
Rose, S., Bisson, J., & Wessely, S. (2001).
Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane
Review). In: The Cochrane Library, 3. Oxford, UK: Update Software.
Available online at http://www.update-software.com/ccweb/cochrane/revabstr/ab000560.htm
If the link is not working,
try searching for the article title at http://www.update-software.com/abstracts/titlelist.htm
[Top of Page]
The following excerpt is from a posting by Mark Reineke to
the Academy of Cognitive Therapy ListServ.
Reprinted with permission.
Subj: Re: [ACT] disaster in nyc
Date: Wed, 12 Sep 2001 5:14:06 PM Eastern Daylight Time
From: Mark Reinecke
To: ACT@LISTSERV.LOUISVILLE.EDU
I just did an interview with the Tribune
regarding how we can help individuals living and working in highrises (e.g., Sears Tower,
Hancock Center, Aon Building) to cope with feelings of anxiety. These are 100 story
buildings in the Chicago loop which were frantically evacuated when the attacks began. Here are my comments:
1) Acknowledge the validity of their concerns.
They're reasonable given recent events...we are, in fact, more vulnerable than we'd
thought. These are horrific events and their reactions are normal. We're all experiencing
them.
2) Note that the the typical
outcome to trauma is recovery. People are resilient. Feelings such as these typically
remit spontaneously within two weeks.
3) Encourage expression and discussion of
thoughts and feelings...talk it out; encourage natural resilience.
4) Seek support from friends, family church, and
coworkers...you're not in this alone. Provide support to others.
5) Provide reassurance as to safety measures
taken.
6) Keep the probability of another attack in
perspective. This was a horrific event, but it was localized. It's still more likely that
you'll be injured in an automobile accident than by a terrorist attack. Although the risk
isn't zero, it remains extremely remote. (Attend to perceptual and memory biases that
accompany anxiety disorders)
7) Don't watch CNN. Saturation coverage and
repeated exposure to images of the buildings collapsing will lead to increased anxiety,
recurrent images of it, and possible nightmares regarding the attack. People can develop
symptoms of PTSD vicariously, particularly when the identify with the victim. Don't let
this happen through repeated exposure to media.
8) Life is going on. It's time to get to
work...to help our families and communities. Maintain a normal routine. Ask, "What
can I do to cope and to move forward for myself, my family, my colleagues, and my
community?" Encourage rational problem-solving and behavioral activity. Resist
withdrawal and avoidance.
9) In some individuals, symptoms may persist
beyond 2 weeks and frank symptoms of PTSD may emerge. Unfortunately, there are few
reliable predictors of response to trauma for individual clients. With this in mind,
individuals whose symptoms persist or become disabling should seek professional attention
(from a therapist using empirically-supported techniques).
Mark A. Reinecke, Ph.D.
Associate Professor of Child & Adolescent Psychiatry
Director, Center for Cognitive Therapy
Department of Psychiatry
University of Chicago
[Top of Page]
The
following excerpt is from a posting by Mark Reineke to the Academy of Cognitive Therapy ListServ. Reprinted
with permission.
Subj: [ACT] Helping children cope with
trauma
Date: Thu, 13 Sep 2001 11:47:55 AM Eastern Daylight Time
From: Mark Reinecke
To: ACT@LISTSERV.LOUISVILLE.EDU
Dear Colleagues,
As a resource for helping children cope with
this week's tragedy, I wanted to share with you several tools prepared by the American
Academy of Child and Adolescent Psychiatry (AACAP). Attached you will find links for the
AACAP's Talking Points - How To Talk To Children and Parents After A Disaster. They're
...somewhat short on specific recommendations for intervention, but are appropriate for
sharing with parents.
The two Facts For Families can be downloaded at:
http://www.aacap.org/publications/factsfam/grief.htm
Facts for Families # 8 - Children and Grief
http://www.aacap.org/publications/factsfam/disaster.htm
Facts For Families #36 - Helping Children After A Disaster.
The "Facts for Families" are designed
to be reproduced and distributed. Please feel free to make these available to your
patients and their families, schools, and any other organizations which may benefit from
the information.
Mark A. Reinecke, Ph.D.
Associate Professor of Child & Adolescent Psychiatry
Director, Center for Cognitive Therapy
Department of Psychiatry
University of Chicago
[Top of Page]
Refers to the September 11, 2001
terrorist hijackings in the United States which led to the crashing of four airliners full
of passengers into the 110 foot tall Twin Towers of the World Trade Center, into the
Pentagon and into the ground in Somerset County, Pa. The World Trade Center was completely
destroyed killing thousands of people. The death toll at the Pentagon exceeds 190 people.
The crash in Pennsylvania killed all 44 people on board. According to CNN.com (09/19/01)
"The number of confirmed dead and those reported missing from the September 11
attacks is more than 5,500." Currently 62 countries have people dead and/or
missing as a result of these acts of terrorism.
[Top of Page]
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