"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.
Australasian Journal of Disaster and Trauma Studies,
1998-1 Online serial at
http://tur-www1.massey.ac.nz/~trauma/issues/1998-1/gist1.htm
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? Australasian Journal of Disaster
and Trauma Studies, 1998-1. Online serial at
http://www.massey.ac.nz/~trauma/issues/1998-1/editial.htm
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 after 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/issues/1997-1/cvs1.htm
Stuhlmiller, C., & Dunning, C. (2000). Challenging the mainstream: From
pathogenic to salutogenic models of posttrauma 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 from
http://www.cochrane.org/reviews/en/ab000560.html
If the link is not working,
try searching for the
article title at
http://www.update-software.com/abstracts/AB000560.htm
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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
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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
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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.
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