Concerns about the effectiveness of critical incident stress debriefing in ameliorating stress reactions

Excerpt

Hammond and Brooks's enthusiasm for critical incident stress debriefing (CISD) [1] causes them to ignore findings suggesting inert or iatrogenic effects of this procedure. So far the data on the effectiveness of debriefing are almost overwhelmingly negative, particularly at follow-up assessments. For example, Carlier et al. [2] found that among police officers who responded to a civilian plane crash, those who underwent debriefing exhibited significantly more disaster-related hyperarousal symptoms at an 18-month follow-up than those who did not receive the treatment. Mayou et al. [3] showed that subjects admitted to hospital after a road traffic accident who received CISD had a significantly worse outcome at 3 years in terms of general psychiatric symptoms, travel anxiety, and overall level of functioning. Bisson et al. [4] found that among a sample of burn trauma victims, 26% of the debriefing group had PTSD at 13-month follow-up, compared with 9% of the control group. Importantly, the Cochrane Review of 11 clinical trials found no evidence that debriefing reduced general psychological morbidity, depression, or anxiety, and recommended that compulsory debriefing of victims of trauma should cease [5]. …