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Critical Incident Stress Debriefing – Dealing with Early Signs of Trauma
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You might have symptoms of traumatic stress, anxiety, or depression after a bad event. Through critical incident stress debriefing, this is less likely to happen. Critical incident stress debriefing, or CISD, is a group intervention with seven steps. Its purpose is to help groups of people deal with the short-term effects of an event that could be traumatic.
Critical Incident Stress Debriefing – Dealing with Early Signs of Trauma
Critical Incident Stress Debriefing
As a sort of crisis intervention, CISD is aimed at providing “psychological first aid” to those who have been exposed to or are directly impacted by a potentially traumatic event. Within 24 to 72 hours following the occurrence, it is common.
In small groups of around 20 individuals, facilitators lead a systematic debriefing procedure known as CISD.
Professor of emergency health services and former first responder Dr. Jeffrey T. Mitchell came up with the idea in 1974. A primary goal of CISD was to assist first responders to cope with emotional distress, therefore reducing their risk of long-term mental health issues.
There are a variety of first responders, including:
- disaster response crews
- emergency dispatchers
- firefighters
- hospital workers
- lifeguards
- military personnel
- paramedics
- police officers
A number of different sectors have lately begun using CISD, including:
- aviation
- banking
- churches
- railroad
- mining
- oil
- education
Critical incident
The meaning of a major occurrence might vary from person to person. Sudden and unexpected events that affect your body or mind might be referred to as traumatic events.
Long-term repercussions on your mental health may result from this life-altering experience.
Some examples of critical events include:
- crashes or mishaps
- When natural calamities like tornadoes or floods are intentionally set on fire, the military goes to battle.
- shootings
- in which children are the victims of hate crimes
Some of the repercussions of significant situations might be felt even if you haven’t been directly involved in them. As a result, witnessing a hate crime, for example, might be a harrowing experience.
“Critical event stress” is a term used to describe any discomfort you feel as a result of this situation.
Critical Incident Stress Symptoms
Individuals are affected by critical stress in their own unique ways, but there are certain warning signals to keep an eye out for. Symptoms like those of post-traumatic stress disorder (PTSD) have been reported in some patients (PTSD).
Emotional signs include anger or rage, anxiety, depression, grief, irritability, and survivor guilt.
Behavioral signs include difficulty relaxing, not showing up to work, social withdrawal, substance use disorder, and reduced communication.
Physical signs include chest pains, dizziness, exhaustion, headache, increased thirst, loss of appetite, shallow, breathing, sleep disturbances, and tremors.
Cognitive signs Include brain fog, confusion, dissociation, flashbacks, impaired ability to make decisions, nightmares, and trouble concentrating.
Critical incident stress debriefing basics
Facilitators: Every five to seven individuals, there’s usually one facilitator on hand. CISD requires a minimum of two facilitators at all times. There must be at least one licensed mental health professional and a person with a comparable background to individuals who were involved in a critical event as the facilitators.
Group: CISD participants in first responders are usually part of the same team or unit. Every single one of them had a “homogeneous” experience, which means that they all had a similar timing and intensity when the essential event occurred. Symptoms of stress and poor functioning may already be present in the group members, or they may develop at some time.
Goals: CISD has three major goals, according to Mitchell:
- cutting down on the long-term effects of the crucial event
- providing emotional support to help someone recover from a horrific incident
- screening for people who could benefit from further help
Sessions: The duration of a CISD session varies from one to three hours. It varies according on the number of individuals engaged and the severity of the trauma.
Process of critical incident stress debriefing
In a single session, CISD goes through seven stages:
Introduction: The facilitators set the tone for the meeting by introducing themselves and outlining a few ground rules.
Fact phase: Everyone is encouraged to walk around the room and provide a quick summary of what they have seen.
Thought phase: Inquiries concerning participants’ first impressions of the event are conducted by the facilitators.
Reaction phase: Participants are asked by the facilitators about the effect and feelings or ideas they’ve had since the event. They may, for example, suffer from sadness and a feeling of loss
Symptom phase: Afterward, facilitators inquire about the team’s symptoms in terms of physical, emotional, and behavioral.
Teaching phase: When the group is experiencing stress symptoms, facilitators explain the logic behind them in order to provide context.
Re-entry phase: The facilitators give a summary of the discussion and links for more help.
Follow-up: In order to foster deeper personal connections among the participants, the facilitators may arrange an informal get-together for refreshments after the group meeting has concluded.
Is debriefing after a significant occurrence effective?
According to Janika Joyner, a Chesapeake, Virginia-based licensed clinical social worker who often incorporates therapy dogs into her debriefing sessions, CISD may help clients feel less alone while they go through their trauma.
It is “effective,” she adds as a psychotherapist who has administered CISD for mass shootings (such as Virginia Beach, 2019) and the loss of several employees for different corporations.
CISD isn’t a substitute for treatment, but it can at least get people talking about it. It may help people decide whether or not to seek treatment and begin therapy for long-term issues that go beyond acute reactions,” she says. To help people cope with their symptoms, therapy is used.
Research on CISD is still inconclusive. Hospital staff believed CISD was useful, but it was not clear if it helped alleviate the symptoms of post-traumatic stress disorder (PTSD). This strategy is successful for disaster survivors and response teams alike, as long as the facilitators are crisis-trained, according to Mitchell’s 2021 evaluation.
When it comes to psychological debriefing following a major occurrence, a 2022 evaluation of research revealed that just one out of nine studies concluded that it was useful in lowering psychological distress. Because some research employs a modified form of Mitchell’s CSID approach, the current body of literature may be difficult to evaluate. CISD is a promising program, but additional study is required to confirm its efficacy.
Pros
- provides a chance to educate personnel on the stress response and possible effects
- maybe convenient to have on-site services
- may reduce burnout and compassion fatigue
- gives an opportunity to connect with others who have similar experiences
- can promote cohesion as a unit
- offers a small group environment
Cons
- may discourage folks who would rather speak privately
- is only a short-term offering, rather than ongoing support
- may be difficult to make time for it in demanding or low staff environments
Summary
Critical incident stress debriefing is aimed at providing “psychological first aid” to those who have been exposed to or are directly impacted by a potentially traumatic event. CISD helps groups of people deal with the short-term effects of an event that could be traumatic. Long-term repercussions on your mental health may result from this life-altering experience. Cognitive signs include brain fog, confusion, dissociation, flashbacks, impaired ability to make decisions, nightmares, and trouble concentrating. CISD participants in first responders are usually part of the same team or unit.
Symptoms of stress and poor functioning may already be present in the group members, or they may develop at some time. Crisis Incident Stress debriefing (CISD) isn’t a substitute for treatment, but it can at least get people talking about it. CISD is successful for disaster survivors and response teams alike, as long as the facilitators are crisis-trained. Additional study is required to confirm its efficacy.
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