Critical  Incident Stress Debriefings

Program Title:

 

Critical Incident Stress Debriefings (CISD)

 

Program Blurb:

 

Critical Incident Stress Debriefing (CISD) is a single-session intervention that is administered shortly after an individual is exposed to a potentially traumatic event. Its primary aim is to reduce the impact of the traumatic event by promoting support and encouraging the individual to process the traumatic experience in a group setting (Mitchell & Everly, 1997). CISD attempts to bolster an individual’s resistance to stress, build their resiliency, and aims to help facilitate both a recovery from traumatic stress and a return to healthy functioning. CISD was originally developed for use with first responders and is often employed alongside other crisis intervention techniques.

Assessment:

Is the program based on research?

N

It is unclear whether CISD was based on existing research at the time of its inception.

Has the program been independently evaluated?

Y

There is currently limited scientific evidence for the effectiveness of CISD. While some research supports the use of CISD following a traumatic event, there is other research to suggest that single-session debriefing does not reduce the chances of developing post-traumatic stress disorder (PTSD) following a traumatic event. In fact, some literature has suggested that it may actually do more harm than good (McNally et al., 2003).

Was the program rigorously tested?

Y

The complexity of CISD poses challenges when measuring the impact that this program has. That being said there are studies that have examined CISD using a randomized controlled trial (RCT) therefore meeting the criteria for level 4 on the Maryland Scientific Scales.

Has the program evaluation been replicated?

Y

Research on CISD has been contradictory at best. Reviews that have solely evaluated existing randomized controlled trials have found that single-session CISD is not effective at reducing negative symptoms following a critical incident (Rose et al., 2002; van Emmerik et al., 2002).

Was the program tested in Canada?

Y

CISD has been tested in a few different jurisdictions in Canada.

In 2006, Marchand and colleagues conducted an RCT with a modified version of CISD with a group of victims of an armed robbery in Montreal, Quebec. MacNab, Sun, and Rev (2003) tested three levels of critical incident stress debriefing with paramedics and emergency personnel in British Columbia. Both studies showed no differences between those groups receiving CISD and those groups who did not.

Comments/cautions:

CISD remains one of the most widely used psychological debriefing techniques utilized across a variety of settings and applications. However, research supporting its continued use remains mixed, warranting caution. Further research utilizing experimental methods (i.e., RCTs, quasi-experimental etc.) is needed to determine the effectiveness of CISD following a traumatic event.

Assessor:

Dr. Amanda Desnoyers, Government of Canada

Dr. Desnoyers is a Behavioural Scientist and Impact Canada Fellow at the Impact and Innovation Unit located in the Privy Council Office. For her fellowship, she has been placed at the Royal Canadian Mounted Police (RCMP) within their Federal Policing Covert Operations branch. Amanda has a Masters degree in Experimental Psychology from Laurentian University and in 2018 earned a Ph.D. in Social Psychology from Wilfrid Laurier University where she studied mindfulness and its impact on mental health.

 

Reviewer:

Dr. Mary Ann Campbell, University of New Brunswick

Mary Ann Campbell is the Director of the, Centre for Criminal Justice Studies and Full Professor of Psychology in the University of New Brunswick. Her main area of research focuses on developing and enhancing the application of evidence-based strategies for crime prevention and reduction. To date, Dr. Campbell's research has included the study of criminal behaviour committed by adults, youths, and special populations; enhancing positive outcomes for justice-involved youth through evidence-based practice; and the evaluation of intervention programs aimed at crime prevention and risk reduction goals (e.g., mental health courts, chronic offender interventions, drug-treatment programs). Dr. Campbell has also been involved in projects evaluating the implementation of intelligence-led policing, application of community policing principles, and the enhancement of best practices in police work (e.g., police responses to intimate partner violence, credibility assessment methods).

Suggested readings:

Macnab A., Sun C., & Lowe, J. (2003). Randomized, controlled trial of three levels of critical incident stress intervention. Prehospital and Disaster Medicine, 18(4) 365–369.

McNally, R. J., Bryant, R. A., & Ehlers, A. (2003). Does early psychological intervention promote recovery from posttraumatic stress?. Psychological science in the public interest, 4(2), 45-79.

Mitchell, J. T. (1983). When disaster strikes … The critical incident stress debriefing process. Journal of Emergency Medical Services, 13(11), 49 – 52.

Mitchell J., & Everly, GJ. (1997). The scientific evidence for critical incident stress management. Journal of Emergency Medical Services, 22:86-93.

Rose, S. C., Bisson, J., Churchill, R., & Wessely, S. (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane database of systematic reviews, (2).

Tuckey & Scott (2015). Group critical incident stress debriefing with emergency services personnel: A randomized controlled trial. Anxiety, Stress & Coping: An international Journal, 27, 38-54.

van Emmerik, A. A., Kamphuis, J. H., Hulsbosch, A. M., & Emmelkamp, P. M. (2002). Single session debriefing after psychological trauma: A meta-analysis. The Lancet, 360(9335), 766-771.

World Health Organization. Psychological debriefing in people exposed to a recent traumatic event. https://www.who.int/mental_health/mhgap/evidence/resource/other_complaints_q5.pdf?ua=1

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