Critical Incident Debriefing (CID)
Critical Incident Debriefing (CID) is a carefully phased intervention implemented
immediately following a major incident such as war zone trauma, civilian disaster,
terrorist incident or natural disaster. The aim of immediate implementation of CID
after such an event is to specifically prevent, limit or alleviate the onset of
Post Traumatic Stress Disorder (PTSD) following exposure to such an incident.
CID was originally developed for the benefit of emergency services and military
personnel who regularly experience as much exposure to traumatic stress in periods
as short as a month than the majority of the population might experience in their
whole life.
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However, CID is not limited to use by HM Forces or the Emergency Services, just as PTSD is not suffered exclusively by them. Anyone can be a victim of violent crime
and without specialist help could experience PTSD at a later date, and so the process
has been refined and developed with experience and is now available to benefit the
general population as well.
The de-briefing process offers a two-fold approach. Initially as short-term intervention
in the early stages post incident it often aids in preventing some of the long term
or cumulative affects associated with traumatic incidents. Over the longer term
the de-briefing process allows people to gain insight and view an incident from
a different, more beneficial viewpoint.
De-briefing is available for both individuals and groups who have been exposed to
trauma.
What is a Critical Incident?
- Industrial accident resulting in injury or death
- National or international disaster
- Sudden death
- Murder
- Suicide
- Terrorism
- Fire
- Assault
Certain sections of the general public are obviously more likely to suffer a Critical
Incident. For example, staff in all night filling stations, off licences, sub post
offices, and late night convenience stores where employees in these locations could
be threatened, or even attacked, by persons armed with guns, knives or other offensive
weapons. The victim absolutely believes that his or her life is in danger at the
time of the attack, and is therefore traumatised.
Psychological Debriefing or Critical Incident Debriefing (the terms are used interchangeably)
is ideally carried out two to three days after an incident, but within one month.
Anecdotal evidence suggests however that a debrief such as this can be beneficial
even many years after an event. Indeed, I have been witness to this myself when
an ex-member of the Foreign Legion successfully dealt with an incident which had
occurred some fifteen years previously.
The most common model employed by Debriefers is the Mitchell and Dyregrove model.
This consists of a seven-stage process which people are guided through by the debriefer/s.
The intention is to allow people the opportunity to talk, express their feelings,
discuss any concerns arising from the incident and most essentially to prevent them
from ‘bottling up’ their feelings and emotions. It is when this happens that psychological
distress becomes a concern. The debriefing process is described by Dyregrove
as:
"a group meeting to review the impressions and reactions that survivors, bereaved
or helpers experience during or following critical incidents, accidents or disasters.
The meeting aims at reducing unnecessary psychological after-effects." Although
Dyregov refers to a group meeting, debriefing can also be successfully used on individuals.
In short, Debriefings accelerate the recovery of normal people experiencing normal
reactions, to abnormal events.
The aim of CID is to minimise unnecessary psychological distress or responses in
the aftermath of a traumatic event by:
Allowing the ventilation of:
- Impressions, Feelings, and Reactions
Helping people to make sense of their experience by:
- Creating a better understanding of the nature of traumatic incidents
- Explaining the normalcy and predictability of reactions
- Allowing feelings to be shared and reversing a natural tendency to 'bottle thing
up'
Harnessing group dynamics to:
- Reduce tension and stress
- Reinforce normalcy and reduce feelings of isolation and being "different"
- Share experiences with people who were there, who helped during or after, and who
'understand'
Discovering and raising awareness of resources by:
- Raising awareness of personal resources (coping skills)
- Raising awareness of group or organisational resources (Avenues of assistance available
via employer for example)
- Raising awareness of other resources (Charity and support groups)
Preparing for the possibility of future reactions by:
- Education
- Making general information available
Providing information on resources Examining future needs for :
- The individual
- Their family
- The peer group
- Their social group
The International Society for Traumatic Stress Studies
"Reactions to traumatic events vary considerably, ranging from relatively mild,
creating minor disruptions in the person's life, to severe and debilitating. It
is very common for people to experience anxiety, terror, shock and upset, as well as emotional numbness and personal or social disconnection. Symptoms and disturbing
reactions can persist or even worsen. This can lead people to find ways to cope
that are not so helpful, such as withdrawing from friends and family, using drugs or alcohol, or avoiding activities that are empowering."
The Institute for Employment Studies / HSE
"Both uncontrolled studies and comparison studies support the idea that traumatised
individuals feel that they benefit from the debriefing process. Organisations should
be able to foresee events and use a range of preventative and reactive solutions.
It is to be expected that people who have been exposed to a traumatic event will
show reaction in the immediate aftermath."
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