5 - Critical Incident Stress Management and Critical Incident Stress debriefings: evolutions, effects and outcomes

Summary

EDITORIAL COMMENTS

Mitchell and Everly present a comprehensive review and update of their seminal and broadly applied model of Critical Incident Stress debriefing, which they describe as a ‘crisis intervention component of Critical Incident Stress Management: a comprehensive, integrated and multi-component crisis intervention system’. In defining debriefing in this context the authors emphasize its linkage as one of crisis intervention to other conceptualizations of this kind, and as but one component of a spectrum of potential trauma-related interventions. The components of critical incident stress management include preincident education/mental preparedness training, individual crisis intervention, support/on-scene support, demobilization after disaster or large-scale events, defusing, critical incident stress debriefing, significant other support services for families and children, and follow-up services and professional referrals as necessary.

Mitchell and Everly emphasize the model as a response system for the prevention and management of stress experienced by emergency response personnel and one implemented through and with the support of their organizations. In this context the model is reported to be effective in reducing stress, returning workers rapidly to functioning after exposure to critical incidents, and at times as reducing symptomatology afterwards.

One of the difficulties that arises, Mitchell and Everly acknowledge, is the confusion over terms and the failure of methodologies to evaluate their specific model of debriefing in the situation for which it was developed (i.e. emergency services) and as part of a comprehensive stress management/crisis intervention framework.