14 - Children and debriefing: theory, interventions and outcomes

Summary

EDITORIAL COMMENTS

This overview of the conceptualization of the debriefing model and its application to children and adolescents reflects a strong clinical basis and understanding of the developmental issues relevant to the impact of critical incidents in this age range. Wraith draws a distinction, as is common in the Critical Incident Stress debriefing/debriefing field, between stress and trauma and emphasizes that, as with adults, the debriefing model is intended to assist with stress but that traumatized children require a specially focussed and individualized approach. There is strong emphasis on the need to assess children before they are provided with a group debriefing process. The model suggested is composed of two parts: psychological Wrst aid and clinical debriefing. However, there is a need to address further the spectrum of preventive, as compared with clinical, interventions, and the sanctions that must apply if an intervention is to be provided at all: i.e. do no harm; consider the ethics, appropriateness and propriety of providing such an intervention; and, if it is to be provided, consider the skills and knowledge necessary for the task.

Wraith questions the appropriateness of debriefing for children and emphasizes the vital role of parents, their needs and responses, particularly for younger children. However, it may be that debriefing is not an appropriate model and it is critical that assumptions of beneWt and social demand that are so powerfully driving the debriefing movement are challenged in this context.