11 - Debriefing with service personnel in war and peace roles: experience and outcomes

Summary

EDITORIAL COMMENTS

This overview of debriefing theory and practice shows that there is still a need for further work to be done in establishing what may be effective and for whom. While the historical context is set, it is clear from the review that models used, for instance in the military setting, cannot be guaranteed to achieve the goals that are hoped for, namely the prevention of post-traumatic stress disorder. Solomon et al. contrast instrumental and psychological debriefing and explore the theoretical rationale for debriefing, as well as some of the models that have been developed.

In their review of effectiveness, they examine studies involving both controlled trials, including the military, and non-controlled trials. The limitations of the few controlled trials that do exist are noted: for instance the fact that in many instances the groups are not well matched and that the debriefed group may start off with a higher level of distress and symptoms, or be self-selected. However, even with these provisions they note grounds for caution with a significant number of studies showing negative results. Solomon et al. hypothesize on possible causes for this: does debriefing actually permit the interaction and working through that are believed to be helpful? The failure to do so may be related to excessive structuring, inadequate time, or even perhaps inappropriate timing. Furthermore, debriefing may be inappropriate or potentially harmful for some, for instance depressive individuals with a tendency to negative ruminations. These could be reinforced by debriefing.