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8 results

  • 6 - Trauma

  • Edited by Stephen Hupp, Southern Illinois University Edwardsville, Cara L. Santa Maria, Fielding Graduate University, California
  • Book:
    Pseudoscience in Therapy
    Published online:
    16 March 2023
    Print publication:
    23 March 2023, pp 69-93

  • Summary

    This chapter describes pseudoscience and questionable ideas related to posttraumatic stress disorder. The chapter opens by discussing controversies such as diagnostic validity. Dubious treatments include critical incident stress debriefing, recovered memory techniques, energy tapping therapies, and eye movement desensitization and reprocessing (EMDR). The chapter closes by reviewing research-supported approaches.

  • Acute Psychological Impact of Disaster and Large-Scale Trauma: Limitations of Traditional Interventions and Future Practice Recommendations

  • Matt J. Gray, Shira Maguen, Brett T. Litz
  • Journal:
    Prehospital and Disaster Medicine / Volume 19 / Issue 1 / March 2004
    Published online by Cambridge University Press:
    28 June 2012, pp. 64-72
    Print publication:
    March 2004

  • Nearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.

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

  • from Part II - Debriefing: models, research and practice
  • Edited by Beverley Raphael, New South Wales Health Department, Sydney, John Wilson, Cleveland State University
  • Book:
    Psychological Debriefing
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 71-90

  • Summary

    This chapter describes and reviews the comprehensive Critical Incident Stress Management (CISM) system. 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, other significant support services for families and children, and follow-up services and professional referrals as necessary. The concepts and mechanisms that are thought to serve as a foundation for CISM as a crisis response system are: early intervention, the provision of psychosocial support, the opportunity for expression, and crisis education. These factors are the four cornerstones of CISM. The studies reviewed in the chapter indicate that a comprehensive, systematic and multicomponent crisis intervention approach to traumatic stress, namely CISM, has an excellent potential for mitigating critical incident stress and restoring people to normal life functions.

  • 9 - Debriefing after massive road trauma: perceptions and outcomes

  • from Part II - Debriefing: models, research and practice
  • Edited by Beverley Raphael, New South Wales Health Department, Sydney, John Wilson, Cleveland State University
  • Book:
    Psychological Debriefing
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 131-144

  • Summary

    This chapter discusses the effects of massive road trauma, and examines the evidence of the efficacy of psychological intervention in these cases. It presents an outline of intervention strategies for survivors, bereaved, personnel and members of the community. It also discusses the recommendations given in relation to debriefing. The conditions under which group debriefing is used and suggested protocols to follow for survivors are described. There are several types of group debriefings, namely, operational debriefings, didactic debriefings, and psychological debriefings. Critical Incident Stress Debriefing (CISD), as developed by Mitchell, is the most widely used protocol for psychological debriefing. Debriefings and other crisis intervention strategies are provided generally after massive road trauma for emergency workers. The persistence of clinically significant sequelae to such disasters highlight the importance of assistance being available beyond the first few weeks, or even first months post crash.

  • 6 - Debriefing with emergency services: Critical Incident Stress Management

  • from Part II - Debriefing: models, research and practice
  • Edited by Beverley Raphael, New South Wales Health Department, Sydney, John Wilson, Cleveland State University
  • Book:
    Psychological Debriefing
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 91-107

  • Summary

    This chapter focuses on Mitchell's model of Critical Incident Stress Management (CISM) and Critical Incident Stress Debriefing (CISD) in emergency service agencies. CISM has all of the characteristics of a crisis intervention model. Knowledge about recovery from trauma is growing. Organizational problems in which the CISM programme is not accepted by the organization or unduly conflicts with existing support services. The essential elements of debriefing needs to be seen within a time context and within a framework that considers the individual and his or her interaction with others, including a debriefing, the immediate social and work support network and the broader community. Emergency services continue to lead the field with respect to trauma management in the workplace. It is important that constructive forums for discussion and writing be developed and maintained so that new developments can be described and improved evaluation research implemented.

  • Mental Health in Disaster in the Philippines

  • Eleanor L. Ronquillo
  • Journal:
    Prehospital and Disaster Medicine / Volume 15 / Issue S2 / September 2000
    Published online by Cambridge University Press:
    28 June 2012, p. S68
    Print publication:
    September 2000
    • Article
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  • The Physician's Role In Canada's Disaster Response System

  • Sunil Sookram, Garnet Cummings
  • Journal:
    Prehospital and Disaster Medicine / Volume 14 / Issue 3 / September 1999
    Published online by Cambridge University Press:
    28 June 2012, pp. 48-51
    Print publication:
    September 1999

  • The most recent tragedy in Manitoba illustrates that disasters can strike any community. Within Canada, a tiered disaster response system exists. Even though physicians often play an integral role in the disaster plan, few participate in the planning process or even appreciate their potential role in the event a disaster should occur. Physician involvement would guarantee health matters be appropriately addressed resulting in reduced mortality and decreased morbidity. There are ample opportunities to become involved in disaster planning and response at all levels government. The objective of this paper to inform physicians about the disaste planning infrastructure that exists in Canada, show them where they may get involved, and urge them to do so.

  • A Model for a Statewide Critical Incident Stress (CIS) Debriefing Program for Emergency Services Personnel

  • Keith W. Neely, William J. Spitzer
  • Journal:
    Prehospital and Disaster Medicine / Volume 12 / Issue 2 / June 1997
    Published online by Cambridge University Press:
    28 June 2012, pp. 43-48
    Print publication:
    June 1997
  • Purpose:

    Emergency services personnel are highly vulnerable to acute and cumulative critical incident stress (CIS) that can manifest as anger, guilt, depression, and impaired decision-making, and, in certain instances, job loss. Interventions designed to identify such distress and restore psychological functioning becomes imperative.

    Methods:

    A statewide debriefing team was formed in 1988 through a collaborative effort between an academic department of emergency medicine and a social work department of a teaching hospital, and a metropolitan area fire department and ambulance service. Using an existing CIS debriefing model, 84 pre-screened, mental health professionals and emergency services personnel were provided with 16 hours of training and were grouped into regional teams.

    Debriefing requests are received through a central number answered by a communicator in a 24-hour communications center located within the emergency department. Debriefings are conducted 48–72 hours after the event for specific types of incidents. Follow-up telephone calls are made by the debriefing team leader two to three weeks following a debriefing. The teams rely on donations to pay for travel and meals.

    Results:

    One hundred sixty-eight debriefings were conducted during the first four years. Rural agencies accounted for 116 (69%) requests. During this period, 1,514 individuals were debriefed: 744 (49%) firefighters, 460 (30%) EMTs, and 310 (21%) police officers, dispatchers, and other responders. Deaths of children, extraordinary events, and incidents involving victims known to the responders (35%, 14%, and 14% respectively) were the most common reasons for requesting debriefings. Feedback was received from 48 (28%) of the agencies that requested the debriefing. All of those who responded felt that the debriefing had a beneficial effect on its personnel. Specific individuals identified by agency representatives as having the greatest difficulty were observed to be returned to their pre-incident state.

    Conclusion:

    CIS debriefings are judged as beneficial. A statewide response team is an effective way to provide these services at no cost to agencies.