EFFECTIVENESS OF CRITICAL
INCIDENT STRESS DEBRIEF IN
COMBATING POSTTRAUMATIC
STRESS DISORDER (PTSD)
Literature Review by D...
This literature review looks at the process of assessing the effectiveness of critical
incident stress debriefs (CISD) fol...
History of CISD
 Established in 1986, the Mitchell model was
designed to help prevent PTSD in emergency
personnel
 Estab...
CISD contains seven separate phases:
Introductory phase – facilitator discusses rules for the
group that can consist of la...
Timeliness
Several studies were conducted to show the effectiveness of
a CISD depending on when the CISD was administered....
Several studies that did evaluate the effects of a CISD with
military personnel were found to be inconclusive due to
limit...
•Possible reasons for recent studies not finding positive
results from CISDs
• The Mitchell model was not followed explici...
Future Studies
 Evaluate effectiveness of CISDs conducted in
Iraq or Afghanistan for traumatic events
 Approximately 535...
Ensure CISDs conducted according to the Mitchell model
Maintain continuity to assess effectiveness
Evaluate reliability of...
Conclusion
 Additional studies of traumatic events need
to be conducted
 Elimination of CISDs in military theater of
ope...
References
Adler, A. B., Litz, B.T., Castro, c. A., Suvak, M.,Thomas, J. L., Burrell, L., McGurk, D.,Wright, K. M., & Blie...
Upcoming SlideShare
Loading in …5
×

Critical Incident Stress Debrief Literature Review

2,400 views

Published on

Effectiveness of CISDs in alleviating PTSD symptoms

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
2,400
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
47
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Critical Incident Stress Debrief Literature Review

  1. 1. EFFECTIVENESS OF CRITICAL INCIDENT STRESS DEBRIEF IN COMBATING POSTTRAUMATIC STRESS DISORDER (PTSD) Literature Review by Danielle Smith Trauma PTSD CISD
  2. 2. This literature review looks at the process of assessing the effectiveness of critical incident stress debriefs (CISD) following a traumatic event in alleviating PTSD symptoms. Several studies have been conducted but with different criteria for a traumatic event, the timeliness of the CISD, and the measures of the outcomes of a CISD. The participants in the review range from military soldiers to police officers to survivors of a hurricane. CISDs were conducted anywhere between 10 hours and six months with the assessments ranging from two days to six years. There are too many variations of measurement for an accurate assessment of the effectiveness to reduce PTSD symptoms that they are not reliable. The literature reviewed has some success in establishing effectiveness of the CISD, while other show there is none. Research needs to be conducted with distinct measures that can be repeated. An accurate assessment needs to be conducted to help mental health providers treating military personnel that suffered traumatic events, being susceptible to PTSD. Abstract
  3. 3. History of CISD  Established in 1986, the Mitchell model was designed to help prevent PTSD in emergency personnel  Established for groups of people in the same field of work to discuss traumatic events  Members articulate what happened and know that others feel the same way that they do  Part of a management model: critical incident stress management, that continues with therapy if needed  Conducted between 24 to 72 hours after a traumatic event  CISDs should last between one to three hours
  4. 4. CISD contains seven separate phases: Introductory phase – facilitator discusses rules for the group that can consist of language, talking one at a time, and respect for others Fact phase – everyone tells what happened, together they get a clear picture of the events Thought phase – what each person thought about what happened Reaction phase – first reactions to what was happening Symptom phase - what symptoms are expected over time Teaching phase – educate group members on possible outcomes after experiencing trauma Re-entry phase – Getting back to work or normal daily activities, seek additional help if needed History of CISD cont.
  5. 5. Timeliness Several studies were conducted to show the effectiveness of a CISD depending on when the CISD was administered. A CISD, according to the Mitchell model, should be conducted within 24 to 72 hours after a traumatic event. One study by Campfield and Hills (2001) conducted a CISD 10 hours after an event and compared it to a group that had a CISD at 48 hours. The assessments were conducted at two days, four days, and two weeks. The research did show reduction in PTSD symptoms between the two groups. A CISD conducted in Iraq with military police and Iraqi detainees proved to be very effective not just in alleviating PTSD symptoms, but also in relations between the two groups. Assessments taken for the studies reviewed were conducted 90 days, six months, or even six years after the CISD was conducted. Only one assessment conducted, without a baseline, could not accurately determine the effectiveness of a CISD. These time frames do not allow for the natural recovery of traumatic events.
  6. 6. Several studies that did evaluate the effects of a CISD with military personnel were found to be inconclusive due to limited number of soldiers that meet the diagnosis for PTSD. The three studies evaluated a total of 1,239 soldiers after a six month rotation to Bosnia. They found that a total of only 63 met the strict criteria for PTSD. These studies conducted a CISD for an entire six month period and not a traumatic event, and assessed the effectiveness of the CISD only once. Traumatic Events
  7. 7. •Possible reasons for recent studies not finding positive results from CISDs • The Mitchell model was not followed explicitly, not effectively assessing the results • CISDs not conducted with the 24 to 72 hours time frame • Assessments completed anywhere from two days to six years after a traumatic event • CISD and assessments conducted 90 days to six months after trauma • Studies not controlled or conducted with randomized participants Standards of Measurements
  8. 8. Future Studies  Evaluate effectiveness of CISDs conducted in Iraq or Afghanistan for traumatic events  Approximately 535 CISDs conducted in Iraq within a six month period  No studies conducted using current data from theater of operations
  9. 9. Ensure CISDs conducted according to the Mitchell model Maintain continuity to assess effectiveness Evaluate reliability of other studies based off same techniques Future Studies Cont.
  10. 10. Conclusion  Additional studies of traumatic events need to be conducted  Elimination of CISDs in military theater of operations if found ineffective  New techniques developed to assist soldiers
  11. 11. References Adler, A. B., Litz, B.T., Castro, c. A., Suvak, M.,Thomas, J. L., Burrell, L., McGurk, D.,Wright, K. M., & Bliese, P. D. (2008). A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers. Journal ofTraumatic Stress, 21(3), 253-263. doi:10.1002/jts.20342 Campfield, K. M., & Hills, A. M. (2001). Effect of timing of critical incident stress debriefing (CISD) on posttraumatic symptoms. Journal ofTraumatic Stress, 14(2), 327(14). Chemtob, C. M.,Tomas, S., Law,W., Cremniter, D., (1997). Post disaster psychosocial intervention: A field study of the impact of debriefing on psychological distress.TheAmerican Journal of Psychiatry (Washington), 154(3). Deahl, M., Srinivasan, M., Jones, N.,Thomas, J., Neblett, C., Jolly, A. (2000). Preventing psychological trauma in soldiers:The role of operational stress training and psychological debriefing. British Journal of Medical Psychology, 73, 9. Everly Jr, G. S., Boyle, S. H., & Lating, J. M. (2001).The effectiveness of psychological debriefing with vicarious trauma: A meta-analysis. Stress Medicine, 15(4), 229(5). Hoge, C.W. (2004). Combat duty in Iraq andAfghanistan, mental health problems, and barriers to care New England Journal of Medicine, 351(1), 13 to 22. doi:10.1056/NEJMoa040603 Hung, B. (2008). Behavioral health activity and workload in the Iraq theater of operations. U.S.Army Medical Department Journal, 39-42. Larsson, G., Michel, P., & Lundin,T. (2000). Systematic assessment of mental health following various types of posttrauma support. Military Psychology, 12(2), 121-135. Leonard, R., &Alison, L. (1999). Critical incident stress debriefing and its effects on coping strategies and anger in a sample of Australian police officers involved in shooting incidents.Work & Stress, 13(2), 144-161. doi:10.1080/026783799296110 Smith, M. H., Brady, P. J. (2006). Changing the face of AbuGhraib through mental health intervention: U.S. army mental health team conducts debriefing with military policemen and Iraqi detainees. Military Medicine (Bethesda), 171(12), 4. References

×