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Critical Incident Stress Debriefing (CISD) is a widely used intervention approach designed to help individuals process and cope with the psychological impact of traumatic events (Mitchell & Everly, 1996). It was developed in the late 1980s to address the needs of emergency service personnel who were frequently exposed to traumatic incidents and were at a higher risk of developing post-traumatic stress disorder (PTSD) (Mitchell, 1983; Mitchell & Everly, 2001). CISD is based on the belief that prompt intervention can prevent the development of long-term psychological distress and facilitate the recovery process (Mitchell & Everly, 1996).

The goal of CISD is to provide timely support and education to individuals who have experienced a critical incident. It typically involves a structured group session led by trained mental health professionals or peer supporters. The CISD session aims to provide a safe and supportive environment where participants can discuss their experiences, thoughts, and feelings about the traumatic event.

The CISD process typically consists of several phases, including the introduction, fact phase, thought phase, reaction phase, and re-entry phase (Mitchell & Everly, 1996). In the introduction phase, participants are given an overview of the CISD process, confidentiality guidelines, and an opportunity to ask questions. This phase is crucial in establishing trust and creating a safe environment for sharing.

The fact phase involves gathering factual information about the critical incident. The facilitator encourages participants to recount the event in a detailed and chronological manner. This helps to establish a shared understanding of the incident and allows participants to validate their experiences.

The thought phase focuses on exploring participants’ thoughts and cognitive reactions to the critical incident. The facilitator may ask questions to encourage participants to reflect on their beliefs and interpretations of the event. This phase aims to help individuals identify and challenge any irrational or unhelpful thoughts that may contribute to their psychological distress.

The reaction phase focuses on the emotional and physical reactions experienced by individuals in response to the critical incident. Participants are encouraged to express their emotions and to discuss any physical symptoms they may have experienced. The facilitator provides validation and support while normalizing these reactions as common responses to traumatic events.

The re-entry phase focuses on assisting individuals in the process of returning to their normal daily activities following the incident. This phase aims to address any concerns or barriers individuals may have in resuming their usual routines. The facilitator may provide information on coping strategies and resources available to support individuals during the recovery process.

CISD is typically conducted within hours or days following a critical incident (Mitchell & Everly, 1996). It is believed that early intervention allows for the timely processing of emotions and cognitive reactions, potentially preventing the development of PTSD or other long-term psychological difficulties.

Empirical evidence on the effectiveness of CISD has been mixed (Raphael, Meldrum, & McFarlane, 1995; Everly & Mitchell, 2008). While some studies have shown positive outcomes in terms of reducing psychological distress and preventing PTSD, others have found no significant effects or even potential harm associated with CISD (Rose, Bisson, Churchill, & Wessely, 2002; Bisson et al., 2003).

One study by Rose et al. (2002) examined the effects of CISD among individuals who had experienced a motor vehicle accident. The study found no significant differences in the incidence of PTSD between those who received CISD and those who did not. Moreover, participants who received CISD reported higher levels of distress at the three-month follow-up compared to the control group. These findings raised concerns about the potential unintended adverse effects of CISD.

It is important to note that CISD is not intended to replace or substitute for formal mental health treatment (Mitchell & Everly, 1996). It is a preliminary intervention aimed at providing immediate support and education to individuals exposed to critical incidents. Individuals who continue to experience psychological distress or exhibit symptoms of PTSD are encouraged to seek further mental health assessment and treatment.