6 - Debriefing with emergency services: Critical Incident Stress Management

Summary

EDITORIAL COMMENTS

This chapter presents a further view of the Mitchell's model of debriefing and Critical Incident Stress Management (CISM), setting it in a crisis intervention context. Robinson highlights the separation of this model from psychotherapy. She then goes on to differentiate it in professional and workplace terminology, as well as examining its historical context, current status and conceptual basis. The latter defines the social and health model in which it sits and its practical role in the emergency services. Here, its evolution is linked to changes in cultural attitudes towards the acceptance of the psychological trauma model, expansion of psychology and the development of the Mitchell model. She reviews evaluation studies in terms of acceptance of CISM in the emergency service workplace, the reported value of the service for recipients and empirical studies. The latter are reviewed with recognition of the methodological problems in those studies having negative, as well as those with positive, outcomes. The need for evolution of research design is emphasized in view of the complexity of trauma experience, response and other variables shaping outcomes. She also highlights her observation that many of the negative studies do notprovide definitions of the model of debriefing used, and target groups other than emergency workers. She emphasizes the need for the evidence base to be broadened and the essential need for systematic and convergent evaluation using a variety of appropriate methodologies to investigate specific research and evaluation questions.