Emergency Service May Abandon Critical Incident Stress Debriefing
Roderick Orner
January 1, 1997
The spring 1996 issue of the ESTSS Newsletter featured an article describing the process by which the Lincolnshire Joint Emergency Service was established through the early part of this decade. Although principally an educational strategy for all emergency services in this county, the initiative has also developed a psychological debriefing resource consisting of about 30 individuals who have participated in an introductory workshop on the Mitchell Model of Critical Incident Stress Debriefing. To date approximately 40 debriefings have been held, and systematic evaluation of the impact of these has been carried out by Matthew Hutt as part of a doctorial dissertation presented to Sheffield University.
Hutt's research and that of others confirm a high degree of consumer satisfaction with debriefing meetings. The evidence for a distinct therapeutic effect of this intervention is far from decisive. Rather, the limitations of this critical incident stress management service becomes more and more conspicuous when the data is examined. For instance, Hutt and others report data suggesting that the rated helpfulness of psychological debriefing is inversely proportional to the reported impact of a critical incident on emergency responders. So, the less affected a responder, the more likely it is the intervention will be considered helpful - hardly a resounding endorsement from those who might be in greatest need of staff support and follow-up services.
In light of this evidence, the Strategic Development Group of the Lincolnshire Joint Emergency Services has decided to review and reconsider the advisability of continuing psychological debriefings using the format proposed by Mitchell et al. After consultation with the members of the Debriefer Group, alternative procedures may be formulated for providing this form of critical incident stress management service. There may be a need to reformulate the aims of psychological debriefing in terms of its being part of an assessment process that explicitly seeks to identify those individuals who may be considered most at risk following critical incidents. This will require changes to the structure and content of debriefing meetings, and it confers centrality to the longer-term follow-up arrangements an emergency service may be advised to put in place.
The hope is to reformulate the protocol for psychological debriefing in time to convene a symposium on this subject during this year's ESTSS conference.
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