Critical Incident Stress Debriefing Guide
Lennis G. Echterling, Ph.D.
James Madison University
Table of Contents
The Process of Recovery
A Rationale for Debriefing
The Process of Critical Incident Stress Debriefing
Scanning for Stress Reactions
Using the Natural Helping Network
The physical effects of a critical incident are graphically
and powerfully obvious. As painful as they are to see, we cannot
ignore the mutilations, the scars, and the injuries that victims may
be forced to endure. However, we often miss noticing that these
victims also have psychological wounds that can be just as painful
and disabling. Flashbacks, depression, anxiety, nightmares,
headaches, and substance abuse are only some of the possible
consequences of a traumatic experience.
To make matters worse, it is not only the direct victim who is
affected by the incident. Those who witnessed the incident, those who
are coworkers, friends or relatives of the victim, and those who
responded to the incident are also affected psychologically. These
indirect victims may experience guilt or shame, they may be plagued
by tension and fears, they may have eating and sleeping problems, and
they may feel haunted by the scenes of the traumatic event.
These problems are distressing to anyone, but they can be
lethal to a law enforcement officer, a fire fighter, or a rescue
worker. These jobs require careful attention to detail,
concentration, good judgment, and an ability to handle the chronic
stress of high risk work. Any psychological symptom of distress that
can impair work effectiveness could be fatal to the individual or to
The purpose of this guide is to provide useful information and
practical suggestions for responding quickly and effectively to the
stress of critical incidents. Offering Critical Incident Stress
Debriefing (CISD) and other forms of support immediately after an
incident can mean the difference between a healthy recovery and
long-term, serious problems.
This guide focuses on providing these supportive interventions
to both civilian populations, in order to reduce the long-term
negative effects of trauma, and to emergency responders, in order to
prevent work impairment following a critical incident.
Following this introduction, the guide offers an overview of
the psychological effects of critical incidents. Next, it details the
specific guidelines for doing CISD sessions and offering other forms
of support to victims. Throughout the narrative, this report
identifies potential resources, discusses the cultural influences on
responses to traumatic stress, and makes specific recommendations for
dealing with the psychological effects of traumas.
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