Critical Incident Stress Debriefing Guide

Lennis G. Echterling, Ph.D.
James Madison University

Table of Contents


The BASIC IDS Model of Psychological Reactions

Critical Incident Stress Debriefing Techniques

Disaster Stress Intervention Tools


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 others.


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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Last update: May 28, 1997

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