CISD might not be a good idea

[Faint]

Research suggests it's not always good to talk

Britain's touchy-feely society may think it's good to talk - but research suggests discussing traumatic events can worsen stress and hinder recovery.

Researchers found that counselling routinely offered to people in the immediate aftermath of disaster seldom protected them from developing post-traumatic stress.

Psychologist Simon Wessely, of King's College, London told the New Scientist: "We have an ideology that it's 'good to talk'. But sometimes that's not so."

Researchers were analysing single session debriefings, where a counsellor talks to a victim to help them prepare for any psychological problems they might encounter.

The team found this process could actually worsen stress for those who might have recovered simply by talking with family and friends, or by blocking out the events until they felt ready.

Mr Wessely was joined by Jon Bisson, of the University of Wales, Cardiff, and Suzanna Rose, of the National Health Service's West Berkshire Traumatic Stress Service, based in Reading.

They analysed 11 briefings, which all took place after people had suffered trauma including fires, car accidents, assaults and dog bites.

Three studies found the counselling was of benefit, six concluded that it had made no difference and two found that the counselling had hindered recovery.

Mr Wessely said he believed the sessions primed people to expect to suffer post-traumatic stress.

Story filed: 19:38 Wednesday 25th June 2003

I know I've been through some of those single sessions, I hate them. I'm told what is bothering me and what will make it better. Bull. And if I try to talk about what is bothering ME the debriefers and the other debriefees will skin me alive-gotta toe the party line. Yet if I don't talk at all and just try to endure the session they'll badger me to death about how I'm in denial and just generally a bad person. Nor can these "strictly voluntary" sessions be avoided. Any attempts to do so will lead to the debriefers breaking out the long knives and doing some serious slicing and dicing. Screw them all.

Faint

[Reasonable Rascal]

I've been through the CISD course as taught by Dr. Jeffery Mitchell. The Iowa EMS Association hosted him at their annual convention back in "91. Long course for what is in essense a short debriefing session. Ritualized expurgation of feelings you may or may not wish to bring in in front of others or even conciously review.

I have mixed feelings on the subject myself. I've sat through several debriefings including one back in "87 that predated the formal CISD movement. The Mitchell method calls for a team of debriefers, of whom half do nothing but sit there and listen "just in case." It's like there is an audience sitting there reviewing you.

In the original pre-CISD movement session I mentioned from "87 there was a single psychologist who'd had some experience in post-traumatic stress cases and was as he put it "a good listener." We'd lost our service director in a job-related crash. Ended up most of the medics made the call one way or another. I had the distinct displeasure of making "the call" as part of the first crew on scene. I don't know whether playing pall bearers at te funeral a few days later helped relieve some stress or added to it, but we were a messed group for a while.

RR

[Maple Flag]

About 8 years ago I went through the CISD provider training program through our organization, and I have kept in touch with the counsellors that run the CISD program for us. They indicated that new infomration (not yet conclusive from what I understand) is that CISD may promote longer periods of critical incident stress signs and symptoms. Part of the problem may be that CIS defusings and debriefings are being looked at by some providers as "the cure" and a lack of follow up monitoring and care for people experiencing CIS is resulting. A lot of the information on this comes from the results of defusings and/or debriefings done with 9-11 survivors.

The counsellors we work with are following these developments pretty closely, and have made some changes to the debriefing process as a result. I think that these issues are in the early stages of understanding.