Workplace Interventions

I have been conducting Critical Incident Stress Debriefings since 1993, was a skills coach at the Justice Institute of BC on the CISD skills practice course, and have consulted with communities interested in establishing their own CISD teams.

Critical Incident Stress Debriefings (CISDs) provide an opportunity for those involved in a traumatic incident to get together to talk about a difficult or tragic event.

CISD’s are a form of psychological intervention, but they are NOT therapy sessions. People experience a range of reactions to a traumatic event. Some individuals may be highly impacted, while others may not be bothered at all. Factors determining the impact of an event include:

• severity and nature of the event
• role and level of responsibility
• degree of personal danger
• degree of personal identification
• previous experience with personal crisis
• circumstances of one’s own life
• behaviour of others

It is not necessary to be strongly affected by an incident to participate in a debriefing. In fact, it is useful to have everyone who was involved attend together – as long as they are all comfortable being there.

Benefits of CISD’s

Completes the Puzzle. Individuals responding to an incident often have different roles and perspectives. Sharing information allows team members to see the “big picture”. Having all of the pieces can help us make sense or come to terms with something that may be difficult to deal with.

Activates Social Support. Getting together to talk about a significant incident on a human level can activate and promote natural support systems. Research consistently points to social support as a great way to “lessen” the impact of stress and trauma.

Normalizes Reactions. Individuals may experience a range of very “typical” reactions following a traumatic event. Having the opportunity to talk about reactions and hear colleagues express similar experiences can go a long way toward reassuring them that what they are experiencing is normal. Knowing what is involved in dealing with a difficult incident often makes it “okay” to talk about what is going on with someone they trust.

Being educated about factors that affect individual impact can also offer reassurance to those who may be wondering if they have lost their compassion when unaffected by an event that is significantly upsetting to others.

“Safety Net”. Many clients have told me that they were not very good at recognizing when they needed professional help, thinking they were managing just fine until something happened to cause them to take a closer look at how they were coping (or not coping). Participating in a CISD following a traumatic event can offer those involved an opportunity to check in with themselves to be sure they are on the right track, serves as a reminder to participants about healthy ways to manage reactions, and when to get extra help.

Sample responses from members to the question:
“Do you find debriefings positive and useful?”

• Very good, very helpful, there should be more of them each and every time something traumatic happens.
• It was. It brought to light some underlying issues that I had not realized.
• EXTREMELY!!! It filled in a lot of the gaps of the story and it made me feel better.
• Yes very informative and positive, good forum to discuss incident.
• Yes, it helped to understand others feelings and concerns which in return helped people discover feelings and concerns they may have had and not realized.
• It gave a whole perspective of the incident through other people's eyes.
• It was positive. I was able to hear the whole story right from the source.
• I believe that these debriefings are always positive if not for me for someone else.

Some of the NORMAL reactions individuals may experience include

• Emotional: numbness, anger, sadness, depression, anxiety, survivor guilt, hyper sensitivity
• Physical: fatigue, headaches, general body tension, changes in eating/ sleeping
• Thinking (cognitive): horror, disbelief, can’t concentrate, confusion, spaciness, flashbacks, preoccupied with incident, hind-sight thinking, self-doubt
• Triggers: specific smells, sights, sounds, taste, or touch, may be a reminder of the event and cause some to feel as though they are reliving the experience, and for some, result in avoiding any similar circumstances or situations

These reactions are a normal part of processing a traumatic event, are most often temporary, and should fade with time. If they don’t go away or become more intense with time, that is a sign you may need a professional to help in dealing with it.

Coping Strategies

Strategies are provided to participants to help improve their ability to cope during the initial aftermath of a difficult event.

Strategies include but are not limited to:

• Do not use alcohol or drugs to cope
• Do not isolate yourself
• Eat well and maintain a physical outlet
• Expect the incident to bother you
• Allow time to recover
• Learn about traumatic stress
• Connect with your friends, family, colleagues
• Take time for fun
• Get help if necessary

Final Considerations

• Debriefings should always be conducted in a private, quiet location.
• Participants should include only those involved in the incident.
• Unless there are mitigating circumstances, everyone involved should be invited to attend – however, participation in the process must be voluntary.

NOTE: There is controversy in the literature regarding use of CISD’s. They are NOT intended to prevent PTSD. The timing of these interventions and decisions about who should be present is critical. Care should be taken to ensure debriefings are offered as appropriate, the group is carefully screened, and the intervention is conducted by a SKILLED mental health professional who is trusted by the group.