The Development and Applications of Critical Incident Stress Debriefing

Judith Herman, a psychiatric researcher, states in her book, Trauma and Recovery, “the conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma.” (Herman 1) She captures the two main schools of thought existing regarding the treatment of Post-Traumatic Stress Disorder (PTSD). Some advocate the act of recounting the traumatic events, while others do not consider this to have therapeutic benefits. This divide was seen in World War 1 and the treatment of shell shock patients and is still seen today. In this paper, the presence of storytelling and lack thereof in traumatic shock treatment from WWI onward will be observed.

Working in the field of Emergency Response I have seen and felt first hand the effects of posttraumatic stress disorder. It is not possible to respond to emergency after emergency and not be subject to some of PTSD’s effects. When I saw this topic in the list I felt compelled to use this opportunity to learn more. My hope is by increasing my knowledge, of a disorder so prevalent in my career field; I can recognize the symptoms in others and myself before there effect becomes devastating.

I agree the biggest issue with dealing with mental health is people are unwilling to accept or even acknowledge that they need assistance. As you stated changing the perception of receiving mental assistance is the key to increasing the amount of first responders accepting help. Changing the stigma of the strong sucks it up and the weak can’t take it, has to be implemented by people in the position of authority. Making it mandatory with first responders and even in the military that critical incident stress debriefing (CISD) should be initiated within 24-48 hour after experiences any traumatic event may reduce any long-term impact.

PTSD having been on the rise following various deployments necessitated by the various wars against terror, where the soldiers encounter traumatic experiences like harsh training conditions, unfavorable living standards, enemy attacks, extreme working environment, explosions, torture by enemies, loss of colleagues as well as long term separation from family back at home (Melinda S & Jeanne S., 2012). This therefore calls for a concerted effort in handling the pandemic of PTSD since it has been constantly on the increase and as a

Posttraumatic stress disorder (PTSD) is a commonly recognized stress disorder found in many combat soldiers after exposure to life-threatening and traumatic experiences. Since 2001, the prevalence of PTSD has increased with over 2.4 million troops deployed to warzones in Afghanistan and Iraq (U.S. Department of Veterans Affairs, 2012). Although researchers and civilians commonly understand symptoms of PTSD, they often fail to recognize the difficulties veterans’ face- reintegration into civilian society, alienation, and identity crises (Demers, 2011). Currently there exist two major sources for best practice guidelines in the management of PTSD. They include the VA/DoD Clinical Practice Guidelines for Management of Post-traumatic

Anger, aggression and confusion are a few symptoms of the fabled myth of Post-Traumatic Stress Disorder (PTSD). An over whelming feeling that devours men and women of the armed forces, but hasn’t been talked about openly until, now. A subject no one likes to openly speak of, due to fear of being cast out as an outsider among the normal people who never witnessed something so traumatic can function in normal society today.

One of the most common personal problems faced by first responders is PTSD. Post-traumatic stress disorder is a prolonged stress response caused by serious and sometimes dangerous emotional events that interfere with daily functioning. Those who suffer from TPSD tend to avoid socializing, have flashbacks of the event, and are emotionally tense (“The Link Between PTSD…”, 2017). Considering the definition and what first responders do, it is understandable that they develop this problem. It is also not confounding to know that they face a 95% increase in their risk of developing it when a fellow employee dies, by being the victim of some form of abuse, or after dealing with psychiatric patients (Khashaba et al., 2014). It is rather common that first responders will become the victim of some type of abuse, either due to premeditated aggression from people who are biased against uniformed workers or by patients who have conditions that make them involuntarily hostile, such as postictal patients who are recovering from a seizure. While both are very stressful events, a study

For a very long time, it has been recognized that stressful life can have an emotional as well as a behavioral effect in a human being. Studies show that 60% of men, 50% of females as well as 90% of the population go through a stressful event in their lives that is life changing or they tend never to forget ever (Marsh, 2014). It is however true to say that not all of the people in this percentage will eventually fall into post-traumatic stress disorder (PTSD). When an individual is involved or encounters an event that is considered as traumatic, it is very common to experience distressing, upsetting, as well as confusing feelings in the near future after the event. The worst part is that these feelings may not emerge or surface immediately, the first thing that you actually go through is emotional numbness where nothing gets to you emotionally, thus the shift in your behavior will follow. After a while, a drastic shift in physical and emotional reactions is experienced in cases such as one being easily upset or simply not being able to get any sleep at all.

The experience leading to posttraumatic stress doesn’t have to last hours on end. In fact, the entire confrontation could last but a short thirty seconds. For many first responders in life-threatening situations, these few seconds can adversely affect the rest of their life (Willis, 2014). From that day or night on, the one affected will be plagued by sleepless nights, nightmares during the minimal hours of rest, and periodic anxiety attacks (Willis, 2014). In just thirty seconds, a well-trained first responder can go from being emotionally stable with a happy heart and life to having an unstable family, marriage, and have an inability to effectively perform many of his or her job duties. In just thirty seconds, one can develop a case of (undiagnosed) posttraumatic stress disorder (Willis, 2014).

The chapter ‘Clinical Histories: From Soldier’s Heart to PTSD’ from the book ‘Fields of Combat’ by Erin Finley, examines U.S. military community’s perception of combat stress casualties. From the Civil War times until now, there has been growth in the understanding that soldiers face extreme psychological consequences, like behavioral and functional problems, after returning home from war. In 1980, this behavioral and functional problem is formally recognized as Post-Traumatic Stress order (PTSD) in the U.S. and it was internationally recognized in the late 1980’s. Not only was the diagnosis given to survivors of combat, but also noncombat traumatic experiences, such as rape, natural disaster, rape and etc. The chapter looks at the historical

Because PTSD typically occurs soon after the traumatic event occurs, early intervention needs to take place. A common means of early intervention for persons suffering from PTSD is known as psychological debriefing (PD). PD attempts to lessen or prevent psychological damage by utilizing specialized debriefing methods. This tries to target the triggers causing PTSD to

Triggers. This is a word that many individuals suffering from Post-Traumatic Stress Disorder (PTSD) are familiar with. Individuals who suffer from PTSD oftentimes avoid trauma related stimuli, because it may trigger a painful experience that will remind them of their previous distressing encounter (Nairne, 2014). Flashbacks, lack of sleep, nightmares, disturbing thoughts; these can all occur to an individual suffering from PTSD. Post-Traumatic Stress Disorder is typically developed after a distressing experience, and results in maladaptive symptoms, such as depletion in cognitive function and fluctuating mood, that affect the individual’s day to day life (Nairne, 2014). This causes PTSD sufferers to avoid anything that may trigger a flashback

During this Canadian military research, the management learned that a great way of preventing combat stress or PTSD is by providing computer base training. This training is built to get the members mentally ready for unforeseen circumstances. The computer base training (CBT) includes but not limited on combat scenarios, first responders to wounded and casualty members. The training tends to be realistic that they will show them how to conduct self aid buddy care (SABC). Self aid buddy care is taught, so during combat the members can assist the injure until medical staff can take over the scene.

Crisis intervention means different things to different events. For example, in terms of PTSD, natural disasters, manmade disasters, and trauma response the intervention is different for each. For example, a soldier who suffers from PSTD may have also experienced psychological crisis while experiencing the events that led to the condition. It is also important to note, that PTSD is not exclusive to people who have served in the military, Kanal (2011) states that this condition is found in people who have experienced multiple traumatic events. Although this is recent diagnoses, PTSD has been present throughout the centuries. However, many people adjust and move on with their lives after such events. The author cites a survey that was conducted

Mitchell has been shown to be credible because of the seven steps he believes to be workable. In 1983, he introduced Critical Incident Stress Debriefing (CISD). The model he developed was designed to prevent and manage the horror resulting from traumatic stress, and reduce the casualties among emergency service personnel. Mitchell model poses the below seven unique phases, which are integrated with stress education and information throughout the process.