Critical Incident Stress Debriefings

Critical incidents are traumatic events that cause powerful emotional reactions in people who are exposed to those events. The most stressful of these are line of duty deaths, co-worker suicide, multiple event incidents, disaster or terrorism, delayed intervention and multi-casualty incidents and more, sadly.

What is CISD?

CISD (Critical Incident Stress Debriefing) is designed to help people deal with workplace trauma incidents by returning back to “normal” as soon as possible. Normal is different for everyone, and it is not easy to quantify. Critical incidents raise stress levels dramatically in a short period of time and after treatment a new normal is established, however, it is always higher than the old level. The purpose of the debriefing process is to establish or set the new normal stress levels as low as possible.

The type of intervention used depends on the situation, the number of people involved, and their proximity to the event. The optimum is a three-step approach that addresses the trauma at various stages of progression: defusing, debriefing, and individual follow-up.

Step 1: Defusing

Defusing is done the day of the incident before the person(s) has a chance to sleep. The defusing is designed to assure the person/people involved that their feelings are normal, tells them what symptoms to watch for over the short term and to offer them a lifeline in the form of a telephone number where they can reach someone who they can talk to. Defusings are limited only to individuals directly involved in the incident and are often done informally, sometimes at the scene. They are designed to assist individuals in coping in the short term and address immediate needs.

Step 2: Debriefing

Debriefings are usually the second level of intervention for those directly affected by the incident and often the first for those not directly involved. A debriefing is normally done within 72 hours of the incident and gives the individual or group the opportunity to talk about their experience, how it has affected them, brainstorm coping mechanisms, identify individuals at risk, and inform the individual or group about services available to them in their community. The final step is to follow up with them the day after the debriefing to ensure that they are safe and coping well or to refer the individual for professional counseling. The debriefing process (defined by the International Critical Incident Stress Foundation [ICISF]) has seven steps: introduction of intervener and establishment of guidelines and invites participants to introduce themselves (while attendance at a debriefing may be mandatory, participation is not); details of the event given from individual perspectives; emotional responses given subjectively; personal reaction and actions; followed again by a discussion of symptoms exhibited since the event; instruction phase where the team discusses the symptoms and assures participants that any symptoms (if they have any at all) are a normal reaction to an abnormal event and “generally” these symptoms will diminish with time and self-care; following a brief period of shared informal discussion (generally over a beverage and treat) resumption of duty where individuals are returned to their normal tasks. The intervener is always watching for individuals who are not coping well and additional assistance is offered at the conclusion of the process.

Step 3: Follow Up

The important final step is follow up. Team members generally do this within the week following the debriefing as a check-in. Please contact us to discuss how we can benefit of your workplace should there be any kind of emergency incident.