Using the title critical incident debriefing (CID) without further clarification, as tends to happen, especially in the popular press, or to have it briefly and dismissively mentioned in passing as 'counselling' tends to give readers the wrong impression. One of these impressions is that CID will always indicate that the same procedures are being followed in each case. This could not be further from the truth. Over the years we have come across nine, seven, five and three step CID models.

On occasion we have come across people offering defusing techniques and calling them CID, which will only ever serve to muddy the waters when the effectiveness or otherwise of CID is being evaluated. In other cases we have come across people in management positions who were very verbal in their hostility to debriefing as a concept, yet who could not give even the most basic explanation for this bias. In other words, they did not know what debriefing was, and had allowed their decisions and views to be influenced by inaccurate reporting based on dogma rather than the facts.

A charge sometimes made against debriefing is that it does not always work. This is to say that it sometimes does? Ironically, this same charge could be levied against psychotherapy, counselling, and hypnotherapy and in fact sometimes is. However it is rarely made against the former with the level of critical disdain that is often made against debriefing.

Rarely, if ever, is it used in an attempt to justify not employing the aforementioned methods of psychological therapy, though it is an argument sometimes employed in an attempt to justify not using debriefing. One of the problems that have become attached to CID over the years is the impression that it is a stand-alone process. 

However, when viewed in a larger context, that of CISM, we find that it becomes one of only a number of stress inoculation techniques, interventions and support mechanisms available to mental health professionals, therapists, charity and voluntary self-help groups.

These include pre-incident educational initiatives, support at the scene, demobilisation, both peer support (similar to the RAP sessions popularised by Vietnam Veterans in the USA) and family support, defusing, relaxation training, follow up services and referral procedures. These all form part of CISM.

Another question that needs to be addressed is does the debriefer inspire confidence? The simple answer is not always! Sometimes a CID will not work simply because of a mismatch between the debriefer and those being debriefed. A roomful of policemen or soldiers might not be very impressed by an obviously very academic degree qualified psychologist, but may have more respect and co-operate more with a former policeman or soldier who understands their way of thinking and dealing with things. In other words someone who has shared his or her world!

Whatever some professionals and other observers might say about CID there is a recent trend among emergency services personnel in the UK to start their own voluntary and charitable support groups. The United States already leads the world in providing and making available these services.

While I was actively involved in a charity offering psychological support to traumatised members of the emergency services and their families last year there was a steady stream of inquiries from other parts of the country. These came from serving officers in all of the emergency services seeking advice and training in setting up their own support groups. 

This situation is very much one of demand and supply. Word on the street is that these services are very much in demand - one ambulance worker attending a charity meeting asks why this had not been done years ago? However, things are viewed differently in the world of the bean counter: life is much safer sitting behind that desk. 

Immediate apologies to those administrators who have gone all the way to help their front line personnel, none whatsoever to those who have not!

Staff Writer...

www.health-concern.com