Psychological debriefing and the workplace: Defining a concept, controversies and guidelines for intervention

Critical incident stress debriefing (CISD), a specific form of psychological debriefing, has gained widespread acceptance and implementation in the few short years since it was first proposed (Mitchell, 1983). However, there has been recent doubt cast on this practice and confusion regarding the terminology used. This article explores the claims frequently made by proponents regarding its use, counterclaims of ineffectiveness by its detractors, and general consensus regarding its specific use and the use of more generic psychological debriefing. We conclude that the recently introduced critical incident stress management (CISM) and its proposed progenitor, CISD, are currently poorly defined and relatively indistinct in the treatment-outcome literature and should be treated similarly. Current expert consensus and meta-analytic reviews suggest that CISD is possibly noxious, generic psychological debriefing is probably inert and that more emphasis should be placed on screening for, and providing, early intervention to those who go on to develop pathological reactions. A set of generic guidelines for the minimisation and management of workplace traumatic stress responses is also proposed.