Editing Debriefing (section)

===Crisis intervention===
{{See also|Posttraumatic_stress_disorder#Psychological_debriefing|label 1 = Psychological debriefing}}
Trauma-exposed individuals often receive treatment called ''psychological debriefing'' in an effort to prevent PTSD, which consists of interviews that are meant to allow individuals to directly confront the event and share their feelings with the counselor and to help structure their memories of the event.<ref name=AHRQ2013/>

However, several [[Meta-analysis|meta-analyses]] find that psychological debriefing is unhelpful and is potentially harmful.<ref name="AHRQ2013">{{cite book|last1=Gartlehner|first1=Gerald|last2=Forneris|first2=Catherine A.|last3=Brownley|first3=Kimberly A.|last4=Gaynes|first4=Bradley N.|last5=Sonis|first5=Jeffrey|last6=Coker-Schwimmer|first6=Emmanuel|last7=Jonas|first7=Daniel E.|last8=Greenblatt|first8=Amy|last9=Wilkins|first9=Tania M.|last10=Woodell|first10=Carol L.|last11=Lohr|first11=Kathleen N.|title=Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma|chapter=Discussion |date=2013|publisher=Agency for Healthcare Research and Quality (US)|url=https://www.ncbi.nlm.nih.gov/books/NBK133347/|language=en|pmid=23658936}}</ref><ref name="Feldner2007">{{cite journal |vauthors=Feldner MT, Monson CM, Friedman MJ |title=A critical analysis of approaches to targeted PTSD prevention: current status and theoretically derived future directions |journal=Behav Modif |volume=31 |issue=1 |pages=80–116 |year=2007 |pmid=17179532 |doi=10.1177/0145445506295057|citeseerx=10.1.1.595.9186 |s2cid=44619491 }}</ref><ref>{{cite journal|last1=Rose|first1=S|last2=Bisson|first2=J|last3=Churchill|first3=R|last4=Wessely|first4=S|title=Psychological debriefing for preventing post traumatic stress disorder (PTSD).|journal=The Cochrane Database of Systematic Reviews|date=2002|issue=2|article-number=CD000560|doi=10.1002/14651858.CD000560|pmid=12076399|pmc=7032695}}</ref> A 2019 Cochrane [[Systematic review|Systematic Review]] found low-quality evidence suggesting potential benefit for some people, however, the studies performed had a high degree of uncertainty due to bias and the evidence is not strong enough to recommend multiple sessions of early psychological interventions for all people who are exposed to trauma.<ref>{{Cite journal|last1=Roberts|first1=Neil P.|last2=Kitchiner|first2=Neil J.|last3=Kenardy|first3=Justin|last4=Robertson|first4=Lindsay|last5=Lewis|first5=Catrin|last6=Bisson|first6=Jonathan I.|date=2019|title=Multiple session early psychological interventions for the prevention of post-traumatic stress disorder|journal=The Cochrane Database of Systematic Reviews|volume=2019|issue=8 |article-number=CD006869|doi=10.1002/14651858.CD006869.pub3|issn=1469-493X|pmc=6699654|pmid=31425615}}</ref> As of 2017 The [[American Psychological Association]] assessed psychological debriefing as ''No Research Support/Treatment is Potentially Harmful''.<ref>{{cite web|title=Psychological Debriefing for Post-Traumatic Stress Disorder|url=https://www.div12.org/psychological-treatments/treatments/psychological-debriefing-for-post-traumatic-stress-disorder/|website=www.div12.org|date=19 August 2014 |publisher=Society of Clinical Psychology: Division 12 of The American Psychological Association|access-date=9 September 2017}}</ref>

Critical incident stress debriefing is a [[crisis intervention]] program that is used to provide initial psychosocial relief to rescue workers. It is generally conducted in a group session and held between 24 and 72 hours of the disaster. Each debriefing session follows seven phases:

# Introduction to set rules
# Fact phase to establish what happened
# Cognition phase to discuss thoughts about what happened
# Reaction phase to discuss emotions associated with what happened
# Symptoms phase to learn the signs and symptoms of distress
# Educational phase to learn about post traumatic stress disorder (PTSD) and coping strategies
# Re-entry phase to discuss any other issues and to provide any additional services.<ref name="Carlier et al., 1998">{{cite journal | last1=Carlier | first1=Ingrid V. E. | last2=Lamberts | first2=Regina D. | last3=Van Uchelen | first3=Annephine J. | last4=Gersons | first4=Berthold P. R. | title=Disaster-related post-traumatic stress in police officers: a field study of the impact of debriefing | journal=Stress Medicine | publisher=Wiley | volume=14 | issue=3 | year=1998 | issn=0748-8386 | doi=10.1002/(sici)1099-1700(199807)14:3<143::aid-smi770>3.0.co;2-s | pages=143–148}}</ref>

The goal of this type of debriefing is to stop the individuals from developing PTSD. Although this debriefing is widely used, there is uncertainty how it affects an individual. Researchers Mayou, Ehlers and Hobbs in 2000 were interested in evaluating the 3-year results of a [[randomized controlled trial]] of debriefing for consecutive subjects admitted to the hospital following a traffic accident. The patients were assessed in the hospital using the Impact of Event Scale (IES), Brief Symptom Inventory (BSI) and a questionnaire, and were then reassessed at 3 years and 3 months. The intervention used was psychological debriefing. The results showed that the intervention group had significantly worse psychiatric symptoms, travel anxiety, physical problems, and financial problems.<ref>{{cite journal | last1=Mayou | first1=R. A. | last2=Ehlers | first2=A. | last3=Hobbs | first3=M. | title=Psychological debriefing for road traffic accident victims | journal=British Journal of Psychiatry | publisher=Royal College of Psychiatrists | volume=176 | issue=6 | year=2000 | issn=0007-1250 | doi=10.1192/bjp.176.6.589 | doi-access=free | pages=589–593| pmid=10974967 }}</ref>

In an earlier study conducted by Carlier et al. in 1998, they looked at the symptomatology in police officers that had been debriefed and not debriefed following a civilian plane crash. The results showed that the two groups did not differ in pre-event or post event distress. Furthermore, those who had undergone debriefing had significantly more disaster-related hyper arousal symptoms.<ref name="Carlier et al., 1998"/>

Overall, these results showed that caution should be used when using Critical Incident Stress Debriefing. Studies have shown that it is ineffective and has adverse long-term effects, and is not an appropriate treatment for trauma victims.