Global InformationCritical incident stress management information
 | The neutrality of this article's introduction is disputed. (February 2024) |
| Critical incident stress management | |
|---|---|
| Other names | CISM |
| Specialty | psychology |
Critical incident stress management (CISM) has been misunderstood and unfairly criticized as a controversial, non-empirical, adaptive, short-term psychological helping-process that focused solely on an immediate and identifiable problem. Much of the "controversy" stems from confusion of terms.[neutrality is disputed] The overall ICISF Model of Critical Incident Stress Management includes several tactics to help mitigate the effects of a critical incident. It includes pre-incident preparedness to acute crisis management through post-crisis follow-up. Its purpose is to enable people to return to their daily routine more quickly and with less likelihood of experiencing post-traumatic stress disorder (PTSD).[1] The term CISM is frequently confused with one of the group intervention tactics under the model. That is the Critical Incident Stress Debriefing (CISD).
Further, many researchers[who?] appear to consider CISM to be some form of treatment when in fact it is a model of psychological first aid.
Although the creators of CISM have never proposed it as prevention of PTSD, researchers criticize it with evidence that debriefing techniques do not decrease rates of PTSD,[2] Whether that is the case or not, CISM is used by thousands of organizations around the world. Some organizations have adapted their practices of immediate psychological care techniques that do not use debriefing such as those endorsed by the CDC, Red Cross, WHO, American Psychological Association and National Center for Post Traumatic Stress Disorder (NC-PTSD).
A 2002 workshop whose goal was to reach consensus on the mental health response to mass violence recommended ending use of the word "debriefing" in reference to critical incident interventions.[3] Recent evidence-based reviews have concluded that CISM is ineffective and sometimes harmful for both primary and secondary victims,[4] such as responding emergency services personnel. CISM was never intended to treat primary victims of trauma.[5][6][7][8][9][10][11][12][13] One analysis of the psychological debriefing method used in CISM linked it to increased rates of PTSD one year after an event.[2] As of 2022[update], peer-reviewed meta-analysis specifically warn against the clinical use of CISM for all patients, primary or secondary, stating, "clinical guidelines for managing post-traumatic stress recommend not to practice psychological debriefing".[4] The International Critical Incident Stress Foundation refutes these analyses by citing Snelgrove [14] and others who argue that the critics have misapplied the established protocols.
- ^ "Critical Incident Stress Management: Purpose" (PDF). Virginia Beach Department of Emergency Medical Services. Retrieved July 16, 2009.
- ^ a b Rose, S.; Bisson, J.; Churchill, R.; Wessely, S. (2002). "Psychological debriefing for preventing post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews (2): CD000560. doi:10.1002/14651858.CD000560. ISSN 1469-493X. PMC 7032695. PMID 12076399.
- ^ "Mental Health and Mass Violence: Evidence-Based Early Psychological Intervention for Victims/Survivors of Mass Violence: A Workshop to Reach Consensus on Best Practices" (PDF). PsycEXTRA Dataset. 2002. Retrieved 2023-01-10.
- ^ a b Arancibia M, Leyton F, Morán J, Muga A, Ríos U, Sepúlveda E, Vallejo-Correa V (January 2022). "Debriefing psicológico en eventos traumáticos agudos: síntesis de la evidencia secundaria". Medwave (in Spanish). 22 (1): e8517. doi:10.5867/medwave.2022.01.002538. PMID 35100248. S2CID 246443705.
Las principales guías clínicas para el manejo del estrés postraumático recomiendan no practicar debriefing psicológico.
- ^ Mitchell JT (February 10, 2003). "CRISIS INTERVENTION & CISM: A Research Summary" (PDF). International Critical Incident Stress Foundation. Retrieved January 29, 2016.
- ^ Rose S, Bisson J, Churchill R, Wessely S (2002). "Psychological debriefing for preventing post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews (2): CD000560. doi:10.1002/14651858.CD000560. PMC 7032695. PMID 12076399.
- ^ Roberts NP, Kitchiner NJ, Kenardy J, Robertson L, Lewis C, Bisson JI (August 2019). "Multiple session early psychological interventions for the prevention of post-traumatic stress disorder". The Cochrane Database of Systematic Reviews. 8 (8): CD006869. doi:10.1002/14651858.CD006869.pub3. PMC 6699654. PMID 31425615.
- ^ Harris MB, Stacks JS. A three-year five-state study on the relationships between critical incident stress debriefings, firefighters' disposition, and stress reactions. USFA-FEMA CISM Research Project. Commerce, TX: Texas A&M University, 1998.
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crit7was invoked but never defined (see the help page). - ^ Dass-Brailsford, Priscilla (2007). A Practical Approach to Trauma: Empowering Interventions. doi:10.4135/9781452204123. ISBN 978-1-4129-1638-7.