A recent review of eight debriefing studies, all of which met rigorous criteria for being well-controlled, revealed no evidence that debriefing reduces the risk of PTSD, depression, or anxiety; nor were there any reductions in psychiatric symptoms across studies. Additionally, in two studies, one of which included long-term follow-up, some negative effects of CISD-type debriefings were reported relating to PTSD and other trauma-related symptoms (1).
Therefore, debriefings as currently employed may be useful for low magnitude stress exposure and symptoms or for emergency care providers. However, the best studies suggest that for individuals with more severe exposure to trauma, and for those who are experiencing more severe reactions such as PTSD, debriefing is ineffective and possibly harmful.
The question of why debriefing may produce negative results has been considered and hypotheses have been formulated. One theory connects negative outcomes with heightened arousal in the early posttrauma phase and in long-term psychopathology (2,3). Because verbalization of the trauma in debriefing is limited, habituation to evoked distress does not occur. The result may be an increase rather than a decrease in arousal. Any such increased distress caused by debriefing may be difficult to detect in a group setting. Thus, attempting to use debriefing to override dissociation and avoidance in the immediate posttrauma phase may be detrimental to some individuals, particularly those experiencing heightened arousal. Another consideration is that the boundary between debriefing and therapy is sometimes blurred (e.g., challenging thoughts), which may increase distress in some individuals (3). Finally, those facilitating the debriefing sessions frequently are unable to adequately assess individuals in the group setting. They may erroneously conclude that a one-time intervention is sufficient to prevent further symptomatology.
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