CISM Debunk - Dr. Bryan E. Bledsoe

• CISM Debunk •iOVERVIEWCritical Incident Stress Management (CISM), and its defining intervention Critical Incident StressDebriefing (CISD), were introduced to EMS in 1983. Since then, it has become widely used inEMS, fire departments, police departments, and other agencies to supposedly mitigate the effectsof traumatic stress.However, there was never any quality scientific evidence to support the practice of CISM/CISD.In fact, most quality studies have found the practice ineffective while some have found that itactually harms some of those debriefed. This page will serve as a repository of scientific studiesrelated to CISM/CISD.Updated 14 JAN 04Amir M, Weil G, Kaplan Z, Tocker T, Witzum E. Debriefing with brief grouppsychotherapy in a homogenous group of non­injured victims of a terrorist attack: a prospectivestudy. Acta Psychiatrica Scandanavia 1998;98:237­234.Bledsoe BE. Critical Incident Stress Management (CISM): Benefit or Risk for EmergencyServices. Prehospital Emergency Care. 2003:7(2):272­79Bledsoe BE, Barnes DE. Beyond the Debriefing Debates. Emergency Medical Services (EMS).2003;32(12):60­68Bledsoe BE. CISM: Possible Liability for EMS Services? Best Practices in Emergency Services.2002;5(6):66­67.Carlier IVE, Voerman AE, Gersons BPR. The influence of occupational debriefing on post­traumatic stress symptomatology in traumatized police officers. British Journal of MedicalPsychology. 2000;73:87­98.Campfield KM, Hills AM. Effect of timing of Critical Incident Stress Debriefings (CISD) on

posttraumatic symptoms. Journal of Traumatic Stress. 2001;14:327­340Deahl MP, Gillham AB, Thomas J, Searle MM, Srinivasan. Psychological sequelaefollowing the Gulf War: Factors associated with subsequent morbidity and the effectivenss ofpsychological debriefing. British Journal of Psychiatry. 1994;165;60­65Devilly GJ, Cotton P. Psychological debriefing and the workplace: Defining a concept,controversies and guidelines for intervention. Australian Psychologist. 2003;38:144­150Groopman J. The Grief Industry: How Much Does Crisis Counseling Help or Hurt? New Yorker.January 26, 2004Greenburg N. A critical review of psychological debriefing: The management of psychologicalhealth after traumatic experiences. J Royal Naval Medical Services. 2001:87(3):158­161Harris MB, Baloglu M, Stacks JR. Mental health of trauma­exposed firefighters and criticalincident stress debriefing. Journal of Loss and Trauma. 2002;7:223­238.Hobbs M, Mayou R, Harrison B, Worlock P. A randomised controlled trial of psychologicaldebriefing for victims of road traffic accidents. British Medical Journal. 1996;313:1438­1439Hytten K, Hasle A. Fire fighters: A study of stress and coping. Acta Psychiatr Scand.1989;80:50­56Jenkins SR. Social Support and Debriefing Efficacy Among Emergency Medical Workers After aMass Shooting Incident. Journal of Social Behavior and Personality. 1996;11(3):477­492Kadet A. Good Grief! Smart Money. 2002 (June):108­114Macnab AJ, Russel JA, Lowe JP, Gagnon F. Critical incident stress intervention after loss ofan air ambulance: two­year follow­up. Prehospital Disaster Medicine. 1999;14(1):8­12.Mayou RA, Ehlers A, Hobbs M. Psychological debriefing for road traffic accident victims.Three­year follow­up of a randomised controlled trial. British Journal of Psychiatry.2000;176:589­593.McNally RT, Bryant RA, Ehlers A. Does early psychological intervention promote recoveryfrom postraumatic stress? Psychological Science in the Public Interest. 2003;4(2):45­79