Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Psychological Debriefing after a
Crisis: Current Evidence
The magnitude of death and■ Would you benefit from andestruction that often results from
opportunity to identify and
The effectiveness of debriefing indisasters and the extent of thetriage people who are inpreventing later mental health problems
aftermath response often demandneed of additional assistance/special attention. Physical safety andis much in debate and some studies haveintervention?
security of victims and relief workers■ Is it feasible to conduct anfound that it can cause harm in somemust take first priority. After safety
ongoing debriefing group?
participants.
is assured, other interventions may
These have been shown to bebegin. Debriefing is one popularmore helpful than a one-time
early intervention following disasters
meeting.
in which small groups of people involved in the disaster,■ Do you have a homogeneous group (e.g. all firefighters)?
such as rescue workers, meet in a single lengthy session toDebriefing to these groups may be more helpful than inshare individual feelings and experiences. The effectivenessheterogeneous groups where participants are strangers
of debriefing in preventing later mental health problems
to each other.
is controversial and some studies have found that it may
even be harmful to some individuals. Debriefing has
If you answer Yes to ANY of these, consider seeking
been largely replaced by an alternative early intervention
consultation prior to debriefing:with strong support called Psychological first aid (PFA),■ Does your group contain individuals with different
which seeks to sustain an environment of (1) safety, (2)levels of trauma and varying types of exposures tocalm,(3) connectedness to others, (4) self-efficacy — orthe crisis? This may spread exposure from thoseempowerment, and (5) hopefulness. However, debriefing iswith high trauma exposure to those with low trauma
still used by some.
exposure resulting in more symptoms in low exposure
individuals.
Consider the following if you include debriefing as■ Is the traumatic event ongoing? Debriefing during thepart of an intervention plan:
event may be particularly problematic.
■ Rest, respite, sleep, food, and water are the primary tools■ Does your group contain individuals dealing with theof early intervention.
death of a loved one and individuals who have survived■ It is important to encourage natural recovery processes
a death threat? This may present a difficulty for thosesuch as participants talking to fellow workers, spouses,
dealing with the death of a loved one. Therefore, it
and friends. This can decrease isolation and facilitateis generally important not to mix those who haveidentification of persistent symptoms and increase theexperienced a loss and those who have experienced life
chances of early recovery.
threatening exposures.
■ Debriefing has not been shown to prevent PTSD. For■ Is your group heterogeneous? This may lead to isolationsome, it may relieve pain, restore some function, andand stigmatization of some participants because groups
limit disability; however, further study is needed.
often tend to want to all agree on a single perspective if
different people have different stories and concerns.
If you answer ‘yes’ to ALL of these, consider
debriefing:
Remember, there are a number of early intervention■ Would you and your group benefit from an opportunity
approaches other than debriefing. Among these are PFA,
for education about responses to trauma (e.g. emotional
which has better evidence of benefit and should be applied
reactions to disaster, somatic reactions, violence,Continued
substance abuse, and family stress)?

to other interventions such as early evaluation, close
follow-up and reevaluation, case management, problem
solving, emotional support training, sleep medication,intermittent psychotherapy, advice giving, and education.
These should be considered as intervention plans.

Additional Resources
Psychological First Aid: How You Can Support Well-Being
in Disaster Victims
https://www.cstsonline.org/resources/resource-masterlist/psychological-first-aid
B. Raphael & J.P. Wilson (Eds.), Psychological Debriefing.
Theory, Practice and Evidence. UK: Cambridge UniversityPress, 2000.

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org