RESPONDING TO THE PHILIPPINES T YPHOON

Center for the Study of Traumatic Stress
The Center for the Study of Traumatic Stress (CSTS) is part of the Department of Psychiatry, Uniformed Services University of the Health Sciences

The Debriefing Debate
The magnitude of death and■■ Debriefing is an opportunityTheeffectivenessofdebriefing
indestruction in disasters and thefor education about responses
preventing later mental health problems
extent of the response demand
to trauma such as emotional
special attention. Physical safety andreactions to disaster, somaticis much in debate and some studies havesecurity of victims and relief workers
reactions, violence, substancefound that it can cause harm in somemust take first priority. After safety
abuse, and family stress.
is assured, other interventions may
participants.
■■ There are a number of early
begin. Debriefing is a popular, earlyinterventions approaches otherintervention following disasters inthan debriefing. Among these are early evaluation, close
which small groups of people involved in the disaster,follow-up and reevaluation, case management, problem
such as rescue workers, meet in a single lengthy session
solving, emotional support training, sleep medication,
to share individual feelings and experiences. However, theintermittent psychotherapy, advice giving, andeffectiveness of debriefing in preventing later mental healtheducation. These should be considered as intervention
problems is much in debate and some studies have foundplans.
that it can cause harm in some participants. As a minimum■■ During a debriefing there is an important opportunity
the following should be considered if you include debriefing
to identify and triage people who are in need ofas part of an intervention plan.
additional assistance/intervention.
■■ Rest, respite, sleep, food and water are the primary tools■■ Ongoing groups are more helpful than a one-timeof early intervention.
meeting.
■■ It is important to encourage natural recovery processes■■ Talking in homogeneous groups, such as firefighters,such as participants talking to fellow workers, spouses
may be more helpful than in heterogeneous whereand friends. This can decrease isolation and facilitate
participants are strangers to each other.
identification of persistent symptoms and increase the■■ Individuals dealing with the death of a loved one may
chances of early recovery.
have difficulty if placed in a group with others who■■ Debriefing has not been shown to prevent PTSD. For
have survived a death threat. Therefore it is generally
some, it may relieve pain, restore some function andimportant not to mix those who have experienced alimit disability; however, further study is needed.
loss and those who have experienced life threatening■■ Debriefing groups with individuals having different
exposures.
levels and types of exposures may spread exposure from■■ Different people have different stories and concerns.
those with high trauma exposure to those with low
Groups often tend to want to all agree on a single
trauma exposure resulting in more symptoms in low
perspective. In a heterogeneous group this may lead to
exposure individuals.
isolation and stigmatization of some participants.
■■ Debriefing during an ongoing traumatic event may beparticularly problematic.
Reference: B. Raphael & J.P. Wilson (Eds.), Psychological
Debriefing. Theory, Practice and Evidence. UK: Cambridge
University Press, 2000.

Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
4301 Jones Bridge Road, Bethesda, MD 20814-4799
Tel: 301-295-2470 | Fax: 301-319-6965
www.CSTSonline.org