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Home » PTSD

Psychiatric Times. Vol. 21 No. 4
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Psychological Debriefing Does Not Prevent Posttraumatic Stress Disorder

By Richard J. McNally, Ph.D. | April 1, 2004

Each of these specious critiques is devoid of merit, and each has been rebutted in detail elsewhere (for a review, see McNally et al. [2003]). Although debriefing advocates often complain that researchers fail to follow protocol precisely in studies showing null or toxic effects, these advocates must first demonstrate that their method actually works. Then their complaints about protocol departures may be warranted--only after they have furnished convincing evidence of the efficacy of their method.

Conclusions

 

Despite repeated attempts to document that psychological debriefing can prevent posttraumatic psychopathology, there is no convincing evidence that it does so. Even if the procedure is not harmful, its continued implementation may delay the development of truly effective crisis interventions, while wasting time, money and resources on a method that is, at best, inert.

 

Dr. McNally is professor of psychology at Harvard University. He has more than 230 publications, many on PTSD, and is author of the book Remembering Trauma (2003), Belknap Press/Harvard University Press.

 

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References

Bisson JI, Jenkins PL, Alexander J, Bannister C (1997), Randomised controlled trial of psychological debriefing for victims of acute burn trauma. Br J Psychiatry 171:78-81 [see comments].

Everly GS Jr, Mitchell JT (1999), Critical Incident Stress Management (CISM): A New Era and Standard of Care in Crisis Intervention (Innovations in Disaster and Trauma Psychology, Vol. 2). Ellicott City, Md.: Chevron Publishing Corporation.

Hobbs M, Mayou R, Harrison B, Worlock P (1996), A randomised controlled trial of psychological debriefing for victims of road traffic accidents. BMJ 313:1438-1439.

Mayou RA, Ehlers A, Hobbs M (2000), Psychological debriefing for road traffic accident victims. Three year follow-up of a randomised controlled trial. Br J Psychiatry 176:589-593 [see comments].

McNally RJ, Bryant RA, Ehlers A (2003), Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest 4(2):45-79.

Mitchell JT (1983), When disaster strikesýthe critical incident stress debriefing process. J Emerg Med Serv 8(1):36-39.

Mitchell JT (2003), Crisis intervention & CISM: a research summary. Available at: www.icisf.org/articles/cism_research_summary.pdf. Accessed Feb. 11, 2004.

Mitchell JT, Everly GS Jr (2001), Critical Incident Stress Debriefing: An Operations Manual for CISD, Defusing and Other Group Crisis Intervention Services, 3rd ed. Ellicott City, Md.: Chevron Publishing Corporation.

Raphael B, Wilson JP, eds. (2000), Psychological Debriefing: Theory, Practice and Evidence. Cambridge, U.K.: Cambridge University Press.

Rose S, Bisson JI, Wessely S (2001), Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane Review). In: The Cochrane Library, issue 4. Oxford: Update Software. Abstract available at: www.update-software.com/abstracts/AB000560.htm. Accessed March 11, 2004.

van Emmerik AA, Kamphuis JH, Hulsbosch AM, Emmelkamp PM (2002), Single session debriefing after psychological trauma: a meta-analysis. Lancet 360(9335):766-771 [see comment].


 
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