CRITICAL INCIDENT

STRESS DEBRIEFING

PREPARED BY:
RIZZA MAE MIRANDA GOÑEZ
Objectives:
You will be able to:

Define “critical incident”

Explain the potential impact of a
critical incident
Describes the steps in critical incident
debriefing
WHAT IS CRITICAL
INCIDENT?
It is an event (or cascade of events)
that overwhelms normal coping
mechanisms and can interfere with
one’s usual ability to function.

Note: Not every stressful event is a

critical incident.
CRITICAL INCIDENT
EXAMPLES
•disasters.
•wars.
•death (actual or threatened)
•vehicle accidents.
•assaults – physical, sexual or
psychological being threatened with
harm.
•being witness to an event that caused
someone harm.
SYMPTOMS
FOLLOWING A CRITICAL
INCIDENT
Sleep Disturbance
Inability to concentrate
Inability to make decisions
Loss of confidence
Extreme fear of making a mistake
Preoccupation with the incident
Social withdrawal
COMMON UNHEALTHY
COPING STRATEGIES
Self-Medication (alcohol, samples,
self-prescribing)
Isolation
Blaming and Anger
Over-Compensation at work
WHAT IS CRITICAL
INCIDENT DEBRIEFING
 Critical Incident Stress Debriefing (CISD) is a specific, 7-phase,
small group, supportive crisis intervention process. It is just one of the
many crisis intervention techniques which are included under the
umbrella of a Critical Incident Stress Management (CISM) program.
The CISD process does not constitute any form of psychotherapy. It is
simply a supportive, crisis-focused discussion of a traumatic event
(which is frequently called a “critical incident”). The Critical Incident
Stress Debriefing was developed exclusively for small, homogenous
groups who have encountered a powerful traumatic event. It aims at
reduction of distress and a restoration of group cohesion and unit
performance.
WHO CAN FACILITATE SESSION
 A respected member of staff
 Willing to take CISD training
 Willing to volunteer time and be available on short notice
 Not involved in the incident they help others to debrief
 STRUCTURED PROCESS
PHASE
1. INTRODUCTION In this phase, the members introduce themselves and describe the process. They present guidelines
for the conduct of CISD and they motivate the participants to engage actively in the process.

2. FACTS This phase helps the participants to begin talking. It is easier to speak of what happened before they
describe how the event impacted them.

3. THOUGHTS The thought phase is a transition from the cognitive domain toward the affective domain. It is easier
to speak of what one’s thoughts than to focus immediately on the most painful aspects of the event.

4. REACTIONS The reaction phase is the heart of a Critical Incident Stress Debriefing. It focuses in the impact on the
participants. Anger, frustration, sadness, loss, confusion, and other emotions may emerge.

5.SYMPTOMS The team members listen carefully for common symptoms associated with exposure to traumatic
events

6. TEACHING The team conducting the Critical Incident Stress Debriefing normalizes the symptoms brought up by
participants. They provide explanations of the participants’ reactions and provide stress management
information

7. RE-ENTRY The participants may ask questions or make final statements. The CISD team summarizes what has
been discussed in the CISD. Final explanations, information, action directives, guidance, and
thoughts are presented to the group
CONCLUSION
 Debriefing is a specific technique designed to assist others in
dealing with the physical or psychological symptoms that are
generally associated with trauma exposure. Debriefing allows
those involved with the incident to process the event and reflect
on its impact. Ideally, debriefing can be conducted on or near
the site of the event (Davis, 1992; Mitchell, 1986). Defusing,
another component of CISD, allows for the ventilation of
emotions and thoughts associated with the crisis event.
Debriefing and defusing should be provided as soon as
possible but typically no longer than the first 24 to 72 hours
after the initial impact of the event.
REFERENCE
 American Psychiatric Association (2000). Diagnostic and Statistical Manual for Mental
Disorders . Washington, DC: American Psychiatric Press.
 Davis, J. A. (March, 2004). On-site critical incident stress debriefing field interviewing
techniques utilized in the aftermath of mass disaster. Training Seminar to Emergency
Responders and Police Personnel, San Diego, CA.
 Davis, J. A. (May, 2003). Graduate seminar in the forensic sciences: Mass Disaster
Preparation and Psychological Trauma. Unpublished Lecture Notes, San Diego, CA.
 Horowitz, M. (1976). Stress response syndrome, character style and dynamic
psychotherapy. Archives of General Psychiatry, 30, 768-781.
 Mitchell, J. 1. (1988). Stress: The history and future of critical incident stress debriefings.
Journal of Emergency Medical Services, 7-52.
 Mitchell, J. T. (September/October, 1986). Critical incident stress management.
Response, 24-25.
 Mitchell, J. T. (January, 1983). When disaster strikes: The critical incident stress
debriefing process. Journal of Emergency Medical Services.
 Young, M. A. (1994). Responding to communities in crisis. National Organization for
Victim Assistance. NOVA, Washington, D.C.