Cognitive Behavioural Psychotherapist.
Critical Incident Stress Debriefing (CISD) is a seven-step, small-group, supportive crisis intervention method. According to the Critical Incident Stress Management (CISM) methodology, it is only one of several crisis intervention strategies.
The CISD procedure is not psychotherapy and should never be substituted for it. Essentially, it is a crisis-focused, crisis-supportive conversation regarding a terrible event (also known as a “critical incident”). The Critical Incident Stress Debriefing was created exclusively for small, homogeneous groups that have undergone a serious traumatic event. It attempts to alleviate pain and restore group cohesion and unit efficiency.
A Critical Incident Stress Debriefing is best described as a psychoeducational technique for small groups. In other words, it is a practice that combines methodical group storytelling with practical information to normalize group members’ reactions to a traumatic event and aid in their rehabilitation.
A CISD is adopted only after a major traumatic event that has elicited intense reactions from the personnel of a particular homogenous group. The selection of a CISD as a tool for crisis management indicates that a traumatic event has occurred, that the group members’ normal coping mechanisms have been overwhelmed, and that personnel are exhibiting symptoms of considerable distress, impairment, or dysfunction.
As a result of a traumatic event, there may be an increase in stress, which can lead to the following severe reactions:
• Social isolation is a feeling of loneliness that the patient experiences as a threat from others, a feeling of loneliness caused by the absence of family and friends, or the lack of a supportive or important personal relationship because of the patient’s unacceptable social behavior or social values, inability to engage in social situations. When working with people who have developmental disabilities, cognitive impairments, dementia, or a traumatic brain injury, it is important to be aware of how likely it is that they will become socially isolated.
• Signs: – Feeling lonely – Rejection – Feeling different from others – Insecurity in public – Sad, lifeless mood – Uncommunicative, withdrawn behavior and lack of eye contact – Obsession with own ideas or repeated, meaningless actions – Aggression in voice and actions
• Paranoia is an irrational fear of other people that can get so bad that it leads to delusions. People who are paranoid worry that people are “out to get them.” Some people who are stressed may have short-term paranoia.
• Signs: Belief that others are plotting against him or her; Preoccupation with unfounded suspicions about friends or coworkers; Reluctance to confide in others out of fear that the information could be used against him or her; Misinterpretation of harmless comments.
•Suicidal Behavior: Suicidal behavior is an extreme reaction that can be caused by a number of mental health problems.
• Signs: – Trying to commit suicide in the past (Those who have made major suicide attempts are at a substantially greater risk of actually committing suicide.)
Depression with a constant bad mood, pessimism, hopelessness, desperation, anxiety, psychological pain, and inner tension; increased alcohol or drug use; recent impulsive or unnecessary risk-taking behavior; making suicide threats or expressing a strong desire to die; plans for self-harm or suicide; giving away prized possessions; sudden or impulsive purchase of a gun; acquiring other ways to kill oneself, such as poisons or medications; unpredictable behavior;
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A Critical Incident Stress Debriefing is a type of “psychological first aid” done in a small group.
The main goal of a Critical Incident Stress Debriefing is to educate and empower a group of people who were all in the same traumatic situation.
A CISD tries to make people more resistant to stress reactions, build resilience, or the ability to “bounce back” from a traumatic experience, and help people recover from traumatic stress and get back to normal, healthy functions.
The Critical Incident Stress Debriefing is not a stand-alone process, and it is only used as part of the Critical Incident Stress Management package of procedures for dealing with crises.
A CISD should be linked to and combined with many crisis support services, such as pre-incident education, individual crisis intervention, family support services, follow-up services, referrals to professional care, if needed, and post-incident education programs. When a CISD is part of a larger crisis support system, it always has the best effects, which are improved group cohesion and unit performance.
Jeffrey T. Mitchell, Ph.D. created Critical Incident Stress Debriefing in 1974 for use with small homogenous groups of paramedics, firefighters, and law enforcement professionals who were traumatized by exposure to a particularly terrible event. It is founded on the crisis intervention and group theory and methods of such luminaries as Thomas Salmon, Eric Lindemann, and Gerald Caplan.
1983 saw the publication of the first article on CISD in the Journal of Emergency Medical Services.
Over time, the usage of Critical Incident Stress Debriefing moved beyond the emergency services professionals to other organizations. The military, airlines, and railroads find the technique to be beneficial. This is especially true when combined with and integrated with other crisis response procedures. Eventually, businesses, industries, hospitals, schools, churches, and community organizations incorporated the Critical Incident Stress Debriefing concept into their total employee crisis support systems.
CISD has three primary goals. They are:
1) The mitigation of the effects of a traumatic event, 2) The promotion of normal recovery processes, and 3) The restoration of adaptive functions in psychologically healthy individuals who have been affected by an unusually distressing occurrence. 3) A CISD serves as an opportunity for screening in order to identify group members who could benefit from further support services or a referral to professional care.
The Critical Incident Stress Debriefing prerequisites are as follows:
1) The small group (about twenty individuals) must be homogeneous, not heterogeneous. 2) The group members must not be involved in the situation at this time. Either their involvement is complete, or the issue has passed its most critical phase. 3) Members of the group should have had comparable exposure to the experience. 4) The group should be psychologically prepared and not too exhausted or distressed to participate in the conversation.
What is avoidance and how does it manifest itself? Avoidance is a coping mechanism characterized by the conscious or unconscious avoidance of specific circumstances, places, or people, which can extend to specific scents and sounds.
People tend to avoid these situations due to the emotional or psychological associations with which they have become attached. If you were involved in a tragic accident, you know that driving past the scene will evoke unpleasant and terrifying memories.
Another illustration concerns army veterans with PTSD. It is commonly documented that they have difficulty shopping at supermarkets. This is due to their training and conditioning to avoid tight, limited locations with blind spots.
Exposure therapy has been extensively examined and is regarded as the most outstanding therapy for PTSD patients since it helps them conquer their fears and process their emotions. The objective of exposure therapy is to aggressively confront a person’s phobias or fears. By exposing oneself to feared circumstances, ideas, and emotions in a safe environment, one might learn to distinguish sensations of fear and anxiety from perceived threats. In essence, what is referred to as “emotional processing” allows them to directly experience that their emotions are real, but they are not in danger.
PTSD sufferers will engage in avoidance behaviors, which will deteriorate over time if left untreated. Sadly, this behavior will continue to have a detrimental impact on their quality of life and cause them extreme distress.
Can a PTSD sufferer use exposure therapy as a self help programme?
Yes, and here are some things to consider it you are planning on this option:
Learn as much as possible about PTSD. Learn about its symptoms, the causes of your disorder, and the origins of your behavior. This will be empowering and develop self awareness.
Create a list of the triggers for your anxiety and PTSD. Start slowly and work your way up with very modest exposures while watching your triggers or spending brief time in places that are triggering.
Find a partner for support. Telling someone about your goals helps you stay on track, and they can provide support in hard situations.
Master relaxation techniques—The goal is to expose yourself to the dreaded situation and maintain self-control long enough for your fear to diminish. Learn to control your breathing, engage your mind with controlled thoughts, and repeat mantras that alleviate nervous sensations.
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