In the wake of tragedies like September 11, 2001, people exposed to a tragic event often need help dealing with their feelings and fears. Some may even develop post-traumatic stress disorder (PTSD). One very common type of post-traumatic care intended to prevent development of PTSD is a single session of psychological debriefing. However, research published in the September 7, 2002 issue of
suggest that debriefing sessions of this kind do not prevent post-traumatic stress symptoms.
Researchers at the University of Amsterdam in the Netherlands analyzed seven studies on the effectiveness of one-time psychological debriefing sessions. This type of study is called a meta-analysis, meaning the researchers pooled and analyzed data from several studies in an attempt to generate an overall estimate of effectiveness.
This meta-analysis included studies of several types of one-time trauma debriefing sessions used to prevent the development of PTSD. The researchers classified debriefing methods as: (1) critical incident stress debriefing (CISD) interventions, (2) non-CISD interventions, or (3) no intervention. Only studies of debriefing sessions provided within one month of the traumatic event were included, because symptoms that persist for one month indicate a diagnosis of PTSD. Any therapy provided after that point would be curative rather than preventive. In addition, only studies that assessed trauma symptoms before and after the intervention were included.
Using data from all seven studies, the researchers compared PTSD-type symptoms among the three groups: CISD interventions, non-CISD interventions, and no intervention. In addition, they compared other trauma-related symptoms among the three groups.
CISD was no more effective at preventing symptoms of PTSD or other trauma-related psychological symptoms than non-CISD interventions or even no intervention at all. In effect, people who had no therapeutic intervention seemed to do as well as those who received debriefing sessions.
Although these findings suggest that one-time psychological debriefing sessions don’t help people cope with traumatic events, this study has its limitations. First, because studies are designed differently, meta-analyses lack a certain degree of precision, though they are helpful for drawing general conclusions about overall effectiveness. Second, the effects of informal psychological and emotional support provided by family, friends, and clergy are not accounted for in this study. This could explain why “no intervention” seemed to relieve trauma symptoms. Third, debriefing sessions provided within one month of the event (before official confirmation of diagnosis) may have led to inclusion of some participants who were not actually at risk for a trauma-related disorder. Finally, this study only assessed the effect of stand-alone, single debriefing sessions. There is no reason to believe that other debriefing methods, counseling, and therapies would not be beneficial.
If one-time psychological debriefing sessions don’t work, what can trauma survivors do? There are several other types of therapy provided on an ongoing basis that may be helpful. Your health care provider can refer you to a mental health professional. And don’t forget about the natural grieving process that occurs among families and friends. The informal counsel of family, friends, and clergy often helps people deal with grief and fear in the wake of traumatic events.
The results of this study confirm other research findings that one-time debriefing sessions are ineffective. However, one-time debriefing sessions are conducted by a broad array of health professionals with varying degrees of training in psychological therapies. Differences in the providers’ training may affect success rates.
van Emmerik AAP, Kamphuis JH, Hulsbosch AM, Emmelkamp PMG. Single session debriefing after psychological trauma: a meta-analysis.
Gist R, Devilly GJ. Post-trauma debriefing: the road too frequently travelled.
Last reviewed Sep 5, 2002 by Richard Glickman-Simon, MD
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