812 words – MR
Do debriefings help or hurt?
by Stephanie Conn
There is a strong debate about the helpfulness of critical incident stress debriefings (CISD). Some say they help officers deal with traumas. Others counter that they make matters worse by re-exposing officers to the trauma, including the traumatic information from fellow officers’ perspectives.
There is research to support that CISD is helpful, harmful and makes no difference at all – so what are we to believe?
Research supports that debriefings facilitate social support with co-workers, normalize traumatic responses with the psycho-educational component, teach officers to manage symptoms that arise and are well-liked by most who participate in them.
The criticism of Critical Incident Stress Management (CISM) is directed at increase of vicarious traumatization from being exposed to the stories of others. For some, it seems to hinder their moving forward because it is more troubling to be forced to talk about and listen to what others experienced.
To be confident that you are doing no harm, it might be wise to focus debriefings on aspects that have been consistently demonstrated to be helpful. For example, research suggests emphasizing the psycho-educational and supportive components while foregoing the discussion of the details of the traumatic event <1>.
Former police officer John Violanti, an expert on mental health issues affecting police, makes a distinction between interventions that are pathogenic and those that are salutogenic. Pathogenic refers to interventions that script officers into traumatic symptoms because it presupposes a sick role <2>. It says “You’re going to get PTSD if you don’t let us help you using these steps” and encourages them to take a helpless, passive sick role that requires outside intervention. Nobody in CISM intends or desires to convey this message; they hope to help fellow officers deal with their exposure to trauma, not make them feel they’re broken unless “fixed” with a debriefing.
On the other hand, salutogenic interventions offered by CISM teams convey a more positive message. This approach recognizes that the vast majority of police officers do not develop PTSD despite continuous exposure to trauma. They are, on the whole, naturally resilient and capable of being active in their own healing from trauma with the support of family, friends and professionals.
Salutogenic interventions assume officers’ potential for growth and healing. As opposed to the pathogenic script, the salutogenic script would be “I can get through this because I have been trained to handle adversity and I have being doing it,” or some variation of this.
I am not proposing that one repeats this script if it does not fit the current situation but, rather, to recognize the individual’s strengths and not merely focus on the challenges. If the officer is experiencing trauma symptoms, these should be acknowledged and they should be offered support that normalizes their response, along with a referral for professional help.
Offering assistance that embraces an officers’ natural resilience and does not write a pathogenic script depends on how the intervention is executed. Flexibility is favoured over rigid adherence to a set of procedures.
Optional attendance at debriefings is one recommended way of being flexible. Admittedly, making a debriefing compulsory may eliminate the stigma associated with attending because you have to go. A choice adds an element of pressure for some due to outward appearances. However, the problem with mandatory debriefings is the presumption of the passive sick role of the officers. This is to be avoided, if possible.
An additional problem with mandating attendance is that it may be perceived as someone merely “checking a box” that they have offered a service without a genuine motive to be helpful. This was the feedback I received in a study of what hindered officers coping with traumatic stress.
The timing of the debriefing can also be problematic, as it might conflict with time off and/or a sleep schedule. Being flexible with the days and times it is offered is another way to promote a salutogenic outcome. Offering the debriefing in a flexible manner that respects officers’ desire to participate and considers their work-sleep schedules demonstrates that the department supports their well-being.
If an officer desires to participate but is not able to make it due to schedule constraints, it is best to follow up individually with them. When they fall through the cracks, it undermines the credibility of the CISM program.
Debriefings, like police work, therapy and anything else, can be done well or poorly. We shouldn’t throw out the baby with the bath water. Debriefings and CISM, as a whole, are incredibly valuable forms of support that deserve departmental support.
{Footnotes}
- Cheryl Regehr (2001). Crisis debriefing groups for emergency responders: Reviewing the evidence. Brief Treatment and Crisis Intervention, 1(2), 87-100.
- John M. Violanti (2001). Post Traumatic Stress Disorder Intervention in Law Enforcement: Differing Perspectives. The Australasian Journal of Disaster and Trauma Studies, Vol. 2.
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