Critical Incident Stress Debriefing (CISD)

Critical Incident Stress Debriefing is a procedure, which aids others in coping with the physical or psychological symptoms that are generally connected with trauma experience. It allows those concerned with the unpleasant incident to first process the incident and then to reflect on its impact. There is a considerable impact of traumatic events either short term or long term on a person exposed to such events. Human beings respond to such trauma by dissociation, somatization, or developing depression. (McFarlane, Shaley &Yehuda, 1999). Diverse symptoms are associated with human response to trauma including shock, sorrow, anger, embarrassment, terror, confusion, fear, frustration, sleep disturbances, depression, and nightmares and in severe cases ideation of homicide and suicide. Flashbacks of traumatic events are also common.

The procedure of debriefing hence plays an important role in dealing with such emotional letdown and helps to relieve anxiety and stress. The process of CSID consists of seven phases.

The first phase is the introductory phase in which the debriefer introduce the process and assess the individuals’ situations and evaluates their exposure to the critical event. The second phase is the fact phase in which the debriefer asks the members of the group to tell the facts regarding the incidence and what they were doing at that time.

The third phase is the thought phase in which the members share their thoughts and feelings when they were experiencing the situation. In fourth phase, which is the reaction phase or feeling phase the facilitator asks about the worst part of the incident and the feelings of the individual at that time. The individuals in this phase try to ventilate their emotions to relieve stress. The fifth phase is symptom phase in which participants disclose any symptoms and stress reaction they are facing due to the event. In sixth phase, which is the education phase, the facilitator provides stress management guidelines to members.

The final phase is the reentry phase in which the debriefer concludes the session, make referrals and discusses the positive outcomes of the session. (Dattilio, Freeman, 2007) The process of Critical Incident Stress Debriefing is a useful technique for not only the community health nurses and health care workers but also for the victims. The community health nurses can provide the CISD procedure to the victims of disaster and trauma as well as to other health care workers experiencing the strong emotional reactions. Hospital stays of the patients are becoming brief and much of the recovery of the patient is taking place in community. The debriefing of the patient can be done when he gets back home by the community health nurse. Hence, the community health nurse can play a crucial role in maintaining the wellbeing of the members of the community.

References

     Dattilio, F. M., & A. Freeman, (2007). Cognitive-behavioral strategies in crisis intervention. New York, Guilford Press.

     McFarlane, A. C., & A. Shalev, & Yehuda. (1999). International handbook of human     response to trauma. New York, Springer.