How to Begin the Process of Debriefing for Survivors
Debriefing is a kind of psychological treatment offered to survivors of natural disasters in order to reduce their psychological morbidity that may appear as a natural reaction to the trauma. It is usually rendered within 10 days after the crises occur and are meant to mitigate acute sufferings following a traumatic loss, assess the necessity for follow-up interventions, and provide victims of the disaster with the feeling that the crisis is over (Rose, Bisson, Churchill, & Wessely, 2002).
Yet, despite the common belief that this help should be provided within a few days, there is no evidence supporting that this can prevent psychological trauma as well as the appearance of chronic psychological problems. Studies reveal that one-time debriefing is even harmful and fails to achieve any of its intended purposes (Perry, 2013).
The common strategy to begin the process of debriefing is to call in individuals who experienced a crisis or a disaster for a debriefing session, where they are asked to describe the event and to share their thoughts and emotions about it (“Combating anxiety disorders,” 2017). However, I believe that the correct approach should start even earlier, with the problem identification stage. Before imposing aid upon a person, professionals should first answer the following questions:
- Could a 2-3-hour-long session improve the condition of the victim, or would he/she need a prolonged treatment?
- Do they have to deal with post-traumatic stress or with complicated grief, in the event of which the therapy is ineffective?
- Are there any chances for the patient to develop chronic psychopathology?
- Does the person need education of anxiety disorders and ways to deal with them, or should he/she be simply left alone to cope with emotions without interventions?
- Could the session aggravate the condition of the patient?
I am convinced that problem assessment is highly important for developing the correct strategy of psychological support, and therefore this stage should not be neglected. In many cases, people need time to handle their feelings and emotions on their own before a specialist can do his/her job successfully. Thus, the process of debriefing should begin with a careful evaluation of whether actual debriefing is needed. If it is, the scheme of its implementation is classical (“Combating anxiety disorders,” 2017):
- the introduction phase (explaining the purpose);
- the fact phase (revealing information);
- the thought phase (sharing thoughts about the event);
- the reaction phase (sharing emotions);
- the symptom phase (examining effects);
- the teaching phase (educating victims);
- the re-entry phase (addressing problems requiring elaboration).
Impact of Different Opinions on Counselor/Responder Training
I believe that the appearance of expert opinions that contradict the general beliefs about the effectiveness of psychological debriefing might greatly affect the counselor/responder training session. When debriefing was believed to bring about only positive consequences, specialists thought that their primary obligation was to render psychological first aid regardless of the circumstances involved. This urge to help is natural.
However, since the World Health Organization denounced the practice as harmful, counselor/responder training has become more sensitive and human-oriented, whereas previously, it was more like a set of oral instructions. The practice is still hard to resist, but the positive tendency is evident: Most of the trainings now are conducted without a fantasy that a psychological disorder can be prevented in a single session. Patients who have a propensity to develop chronic psychopathology are given more attention and are sent to further examinations. Specialists started to pay more attention to all the factors involved in the tragedy in order to avoid criticism on behalf of those who disapprove of the approach.
Thus, despite creating a heated debate, negative opinions might actually produce long-lasting positive results making the approach more flexible and conscious. Perhaps, if comprehensive changes are achieved, psychological debriefing has a chance to remain among the major options of addressing post-traumatic stress symptoms.
References
Combating anxiety disorders with psychological debriefing. (2017). Web.
Perry, S. (2013). One-time ‘psychological debriefing’ after trauma is harmful, studies suggest. MinnPost. Web.
Rose, S. C., Bisson, J., Churchill, R., & Wessely, S. (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). The Cochrane Library, 2(1), 1-34.