Critical incident stress debriefing (CISD) is a small group, crisis intervention which is conducted following psychologically traumatic events.  Many employers routinely arrange for them when their employees have been exposed to very upsetting experiences.  Mental health professionals or trained peer counselors are asked to conduct group crisis interventions within hours of an event.  The best practice is for the debriefer to provide useful educational information about stress management and the normal psycho/physiological response to acutely stressful situations.  While it is very common for group particitpants to express profound feelings about an incident they have witnessed or expericenced, a CISD is not a group psychotherapy session.  Feelings expressed are acknowledged and normalized, but not probed by the group leader.  When properly structured and facilitated, these sessions result in participants feeling that they are experiencing normal reactions to an abnormal event and have the tools with which to better manage the stress.  In some cases the CISD affords the debriefer the opportunity to identify individuals who need follow up assistance.  Some of these may require referrals for psychotherapy.

There is controversy within the field.  Although tens of thousands of "critical incident stress debriefings" are being conducted each year, there is no universal quality control on the protocols used by the group leaders.  A "CISD" may just be whatever a particular group leader is doing.  One well respected group, the International Critical Incident Stress Foundation (ICISF) has developed standards and protocols for crisis incident stress management, including CISDs.  Even though the ICISF originally developed these guidelines for emergency response personnel such as police and firefighters, the critical incident stress management training they provide to clinicians and peer counselors is viewed by many in the field as the "gold standand".  However, no professional mental health association endorses this or any other CISD training certification.

Another point of contention among professionals is over the benefit derived in these group interventions.  Originally, it was assumed that they prevented the incidents of post traumatic stress disorder among participants.  Research studies have not substantiated this.  Some reputable professionals even suggest that mandatory debriefings might be harmful to some participants.

Employers need to play an active role in arranging for critical incident stress debriefings.  Some questions which they should consider are:

• What is the purpose of the crisis intervention? 
• What are the goals and how will we know they have been achieved?
• Do employees want to attend a debriefing session?
• When and where should the session(s) be held?
• Who will be conducting the intervention?
• What training have they had in group crisis intervention?
• What is the plan to follow up with employees who may need additional assistance?
• What level of confidentiality can the employer and debriefer promise the participants?

Being an alert consumer is prudent in purchasing crisis intervention services.  Planning and managing them is crucial to a successful outcome.