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Trauma Counselling

Critical Incident Stress Debriefing for Trauma

How It Supports Trauma Recovery

In CISD, these professional debriefings help people cope with and recover from an incident’s after-effects. I have found that over the past 20 years of facilitating CISD groups and individual sessions – it enables the person to understand that they are not alone in their reactions to a distressing event. It also provides them with an opportunity to discuss their thoughts and feelings about the event in a controlled and safe environment. 

In CISD, these professional debriefings help people cope with and recover from an incident’s after-effects. I have found that over the past 20 years of facilitating CISD groups and one of one sessions, it enables clients to understand that they are not alone in their reactions to a distressing event. It provides them with an opportunity to discuss their thoughts and feelings about the event in a controlled, safe environment.

I have worked with many organisations and individuals who have endured traumatic events. These have included being the victim of an armed robbery in the workplace for instance. Or, witnessing the death of a co-worker revered by many employees where a vast amount of staff is impacted and require critical incident debriefing individually or in the safety of a group.

During these group sessions, I facilitate a process that helps participants to understand their emotional reactions, validate their responses, and provide stress management tools and resources for continued support.

CISD is provided as a safe and non-judgmental space for trauma survivors. Each participant will be encouraged to share their initial reactions and emotions following the incident. The group sessions can reduce trauma impact, will help survivors recover, and identify those individuals who will require individual support. 

After identifying a person needing additional support, beyond what can be achieved in a group setting, an individual session is arranged to help in the healing process. This helps form a healthy pathway back to their former (i.e., prior to the traumatic event) day to day functioning.

Following the exposure to trauma, an individual experiences physical and psychological symptoms. CISD allows survivors to both process and reflect on the traumatic events they’ve experienced.

CISD is a step-by-step process that promotes resiliency at the same time as starting on the path to recovery for individuals who have been exposed to high levels of stress and/or trauma.

Ideally, stress debriefing should occur right after the traumatic event to increase the method’s effectiveness and get ahead of the traumatic mental patterns before they become ingrained. 

It’s recommended that CISD occur even within the first 24 to 72 hours. Also, it provides the greatest support to the trauma survivor. 

However, there are still major benefits in receiving treatment for events that took place a long time ago.  

What Defines a Critical Incident?

Anyone who has experienced a large degree of trauma, anguish, and/or a catastrophic event may benefit from CISD. These extenuating events/critical incidents may be;

  • The sudden death of a loved one, and/or someone close by.
  • An Armed Robbery
  • Incidents that involve children and adolescents
  • Serious physical injuries to oneself (i.e. domestic violence)
  • A threat to an individual’s safety such as natural disasters.
  • A distressing situation or event that profoundly disrupts an individual’s physical health or psychological function

Chances are, individuals who endure any of the above-mentioned incidents are likely to experience a collection of debilitating long term effects and short-term emotions. The symptoms of trauma and reactions to the event may be quite negative.

CISD conducted by a trained health care professional following a traumatic event can lead to healing and restored hope.

This recovery and healing gives the survivor a voice, offers closure, and allows the individual to gain a restored sense of security.

Acute Stress Reaction (ASR)

An acute stress reaction (ASR) can appear quickly after an exceptional physical or mental stressor such as a bereavement, road traffic incident, physical abuse, and assault such as an armed robbery, however, this does not usually last long.

Symptoms of ASR are anxiety and dissociative behaviour following exposure to a traumatic and unexpected life event. An individual may feel disconnected from themselves, have difficultly handling emotions, suffer mood swings, become depressed and anxious, and may have panic attacks. They often experience difficulty sleeping, poor concentration, and recurrent dreams and flashbacks, and may avoid situations that trigger memories of the event. Some individuals have physiological symptoms such as raised heart rate, breathlessness, excessive sweating, headaches, chest pain, and nausea.

ASR is described as acute because the symptoms come on fast, however, do not usually last. Symptoms of ASR can begin within hours of the stress and are resolved within a month; if they last longer, they may turn into the longer term symptoms of PTSD.

Some of the emotional symptoms of experiencing trauma are;

  • Shock
  • Denial
  • Anger
  • Rage
  • Moodiness
  • Sadness
  • Sorrow
  • Grief
  • Depression Anxiety
  • Confusion
  • Blame
  • Shame
  • Humiliation
  • Guilt
  • Grief
  • Frustration
  • Fear
  • Terror
  • Hyper-vigilance
  • Paranoia
  • Phobia
  • Suicidal ideation
  • Homicidal ideation

Some common physical symptoms are:

  • Restlessness
  • Fatigue
  • Sleep disturbances
  • Eating disturbances
  • Muscle tremors
  • Nightmares
  • Flashbacks
  • Profuse sweating
  • Heart palpitations
  • Vomiting
  • Diarrhea

Some symptoms immediately follow the event, while others surface over time. If these reactions become chronic, individuals may begin with substance abuse (including alcohol) in an effort to cope with the trauma. This can easily develop into a substance use disorder.

In my experience, sometimes when individuals experience a longer-term adverse reaction – in the form of an acute stress reaction to the incident – it becomes such an emotional crisis. In this case, the event has been so disruptive to the person’s psyche. For instance, their workplace has been a safe and consistent part of their life over many years. After the incident, the victim/individual is forced to re-evaluate how they perceive their own identity, the meaning, and purpose of their life post the extenuating event.

This can create a complete meltdown – no longer knowing where they fit/belong, as their identity has revolved around their job, or being a family member. At this time, the old/usual way of being no longer fits, and this causes profound pain, discomfort, and chaos.

Ultimately, I have often seen individuals take on a new career, move homes etc. The person sometimes creates a wonderful life removed from their previous lifestyle, and the happiness and fulfillment they create in these instances, is so incredible and a very positive outcome after such an adverse experience.

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