Many of us, unfortunately, have experienced a traumatic situation. It could be an accident, the death of loved ones, a fire in a house, a terrorist attack... After the incident, the state of a person’s psyche is so unstable that it can be compared to the top point of a pendulum. The slightest breath of wind can affect the further trajectory.
The first psychological conversation with a specialist after extreme incidents has a special meaning and purpose. Indeed, at such moments, people need help and support more than ever.
Debriefing is a consultation with a person or group of people who have experienced an emergency situation, most often taking place in the form of training in the first two days after the incident.
Types of debriefing
In psychology, this procedure has two types: analytical and crisis debriefing.
The first is a conversation between the experimenter and the subject. The purpose of analytical debriefing is to ensure that the participant in the experiment is not harmed or psychologically traumatized.
The crisis method is used as first aid after stressful situations. This type of debriefing is aimed at minimizing the risk of developing PTSD.
Critical Incident Stress Debriefing
Quite often, specialists in certain areas face critical incidents: police officers, doctors, firefighters, the Ministry of Emergency Situations, the military, etc. They constantly face stressful situations, so even they need psychological help in the form of debriefing in order to reduce emotional stress and come to terms with situations.
The conversation is conducted by the facilitator for 2.5 hours, during which the person expresses his feelings, talks about what happened, listens to the opinion of the facilitator, and receives support and understanding.
The essence of the analytical conversation
Some psychological research may be potentially dangerous to humans. The experimenter sometimes uses techniques that border on morality. The subject is often not informed about many of the nuances of research, so that their indicators are as truthful, natural and objective as possible.
Since psychology is an intangible science, it seems that experiments with the psyche are self-indulgence. In fact, the consequences can be incredibly fatal and global. If medical experiments have obvious consequences in case of failure, then psychological ones are as latent as possible, hidden.
There have been cases in experimental psychology where a boy was raised like a girl. The reason was supposedly damage to the organ during circumcision; in fact, it was an experiment by John Money, who wanted to prove that gender is the result of upbringing, not nature.
As a result, the life of the boy and girl was broken, his twin brother was in constant depression, the parents who agreed to this step attempted suicide. The main character of the experiment, who completed what he started at the age of 38, also tried to commit suicide.
To avoid broken lives, after the experiment a short conversation is held between the participant and the researcher, which helps to ensure that the subject was not harmed.
Debriefing is carried out only after potentially dangerous experiments in which there is a catch, omission or deception.
Features of conversation with emergency victims
Conversations with victims are carried out in the first 2 days after the incident, since during this period there is a high probability of preventing psychological problems.
Debriefing has the most noticeable effect on the first day, when the person has not had time to sleep or take tranquilizers. If this conversation has to be postponed, then experts notice that the events that happened have already passed into permanent memory. Therefore, the task of psychologists is to prevent the consolidation of memory traces and to minimize any negative mental manifestations after experiencing stress.
Bottom line
Stressful situations always leave trauma in a person’s soul. It is not always possible for an individual to cope with emotions that greatly hurt, frighten, disturb, or disturb. If he does not receive external psychological support, this can turn into psychotrauma, which will now bother him every time a trigger arises.
Debriefing helps eliminate negative emotions so that they do not develop into psychological trauma. If the work is carried out in a team, then getting rid of irrational emotions will happen faster.
Debriefing script
Each conversation should have a script; it will be an additional support for a psychologist who also has to work in extreme conditions.
Debriefing is often carried out in the form of a training session, when participants sit in a circle, but in this case they prefer not to leave empty space in the center, because this unusual environment can be perceived by the participants as a threat. To make the conditions as comfortable as possible, use a round table.
Debriefing consists of three main parts:
1. Reproduction of what happened.
2. Analysis of symptoms and reactions.
3. Mobilization of the psychological state of health.
In addition, the entire process is divided into phases:
- Acquaintance. As in a regular training, participants must give a name and tell some information about themselves.
- Statement of facts. At this stage, the victims tell what exactly they had to endure. How they realized that trouble was approaching, their further actions.
- Impression phase. Participants share their experiences, thoughts, emotions. If the conversation reaches a dead end, the coach must warm it up with questions: “What did you think about what happened?”, “How did you assess the situation around you?”
- Feeling phase. The longest and most important stage. Many victims experience emotions that were previously unfamiliar to them, which makes them seem wild, strange, and shameful. Everyone believes that such a revolution of consciousness is happening only to him, but during the conversation he understands that everyone is experiencing similar feelings. Mutual support and emotional connection are born. This key point in the debriefing depends primarily on the trainer, who must encourage participants to be sincere.
- Symptom phase. It doesn’t have to be singled out as separate; it is often included in the previous one.
- The presenter and his assistants (also psychologists) must process information about the feelings of the participants, give instructions for the future, and talk about possible psychological manifestations.
- Training to smooth out negative psychological manifestations in the future. At this stage it is possible to arrange another meeting.
Debriefing as part of the training
In the case when debriefing is a group stress therapy, its main goal is to discuss impressions and experiences in order to mitigate the influence of a traumatic factor. If debriefing is used as training, then the discussions concern only the assimilation of the studied material and its consolidation. This is due to the fact that no form of training is perfect without subsequent discussion of its results.
Literally, the term “debriefing” can be translated as “questioning after completing a task.” Its essence lies in the fact that participants should discuss among themselves the experience that they gained during the training they recently completed.
If the training consisted of performing a specific task in which the participants received their individual roles, then the debriefing may aim to remove the entire group from these roles, reduce emotional stress, and discuss experiences. The experience gained is also touched upon, that is, the group can discuss the entire sequence of events that occurred during the training, share their views on what was happening, and understand why the action developed exactly the way it happened.
According to its technique, debriefing as part of the training consists of asking the group guiding questions that will help them better understand and consolidate the experience gained, as well as identify possible mistakes and note for themselves subsequent “zones of growth.” Thus, debriefing is a key phase necessary for any training, without which exercises can turn into a simple set of drills and games that are completely incomprehensible to most participants.
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What is multi-level debriefing?
The structure and scale of this psychological intervention may vary depending on the global nature of the incident. If these are man-made disasters, natural disasters, or mass terrorist attacks, then multi-level debriefing is used.
The first level is the work of psychologists, doctors, and emergency workers with victims.
The second level is the work of psychologists with those specialists who provided assistance at the scene. After all, working at the epicenter is a strong emotional burden.
PTSD
Post-traumatic stress disorder is a severe mental condition that can be caused by a traumatic situation.
Mental trauma can lead to a borderline state. It is worth separating mental and psychological trauma.
The mental one is more global, can be permanent and be inherited. Psychological - temporary, a person recovers relatively quickly after such an injury, adequacy and the ability to adapt to the external environment are preserved.
Stress disorder is characterized by constant mental return to the traumatic event. During one of these attacks, thoughts of suicide may arise, since mental anguish may be incompatible with life.
The victim tries not to return to those places that provoke memories, not to communicate with people associated with the tragic events, and to avoid any conversations on this topic.
At first, a person experiences anxiety associated with the repetition of events; he is constantly in an exciting tone, which can provoke somatic disorders and illnesses.
To treat PTSD, a combination of medications and psychotherapeutic methods is used.
Is there any point in debriefing?
So, debriefing is about preventing the onset of post-traumatic stress disorder or reducing the likelihood of PTSD.
The word “probability” immediately makes one skeptical about this method. Firstly, all preventive measures in almost any matter, especially psychological ones, are not visible. There is no way to measure the benefits of preventive measures and prove whether they helped or not.
The only way to test the effectiveness of this method is to compare the results obtained in the control and experimental groups. But there is no way to prove what would have happened otherwise specifically with these subjects, since there is no parallel reality.
Definitely, there are people for whom the debriefing helped, there are those for whom it had no effect, and there are also victims.
What is the main point of debriefing? Verbalize all your experiences, speak out, let off steam. But who said that this method is equally useful for everyone?
There are extroverts, the process of verbalization helps them, and there are introverts for whom it is easier to think about everything silently, and any vocalization only aggravates the problem in their brain. It is very strange that leading psychologists did not take into account individual personality characteristics.
Differences between feedback and debriefing (by Tim Russell)
In Tim Russell's book Effective Feedback, the author distinguishes between feedback and debriefing.
He proceeds from the fact that in the training we touch on 4 aspects: we study theory, practice skills, work with attitudes, and also help develop judgments that affect the ability to make decisions based on what has been learned. Feedback can be used to assess the correctness/incorrectness of knowledge and skills. Without it, progress is impossible, as it provides information on what to do differently and what mistakes the participant made.
Debriefing can help us work through attitudes and make judgments. Since this area cannot be judged as right or wrong, debriefing with questions allows you to gather different opinions and broaden the students' horizons and thinking.
Each person has his own permissible amount of feedback perception. Students can be divided into 3 types: “thimble”, “glass”, “bucket”. Based on certain signals (statements of participants, non-verbal manifestations, etc.), you can understand with whom the trainer is dealing and, depending on this, make a decision when it is necessary to stop giving feedback and move on to debriefing.
Each participant should be given equal time to discuss their work. However, the time between feedback and debriefing may not be equally divided. For a “thimble”, for example, the emphasis will be on debriefing, since the volume of perception of possible feedback is smaller.
If the amount of feedback reaches the limit, criticism ceases to be perceived and the training participant starts to have a defensive reaction.
Defensiveness is an important element for preserving a participant's self-respect in the eyes of the group. And the coach must respect and understand this need of any student.
A defensive reaction can be of three types: at the first stage, external factors are invoked as an explanation for the failure (time limitations, video camera, presence of observers, etc.), at the second stage, they refer to unclear instructions, the unrealism of the situation, poor organization of the process, at the third stage - they directly accuse the coach of unprofessionalism and join the opposition.
In order not to provoke the participant to move to the next stage of defense, you need to accept his explanations and carefully translate the feedback into a debriefing.
Debriefing allows you to shift the focus from a specific participant and discussion of his success to a discussion with the group about common points on the topic raised. In this case, the participant who received the feedback feels safer and is more willing to accept it more enthusiastically.
Debriefing Research Results
A huge amount of research has been conducted on this procedure. And these observations showed that debriefing does not reduce the likelihood of complications for people who have experienced psychological trauma. In some cases it can even be dangerous.
For example, researchers found that fire victims who participated in a debriefing were more likely to have PTSD 13 months later than a control group. And the victims of road accidents who participated in this procedure, after 3 years, had psychopathologies caused by the accident.
Scientists have concluded that debriefing is a therapy that does not have positive results, and in some cases even cripples.
The essence of psychological debriefing and its stages
Definition 1 Psychological debriefing is a way of talking with a person who has experienced psychological trauma.
The purpose of psychological debriefing is to prevent the development of post-traumatic stress disorder and other negative consequences.
Definition 2
Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who experience a shocking, scary, or dangerous event.
It is natural for a person to be afraid during and after a traumatic situation. Fear triggers many processes in the body to help protect against or avoid danger. The fight-or-flight choice is a typical response designed to protect a person from harm. After an injury, almost everyone will experience a range of reactions, but most people naturally recover from the initial symptoms. Those who continue to experience problems may be diagnosed as having PTSD. People with PTSD may experience stress or fear even when they are not in danger.
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Most psychological debriefing procedures involve one session, which can last from one to three hours, in the days immediately following the traumatic event. The timing and method of treatment depends on the qualifications of the personnel conducting the psychological debriefing. It is often carried out in groups.
The effects of debriefing tend to be evident soon after debriefing, but the medium- and long-term effects of this method of intervention on the response to trauma are highly questionable. It has been suggested that psychological debriefing may interfere with natural recovery processes after a traumatic event. This is true both for a single session and for multiple sessions. However, as of 2021, the American Psychological Association has given psychological debriefing a positive rating, as the lack of support (research and treatment) is potentially harmful.
Psychological debriefing is not the same as short-term cognitive behavioral therapy (CBT), prescribed for acute stress disorder, which is given approximately 2 weeks after the injury and lasts four to five sessions.
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People who have experienced catastrophic events often receive a treatment called psychological debriefing to prevent post-traumatic stress disorder. They are interviewed (conversation), which is designed to allow people to directly confront the event and share their feelings with the counselor. This will help them structure their memories of the event.
In other words, psychological debriefing is a crisis intervention program that is used to provide initial psychological assistance. It is usually conducted in a group session between 24 and 72 hours after a disaster.
The idea behind this method is to “tell what happened” with a sense of reviewing or examining experiences or actions in order to achieve order in the mind and make sense of what was reported. It is a structured process that also evaluates the contributions of various participants in determining the success or failure of the operation. Processes may include receiving explanation, information, and situational reminders of context, as well as reporting on performance indicators and opportunities for further study, investigation, or performance evaluation after completion of participation.
Stages of psychological debriefing
Each psychological debriefing session consists of seven stages:
- establishing rules;
- fact finding to determine what happened;
- discussing thoughts about what happened; (
- discussing emotions related to what happened;
- identifying signs and symptoms of distress;
- exploring post-traumatic stress disorder (PTSD) and coping strategies;
- re-discussion of any other issues and provision of any additional services
The purpose of this type of interview, as noted earlier, is to prevent the development of PTSD.
The paradox of debriefing
Despite the fact that scientists have proven the uselessness of this method, many victims after this procedure claimed that they felt better. They were sincerely convinced that the ambulance was effective.
In fact, there is a type of psychologically resilient people who are able to survive trauma themselves without developing PTSD. Therefore, their presence or absence at the debriefing procedure does not play a big role; they themselves soon fully recover.
