Contents & Abstracts
Guest Editorial : Psychological
(Stress) Debriefing: Where are we now?
by Justin Kenardy, PhD
Recent attempts to characterize the growing academic controversy regarding debriefing and its conceptual cousins as "muddying waters" or "study wars" grossly misrepresent the seriousness and the consistency of findings emerging through the refereed press. Data-driven objective assessments and systematic reviews of the empirical base are repeatedly promulgating findings of no effect and, with disturbing frequency now, suggestions of iatrogenic harm to at least some participants_yet still, at least within the popularized movement, the band plays on. This article provides a review of the debate and a critical assessment of the quality of information proffered in the face of accumulating evidence of inefficacy and possible harm.
In the past, awareness of the nature of emergency worker stress has been constrained by images of individual strength and coping even in the face of extreme events. Today, it is often assumed that certain events are so horrific that virtually everyone will react the same way. The stereotype of the macho stoic has been replaced by that of the vulnerable emergency worker. This paper argues against both stereotypes. Although certain circumstances can be horrific in themselves, emergency workers have a variety of coping styles and not all will be affected by events to the same degree. Moreover, debriefing may sometimes run counter to individual coping and impair rather than help some individuals. Acceptance of individual differences in reactions to traumatic stress may help us better manage emergency workers' training and in-service education, but there is the risk it may be misinterpreted as blaming an individual for reacting to events.
The question of the effectiveness of psychological debriefing has stimulated considerable debate. Evidence is contradictory. While evidence for its effectiveness is apparent when evaluation is conducted shortly after intervention takes place, it becomes less likely as the time interval between debriefing and intervention increases. This paper adopts an organisational psychological approach to ask what might happen during this interval to influence effectiveness. It explores the theoretical nature of work-related traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social and organisational influences on response are identified and used to tentatively offer explanations for the differential effectiveness of debriefing observed in evaluation studies. General conclusions regarding the implications for intervention effectiveness and design are discussed.