Deep divisions over disaster debriefings

March 22, 1996

Disaster debriefings, which are becoming increasingly popular, may make victims worse, a psychologist said this week.

Debriefings, which were offered to survivors and relatives after the killings at Dunblane primary school in Scotland last week, aim to help people to process traumatic events as soon as possible so that they avoid post-traumatic stress disorder later on.

But an international conference on traumatic stress this week revealed deep divisions between psychologists over whether debriefings are useful.

Justin Kenardy, senior lecturer in clinical psychology at the University of Queensland, Australia, described a study of 200 professional and volunteer disaster workers who experienced an earthquake in Newcastle, Australia. Half were debriefed afterwards. Those who were debriefed fared no better over the next two years than those who were not. In fact the debriefed group appeared to do worse, although this difference was not statistically significant. Both groups were measured with accepted scales such as the General Health Questionnaire.

Dr Kenardy said the study was not strong enough to confirm that debriefing is not effective. "It is a very popular technique but there is no evidence that it works. We need to examine the possibility that in some people debriefing may be counterproductive," he said.

He cited five other studies, including an intervention in a school after a suicide and interventions with soldiers after the Gulf War, which had found no benefits.

Atle Dyregov, of the Centre for Crisis Psychology in Bergen, Norway said that debriefings could go wrong if there was conflict within the group, or if victims heard others describe details of the disaster that they had not seen for themselves.

However, Jeffrey Mitchell, of the International Critical Incident Stress Foundation, who founded an increasingly popular process known as critical incident stress management, which includes debriefings, vigorously defended them. He said: "Debriefings will not cure. They are only a step in another process. We're going through the same experience now that psychoanalysis went through."

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