Trauma Recovery and CISD

            Perhaps the greatest differences between trauma recovery and Critical Incident Stress Debriefing (CISD) is the duration of the sessions, the process, and the groups affected by the crisis.  Trauma recovery does not involve restoring the person to normal, but rather helping them create a new normal.  The recovery process takes place over a longer period of time, and is also more individually focused than CISD.  The recovery process should be taken slowly and it progresses through three stages: the cognitive stage, the emotional stage, and the mastery stage (Wright, 2011).

            The first stage of the recovery process is the cognitive stage, and it involves the individual completely facing the trauma through remembering it or even mentally reconstructing the event (Wright, 2011).  The individual is not living in the past event, but instead he pulling together all of the past memories to make sense of their present condition as a disconnected viewer.  Re-exposure is critical, as well as how and when they are re-exposed (Wright, 2011).  The emotional stage involves the way the individual heals and recovers and is helps with dealing with blocked feelings caused by the crisis. Emotions such as anxiety, anger, grief, fear and sadness are common and individuals must experience these emotions on a deeper level to understand they do not have to act on them (Wright, 2011).  The final stage, the mastery stage, involves the individual finding a new outlook because of their experience and developing an attitude of being a survivor.  Individuals with a biblical worldview have a greater chance of becoming survivors (Wright, 2011). 

            The CISD approach to crisis is directed primarily toward first-responders; police officers, firefighters, EMT’s, and military personnel.  This approach usually involves small group settings limited to individuals exposed to the trauma and a facilitator or team of professionals (Fullerton, Ursano, Vance, & Wang, 2000).  The debriefing involves a group of individuals limited to those exposed to the crisis and it takes place between 2 to 10 days following the event (Wright, 2011).  Individuals are led through a seven-step model: introduction, fact phase, thought phase, reaction, or feeling phase, symptom phase, teaching, or educational phase, and the reentry phase.  Each stage is designed to be taken chronologically, and in group settings, members are encouraged to participate in each phase.  The CISD session normally lasts between one and two and one-half hours (Wright, 2011).

            Short term approaches to trauma recovery such as CISD can help reduce the chances of individuals suffering from post-traumatic stress disorder (PTSD) (Fullerton, et al., 2000).  Following CISD, long term trauma counseling will assist the individual in establishing a new normal to reduce the frequency of symptoms, reduce the fear of the symptoms, reduce the fear of insanity, and redirect feelings of anger and guilt (Wright, 2011).

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References

Fullerton, C. S., Ursano, R. J., Vance, K., & Wang, L. (2000). Debriefing following trauma. Psychiatric Quarterly, 7(3), 259-276.

Wright, H. N. (2011). The complete guide to crisis and trauma counseling: What to do and say when it matters most!. Grand Rapids, MI: Bethany House Publishers.