Talk:Critical incident stress management

Refs
Wow, GrayMtr must have done a lot of work to get ready for that one substantial change. I see that a couple of editors have removed information in an effort to fix formatting. Here's the list of the new references, with the formatting fixed:


 * ICISFa
 * ICISFb
 * Newbold, K.M., Lohr, J.M., & Gist, R. (2008). "Apprehended without warrant." Criminal Justice and Behavior. 35(10), 1337-1353. Retrieved August 11, 2009 from Sage Publications database.
 * Mitchell, J.T. (1983) "When disaster strikes... the critical incident stress debriefing process." Journal of Emergency Medical Services, 8, 36 -39.
 * Mitchell, J.T. & Everly Jr, G.S. (2001) Critical Incident Stress Debriefing: an Operations Manual for CISD, Defusing and Other Group Crisis Intervention Services. Ellicott City, MD: Chevron Publishing.
 * National Child Traumatic Stress Network and National Center for PTSD. (2006). Psychological first aid: Field operations guide. 2nd edition. Retrieved from http://www.ncptsn.org/

If there's any chance of figuring out which ones support which statements, it would be great to use them as inline citations. Otherwise, we'll just add them to the end. WhatamIdoing (talk) 23:54, 16 September 2009 (UTC)

Rescued text
Here's a bit of text that may or may not be present in the article in a revised form:

Critical Incident Stress Management (CISM)is a comprehensive, multicomponent crisis intervention procedure that spans pre-incident preparedness to acute crisis to post-crisis follow up (ICISFa). It is a multifaceted approach to mitigate the impact of workplace stress designed specifically for the workplace culture of emergency services professionals (and is also appropriate for volunteer and paid on call departments) and other responders to trauma and crises. CISM is a team approach (mental health professionals and peer support) comprised of several activities designed to educate responders regarding the possible symptoms of acute stress disorder (ASD) and posttraumatic stress disorder(PTSD). This psychoeducation takes place in advance of an incident and is ongoing throughout the career, for many occuring as a component of the initial responder training. It is this continual training that allows responders to work through horrendous scenes, allowing them to possibly work through immediate ASD symptomology. The low incident rate is also due to the growth of intervention programs, such as critical incident stress management programs/teams (Mitchell, & Bray, 1990)

Another component of CISM is incident response. Defusings are a form of psychological first aide for responders, this process allows immediate care for those distressed by a specific event. Defusing activities may occur at a scene before return to the station house or at the station once the responders are finished with the assignment. Care is taken by team members to identify those who are clearly distressed and assist those individuals. This assistance may be simply assisting individuals in making connections with their establish support system (family member, peers, minister, etc...) to assist them as needed while they are off duty.

Critical Incident Stress Debriefing (CISD)is another component of CISM it is designed to help people deal with their trauma one incident at a time by allowing the individual to talk about the incident when it happens without judgment or criticism. The program is peer-driven and the people leading the debriefing process are mental health professionals, in some locations clergy are used in this role. Several peer support team members should also be in attendance at a debriefing to complete the "team". All debriefinga discussions are confidential, with an important exception being a participant indicating being danger to themself or to others. The emphasis is always on mitigating the impact of the stressful event and returning them quickly to pre-incident levels of functioning as soon as possible.

A number of studies have questioned the effectiveness of CISD as a psychoeducational(PE) tool. The greater majority of those studies are not comparing apples to apples. CISD studies have focused on single session debriefings absent of the additional pre-incident psychoeducation and other CISM program components. CISM does not focus on primary victims such as auto accident victims, dog bite victims, women suffering post-partum depression, women who have lost a child in a miscarriage, child abuse victims, substance abusers, victims of elder abuse or sexual assault victims all of whom are typically served through various other crisis intervention programs. These populations were studied to determine the validity of CISD. (ICISF) These findings should not be used to support the effectiveness of CISM with it's intended audience. Newbold, Lohr, and Gist (2008) discuss the British study finding the single-session debriefing to be potentially damaging when applied to the general public and question why CISM maintains such a persistent hold in the emergency services community. Perhaps the reason responders continues to find CISM useful is because it has proven to be successful with the intended population(ICISF). Emergency services professionals are less likely to seek traditional mental health resources.

Hearing that CISD is potentially harmful some departments have discontinued the use of CISM for personnel choosing to leave all mental health related assistance up to EAP programs that may or may not be trauma-informed in their care provision and certainly may be unaware of the specific workplace culture of responders. But there is ample data regarding the usefulness of CISD/CISM for responders. At http://www.icisf.org/articles/Acrobat%20Documents/CISM_Defense_of_Field.pdf one can find a listing of research studies and the finding that support the use of CISM and CISD for a wide variety of emergency services responders. At least one study determining CISD to be more effective as a component of the larger CISM rather than as a stand-alone process.

Some of this text likely has problems with our WP:No original research (e.g., no coming to your own conclusions) and Wikipedia is not an instruction manual policies, but please feel free to cut, copyedit, revise, and match to references whatever is useful and appropriate, which should be placed back into a relevant section of the article. Also, please delete from here anything that seems like it won't fit any longer. (If you move something to the other page, be sure to remove it from this page, so that it doesn't end up in there twice.) WhatamIdoing (talk) 00:28, 17 September 2009 (UTC)

CISM is basically useless
If you even do a cursory search of peer-reviewed literature, you cannot escape the conclusion that CISM is not helpful and may in fact worsen the psychological impact of trauma. Mitchell is the only one still defending it. I added some references to the criticism section but lack the motivation to make more substantial changes to the article. —Preceding unsigned comment added by 98.113.142.174 (talk) 01:30, 9 June 2010 (UTC)


 * Try not doing a "cursory search" and read the criticism of the critics!
 * Mitchell is far from the only one defending it. This is an incredibly biased article and I've tried to add some perspective by pointing out the enormous errors in the criticism - misusing group protocols on individuals, failing to be clear about what protocols they were actually studying, etc.
 * CISM has a very small number of very loud critics. You might also try to understand the financial motivation of the original Cochrane report. It was commissioned with the specific purpose of discrediting CISM. See https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/024040015.pdf Narnett (talk) 19:49, 7 December 2023 (UTC)
 * A cursory search on the topic may give you that impression but any in depth research on CISM shows that this argument is based on the misrepresentation of data from studies such as [Rose S, Bisson J, Churchill R, Wessely S (2002). "Psychological debriefing for preventing post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews (2): CD000560. doi:10.1002/14651858.CD000560] and [Jacobs, J., Horne-Moyer, H. L., & Jones, R. (2004). The effectiveness of critical incident stress debriefing with primary and secondary trauma victims. International journal of emergency mental health, 6(1), 5–14] for example. The most critical arguments against CISM that I have seen were clearly a misrepresentation and bastardization of data from the academic sources they reference. AliceInResearchland (talk) 10:56, 22 January 2024 (UTC)

More references are needed for para. 1
Where is it shown that the last few sentences of this article are factual? 2604:3D09:971:A500:6D4C:9F1A:52C2:5213 (talk) 13:58, 25 April 2023 (UTC)

POV slant in lead paragraph
The phrasing used in the opening paragraph is, in my view, a clear violation of WP:NPOV (emphasis below is mine):
 * Critical incident stress management (CISM) has been misunderstood and unfairly criticized as a controversial, non-empirical, adaptive, short-term psychological helping-process that focused solely on an immediate and identifiable problem. Much of the "controversy" stems from confusion of terms.

The introduction as it stands is written as a pre-rebuttal of criticism of CISM, which goes against NPOV and is unencyclopedic. Words like "unfairly" heavily inject opinion into the introduction (see MOS:EDITORIAL, and the use of scare quotes goes against the manual of style (see MOS:QUOTEPOV and MOS:SCAREQUOTES). --Delta1989 (talk) (contributions) 04:19, 22 February 2024 (UTC)
 * Even though I made this edit, I barely checked the diff because it seemed huge and I had so much else on my plate, so I didn't notice the new opening text. Yeah, it's ... problematic, but fixing it won't be that easy )reverting all the recent edits is possible, but probably wouldn't be the best way out of this). I think I'll take this page off my watchlist now. Graham87 (talk) 06:56, 22 February 2024 (UTC)
 * It honestly needs an extensive rewrite from an expert in the field IMHO; it's not something that can be easily reverted out of. Definitely appreciate you having a go at it regardless. --Delta1989 (talk) (contributions) 15:42, 22 February 2024 (UTC)
 * Svhorner and Narnett, can you talk to us about what you think would improve this article? For example, articles normally being with a very brief description of what the subject is, and this one seems to begin with a bunch of defensive protestations about it not really being controversial. WhatamIdoing (talk) 03:41, 28 February 2024 (UTC)
 * Also, if you'd like an editing environment that looks more like MS Office or Google Docs, then please try this link:  https://en.wikipedia.org/wiki/Critical_incident_stress_management?veaction=edit WhatamIdoing (talk) 03:43, 28 February 2024 (UTC)

Concerns about the article
This article's POV pushing on being "unfairly criticized" was my original call to attention to this article. However, what's struck me is the implication of major criticism at all. I've not dived much into "critical incident stress management," but I'm having quite a lot of trouble finding much criticism or opposition at all. It seems, about two months ago, without being noticed, an account which was only used once in 2009 and in this article, a ton of POV-pushing was forcefully inserted into the article.

I'm going to manually undo these to the best of my ability, but this article is still very concerning regardless. If anyone sees this, this article is in desperate need of improvement. Thanks, Neuropol  Talk  14:50, 6 June 2024 (UTC)