Critical Incident Stress Debriefing

Critical Incident Stress Debriefing


Critical Incident Stress Debriefing, or CISD, is a form of intervention counseling within Critical Incident Stress Management, or CISM, used to treat victims of critical incidents. It is usually offered as a free service in the workplace in the event that something traumatic occurs at work and puts the affected employees at risk for post-traumatic stress disorder (PTSD). CISM was first mentioned during the American Civil War. Back then, it was common for the unfortunate soldiers with “combat stress” to experience imprisonment, ridicule, or even death by gunfire due to their fellow soldiers believing they were now siding with the enemy.  This “combat stress” was not recognized for what it was until many years later, and today, we used it to describe how we react to traumatic events although its origin lies within the military. CISD is a very common practice that helps victims handle their symptoms of the shocking event experienced.

Goals of Critical Incident Stress Debriefing

The primary goal of CISD is support. This early intervention counseling method works to provide a group of traumatized individuals with support very soon after the event has been experienced. The victims are given help with coping and recovering from these incidents, and help to realize that they are not alone. It also gives employees the opportunity to reach out to potential future counseling as needed. CISD also lowers the risk of PTSD.

When is Critical Incident Stress Debriefing Used?

CISD is used for people who have been directly or indirectly affected by a “critical incident”, or a traumatic event that has been witnessed and causes stress and the inability to function normally. Some examples include serious injuries, the death of someone close (especially suicide), or events that involve disasters, children, terrorism, a threatening or violent scenario at work, or anything with a negative outcome. Usually critical incident stress lasts between two days and four weeks, whereas PTSD lasts more than four weeks.

Physical symptoms of critical incident stress include fatigue, headaches, unusual thirst, dizziness, chills, and chest pain. Cognitive symptoms include poor attention and decision-making abilities, confusion, poor memory and concentration, uncertainty, nightmares, and poor problem solving abilities. Emotional symptoms include intense anger, chronic anxiety, fear, guilt, apprehension and depression, grief, and irritability. Behavioral symptoms include an increase in alcohol consumption, an increase or decrease in appetite, withdrawal, being unable to rest, a change in communication, and antisocial behavior.

How Critical Incident Stress Debriefing Works

There are a few emergency steps to take note of to amount for the time between the critical incident and the beginning of the debriefing process. Victims should take a 15 minute rest immediately, avoid odors and noise as much as possible, talk about how they feel, drink anything that doesn’t contain caffeine, and eat anything low in fat and sugar. It is important that the victim is not hurried back to work.

The debriefing session is a group process that occurs within 72 hours of the critical incident. It gives the victims a chance to talk about what they experienced and how they feel about it. They are often asked to describe the incident from their point of view as well as the aftermath.

Generally speaking, there are seven steps to the CISD process. The introduction process audits the critical incident on the victims and gives them a chance to introduce themselves. The Fact Phase identifies the most important issues related to security and safety. The Thought Phase gives victims the opportunity to express their thoughts and feelings as well as share their personal experiences of the event. The Reaction Phase predicts the reactions of events that could occur from the aftermath of the original incident. The symptom phase takes note of the incident’s apparent impact on the survivors physically, emotionally, and cognitively. Maladaptive behavior must also be reported. The Teaching Phase is meant to provide closure to the survivors as a means of initiating the building process. For example, they might do this by identifying the positive experiences, if any, taken from the event. The final step, known as the Re-Entry Phase, reviews the events that took place right before, during, and right after the critical incident. This can be done one-on-one or even in smaller groups rather than the group as a whole, depending on the circumstances.

Criticism of Critical Incident Stress Debriefing

Studies have proved that CISM does not work for everyone consistently, and in fact sometimes makes the victim’s trauma symptoms even worse. In fact, most results have yielded either no benefit at all from CISM or a negative impact.


University of Washington: Critical Incident Debriefing. 2007.

Shalev, Arieh Y. (Ed); Yehuda, Rachel (Ed); McFarlane, Alexander C. (Ed), (2000). International "">handbook of human response to trauma. The Plenum series on stress and coping., (pp. 379-387). Dordrecht, Netherlands: Kluwer Academic Publishers, xvi, 477 pp. doi: 10.1007/978-1-4615-4177-6_27

Critical Incident Stress Debriefing (CISD): A meta-analysis.Everly Jr., George S.; Boyle, Stephen H. International Journal of Emergency Mental Health, Vol 1(3), 1999, 165-168.

Help Us Improve This Article

Did you find an inaccuracy? We work hard to provide accurate and scientifically reliable information. If you have found an error of any kind, please let us know by sending an email to, please reference the article title and the issue you found.

Share Therapedia With Others