Special Education

Appendix 3 - Critical Incident Stress Debriefing

Critical Incident Debriefing , sometimes called CID or Critical Incident Stress Debriefing in the literature, has been developed as a structured intervention to help groups who have been affected by a critical incident. Jeffrey Mitchell of the Department of Emergency Health Services, University of Maryland, developed the Critical Incident Stress Debriefing for use with fire and other emergency response workers who experience traumatic events in their work.

Sometimes an entire class, staff or whole school community is affected as a group by a critical incident. The death of a student or staff member, a natural disaster occurring during school hours, witnessing of a violent crime, child abuse by a staff member, and other traumatic events can present the need for a group intervention. An adapted form of Mitchell's debriefing method can be used to deal with such situations. Such debriefings are not a substitute for professional counselling or psychotherapy, but an opportunity for the group, whether students or staff, to sort out the events and to deal with the crisis.

Mitchell's work describes debriefings as structured group discussions which allow individuals to express their reactions to the critical incident and to develop understanding of the event and their own emotions. This process helps the individual to increase their own feeling of personal control. Research has indicated that ongoing support is still needed by people who have experienced trauma even if Critical Incident Stress Debriefing does have a positive short term affect.

Suggestions for leading a school group

The school counsellor or sometimes a skilled classroom teacher will be the leader of a debriefing for students. The purpose of a debriefing discussion is not therapy, but rather education which goes beyond that provided in the classroom by the initial session in which students were informed of the critical incident. The key actions involve the establishment of ground rules, exploration of facts, sharing of feelings, and learning about future possibilities. If no staff person in the school is trained in critical incident debriefing techniques, then the School Critical Incident Team should find a counsellor or other experienced person from outside the school to assist in the group. The style of the leader can vary, but the qualities of warmth, acceptance, and a non-threatening nature combined with the ability to control the group process quietly are particularly helpful.

Ground rules

The leader should set the ground rules for the debriefing session or discussion. Alternatively the ground rules may be developed by the group in order to make them feel more comfortable. These rules may vary, but some commonly used ones include the following:

• maintain confidentiality ("What is said here stays here."),
• no put-downs,
• no interruptions, and
• speak only for yourself.

In making any assurance of confidentiality, the leader should remind the group of any limits to confidentiality such as the duty to report child abuse or endangerment. It is not uncommon for the feelings of trauma after a critical incident to create a climate for disclosure of other traumatic events.

Discussion format

During group discussion, the leader will need to ensure that each individual has an opportunity to contribute. For example, during the facts and feelings portions of a debriefing, individuals are invited to share what they saw when they experienced the incident, what they have heard about it, and what they have felt. Using the word "felt" can confirm the ambiguity of sensations versus the validity of feelings. Relating the material in a group "round robin" can allow the reality of the experience to emerge and gives each person an opportunity to participate. The leader will have to decide whether to allow open discussion or keep it controlled. Care must be taken that each individual has an opportunity to share, but is not coerced by the group or the leader. If a student appears to need further support, the teacher should immediately refer them to the school/district counsellor or principal.

Managing the appropriate timing for discussion is another decision the leader must make. If the session becomes dominated by an individual or digresses into unproductive discussion, it should be ended. As long as it is focused and constructive, it should go on.

Connections to past incidents

As the group discusses the critical incident and their own responses, students may need to talk about similar incidents they have experienced or heard about in the past. This is a normal behaviour as part of the process of sorting out the present experience. The present critical incident may be less serious than the past one, such as the death of a student who is not known bringing up feelings about the death of a parent.

Children may disclose facts about abuse or family violence in the atmosphere following a critical incident, so groups leaders need to ensure that they are knowledgeable about the protocol for reporting abuse for child protection. The facilitator will also need to be sensitive to underlying social issues related to the critical incident and feel comfortable discussing them in a frank and honest manner. The leader may need to provide clarification and provide a balanced understanding of the current crisis in the context of larger issues affecting young people in our society.

Jeffrey Mitchell's critical incident stress debriefing
(Adapted to a school setting)

1. Introductory phase

The choice of facilitator will depend on the nature of the group. In the case of a school staff, the facilitator might be the principal, school counsellor or a trained community person. For a class of students, the leader will usually be their regular teacher. The person leading the session should be the first to present the facts or any new information about the incident and should also set the basic rules for participation to provide security for the group.

Talking about disturbing events is difficult. Providing a clear structure and an assurance of confidentiality is important. The group needs to be protected from fear of social judgement so they can risk expressing feelings. The facilitator sets the tone for the entire session during the introductory phase.

2. Facts phase

The participants discuss the sequence of events surrounding the critical incident and the role each may have played in the incident or in responding to the incident. During this phase, each person should have an opportunity to describe the incident from his or her perspective. By the end of this phase, everyone should feel clear about the events and realize that they are not alone in the experience and emotional responses to the incident. From this, a shared perspective of the incident will begin to emerge.

3. Feelings phase

During this phase, members of the group or class are encouraged to explore their feelings in a supportive context. Each person is given an opportunity to share his or her feelings without pressure. Some individuals can still benefit from listening, even if they are not comfortable expressing their feelings in the group. The facilitator needs to ensure that the participants all understand that feelings are not right or wrong; they just are.

4. Teaching phase

The facilitator of the session teaches or review for the group the nature of normal reactions to a critical incident and anticipated reactions. The group learns about post traumatic responses, so they can validate the normalcy of their individual experiences. Misconceptions are cleared up and the group is informed of other resources, such as the school counsellors or employee assistance services. Community resources, beyond the school district, can be discussed. A list of community resources should be made available to students, parents and staff.

5. Closure phase

A debriefing can be a significant event in the life of the staff or class and can affirm group cohesiveness and the community sense of the school. In the final phase of the meeting, the group may decide to devise some plan of action to regain a feeling of at least partial control over fate. The facilitator should invite the group or individuals to a further discussion at a later date so that they will know that support could continue past this session.

The group's sense of security needs to be established by a return to a normal routine at the end of the debriefing session. The critical incident has been a disruption and changes in routine made to deal with the critical incident further disrupt people's lives. Plans designed to provide support can themselves become unsettling. A sense of hope and continuity will be provided by a return to the normal daily routine. The facilitator should firmly lead the group back to the normal routine, and at the same time be sensitive to people who are not ready and need immediate support of a health professional or counsellor.

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