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Child Debriefing: A Review of the Evidence Base

Published online by Cambridge University Press:  14 April 2015

Betty Pfefferbaum ,
Anne K. Jacobs ,
Pascal Nitiéma  and
George S. Everly Jr.
Betty Pfefferbaum*
Affiliation:
Terrorism and Disaster Center, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma USA
Anne K. Jacobs
Affiliation:
Terrorism and Disaster Center, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma USA
Pascal Nitiéma
Affiliation:
Terrorism and Disaster Center, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma USA
George S. Everly Jr.
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA Department of Psychology, Loyola University Maryland, Baltimore, Maryland USA
*
Correspondence: Betty Pfefferbaum, MD, JD Department of Psychiatry and Behavioral Sciences College of Medicine University of Oklahoma Health Sciences Center P.O. Box 26901, WP 3417 Oklahoma City, Oklahoma 73126-0901 USA E-mail: betty-pfefferbaum@ouhsc.edu
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Abstract

Introduction

Debriefing, a controversial crisis intervention delivered in the early aftermath of a disaster, has not been well evaluated for use with children and adolescents. This report constitutes a review of the child debriefing evidence base.

Methods

A systematic search of selected bibliographic databases (EBM Reviews, EMBASE, ERIC, Medline, Ovid, PILOTS, PubMed, and PsycINFO) was conducted in the spring of 2014 using search terms related to psychological debriefing. The search was limited to English language sources and studies of youth, aged 0 to 18 years. No time limit was placed on date of publication. The search yielded 713 references. Titles and abstracts were reviewed to select publications describing scientific studies and clinical reports. Reference sections of these publications, and of other literature known to the authors that was not generated by the search, were used to locate additional materials. Review of these materials generated 187 publications for more thorough examination; this assessment yielded a total of 91 references on debriefing in children and adolescents. Only 15 publications on debriefing in children and adolescents described empirical studies. Due to a lack of statistical analysis of effectiveness data with youth, and some articles describing the same study, only seven empirical studies described in nine papers were identified for analysis for this review. These studies were evaluated using criteria for assessment of methodological rigor in debriefing studies.

Results

Children and adolescents included in the seven empirical debriefing studies were survivors of motor-vehicle accidents, a maritime disaster, hostage taking, war, or peer suicides. The nine papers describing the seven studies were characterized by inconsistency in describing the interventions and populations and by a lack of information on intervention fidelity. Few of the studies used randomized design or blinded assessment. The results described in the reviewed studies were mixed in regard to debriefing’s effect on posttraumatic stress, depression, anxiety, and other outcomes. Even in studies in which debriefing appeared promising, the research was compromised by potentially confounding interventions.

Conclusion

The results highlight the small empirical evidence base for drawing conclusions about the use of debriefing with children and adolescents, and they call for further dialogue regarding challenges in evaluating debriefing and other crisis interventions in children.

PfefferbaumB, JacobsAK, NitiémaP, EverlyGSJr.Child Debriefing: A Review of the Evidence Base. Prehosp Disaster Med. 2015;30(3):110.

Keywords

childrencrisis interventiondebriefingdisasterdisaster response
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 3 , June 2015 , pp. 306 - 315
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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References

1. Mitchell, JT, Everly, GS. Critical Incident Stress Debriefing: CISD, An Operations Manual for The Prevention Of Traumatic Stress Among Emergency Services and Disaster Workers. Second Ed. Ellicott City, Maryland USA: Chevron Publishing Corporation; 1995/1996.Google Scholar
2. Mitchell, JT, Everly, GS. “Critical incident stress management and critical incident stress debriefings: evolutions, effects, and outcomes.” In: Raphael B, Wilson JP, (eds). Psychological Debriefing: Theory, Practice, and Evidence. New York, New York USA: Cambridge University Press; 2000: 71-90.Google Scholar
3. Regel, S. Psychological debriefing – does it work? Healthcare Counseling and Psychotherapy Journal. 2010;10(2):14-18.Google Scholar
4. Hawker, DM, Durkin, J, Hawker, DSJ. To debrief or not to debrief our heroes: that is the question. Clin Psychol Psychiatr. 2011;18(6):453-463.Google Scholar
5. Tuckey, MR. Issues in the debriefing debate for the emergency services: moving research outcomes forward. Clin Psychol Sci Pract. 2007;14(2):106-116.Google Scholar
6. Chemtob, CM. “Delayed debriefing: after a disaster.” In: Raphael B, Wilson JP, (eds). Psychological Debriefing: Theory, Practice, and Evidence. New York, New York USA: Cambridge University Press; 2000: 227-240.Google Scholar
7. Stallard, P, Salter, E. Psychological debriefing with children and young people following traumatic events. Clin Child Psychol Psychiatr. 2003;8(4):445-457.CrossRefGoogle Scholar
8. Dyregrov, A. Caring for helpers in disaster situations: psychological debriefing. Disaster Management. 1989;2(1):25-30.Google Scholar
9. Rose, S, Tehrani, N. “History, methods, and development of psychological debriefing.” In: Psychological Debriefing: Professional Practice Board Working Party. Leicester, United Kingdom: British Psychological Society; 2002: 2-7.Google Scholar
10. Everly, GS, Hamilton, SE, Tyiska, CG, Ellers, K. Mental health response to disaster: consensus recommendations: Early Psychological Intervention Subcommittee (EPI), National Volunteer Organizations Active in Disaster (NVOAD). Aggress Violent Beh. 2008;13(6):407-412.Google Scholar
11. Dyregrov, A. Helpful and hurtful aspects of psychological debriefing groups. Int J Emerg Mental Health. 1999;3(1):175-181.Google Scholar
12. Mitchell, JT. When disaster strikes... The critical incident stress debriefing process. J Emerg Med Serv. 1983;8(1):36-39.Google ScholarPubMed
13. Rose, SC, Bisson, J, Churchill, R, Wessely, S. Psychological debriefing for preventing posttraumatic stress disorder (PTSD): review. The Cochrane Library. 2009;1:1-46.Google Scholar
14. Bisson, JC, McFarlane, AI, Rose, S, Ruzek, JI, Watson, PJ. “Psychological debriefing for adults.” In: Foa EB, Keane TM, Friedman MJ, Cohen J, (eds). Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. New York, New York USA: Guilford Press; 2009: 83-105.Google Scholar
15. Bisson, JI, Jenkins, PL, Alexander, J, Bannister, C. Randomized controlled trial of psychological debriefing for victims of acute burn trauma. Brit J Psychiat. 1997;171:78-81.Google Scholar
16. Hobbs, M, Mayou, R, Harrison, B, Worlock, P. A randomized controlled trial of psychological debriefing for victims of road traffic accidents. Br Med J. 1996;313(7070):1438-1439.Google Scholar
17. Mayou, RA, Ehlers, A, Hobbs, M. Psychological debriefing for road traffic accident victims. Brit J Psychiat. 2000;176:589-593.Google Scholar
18. Sijbrandij, M, Olff, M, Reitsma, JB, Carlier, IVE, Gerson, BPR. Emotional or educational debriefing after psychological trauma: randomized controlled trial. Brit J Psychiat. 2006;189:150-155.Google Scholar
19. Litz, BT, Gray, MJ, Bryant, RA, Adler, AB. Early intervention for trauma: current status and future directions. Clin Psychol: Sci Pract. 2002;9(2):112-134.Google Scholar
20. Raphael, B. “Conclusion: Debriefing – Science, Belief, and Wisdom.” In: Raphael B, Wilson J, (eds). Psychological Debriefing: Theory, Practice, and Evidence. Cambridge, United Kingdom: Cambridge University Press; 2000: 351-359.Google Scholar
21. Lilienfeld, SO. Psychological treatments that cause harm. Perspect Psychol Sci. 2007;2(1):53-70.CrossRefGoogle ScholarPubMed
22. Dyregrov, A, Regel, S. Early interventions following exposure to traumatic events: implications for practice from recent research. J Loss Trauma. 2012;17(3):271-291.CrossRefGoogle Scholar
23. McFarlane, A. “Can debriefing work? Critical appraisal of theories of interventions and outcomes, with directions for future research.” In: Raphael B, Wilson JP, (eds). Psychological Debriefing: Theory, Practice, and Evidence. New York, New York USA: Cambridge University Press; 2000: 327-336.Google Scholar
24. Everly, GS, Mitchell, JT. The debriefing “controversy” and crisis intervention: a review of lexical and substantive issues. Int J Emerg Mental Health. 2000;2(4):211-225.Google Scholar
25. Adler, AB, Bliese, PD, McGurk, D, Hoge, CW, Castro, CA. Battlemind debriefing and battlemind training as early interventions with soldiers returning from Iraq: randomization by platoon. J Consult Clin Psychol. 2009;77(5):928-940.Google Scholar
26. Deahl, MP, Srinivasan, M, Jones, N, Neblett, C, Jolly, A. Evaluating psychological debriefing: are we measuring the right outcomes? J Trauma Stress. 2001;14(3):527-529.Google Scholar
27. Everly, G, Boyle, S, Lating, J. Effectiveness of psychological debriefing with vicarious trauma: a meta-analysis. Stress Med. 1999;15(4):229-233.3.0.CO;2-M>CrossRefGoogle Scholar
28. Tuckey, MR, Scott, JE. Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial. Anxiety, Stress, & Coping. 2014;27(1):38-54.CrossRefGoogle ScholarPubMed
29. Foa, EB, Keane, TM, Friedman, MJ, Cohen, JA. “Acute interventions for children and adolescents.” In: Foa EB, Keane TM, Friedman MJ, Cohen JA, (eds). Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. Second Ed. New York, New York USA: Guilford Press; 2009: 542-545.Google Scholar
30. Pfefferbaum, B, Shaw, JA. American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues. Practice parameter on disaster preparedness. J Amer Acad Child Adolesc Psychiat. 2013;52(11):1224-1238.Google Scholar
31. Cremniter, DL, Crocq, L, Louville, P, et al. Posttraumatic reactions of hostages after an aircraft hijacking. J Nerv Ment Dis. 1997;185(5):344-346.CrossRefGoogle ScholarPubMed
32. Dyregrov, A, Gjestad, R. A maritime disaster: reactions and follow-up. Int J Emerg Mental Health. 2003;5(1):3-14.Google ScholarPubMed
33. Dobryakov, IV, Nikolskaya, IM. Short-term crisis psychotherapy in children with post-traumatic stress disorders in the framework of the Dobryakov-Nikolskaya Rehabilitation Model. Neurosci and Behav Physiol. 2011;41(2):183-187.Google Scholar
34. Webb, NB. Groups for children traumatically bereaved by the attacks of September 11, 2001. Int J Group Psychother. 2005;55(3):355-374.Google Scholar
35. Casswell, G. Learning from the aftermath: the response of mental-health workers to a school bus crash. Clin Child Psychol Psychiatr. 1997;2(4):517-523.Google Scholar
36. Morgan, KE, White, PR. The functions of art-making in CISD with children and youth. Int J Emerg Mental Health. 2003;5(2):61-76.Google Scholar
37. Poijula, S, Dyregrov, A, Wahlberg, KE, Jokelainen, J. Reactions to adolescent suicide and crisis intervention in three secondary schools. Int J Emerg Mental Health. 2001;3(2):97-106.Google Scholar
38. Poijula, S, Wahlberg, K, Dyregrov, A. Adolescent suicide and suicide contagion in three secondary schools. Int J Emerg Mental Health. 2001;3(2):163-168.Google Scholar
39. Stallard, P, Law, F. Screening and psychological debriefing of adolescents survivors of life threatening events. Brit J Psychiat. 1993;163:660-665.Google Scholar
40. Stallard, P, Velleman, R, Salter, E, Howse, I, Yule, W, Taylor, G. A randomized controlled trial to determine the effectiveness of an early psychological intervention with children involved in road traffic accidents. J Child Psychol Psychiat. 2006;47(2):127-134.Google Scholar
41. Thabet, AA, Vostanis, P, Karim, K. Group crisis intervention for children during ongoing war conflict. Eur Child Adolesc Psychiat. 2005;14(5):262-269.Google Scholar
42. Vila, G, Porche, LM, Mouren-Simeoni, MC. An 18-month longitudinal study of posttraumatic disorders in children who were taken hostage in their school. Psychosom Med. 1999;61(6):746-754.Google Scholar
43. Yule, W. Posttraumatic stress disorder in child survivors of shipping disasters: the sinking of the Jupiter. Psychother Psychosom. 1992;57(4):200-205.Google Scholar
44. Yule, W, Udwin, O. Screening child survivors for post-traumatic stress disorders: experiences from the “Jupiter” sinking. Brit J Clin Psychol. 1991;30:131-138.Google Scholar
45. Zehnder, D, Meuli, M, Landolt, MA. Effectiveness of a single-session early psychological intervention for children after road traffic accidents: a randomized controlled trial. Child Adolesc Psychiat Mental Health. 2010;4(7):1-10.Google Scholar
46. Kenardy, JA, Carr, V. Imbalance in the debriefing debate: what we don’t know far outweighs what we do. Bull Australian Psychol Soc. 1996;February: 4-6.Google Scholar
47. Horowitz, M, Wilner, N, Alvarez, W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41(3):209-218.Google Scholar
48. Birleson, P. The validity of depressive disorder in childhood and the development of a self-rating scale: a research report. J Child Psychol Psychiatr. 1981;22(1):73-88.Google Scholar
49. Birleson, P, Hudson, I, Buchanan, DG, Wolff, S. Clinical evaluation of a self-rating scale for depressive disorder in childhood (Depression Self-Rating Scale). J Child Psychol Psychiatr. 1987;28(1):43-60.Google Scholar
50. Kovacs, M. The Children’s Depression Inventory (CDI). Psychopharmacol Bull. 1985;21(4):995-998.Google Scholar
51. Reynolds, CR, Richmond, BO. What I think and feel: a revised measure of child manifest anxiety. J Abnormal Child Psychol. 1978;6(2):271-280.Google Scholar
52. Pfefferbaum, B, Jacobs, AK, Houston, JB. Children and disasters: a framework for mental health assessment. J Emerg Manag. 2012;10(5):349-358.Google Scholar
53. Bolton, D, O’Ryan, D, Udwin, O, Boyle, S, Yule, W. The long-term psychological effects of a disaster experienced in adolescence: II: General psychopathology. J Child Psychol Psychiatr. 2000;41(4):513-523.Google Scholar
54. Goenjian, AK, Pynoos, RS, Steinberg, AM, et al. Psychiatric comorbidity in children after the 1988 earthquake in Armenia. J Am Acad Child Adolesc Psychiatr. 1995;34(9):1174-1184.Google Scholar
55. Norris, FH, Friedman, MJ, Watson, PJ, Byrne, CM, Diaz, E, Kaniasty, K. 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002;65(3):207-239.Google Scholar
56. Silverman, WK, La Greca, AM. “Children experiencing disasters: definitions, reactions, and predictors of outcomes.” In: La Greca AM, Silverman WK, Vernberg EM, Roberts MC, (eds). Helping Children Cope with Disasters and Terrorism. Washington DC, USA: American Psychological Association; 2002: 11-33.Google Scholar
57. Hunt, N. “Debriefing children and young people.” In: Psychological Debriefing: Professional Practice Board Working Party. Leichester, United Kingdom: British Psychological Society; 2002: 59-63.Google Scholar
58. Wraith, R. “Children and debriefing: theory, interventions, and outcomes.” In: Raphael B, Wilson JP, (eds). Psychological Debriefing: Theory, Practice, and Evidence. New York, New York USA: Cambridge University Press; 2000: 195-212.Google Scholar
59. Pfefferbaum, B, Sweeton, JL, Noffsinger, MA, Varma, V, Nitiéma, P, Newman, E. Child disaster mental health interventions: components and techniques. Prehosp Disaster Med. 2014;29(5):1-9.Google Scholar
60. Dyregrov, A. The process in psychological debriefings. J Trauma Stress. 1997;10(4):589-604.Google Scholar
61. Eaves, C. The development and implementation of a crisis response team in a school setting. Int J Emerg Mental Health. 2001;3(1):35-46.Google Scholar
62. Ormerod, J. “Current research into the effectiveness of debriefing.” In: Psychological Debriefing: Professional Practice Board Working Party. Leichester, United Kingdom: British Psychological Society; 2002: 8-17.Google Scholar
63. Yule, W. When disaster strikes –the need to be “wise before the event:” crisis intervention with children and adolescents. Advances in Mind-Body Medicine. 2001;17(3):191-196.Google Scholar
64. Devilly, GJ, Gist, R, Cotton, P. Ready! Fire! Aim! The status of psychological debriefing and therapeutic interventions: in the work place and after disasters. Rev Gen Psychol. 2006;10(4):318-345.Google Scholar
65. McNally, RJ, Bryant, RA, Ehlers, A. Does early psychological intervention promote recovery from posttraumatic stress? Psychol Sci Publ Interest. 2003;4(2):45-79.Google Scholar
66. Cohen, JA. Treating acute posttraumatic reactions in children and adolescents. Soc Biol Psychiat. 2003;53:827-833.Google Scholar