Acute human suffering is hardly a novel enterprise in mortal phenomenology. For millennia humankind has inflicted one another with torture, been subject to peril, and witness to ghastly and horrific imagery (Saigh & Bremner, 1999; Tafoya & Del Vecchio, 1996; Tindall & Shi, 1996). Relatively novel; however, is the growing cross-cultural recognition of the utility of professional mental health providers in alleviating symptoms of trauma (Wilson, 2004). Research shows that many countries and many states/provinces within such countries are adopting traumatic intervention programs to address the needs of those left psychologically maligned secondary to traumatic encounters (Jacobs, Quevillon, & Stricherz, 1990; MacDonald, 2003; Mitchell, 2005).
As we rush into this era of modern philanthropy; however, the elemental question of basic needs becomes increasingly salient. That is, while we have burgeoned a literature as well as technologically advanced mechanisms to distribute and disseminate such psychological services for acute trauma victims, it is not clear whether such services are (1) soundly developed, (2) wanted by others, and (3) needed to actuate good mental health. Indeed, many have noted that traumatic reactions to acute distress are often functional, rather than dysfunctional (Bonanno, 2004). In fact it may be that the person who lacks traumatic symptoms in the face of trauma is the individual in need of intervention!
This sobering reflection sets the stage for one of psychology’s most controversial current practices, that of Critical Incident Stress Debriefing (CISD). CISD is a program developed with the intention of intervening with those exposed to trauma before allowing traumatic symptoms to fester over time (Everly & Mitchell, 2005). The basic tenet of CISD is that proper intervention reduces later onset of PTSD symptom development (Flanner & Everly, 2000). Critics of CISD claim that such a brief and rigid protocol for traumatized individuals is uncalled for, and recent evidence seems to raise doubt over the assumption that general trauma usually leads to longitudinal dysfunction (Bonnano, 2004; Devilly & Cotton; Resnick, Galea, Kilpatrick, & Vlahov, 2004; Satel & Sommers, 2005). Further, some data suggests that CISD may actually increase the rates of trauma over no treatment or other treatments (for a review see Everly & Boyle, 1999; McNally, Bryant, & Ehlers, 2003; Mitchell 2005; van Emmerik, Kamphuis, Hulsboch, & Emmelkamp, 2002).
While the literature appears to be conflicted regarding CISD, the need for psychological interventions seems to be growing rapidly, especially given the global increases in technological and terror-based warfare, potential for pandemics such as the putative “bird-flu,” as well as atypical seasonal disasters of recent years (e.g., hurricanes, typhoons, tsunami’s, etc).
-Heath Sommer
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