Network crisis intervention in a college setting

This article discusses the use of crisis intervention and networking principles with emotionally disturbed college students. In addition, the article demonstrates how these principles can be applied to larger systems such as entire living units or service organizations which are experiencing a crisis. Through the use of case examples the author identifies pressures experienced by college students and organizations and suggests intervention strategies emphasizing the use of available social supports. With the use of individual interviews, small and large group meetings, telephone conferences, homework assignments, and debriefing sessions, clients and their systems can be taught to cope with crises with a minimum of professional assistance.     

An analogue study of the effects of Psychological Debriefing on eyewitness memory

Sixty-one participants from the community participated in a randomised controlled trial of group debriefing to assess the effect of this intervention upon memory for a stressful event. Participants were randomly allocated to one of three groups: debriefing; debriefing with an experimenter confederate present (who supplied three pieces of misinformation to the group regarding the stressful event); and a no-treatment control. All groups were shown a very stressful video and were again reviewed after 1 month. Members of the debriefing group where a confederate provided misinformation were more likely to recall this misinformation as fact than members of the other two groups. The debriefing group was also more accurate in their recall of peripheral content than the confederate group. Across all groups, participants were found to be more accurate at central rather than peripheral recall yet more confident for incorrect memories of the video than correct memories.     

Family crisis intervention in social services

This article advocates the use of family therapy in crisis intervention. It relies upon the literature on crisis intervention, on family therapy literature, and on ten years experience of working in a social services area office, in which social workers are often required to respond alone to many different kinds of crises. Two typical referrals demanding crisis intervention and the responses to them are described.     

Critical Incident Stress Debriefing and crisis groups: A review of the literature

The concern about the psychological consequences to groups of individuals exposed to traumatic events as part of their work role has led to the introduction of a group mode of intervention for work systems called Critical Incident Stress Debriefing. However, the term debriefing is foreign to the language of group psychotherapy. Most journal articles and leader training workshops do not address CISD within the familiar context of group psychotherapy. This paper seeks an integration through discussion of the literature on crisis theory, group modes of crisis intervention, and the history, development, and process of CISD. It will be shown that CISD can be understood as a form of crisis group with some similarities to as well as differences from the crisis groups noted in the literature.     

Debriefing individuals affected by violence

For some time there has been a growing concern about violence in the workplace. This concern has tended to focus on employees with jobs which involve them in witnessing and dealing with the effects of disasters or traumas, such as the police, firefighters and ambulance personnel, rather than the actual victims of violent incidents. In the early 1980's, a psychological intervention known as either critical incident or psychological debriefing was introduced by the emergency services as a way of reducing the long term effects of exposure to traumatic events. The techniques involved in debriefing have been described by a number of workers (Dyregrov, 1989; Mitchell & Everly, 1993; Raphael, 1986). In all these models of debriefing, the debrief is undertaken with groups of victims, all of whom have been involved in a single traumatic incident as emergency workers. This paper describes the common features of the debriefing process; explains why debriefing is helpful; differentiates between debriefing and counselling; explores and contrasts three models of debriefing. Finally, it looks at a model of individual debriefing developed within the British Post Ofice to meet the specific needs of employees who have suffered personal attacks or other traumatic incidents.     

Critical incident debriefing in groups: a group analytic perspective

This paper looks at providing critical incident debriefing in groups. It outlines key group analytic concepts that are relevant to debriefing, including mirroring, group dynamics and supervision. It details how these concepts, along with the facilitator's and supervisor's free-floating attention, can help in thinking about the group and the organizational impact on the individual and the group. Using examples of debriefing, suggestions are made about how to use these concepts within the debriefing session and the impact of the dynamics of the organization on the debriefing.

The paper emphasizes the importance of supervision for debriefers and how the dynamics of the debriefing and the organizational context can be mirrored in the supervision. It illustrates the interplay between the individual, the group and the organization through commentary on vignettes, which include a debriefing session and the subsequent supervision session for debriefers.     

The training of telephone crisis intervention volunteers

Telephone crisis intervention services are growing at a very rapid rate. A review of the literature reveals that there are very few references to this new phenomenon and even fewer that deal with evaluating the effectiveness of telephone crisis training. Herein 7 articles are reviewed which deal with volunteer selection and training. These articles demonstrate that no consistent rationale for volunteer selection or training exists. Selection of volunteers typically consists of a gross screening to eliminate any obviously unsuitable persons, with training serving as a further sorting procedure where volunteers who are uncomfortable with the role of a crisis interventionist can be encouraged to drop out. The authors suggest that a training model be built around crisis intervention theory using principles of social learning as the methodology for training.     

The demonstration group: a tool for observing group process and leadership style

Demonstration groups, a major modality for observing group process, have not been addressed in the group psychotherapy literature. This article defines the demonstration group and describes and discusses its various components: the volunteers (group members) and their recruitment, the demonstration group itself, group member debriefing, and the didactic component. Discussion of the physical setting, group agreements, and boundary considerations, as well as leadership tasks, challenges, and pitfalls are illustrated with examples. Leadership tasks in demonstration groups are compared with those in therapy groups. Guidelines that are likely to promote successful demonstration group experiences are provided. The leader's facility with the unconscious defense mechanism of projective identification is stressed.     

Helping Teams to Help Themselves: Comparing two Team‐Led Debriefing Methods

Team‐based structures have become more widely used in organizations. Therefore, it is important for team members to perform well in their current team and to build skills and enthusiasm for working on future teams. This study examined team debriefing, an intervention in which team members reflect on recent experiences to prepare for subsequent tasks. Prior researchers have shown that facilitated team debriefs work, but they have not examined how to enable teams to conduct their own debriefs or studied how debriefs affect individual level outcomes. Therefore, we compared 2 team‐led debriefing techniques: (a) an unguided debrief and (b) a guided debrief designed to incorporate lessons learned from prior debriefs. We collected data from 174 business students who were members of 35 teams from 9 sections of a Strategic Management course. Class sections were randomly assigned to one of the debriefing conditions, and teams completed 4 business cases over 10 weeks. A multilevel design was employed and a multistage model building approach was used to test the hypotheses using hierarchical linear modeling techniques. Results of this cluster randomized, quasi‐experimental design suggest that the team‐led guided debrief intervention resulted in superior team processes as compared to the unguided debriefing method. Team processes, in turn, related significantly to greater team performance and increased individual readiness for teamwork and enthusiasm for teaming. Implications for future research and practice are discussed.     

Borderline Personality Disorder,Divorce and Family Therapy: The Need for Family Crisis Intervention Strategies

Recent literature reviews, point out the lack of crisis intervention and crisis prevention programs that are in existence to address crises experienced by first-degree and divorced family members of Borderline Personality Disorder (BPD) probands. The focus of such intervention programs should be to facilitate the improved ability of the first-degree and divorced family members to manage and transcend the unstable family environment. Correlations between personal instability and frequency of psychosocial crises have been examined, as well as the ripple effect of frequent individual crises on family environments. Reviews of current therapeutic interventions, as well as a synthesis of practical family therapy interventions focusing on breaking the cycle of dysfunctional multi-generational family environments are also examined.     

Family crisis intervention: fish or fowl?

This paper considers the status of family intervention as an area of interest defined by its literature (70 publications) and includes a brief history, assessment of present status, and recommendations for future development of family crisis intervention as a distinct field with concepts and goals that can be clearly defined, taught, researched, and repeated in treatment. Recommendations are made for the development of an explicit paradigm for intervention with a clear, common language of terms and concepts for family involvement. Suggested directions for developing the paradigm and language are explored.     

Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial

Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure.     

Crisis in Context Theory: An Ecological Model

This article outlines a theory for understanding the impact of a crisis on individuals and organizations. Crisis in context theory (CCT) is grounded in an ecological model and based on literature in the field of crisis intervention and on personal experiences of the authors. A graphic representation denotes key components and premises of CCT, while a proposed formula summarizes the theory. Recommendations for future research are also included.     

Couples’ Experiences of Hope When Participating in the Reflecting Team Process: A Case Study

Hope is believed to be influential to therapeutic change. However, no studies have explored couples’ experiences of hope during participation in a reflecting team process. This exploratory case study attends to this gap in the research literature. Three couples reported on their experiences of hope in relation to participating in the reflecting team process as part of their couple therapy. Themes related to hope were identified during three separate stages of the intervention: anticipating, participating in, and debriefing the reflecting team process. Reflecting team experiences related to hope included: seeking new perspectives, maintaining a positive momentum, identifying strengths, normalizing difficulties, presenting inspiring possibilities, providing support, highlighting growth, and strengthening resolve. These findings serve as a foundation for attending to clients’ hope as an active force during the reflecting team process.     

Juror reactions to jury duty: perceptions of the system and potential stressors

Jurors were surveyed on their general perceptions of the court system and factors that may cause stress immediately after trial, after participating in a post-trial debriefing, and a month after trial. Jurors had an overall positive view of the court system but did report some perceived inequities. The two most stressful elements of jury duty were related to the complexity of the trial and the decision-making involved in the trial, although jurors reported low levels of stress overall. Women reported more stress than men, and trial characteristics such as trial length also affected stress levels. The debriefing intervention was perceived as helpful, but jurors' stress levels were similar at pre- and post-debriefing. Finally, although stress on some measures was lower at the 1 month follow-up, this reduction was not moderated by whether or not jurors received the debriefing.     

Families-at-risk and home-based intervention: A therapist training model

Home-based family therapy programs are designed to provide intensive family intervention for at-risk children and adolescents. However, examination of the literature reveals limited publications about training therapists for this difficult task. The purpose of this paper is to describe a therapist training model based upon a family-as-context approach to crisis intervention. Specific units covered during the course include: family-as-a-system, structural family therapy, family crisis intervention, family assessment and simulation. It is concluded that the effective prevention of placement for at-risk children and adolescents requires both a home-based family treatment program and a specific therapist training model for family intervention.John J. Zarski, PhD, is a professor in the marriage and family therapy training program at the University of Akron. Carol A. Pastore is program coordinator for the T.I.E.S. program in Canton, OH. A. Lynette Way and Richard N. Shepler are home-based therapists with T.I.E.S. The authors would like to express their appreciation to Professor John West for his helpful comments on drafts of this article.     

Evaluation of the 113Online Suicide Prevention Crisis Chat Service: Outcomes,Helper Behaviors and Comparison to Telephone Hotlines

Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer‐operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003–2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention.     

The effect of stressor severity on outcome following group debriefing

This analogue study reports data on the efficacy of group debriefing in the mitigation of distress for a stressful video, which had two levels of severity. It also provides a new procedure for use in experimental psychopathology studies. One hundred and nineteen participants were shown one of two stressful videos and, subsequently, 67 participants received group debriefing whilst 52 participants acted as a control. A statistical difference was found between the two groups for level of distress at follow-up, with those who had watched the more stressful video scoring higher on video distress and trauma-type symptomatology than those who watched the less stressful video. This was particularly the case for those who received debriefing -- adding further caution to the longer-term effects of systematised group interventions following harrowing events.     

Postnatal debriefing: have we thrown the baby out with the bath water?

Postnatal debriefing is offered by 78% of maternity services in the UK despite little evidence from randomised controlled trials (RCTs) that it is effective. RCTs in this area have applied debriefing as a prophylactic to all or high risk women, rather than as a treatment for women who request it. This pragmatic trial therefore evaluated existing postnatal debriefing services that provide debriefing as a treatment for women who request it. Forty-six women who met criterion A for posttraumatic stress disorder (PTSD) and requested debriefing 1.3–72.2 months (median 16 weeks) postpartum completed measures of depression, PTSD, support and negative appraisals of the birth before and one month after debriefing. Women were compared with others who gave birth in the same hospitals during the same time period (n = 34), who met criterion A for PTSD but had not requested debriefing. Results showed PTSD symptoms reduced over time in both groups but greater decreases were observed in women who attended debriefing. Debriefing also led to reduction in negative appraisals but did not affect symptoms of depression. Therefore, results suggest providing debriefing as a treatment to women who request or are referred to it may help to reduce symptoms of PTSD.