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Stress and Debriefing

Stress and Debriefing. Critical Incident Stress Debriefing. Critical Incident Stress Debriefing. A health promotion model that provides immediate emotional support and education about normal stress reactions, and may reduce the risk of chronic and disabling emotional and physical consequences.

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Stress and Debriefing

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  1. Stress and Debriefing Critical Incident Stress Debriefing

  2. Critical Incident Stress Debriefing • A health promotion model that provides immediate emotional support and education about normal stress reactions, and may reduce the risk of chronic and disabling emotional and physical consequences

  3. Statistics • All employees face some exposure to violence • Almost 2 million people in the US are assaulted each year while at work. • Healthcare providers have the highest percentage

  4. Exposure • Evidence indicates that exposure to workplace violence and other stressful situations, increases the risk of stress-related illnesses • This includes acute stress disorders, PTSD, and adverse medical outcomes

  5. A Critical Incident(an acute stress response) • Refers to a powerful and overwhelming event that lies outside the range of usual human experience. • It has the potential to exhaust one’s usual coping mechanisms • Can result in psychological distress and disrupting of normal adaptive functioning

  6. Encounters • A violent or traumatic situation evokes powerful emotions beyond one’s usual ability to mobilize coping resources • Intense anxiety often ensues and the person’s response is numbness, in a state of shock, then intense fear followed by anger

  7. Function • Ordinarily, critical incidents are so emotionally overwhelming that the person has difficulty functioning and often resorts to using distorted thinking and coping. • This presents as fear, intense anxiety and depression • Some may blame themselves, withdraw or deny any effects

  8. Coping • Individual coping responses often depend on the type of stressor and vary from one traumatic event to another • Chronic, cumulative stress reactions, as well as acute responses, are the basis of critical incidents

  9. Stress Reactions (Emotional) • Shock • Anger • Disbelief • Guilt • Terror • Sadness • Depression • Fear

  10. Stress Reactions (Behavioral) • Social Withdrawal • Alienation • Hypervigilance • Excessive change in communication or interactions • Irritability and agitation • Maladaptive coping responses, such as drinking excessively or using other mind-altering substances

  11. Stress Reactions (Biological) • Sleep disturbances • Appetite disturbances • Trembling • GI Disturbances • Nightmares • Hyperarousal • Autonomic nervous system arousal • Startle response

  12. Stress Reactions (Cognitive) • Decreased concentration • Confusion • Intrusive thoughts • Self-blame • Decreased self-confidence and self-esteem • Flashbacks • Forgetfulness • Upsetting dreams and images

  13. CISD Teams • Typically consist of mental health professional and non-mental health professionals • Interventions offered within 2-7 days post trauma

  14. Debriefings • Is NOT psychotherapy • Is an opportunity to process the experiences and put them into perspective • Participation is voluntary

  15. Introductory Phase • Review the ground rules including the goals of a CISD • Maintain confidentiality • Provide immediate emotional support from feedback of peers • Encourage the person to speak for themselves • Inform the person that this is NOT psychotherapy

  16. Fact Phase • Each person describes what happened regarding themselves, the incident and their behavior during the event • Retell the story to promote cognitive re-struction of the event and experience emotional release • Describe sensory perceptions during the event, such as smells, sounds or sights

  17. Thought Phase • Ask participants to reveal their first thought during the event • Participants affirm and validate their own thoughts and feelings • Participants repair their cognitive perception of safety, trust, power, self-esteem, and intimacy • Participants share what thoughts they will carry with them

  18. Reaction Phase • Participants focus on their own reactions or emotions during and subsequent to the event (on both them and others) • Assess emotional responses: crying, anger, fear, horror, guilt • Anxiety promotes order. Help participants focus on and express their feelings to gain more information about the normalcy of one’s feelings and thoughts about the event

  19. Symptom Phase • Transition from an emotional level to a mind cognitive level

  20. Educational Phase • Discuss stress symptoms • Remind participants about normalcy of their reactions to an abnomral situation and the need to talk to each other rather than isolating

  21. Re-Entry • Debriefing comes to a close • Reassurance is provided • Gather closing statements about the process • Make appropriate referrals and follow ups

  22. Activation • Anyone can request a debriefing • There are teams throughout the county, including both hospitals • Contact a member of the management team if you feel a debriefing is in order • Events are not isolated to violence, they can be anything that overwhelms the staff

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