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

Anxiety Stress Coping. 2014 Jan;27(1):38-54. doi: 10.1080/10615806.2013.809421. Epub 2013 Jun 25.


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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Alcohol Drinking / psychology
  • Australia
  • Crisis Intervention*
  • Emergency Responders / psychology*
  • Evidence-Based Medicine
  • Female
  • Firefighters / psychology*
  • Follow-Up Studies
  • Group Processes
  • Humans
  • Life Change Events*
  • Male
  • Mass Screening / psychology
  • Middle Aged
  • Occupational Diseases / diagnosis
  • Occupational Diseases / psychology
  • Occupational Diseases / therapy*
  • Psychotherapy, Group*
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Surveys and Questionnaires