A Qualitative Analysis of the Experiences of Critical Incident Stress Debriefers

Through narrative inquiry of participants experienced in providing Critical Incident Stress Debriefing (CISD), this study sought to explore the factors of CISD that are salient in assisting first responders and survivors post critical incident. In response to the debate on the efficacy of CISD, Mitchell (2004) challenged researchers to focus on influential factors affecting outcome rather than general efficacy. It was determined that a qualitative approach utilizing narrative inquiry would best provide in-depth understanding of these factors in the provision of CISD to first responders and survivors. Eight participants located throughout the state of Washington were interviewed. All participants self-identified as Caucasian and endorsed they were certified to provide CISM. Experience providing CISM ranged from 2 to 15 years and all endorsed providing a debriefing to first responders within the past 10 years. Seven participants identified as male, one female, and age ranged from 43 to 65 (M = 58). Following qualitative methodology, narratives were transcribed, codes were created, codes were grouped into 64 themes, themes were grouped into 16 categories, and five concepts emerged. The concepts: (a) belief in CISM, (b) structure and preparation, (c) processing, (d) impact of responding and caring for others, and (e) restoration of functioning, are conceptualized as pertinent concepts in the process of CISD. Factors imbedded in these concepts were considered both positive and negative in relation to their effect on responders during the debriefing process. Participants found the following factors helpful: information gathering, preparation, introduction, structure, psycho-education, and processing thoughts and emotions. Less helpful factors included resistance and debriefers' idiosyncratic opinions of CISD structure and content. Further implications of this study include an isomorphic process where both first responders and debriefers experience the psychological impact of the secondary or tertiary exposure to trauma and subsequent need for peer-to-peer processing post exposure. Additionally, findings highlight a need for further stabilization and standardization of terminology used within CISM and the field of crisis intervention. A preponderance of data on first responders may reflect participants' recognition of the unique utility of CISD with first responders. Further research should clarify the utility of CISD with survivors.