A WARNING OF THE DANGERS OF POST-DISASTER PSYCHOLOGICAL DEBRIEFING

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Quotation:

Dr. Tana Dineen, commenting on trauma counselors: "We have a choice. We can ignore them and assert our humanity, or we can follow their lead into whining victimhood."

A group of psychologists have issued a warning about the dangers of certain types of psychological debriefing after traumatic experiences.

The term "iatrogenic" may not be familiar to some of our readers. It means "physician induced disorder."

Our Latin is a little rusty after five decades of disuse, but we think that "Primum non nocere" means "First, do no harm."

A WARNING ABOUT CRISIS INTERVENTION THERAPY

Several independent studies now demonstrate that certain forms of postdisaster psychological debriefing (treatment techniques in which survivors are strongly suggested to discuss the details of their traumatic experience, often in groups and shortly after the disaster) are not only likely to be ineffective, but can be iatrogenic.

Primum non nocere.

The enormity of the atrocious events of September 11 is difficult to grasp. There can be little doubt that the psychological impact of these horrific events will be felt at both individual and community levels for days, months, and even years to come. As psychologists, our instinct is to help, and indeed there is much that we can do. As citizens, we can give blood and make financial contributions to emergency  organizations. As specialists in human behavior, we can offer our support to victims and their families. We can do our best to empathize with their suffering, and we can reinforce constructive coping responses.

In concert with other health care providers, we can offer appropriate psychological services to those who develop psychological disorders such as post traumatic stress disorder or depression. For example, there is evidence that cognitive behavior therapy provided a few weeks after a traumatic event in those with persistent problems can be effective.

But in times like these it is imperative that we refrain from the urge to intervene in ways that -- however well intentioned -- have the potential to make matters worse. Several independent studies now demonstrate that certain forms of postdisaster psychological debriefing (treatment techniques in which survivors are strongly suggested to discuss the details of their traumatic experience, often in groups and shortly after the disaster) are not only likely to be ineffective, but can be iatrogenic.

Unfortunately, this has not prevented certain therapists from descending on disaster scenes with well-intentioned but misguided efforts. Psychologists can
be of most help by supporting the community structures that people naturally call upon in times of grief and suffering. Let us do whatever we can, while being careful not to get in the way.

James D. Herbert, Ph.D., MCP Hahnemann University
Scott Lilienfeld, Ph.D., Emory University
John Kline, Ph.D., Florida State University
Robert Montgomery, Ph.D., Independent Practice, Roswell Georgia
Jeffrey Lohr, Ph.D.,University of Arkansas
Lynn Brandsma, Ph.D., Villanova University
Elizabeth Meadows, Ph.D., Central Michigan University
W. Jake Jacobs, Ph.D., University of Arizona
Naomi Goldstein, Ph.D., MCP Hahnemann University
Richard Gist, Ph.D., KS City Fire Department/University of Missouri-Kansas City
Richard J. McNally, Ph.D., Harvard University
Ron Acierno, Ph.D., Medical University of South Carolina
Morag Harris, Ph.D., Texas A&M University-Commerce
Grant J. Devilly, Ph.D., University of Melbourne, Australia
Richard Bryant, Ph.D., University of New South Wales, Australia
Howard D. Eisman, Ph.D., Coney Island Hospital
Ronald Kleinknecht, Ph.D., Western Washington University
Gerald M. Rosen, Ph.D., University of Washington
Edna Foa, Ph.D., University of Pennsylvania

Reference:

1. Tana Dineen, "Trauma counselors do more harm than good," 2001-SEP-20, Vancouver Sun, Vancouver BC, Canada.

No copyright © is claimed by Ontario Consultants on Religious Tolerance
Originally posted 2001-SEP-18
Latest update: 2001-SEP-18
Authors: as noted.