PSYCOLOGICAL DEBRIEFING AND EVIDENCE BASED PRACTICE

Suzanna Rose


ABSTRACT

It has been suggested that giving people the opportunity to talk about a traumatic event 
in a structured way may prevent the development of a later disorder. A systematic 
literature search/review was undertaken of one-off psychological interventions following 
trauma. Only 6 randomized controlled trials were found and none of these were of group 
interventions. Of the six trials two studies associated the intervention with a positive 
outcome, two demonstrated no difference on outcome between intervention and non-
intervention groups and two showed some negative outcomes in the intervention group. 
This review suggests that early optimism for one-off interventions including debriefing 
was misplaced and that there is an urgent need for randomized controlled trials of group
debriefing and other early interventions. This review formed the basis of a new Cochrane 
Collaboration Review.

Subsequently, a randomized controlled trial of psychological debriefing for victims of 
violent crime was undertaken. We tested the efficacy of two brief interventions, education 
and psychological debriefing, designed to prevent adverse psychological reactions to 
criminal victimization. 157 individuals who had been the victims of a violent crime within 
the past month were randomly assigned either to an education condition, to a psychological 
debriefing plus education condition, or to an assessment only condition. Education involved 
providing information about normal post-traumatic reactions. Debriefing involved in-depth 
probing about events, thoughts and feelings experienced during the crime. Subjects were 
recruited from police and hospital sources and interviewed in their own homes. 138 were 
followed up at 6 months, and 92 at 11 months. Outcome was assessed using a DSM-IIIR 
diagnosis of PTSD, the Post-traumatic Symptom Scale, the Impact of Event Scale, and 
the Beck Depression Inventory. All groups improved over time but there were no 
between-group differences. No evidence was found to support the efficacy of brief 
one-session interventions for preventing post-traumatic symptoms in victims of 
violent crime. When the data were examined predictively it was possible to identify 
the minority of victims who subsequently went on to develop PTSD and currently a 
brief screening instrument is being developed around these findings.

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