The Debate over Psychological Debriefing for PTSD

Abstract

Psychological Debriefing (PD) is an early intervention administered to trauma victims in order to prevent the onset of posttraumatic stress disorder (PTSD). The method has been considered a "mandatory" intervention and has long been endorsed by the American Red Cross and several relief agencies around the globe (Litz, Gray, Bryant & Adler, 2002), yet it has also incited warnings of contraindication from 20 renowned trauma experts shortly after 9/11 (Herbert, Lilienfeld, Kline, Montgomery, Lohr, Brandsma et al., 2001) in an APA Monitor open letter and from the World Health Organization (van Ommeren, 2002). Given that lifetime exposure to potentially traumatic events in the general population is extremely high over 60% (Kessler, Sonnega, Bromet, Hughes & Nelson, 1995) any measures to prevent PTSD deserves ongoing in-depth evaluation. Fortunately, the vast majority of these trauma-exposed people do not go on to develop an acute, chronic, or delayed onset PTSD, attesting to the protective resiliency prevalent in the normal population. This fact alone immediately raises the question of whether any type of early psychological intervention should continue to be administered, especially if there is mounting empirical evidence to suggest that certain forms of intervention such as PD may either be inert or can even exacerbate and solidify the very symptoms of PTSD that mental health professionals and relief workers set out to prevent in the first place.