GPS: Trauma Information: Critical Incident Debriefing

Trauma: Critical Incident Debriefing
(last updated September, 2003)

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What this page contains:

Critical Incident Stress Information Sheet

Physical Signs

Cognitive Signs

Behavioural Signs

Emotional Signs

Coping With Trauma

Best Practices in Trauma Intervention

Helping Others Cope

Critical Incident Stress Information Sheet
courtesy of the Los Angeles County Department of Mental Health

You have experienced a traumatic event. Even though the event may be over, you may now be experiencing or may experience later some strong emotional or physical reactions. It is very common, in fact quite normal. for people to experience emotional aftershocks when they have passed through a horrible event.

Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Sometimes they may appear a few hours or a few days later. And, in some cases, weeks or months may pass before the stress reactions appear.

The signs and symptoms of a stress reaction may last a few days, a few weeks or a few months and occasionally longer depending on the severity of the traumatic event. With the understanding and the support of loved ones, stress reactions usually pas more quickly. Occasionally, the traumatic event is so painful that professional assistance from a therapist may be necessary. This does not imply craziness or weakness. It simply indicates that the particular trauma was just too powerful to manage without help.

Below are some very common signs and signals of a stress reaction.

Physical Signs

* Fatigue

* Nausea

* Muscle tremors

* Twitches

* Chest pain°

* Difficulty breathing°

* Elevated blood pressure

* Rapid heart rate

* Thirst

* Visual difficulties

* Vomiting

* Grinding of teeth

* Weakness

* Dizziness

* Profuse sweating

* Chills

* Shock symptoms°

* Fainting

* etc.

° Definite indication of the need for medical evaluation!

Cognitive Signs

* Blaming someone

* Confusion

* Poor attention

* Poor decisions

* Heightened or lowered alertness

* Poor concentration

* Memory problems

* Hypervigilance

* Difficulty identifying familiar objects or people

* Increased or decreased awareness of surroundings

* Poor problem solving

* Poor abstract thinking

* Loss of time, place, or person orientation

* Disturbed thinking

* Nightmares

* Intrusive images

* etc.

Need help finding a trauma therapist in your area?

If you live near Halifax, NS, you may wish to consult with one of our therapists. Visit our therapy page for more information.

If you live outside the Halifax area, we provide extensive information on therapy and therapists in North America on our Find a Therapist Page.

Visit some of our links for more information on PTSD or links to PTSD support groups.

For additional information about PTSD, navigate to the APA HelpCenter.

Are you or is somebody you know experiencing these symptoms following a significant traumatic experience? Find out more about Posttraumaitc Stress Disorder in our Information Pages.

All About PTSD

PTSD Recognition

PTSD and Motor Vehicle Accidents

PTSD and Trauma

Behavioural Signs

* Change in activity

* Change in speech patterns

* Withdrawal

* Emotional outbursts

* Suspiciousness

* Change in usual communications

* Loss or increase of appetite

* Alcohol consumption

* Inability to rest

* Antisocial acts

* Nonspecific bodily complaints

* Hyperalert to environment

* Startle reflex intensified

* Pacing

* Erratic movements

* Change in sexual functioning

* etc.

Emotional Signs

* Anxiety

* Guilt

* Grief

* Denial

* Severe panic (rare)

* Emotional shock

* Fear

* Uncertainty

* Loss of emotional control

* Depression

* Inappropriate emotional response

* Apprehension

* Feeling overwhelmed

* Intense anger

* Irritability

* Agitation

* etc.

Coping With Trauma

* Give yourself permission and TIME to grieve.

* Focus on your strengths and coping skills.

* Ask for support and help from your family, friends, church or other community resources. Join or develop support groups.

* Redefine your priorities and focus your energy and resources on those priorities.

* Set small realistic goals to help tackle obstacles. For example, reestablish daily routines for yourself and your family.

* Clarify feelings and assumptions about your partner. Remember that men and women react differently. Women tend to be caretakers and put others first. Men have difficulty acknowledging and expressing feelings of helplessness and sadness and believe in "toughing it out."

* Eat healthy meals.

* Get enough rest to increase your reserve strength.

* Acknowledge unresolved issues and use the hurt and pain as a motivator to make the necessary changes to heal.

* Continue to educate yourself and family about normal reactions to a disaster.

* Talk to your children. Be supportive. Set an example by expressing your feelings and showing problem solving skills in dealing with family problems.

* Remember that you are not alone.

* Physical exercise can help relieve stress. Strenuous exercise alternated with relaxation will help alleviate physical reactions.

* Remember that you're experiencing normal reactions to an abnormal situation.

* Talk to people. Talk is healing medicine.

* Accept support -- from loved ones, friends and neighbors. People do care.

* Give yourself permission to feel rotten. You're suffering from loss. And, it's all right to grieve for the loss of material things. You wouldn't have obtained them or kept them around if they didn't have some meaning to you.

* When you're feeling rotten, remember that those around you are also under stress.

* Don't make any big life changes immediately. During periods of extreme stress, we all tend to make misjudgments.

* Be kind to yourself.

Best Practices in Trauma Intervention

For most people, the response to trauma, including fear, anxiety, re-experiencing, urges to avoid, and hyperarousal symptoms, will gradually decrease over time.

People should be encouraged to use natural supports and to talk with those they are comfortable with — friends, family, co-workers — at their own pace. They should follow their natural inclination with regard to how much and to whom they talk.

Outcome studies of Psychological Debriefing do not overall support the use of a one-session intervention shortly after the trauma. In fact, some studies found that in the long run, a single-session may hinder natural recovery (see Bisson, Jenkins, Alexander, & Bannister, 1997; Mayou, Ehlers, & Hobbs, 2000).

It is recommended that brief interventions consist of 3-4 visits over 2-6 weeks time.

Individuals who continue to experience severe distress that interferes with functioning after three months are at higher risk for continued problems. These individuals should receive additional treatment.

References:
Foa et al. Guidelines for mental health professionals' response to the recent tragic events in the US.

Helping Others Cope

* Listen and empathize. A sympathetic listener is important.

* Spend time with the traumatized person. There is no substitute for personal presence.

* Offer assistance and sympathy. Voiced support is critical.

* Re-assure children, the elderly and even adults: they are safe.

* Don't tell traumatized people that they are "lucky it wasn't worse". Traumatized people are not consoled by such statements. Tell them, instead that you're sorry such an event has occurred, and that you want to understand and assist them.

* Respect a family member's need for privacy and private grief.