Questionable Practice: Critical Incident Stress Debriefing
Last week, I was listening to a Joe Rogan podcast on my way home from the store. His guest was Dr. Nancy Panza, a clinical psychologist from Cal State Fullerton. Aside from lecturing undergrads, Dr. Panza’s research interests include criminal forensic assessment and police psychology. She has worked with police departments from New York City, Alabama, and California. As you can tell, she seems to be very qualified to be talking on the subject of police reform and mental health.
While on the podcast, Joe Rogan asked for her suggestions on psychological standardization procedures for police departments across the country. She advocated for two: pre-employment psychological testing and critical incident stress debriefing. In her words, “critical incident debriefings are a must and should always occur, and they should be mandatory because they take away the stigma”. For those of you who don’t know, critical incident stress debriefing (CISD) encourages individuals involved in a traumatic event to share their thoughts and feelings, making sense of this “critical incident”. In addition to the supportive aspect of this intervention, CISD also provides participants with information about necessary coping skills. This immediate intervention is hoped to delay or eliminate stress reactions from the incident.
Seems like a convenient and effective strategy, right? Not quite. There is little available evidence to prove the effectiveness of CISD. Although it may seem intuitive that CISD would reduce the prevalence of later psychological disorders, there is limited empirical data showing that it reduces later psychological symptoms. For example, a meta-analysis from 2002 showed that non-CISD interventions and no intervention improved symptoms of post-traumatic stress disorder, while CISD did not affect these symptoms.
Other studies have even shown that groups receiving CISD actually wound up worse than groups that received no treatment after a traumatic event. In a follow-up to a randomized controlled trial, patients who had received psychological debriefing following a car accident had significantly worse long-term outcomes in terms of psychiatric symptoms, travel anxiety, pain, physical problems, and overall level of functioning.
What would explain these findings? The basic argument is that CISD hinders the natural information processing following psychological trauma. Individuals are taught to rely on health professionals, rather than the support and comfort of close family and friends. Research has shown that most trauma survivors have symptoms relieved within three months of the initial incident, without any intervention.
Years and years of research have shown evidence of the ineffectiveness of CISD, and yet, a clinical psychologist is still advocating for this practice to be implemented into police departments across the country. It is time that we begin to look at different interventions to limit negative mental health outcomes in the police.
Future Practices: Pre-employment Screening & Critical Incident Training
Although there is little research on the effectiveness of police prescreening, many agencies use evidence-based personality assessment tools such as the Minnesota Multiphasic Personality Inventory (MMPI) and the Inwald Personality Inventory (IPI). Both the MMPI and IPI have shown evidence of predictive validity in the area of job performance among police officers. For example, high scores on the IPI Family Conflict scale were associated with poorer job performance at one year and conflicts with supervisors and peers. The IPI Guardedness domain, which measures the tendency to hide personal flaws, also predicted future job performance.
Beyond pre-employment testing, more needs to be done in the area of training police officers for distressing situations. Police who received trauma resilience training as rookies show less negative mood, less heart rate reactivity, and better police performance compared to a control group. Trauma resilience training involves initial psychological sessions, consisting of relaxation and imagery training with mental skill rehearsal. In addition, the officers participate in critical incident stimulation, which involves confrontation by an armed suspect (actor). The relaxation and imagery training was found to improve the performance of adaptive police behaviors during the critical incident stimulation, such as safety and control of the bystanders.
Both pre-employment psychological screening and trauma resilience training are necessary to limit negative mental health outcomes among police officers. These evidence-based techniques have been shown to predict job performance, and in some instances, mitigate unfavorable consequences of critical situations. Critical incident stress debriefing has unreliable potential and should not be included in the interventions that police departments utilize.
Police Psychology Resources (from APA website)
- Blau, T.H. (1994). Psychological Services for Law Enforcement. New York: John Wiley & Sons.
- Kirschman, E. (1997). I Love a Cop: What Police Families Need to Know. New York: Guilford Press.
- Kurke, M.I., & Scrivner, E.M. (Eds.). (1995). Police Psychology into the 21st Century. Hillsdale, N.J.: Lawrence Erlbaum Associates.
- Visit policefamilies.com for resources for families of police officers.
- For more information on the Police Psychological Services Section of the International Association of Chiefs of Police, visit www.theiacp.org or contact Kim Kohlhepp at (800) 843-4227, ext. 237.
- APA’s Div. 18 (Psychologists in Public Service) includes a section on Police and Public Safety.
- The National Institute of Justice’s Corrections and Law Enforcement Family Support Program’s Web site is www.ojp.usdoj.gov/nij/clefs.
The information and suggestions that I have provided here is in no means professional. This post has been reviewed by a faculty member of the University of Notre Dame Department of Psychology to verify accuracy.
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Detrick, P. and Chibnall, J. T. 2002. Prediction of police officer performance with the Inwald Personality Inventory. Journal of Police and Criminal Psychology, 17: 9–17.
Hobbs, M., & Adshead, G., (1997). Preventative psychological intervention for road crash survivors. In M. Mitchell (Ed). The aftermath of road accidents: Psychosocial, social, and legal consequences of an everyday trauma (pp. 159-171). London: Routledge
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Michael S. Rogers, Dale E. McNiel and Renée L. Binder. (2019) Effectiveness of Police Crisis Intervention Training Programs. Journal of the American Academy of Psychiatry and the Law Online September 2019, JAAPL.003863-19; DOI: https://doi.org/10.29158/JAAPL.003863-1
Rose, S., & Bisson, J. (1998). Brief early psychological interventions following trauma: A systematic review of the literature. Journal of Traumatic Stress, 11, 697–710.
Scogin, F., Schumacher, J., Gardner, J., & Chaplin, W. (1995). Predictive validity of psychological testing in law enforcement settings. Professional Psychology: Research and Practice, 26(1), 68–71. https://doi.org/10.1037/0735-7028.26.1.68
van Emmerik AAP, Kamphuis JH, Hulsbosch AM, Emmelkamp PMG. Single session debriefing after psychological trauma: a meta-analysis. Lancet 2002; 360: 766.