CLINICIAN ’ S TRAUMA UPDATE 2 ( 3 ) , JUNE 2008 Treatment

CISD has limited benefit for military peacekeepers. Critical Incident Stress Debriefing (CISD) is often used in military and other organizational settings in an attempt to prevent or minimize adverse outcomes of traumatic exposure. The intervention has generated controversy, perhaps in part due to its widespread use in the absence of solid empirical evidence from randomized clinical trials to demonstrate its effectiveness. Now a new study by VA and DoD investigators provides the first such evidence—and the results are disappointing. The investigators randomly assigned 952 military personnel who were serving on a 6-month peacekeeping mission in Kosovo to one of 3 group conditions: a CISD session, a stress management class, or assessment only. Study participants completed assessments of PTSD, depression, aggressive behavior, and other symptoms before and after the intervention, and then 3-4 and 8-9 months later. There were no differences among groups on any of the outcomes. Among individuals who experienced greater exposure to traumatic events, there were small but clinically insignificant improvements in PTSD and aggressive behavior in the CISD group, but there also were small (and again, clinically insignificant) increases in problem drinking among more highly exposed participants. The investigators noted that despite the absence of meaningful effects, CISD was rated favorably and was not harmful. They suggest that despite the lack of efficacy of CISD, “human, social, and informational needs” may be a reason to continue its use in military personnel and other workers exposed to traumatic events.