Experts Report New Consensus on Trauma Support for Journalists, First Responders
01 July 2007
Should journalists, as well as emergency first responders or witnesses, receive mandatory counselling or debriefing after violent or traumatic events?
No, concludes a major article published in the July 1, 2007 edition of the American Journal of Psychiatry (AJP).
In the article, two of the world's leading authorities in different approaches to trauma response agree on the importance of practical and pragmatic support and of a trauma-aware newsroom culture rather than the automatic provision of counselling for journalists and others affected by traumatic events.
The AJP article, by British trauma psychiatrist and researcher Jonathan Bisson of the Cardiff University and psychologist George Everly of Johns Hopkins University and the US-based Critical Incident Stress Foundation (CISF), is significant in uniting proponents of what until relatively recently had been conflicting, and to both professionals and non-professionals confusing, approaches to trauma response.
The paper culminates a two-year discussion between the two experts, initiated and mediated by the Dart Center for Journalism and Trauma, based at the University of Washington in Seattle, and its London affiliate, the Dart Centre in Europe.
Bisson and Everly use a case study involving a fictional journalist distressed by reporting the aftermath of a bomb attack. They argue for pragmatism, empathy and information as the most important immediate elements of trauma response, followed by formal psychological intervention only if individuals are assessed to need it.
"We're delighted to have helped them find this sensible common ground," said the Dart Centre's chairman emeritus Frank Ochberg, M.D., and Mark Brayne, director of Dart Centre in Europe, who are named in the AJP paper as co-authors.
"Bisson and Everly speaking together on this most authoritative platform sends all the right signals to trauma professionals," said Brayne and Ochberg.
"It will also help the media to understand what's now known to work best in supporting people who've been through the worst possible experiences."
In the 1980s, George Everly (Johns Hopkins School of Medicine and the Johns Hopkins Center for Public Health Preparedness) co-developed with former US fireman Jeffrey Mitchell an approach to disaster mental health which became known as Critical Incident Stress Management (CISM), more widely popularised as Critical Incident Stress Debriefing (CISD), or simply Psychological Debriefing.
In CISD, a trained facilitator encourages survivors and victims to share their experiences and emotions while the impact of the trauma is still fresh. Despite what Bisson and Everly agree in their paper was an absence of reliable evidence as to its effectiveness, CISD has become widely used around the world in the aftermath of traumatic incidents.
Jonathan Bisson, Senior Lecturer in Psychiatry at Britain's Cardiff University, was one of the British government's key advisers in drawing up recommendations in 2005 (National Institute for Clinical Excellence) explicitly discouraging the use of such debriefing for individuals as a routine form of support in the immediate aftermath of traumatic events.
"People cope with stress in differing ways," write Bisson and Everly in their AJP paper, "and no formal intervention should be mandated for everyone."
Instead, they recommend that those affected be provided shortly after the event with empathic, practical and pragmatic psychological support, with information about possible reactions, about what they can do to help themselves and how they can access support from family and community.
"It is important that provisions be made for individuals to obtain the appropriate early support after a traumatic event," they continue. "However, any early intervention approach should be based on an accurate and current assessment of need."
Their AJP paper also encourages exploration of what they term a psychological first aid approach which takes explicit account of people's natural resilience.
In the journalistic case study, Bisson and Everly say that despite the journalist's significant initial distress after covering the aftermath of the bomb attack, there was no indication that an early formal intervention would have helped.
They go on, however, to highlight the value of awareness training and peer support in the workplace which enabled the journalist and his colleagues to recognise some weeks after the bomb attack that he had been affected, becoming withdrawn, irritable and hypervigilant, and displaying many of the symptoms of acute Post Traumatic Stress Disorder (PTSD).
In their case study, Everly and Bisson describe how the journalist was encouraged, successfully, to seek professional therapeutic help in the form of cognitive behavioural therapy.
For further information, please contact UK: Mark Brayne, Director Europe, Dart Centre for Journalism & Trauma +44 20 81233549 firstname.lastname@example.org
USA: Bruce Shapiro, Executive Director, Dart Center for Journalism & Trauma +1 206 616 4281 email@example.com