Debriefing

The act of discussing or talking through a recent experience, such as a crisis

-commonwealth Department of Health and Family Service 1998 p.257

Psychological debriefing for preventing post traumatic stress disorder (PTSD)

This review concerns the efficacy of single session psychological "debriefing" in reducing psychological distress and preventing the development of post traumatic stress disorder (PTSD) after traumatic events. Psychological debriefing is either equivalent to, or worse than, control or educational interventions in preventing or reducing the severity of PTSD, depression, anxiety and general psychological morbidity. There is some suggestion that it may increase the risk of PTSD and depression. The routine use of single session debriefing given to non selected trauma victims is not supported. No evidence has been found that this procedure is effective.

Authors' conclusions:

There is no evidence that single session individual psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease. A more appropriate response could involve a 'screen and treat' model (NICE 2005).

Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD000560. DOI: 10.1002/14651858.CD000560.

This version first published online: 22 April 2002 in Issue 2, 2002. Re-published online with edits: 21 January 2009 in Issue 1, 2009. Last assessed as up-to-date: 2 December 2001.

Preventing Mental disorders

Treating subthreshold symptoms in pregnant women

For symptoms of depression and/or anxiety that do not meet diagnotic criteria but significantly interfere with personal and social functioning consider:

• brief psychologial treatment (4 - 6 sessions), such as interpersonal psycholtherapy (IPT) or cognitive behavioural therapy (CBT), for women who have had a previous episode of depression or anxiety
• social support (regular informal individual sessions or group-based) for those who have not had a previous episode of depression or anxiety

Routine antenatal and postnatal care

psychosocial interventions (for example, group psychoeducation) designed specifically to reduce the likelihood of the woman developing a mental disorder during pregnancy and the postnatal period should not be part of routine antenatal and postnatal care.

Traumatic birth and stillbirth

Do not routinely offer single-session formal debriefing focused on the birth to women who have experienced a traumatic birth.

• maternity staff and other healthcare professionals should support women who wish to talk about their experience, encourage them to make use of support from family and friends, and consider the effect of the birth on the partner.
• Do not routinely encourage mothers of infants who are stillborn or die soon after birth to see and hold the dead infant. Offer an appropriate follow-up appointment in primary or secondary care.

- NICE 2007 p.9