Psychological debriefing was developed in the 1980s as an approach for use with people whose work exposes them to stressful incidents. It aims to help them to process the thoughts and emotions arising from their work. Subsequently, several randomized controlled trials tested truncated forms of debriefing in a different population: primary victims of unexpected trauma. These trials, and particularly two in which debriefing appeared to be harmful, led two major reviews to warn practitioners not to offer debriefing. Consequently, many organizations have stopped providing debriefing to employees who face trauma in their routine work. This paper argues that there are at least three reasons for the apparent failure of 'debriefing' in the two studies that reported adverse effects. First, the 'debriefing' did not follow protocol in terms of timing, length, and training and independence of the debriefer. Second, the patients who were 'debriefed' reported more severe initial symptoms than those who were not. Third, 'debriefing' was used with individuals for whom it was not originally intended. Psychological debriefing is intended to be used with groups of people who have been briefed together before going on to work together in stressful situations. Such groups have reported that they find psychological debriefing helpful, and research is emerging indicating that appropriate debriefing may indeed benefit these groups. We call for reviewers to recognize the limitations of debriefing research and not to overgeneralize their conclusions.

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Introduction: psychological and psychiatric problems - Stressors in the wilderness - Considerations before departure - Psychiatric conditions - Psychological reactions to traumatic events - Post-traumatic stress disorder - Serious psychological threats - Recreational drugs and alcohol - After the expedition - P—assess perception - I—obtain the person’s invitation - K—give knowledge and information - E—address emotions with empathic responses - S—strategy and summary

Introduction: psychological and psychiatric problems - Stressors in the wilderness - Considerations before departure - Psychiatric conditions - Psychological reactions to traumatic events - Post-traumatic stress disorder - Serious psychological threats - Recreational drugs and alcohol - After the expedition - P—assess perception - I—obtain the person’s invitation - K—give knowledge and information - E—address emotions with empathic responses - S—strategy and summary

No abstract