Critical Incident Stress Debriefing is an intervention that assists patients and families to master the stresses resulting from being a witness to or victim of violent acts. Intervening at the level of the family system, the clinical nurse specialist can facilitate communication, decrease anxiety, and provide education regarding the posttrauma response.
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V IOLENCE and its consequences is one of the most critical concerns facing our society. The incidence of interpersonal violence in the United States is escalating. Blair (1992) notes 1991 was "the bloodiest year in US history with greater than 25,000 murders as compared with 23,440 in 1990" (p. ix). Complex psychosocial issues are often connected with injury suffered as a result of violent acts. When faced with the sights and sounds of violence, death, and destruction in the media one can choose not to look or listen, thereby reducing the impact of such negative stimulation. When the individual becomes personally involved as a witness or victim such avoidance is impossible.
In 1983, Jeffery Mitchell, PhD, designed a hybrid form of crisis intervention known as Critical Incident Stress Debriefing (CISD). The program was initially targeted for emergency services personnel who routinely cope with trauma as part of their work. CISD assists providers in avoiding or minimizing acute stress reactions resulting from involvement in critical incidents (Back, 1992;Clark & Friedman, 1992;Freehill, 1992).
According to Mitchell (1983), an event described as critical incident has the following characteristics: it happens suddenly and unexpectedly,