When the Stress is Critical, Avoid Pseudoscience, Psychologist Says

FAYETTEVILLE, Ark. – A case study of Critical Incident Stress Debriefing, known as CISD, shows that this approach to crisis management meets all criteria for a pseudoscience. The good news is that scientifically validated approaches are available to respond effectively to critical situations, according to University of Arkansas psychologist Jeffrey M. Lohr.

Lohr and colleagues Katherine M. Newbold and Richard Gist evaluated a discredited but well publicized approach that was used for a time by the FBI to debrief employees who had been involved in potentially traumatic situations. CISD, sometimes known as Critical Incident Stress Management, is used worldwide to prevent post-traumatic stress disorder, although it lacks scientific validation, the researchers wrote. As evidence has mounted questioning the efficacy of CISD, the World Health Organization and governmental bodies in Great Britain and Australia have recommended against routine use of debriefing in crisis situations.

The CISD approach assumes that “exposure to ostensibly traumatic life events is a sufficient precursor for the development of psychological symptoms that can readily grow to pathological proportions,” the researchers wrote. Additionally, CISD is based on the notion that early intervention involving some element of emotional release is all that is needed to prevent such serious outcomes as PTSD. Neither of these assumptions passes the tests of science, according to Lohr and his colleagues.

The researchers identified ways in which CISD conforms to the five criteria that identify a pseudoscience.

First, like other pseudosciences, CISD promotes its product through persuasion, rather than by objective measures of effectiveness.

Second, when pressed, CISD proponents will offer their own supposedly scientific analysis of the system, but on investigation, their studies show serious flaws and “strongly suggest that their function is to deflect the impact of independent studies.”

Third, CISD proponents share an opposition to skeptical inquiry typical of pseudosciences. While scientists engage in the process of inquiry, the efforts of pseudoscientists center on the “capacity to secure and maintain believers,” the researchers wrote.

Fourth, pseudoscience avoids rigorous testing. Not only does it begins with the assumption that theories and techniques are adequate and “even venerable,” the researchers wrote, “Its objective is to prove their accuracy and benefit.”

Fifth, pseudoscientific endeavors consistently resist self-correction, as did the CISD unit at the FBI for a time.

 “CISD is not the only option” when people have been involved in a crisis situation, Lohr said. “Other scientifically validated approaches are available, such as the guidelines and reviews developed by the Australian Centre for Posttraumatic Mental Health in 2007.”

The researchers noted that it is possible to make an assessment of those who need further help through simple, non-intrusive instruments for screening, such as the Trauma Screening Questionnaire, that have shown “high sensitivity, specificity and screening efficiency.” One strength of these scientifically verified methods is that they can be used in health settings or for self-screening and self-referral.

The researchers concluded that the use of CISD involves issues of ethical principles and conduct for mental health professionals: “The influence of nonscience, junk science, and pseudoscience raises major ethical implications for mental health practice in its entirety, with professional psychology providing a particularly well-placed example of our concerns.”

Lohr is a professor of psychology in the J. William Fulbright College of Arts and Sciences at the University of Arkansas. Newbold is retired from the FBI and teaches criminal justice at Illinois Valley Community College. Gist is on the research faculty in the department of preventative medicine at the Kansas City University of Medicine and Biosciences. Their article “Apprehended Without Warrant: Issues of Evidentiary Warrant for Critical Incident Services and Related Trauma Interventions in a Federal Law Enforcement Agency” was published in the October issue of Criminal Justice and Behavior.