The history of psychological trauma is littered with episodes of knowledge and forgetting, just as post-trauma memory is scattered with episodes of remembering and amnesia. This authoritative text goes some way towards the prevention of the threatened but premature death-knell for psychological debriefing. Few issues in mental health are as controversial as psychological debriefing, with polarised views common. The term ‘psychological debriefing’ has been used for different types of intervention, and this book highlights the range of conceptualisations, methodologies and interventions that constitute the area of debriefing, with single sessions superseded by critical-incident stress management (the Cochrane Collaboration review examined only randomised controlled trials incorporating one-off sessions (Reference Rose, Wessely and BissonRose et al, 2001)).
The editors, Raphael & Wilson, have an impressive track record in theirInternational Handbook of Traumatic Stress Syndromes (Reference Wilson and Raphael1993), a seminal text on psychological trauma. Here, they precede each chapter with an editorial commentary, which provides a helpful overview. The book comprises 25 chapters in four parts, and the contributors include leading trauma researchers. The first part focuses on key conceptualisations, the last provides an overview of debriefing. In between, Part II contains chapters detailing models, research and debriefing practice and Part III outlines the adaptation of debriefing models to various groups.
Particularly helpful chapters are those examining or highlighting the shortcomings and difficulties of research strategies (Chapter 1); the possibility of consensus (Chapter 23); and an examination of the background and evolution of debriefing (Chapter 24). The wish to tackle the dilemmas facing debriefing strengthens the text and emphasises the editors' desire to analyse the evidence appropriately. The sections, and chapters therein, vary in interest for expert and non-expert, with Parts I and IV of greatest interest to the non-expert.
Two recurring themes are welcome and reassuring. The first is the need to target interventions to those needing help (and thereby letting sleeping dogs lie!), and the second is that debriefing should not be compulsory. The humane wish to assist individuals at the point of major trauma or disaster is not helped by a closed debate, with advocates and antagonists retreating to their enclaves. Consensus can only be reached by further research and open discussion. This book highlights the key questions needing answers. Other interventions, such as psychological first aid, should not be adopted without supporting empirical evidence simply because evidence supporting debriefing is inconclusive.
This book is uniformly well written and offers some chapters to provoke, others to reference and none to bore. It has international appeal, covers a range of trauma and will be appreciated by many professionals, not just those with a special interest in psychological trauma.
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