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This overview of the conceptualization of the debriefing model and its application to children and adolescents reflects a strong clinical basis and understanding of the developmental issues relevant to the impact of critical incidents in this age range. Most of the debriefing practices currently provided for children are replications or derivatives of the adult models and are given a range of names, including creative debriefing, group treatments, classroom interventions and Critical Incident Stress Debriefing (CISD). This chapter introduces a framework for differentiation of the concept of debriefing from the group-based technique or format and the processes engaged within a well conducted debriefing. Prior to engaging a child in any response or management activity, including group debriefing, it is essential to identify, for each child, the quality of the impact of the event and the life context in which it has occurred for that child.
This chapter reviews concepts of stress as applied to health care professionals, and the perceived extent of the problem. It discusses factors that have been identified as contributing to the psychological symptoms and distress of health care professionals. The chapter also explains the models of interventions that have been used in some settings, as part of a critical evaluation of the role of Critical Incident Stress Debriefing (CISD) in these settings. The applicability of traumatic stress models to experience in health care fields is evidenced by the nature of stressors themselves. Several studies have described the extent of concerns experienced by staff working in the area of HIV, documenting varying levels of stress. Training needs to provide appropriate recognition of the emotional vulnerability of health care professionals and appropriate mechanisms of support and intervention that are readily available and nonstigmatizing.
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