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Should our organisations provide debriefing for aid workers either after a critical incident, or on return from an overseas assignment? What does debriefing actually involve and what’s the best way to go about it? I recently joined a workshop in London on debriefing aid workers conducted by clinical psychologist Dr Debbie Hawker to learn both practical tips for debriefing and the theory behind its importance.

What is debriefing?

Critical incident debriefing (CID) occurs soon after a traumatic event and helps an individual process their experience, cope with stress-related symptoms, promote normal recovery and prevent subsequent psychological problems. It typically lasts two to three hours and involves talking about the facts of what happened, and the individual’s thoughts and feelings about it. The brain often can’t make sense of a traumatic event so stores it in “active memory”; talking about the event helps the brain process it and store it in long-term memory. This provides a sense of closure and reduces the risk of post-traumatic stress disorder (PTSD).

Routine debriefing occurs after the end of an overseas assignment and involves discussing both the best and worst aspects of the experience. Sixty per cent of aid workers report predominantly negative feelings on return home and a personal debriefing is one way for them to come to terms with this and focus on the future.

Why should we debrief?

Aid workers can experience everything from kidnapping, robbery and sexual harassment, to stresses such as communication problems, isolation and cultural frustrations. It’s no surprise then that approximately 50% of aid workers develop a psychological disorder while overseas or shortly after returning home (Lovell, D. M. 1997, Psychological adjustment among returned overseas aid workers) ranging from depression to PTSD. Worryingly, aid agencies only know about 7.5% of these cases according to Dr Hawker.

The 2009 People In Aid report Approaches to staff care in international NGOs concluded: “The area where most improvements can be made is that of post-assignment/ re-entry. In a sector where one assignment/ deployment flows into another … some international staff may “fall through the cracks”, risking their personal health and wellbeing, and putting the organisation at risk of liability”.

Research shows about 24% of non-debriefed people had clinical levels of traumatic stress about a year after returning home, compared with just 7% of debriefed people (Lovell, D. M. 1999, Evaluation of Tearfund’s critical incident debriefing process). Debriefing encourages well-being and increased self-awareness, and helps individuals find ways to cope with stress or the aftermath of an experience. Debriefed people may be more inclined to support their organisation and look positively on it even if they’ve had a negative experience. In one study of 600 agencies across 22 countries, debriefing correlated with retention (Hay et al., 2007, Worth Keeping: Global perspectives on best practice in missionary retention). Organisations can also learn and improve practice based on what is shared during debriefings.

Tips for debriefing

1. Don’t mix personal and operational debriefings.

It’s recommended that an operational debriefing takes place first to enable an individual to offload work-related information so they can then move on to unpacking the personal side of an assignment. An operational debriefing shares information about the work performed and what was achieved. A personal debriefing asks how the experience was for the individual to help them integrate it into their life, perceive the experience more meaningfully, and bring a sense of closure.

2. Length of the debriefing.

Research shows that there’s no point doing a debriefing if it’s too short and some studies show a debriefing under one hour can have a negative effect or no effect.  Adequate debriefing takes at least two hours and often longer.

3. Timing of the debriefing.

If a debriefing takes place in the first 24 hours after a critical incident, then it’s not worthwhile. It’s recommended that debriefing takes place 48 to 72 hours after a critical incident, and one to three weeks after the end of an assignment.

4. Debriefer is active listener.

If the debriefer is a poor listener, the debriefee may go away feeling the session was a waste of time. It’s important to find a balance between being overly emotional or emotionless and distant. It’s important for the debriefer to remember that the session is not about them and isn’t an opportunity to recount their experiences and talk over the debriefee.

5. Debriefer is credible.

The debriefer should be trained and professional. It also helps for them to explain the purpose of the session and that it is confidential.

6. Adjust to the context.

It’s important to adjust the session itself depending on the incident, as well as any context-specific gender or cultural issues. A group debriefing might be preferred if a team have gone through a traumatic incident such as a kidnapping together. An individual session may be more beneficial for a routine end of assignment session. Some individuals may have a preference for an internal or external debriefer, as well as one of a certain gender or age. Be aware of any potential role conflicts; it’s best not to be debriefed by a line manager or close friend. It’s also important to localise any ways of coping for example, if the individual normally deals with stress by going swimming or shopping and these outlets aren’t available in their current environment then work with them to find different coping mechanisms.

7. Find the right environment.

It’s important that a debriefing takes place in a secure, confidential environment that the individual feels comfortable in. This is a place where others won’t interrupt or see the session taking place. If debriefing is taking place remotely over phone or Skype then think of any practical considerations such as a back-up phone number or way of getting in touch if communications break down. Encourage the debriefee to replicate a secure, confidential and calming environment wherever they are.

The CHS Alliance Debriefing Aid Workers and Missionaries Manual is available for download here and is free for members and £10 for others. The CHS Alliance offers a Debriefing Aid Workers workshop. Bespoke or in-house workshops may also be arranged. Please email info@chsalliance.org to find out more.

Do you think organisations should encourage debriefing? Should it be offered on an opt-in or opt-out basis? What tips have you found useful for debriefing?