The American Association of Christian Counselors (AACC) has announced “More than 7000 Individuals Trained” in “Christian Crisis Response Training” (AACC “Fall/Winter 2004 Schedule”). AACC sells “2 Day Intensive Certificate Training Programs.” The training AACC offers is based on the “Critical Incident Stress Management” (CISM) model. Dr. Tim Clinton, AACC President, introduces the AACC certificate training by saying:
September 11, 2001, the ongoing threats of terrorism and the war in Iraq have changed our lives forever. Life is more complex now than ever. Most agree, the Church was totally unprepared to respond. But now we can be. I am pleased to announce there are now three Crisis Response trainings to choose from: Basic CISM, Spiritual Crisis Intervention and School Crisis Intervention (with children and teens).
Based on the work of Dr. Jeffery Mitchell, the CISM Model is known as the premier crisis response training program in the country. Thousands of counselors, teachers, pastors, police officers, emergency technicians, and healthcare workers use this skills-based training everyday in their work.
Sounds terrific, doesn’t it? But, wait a minute! What if this AACC puff piece for CISM is contradicted by scientific research? Well, what does the scientific research say?
The Australian Psychologist ran a research article titled “Caveat emptor, caveat venditor, and critical incident stress debriefing/management (CISD/M).” The article was reviewed and summarized in The Scientific Review of Mental Health Practice. The reviewer states that the researchers conclude:
. . . that critical incident stress debriefing and critical incident stress management appear to be essentially equivalent treatments. Moreover, they maintain that CISD/M has become a multimillion-dollar industry despite the lack [of] evidence that it is efficacious. In addition, they note that approximately 28% of Americans were offered trauma counseling following the September 11 attacks, and that tens of thousands of individuals are trained in CISD/M and related methods each year. They conclude that there are “no reliable studies demonstrating the efficacy of group debriefing” and that there are reasons to suspect that debriefing may be harmful in some instances (bold added).
In the field of counseling there has been a huge gap between what the researchers say and what the practitioners do. Nowhere is this gap more evident than in the practice of CISD/M when the promotion and practice are contrasted with scientific research.
Keeping in mind that CISD and CISM “appear to be essentially equivalent treatments” and also remembering the tremendous support, endorsement and promotion of CISM by the AACC, note what the Psychotherapy Networker, a publication for mental health professionals, says about such interventions:
Despite its widespread application, considerable research indicates that those who receive CISD typically do no better than those who don’t, and that a significant number of people treated with CISD do even worse than those who didn’t receive any treatment. This negative reaction seems to emerge because, for some people, the very act of focusing on their negative feelings in CISD increases their distress and leads to more difficulties, such as flashbacks, nightmares, and anxiety attacks. According to trauma expert Richard Gist, “Not only did CISD not deliver much in the way of preventive efficacy, it seemed to inhibit natural resolution for some.” The Cochrane Collaboration of Great Britain, one of the most prominent gatekeepers in medicine, charged with assessing the effectiveness of procedures ranging from open heart surgery to psychotherapy for depression, evaluated CISD and found it to be without empirical support (Jay Lebow, “War of the Worlds,” Psychotherapy Networker, Vol. 27, No. 5, p. 79, bold added).
In spite of the thousands of counselors trained in CISD/M and similar early interventions, most scientifically controlled studies demonstrate no positive effects of these interventions. Think about all the hype from AACC and the fact that more than 7,000 individuals have already been trained by them with no doubt thousands more to follow. And then think about the fact that CISD/M, which is the very training provided by the AACC is “without empirical support.” Further, think about the millions of dollars the AACC customers have spent and will spend and the thousands of hours they have been sitting and will sit for training in a crisis approach that is “without empirical support.” Then, think about the fact that, as far as we know, we are the only ones critical of the ongoing counselor training by the AACC that so often lacks empirical support. Finally, think about all the Christians in crisis who are learning to rely on the ways of the world when bad things happen to them.
Caveat Emptor (Let the buyer beware.) and Caveat Venditor (Let the seller beware.) are two warnings that have not and apparently will not be heeded by the profit-driven AACC and its eager certificate-hungry, problem-centered counseling customers. The AACC is just one piece and admittedly a large piece of the unholy mixture of psychology and the Bible that they call integration and we call psychoheresy. As we have said elsewhere, there is nothing unusual about this integration approach. It can be found in practically every Bible College, seminary, Christian school and church in America. The ones that are not integrated are the exceptions. This plethora of psychoheresy in the church is an abomination! As we have continually asked: Where are the pastors, theologians, and church leaders who are willing to speak out against such heresy?
PAL V12N6 (Nov-Dec 2004)