We have written previously about the American Association of Christian Counselors (AACC) and their marketing of Christian Crisis Response Training and their promotion of Critical Incidence Stress Management (CISM), a grief debriefing approach.1 At the time there were 7000 individuals trained by them at a great profit for the program. That was six years ago and since the program is still offered by AACC, there are probably thousands more than have been trained by them for additional profits. Also, at the time, we noted that, according to the researchers, CISM and Critical Incident Stress Debriefing (CISD) are essentially equivalent treatments. Furthermore, we revealed that group debriefing approaches, such as CISM and CISD lacked sufficient scientific support and “that there are reasons to suspect debriefing may be harmful in some instances.”2
A recent visit to the AACC web site shows that the program is still offered there with numerous hours and days of training needed to be certified, meaning a lot more income for AACC.3 Since we first wrote about the AACC and their CISM training, much more research has been conducted, which has confirmed what we have reported.
The added research that has been done is reported in the book Science and Pseudoscience in Clinical Psychology. While the research is about CISD, it obviously applies to CISM as they are known as essentially equivalent treatments. The following are quoted from the CISD section:
CISD is predicated on two basic assumptions: first, that exposure to traumatic life events is a sufficient precursor for the development of psychological symptoms that can readily grow to pathological proportions, and second, that early and proximal intervention, often presumed to involve some element of emotional catharsis, is necessary for prevention of such sequelae and the amelioration of such sequelae should they occur.4
CISD is conducted in groups and is administered within 24-72 hours following a stressful event…. The Intervention strategy is a version of standard group counseling…that is based on the premise that group disclosure produces beneficial effects (primarily, normalization). The CISD protocol follows seven steps: (1) introduction of the debriefing, (2) statement of facts regarding the nature of the traumatic event, (3) disclosure of thoughts regarding the event, (4) disclosure of emotional reactions (specifically focused on those with the strongest negative valence), (5) specification of possible symptoms, (6) education regarding consequences of trauma exposure, (7) planned reentry to the social context.5
One research study:
…investigated the structure and efficacy of debriefing following the crash of a wide-bodied airliner in Sioux City in which 112 of 296 passengers died. The findings of that study, including a nearly complete sample of career firefighters engaged in body recovery and related operations, showed no clinically significant impact on personnel at 2 years post-incident, no evidence of superior resolution for debriefed responders versus those who declined, a slight but statistically significant trend toward worsening in resolution indices for those accepting debriefing, and a clear preference for informal sources of support and assistance that correlated strongly with effective resolution (bold added).6
In a most recent study regarding debriefing following motor vehicle accident injuries found that:
…patients who received the intervention fared worse on several measures. Most tellingly, those who initially had high levels of avoidance and intrusion symptoms remained symptomatic if they had received debriefing, but recovered if they had not. The authors of this study concluded that “psychological debriefing is ineffective and has adverse long-term effects. It is not an appropriate treatment for trauma victims” (bold added).7
In conclusion the chapter states:
The prestigious Cochrane Reviews on the topic of psychological debriefing…offered this decisive conclusion: “There is no current evidence that psychological debriefing is a useful treatment of posttraumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease” (bold added).8
The authors of this chapter on psychological debriefing state that CISD and other such approaches “have not met their reasonable burden of evidence, but have often acted as though they have” (bold added).9 The authors also say: “If a procedure [referring to psychological debriefing, such as CISM/D] is extensively promoted through extraordinary claims [which AACC has done], those claims must be accompanied by extraordinary evidence [which AACC has not provided].”10
It is amazing that Christians, who should be operating a business at the highest possible level of integrity and responsibility, would ignore the scientific evidence and continue to promote, for money, such a questionable debriefing practice as AACC does. It is also amazing that, after an internet search, we discovered that we are apparently the only ones critical of AACC. It is doubly amazing that evidently not one of the PhDs, MDs, and other highly educated and knowledgeable individuals who are part of the AACC has informed the organization of this vital information.
We conclude from the evidence presented in this present article and in past articles about the AACC that it is not a trustworthy organization and that some of their educational offerings are questionable at best and yet have garnered huge sums of money. As we have said before regarding AACC, caveat emptor (let the buyer beware)!
(Endnotes)
1 Bobgan, “AACC Caveat Emptor, Caveat Venditor,” PsychoHeresy Awareness Letter, Vol. 12, No. 6.
2 Review of “Caveat Emptor, Caveat Venditor, and Critical Incident Stress Debriefing/Management” from Australian Psychologist in The Scientific Review of Mental Health Practice, Vol. 3, No. 1, p. 76.
3 http://www.aacc.net/courses/specialized-training/cism/.
4 Jeffrey M. Lohr, Wayne Hooke, Richard Gist, David F. Tolin, “Novel and Controversial Treatments for Trauma-Related Stress Disorders” in Science and Pseudoscience in Clinical Psychology, Scott O. Lilienfeld et al, eds. New York: The Guilford Press, 2003, p. 259.
5 Ibid., p. 260.
6 Ibid., pp. 260-261.
7 Ibid., p. 261.
8 Ibid.
9 Ibid., p. 262.
10 Ibid., p. 263.
(PsychoHeresy Awareness Letter, November-December 2010, Vol. 18, No. 6)