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My contact with that individual was by chance. He happened to be at a
conference where I was presenting. Someone brought him up to me and
introduced him. He thanked me for mentioning his relative. Then a
brief conversation ensued in which he highlighted what Dr. Srodes had
told him about his contacts with soldiers during the invasion. Dr.
Srodes told him that he just tried to sit with as many groups of
soldiers as he could and just asked them what they had experienced while
coming ashore and during the first hours of the battle. There was very
little structure to the conversations. Mostly he asked what they had
been through and listened carefully to their stories. He offered a few
words of appreciation for their efforts, understanding of their fear,
stress and grief. Then he offered what encouragement he could and moved
onto the next group. What I remember most about the conversation was
the part in which Dr. Srodes' relative told me that when some Lts. and
Capts. approached Dr. Srodes and asked what he was doing with the
soldiers he thought he might have offended the officers. Dr. Srodes had
to be reassured that the officers were not distressed, but only curious
because they had the impression that groups that Dr. Srodes had spent a
little time with were more alert and seemed more ready for combat than
those who did not have the opportunity to visit with Dr. Srodes. This
man said that Dr. Srodes had described his work as "debriefings" and
wondered if I thought they were. I responded that they were rudimentary
debriefings which may not have had the structure used in the 1980's but
were probably quite helpful for the personnel under the extraordinary
circumstances encountered by troops during the invasion. In my view his
work was a battlefield application of a debriefing model and it
contributed to the development of the current CISD tool.
{I am sure there were many other mental health professionals involved in
the war who made small individual contributions such as those made by
Dr. Srodes. Unfortunately, most of their acts of kindness will be lost
forever to the history books.}
Keep in mind that the CISD is only a support tool. It is not
psychotherapy, nor is it a substitute for psychotherapy. It is a small
group crisis intervention supportive process that has three primary
goals. First it is used to lessen tension and mitigate the impact of a
traumatic event. Second it is designed to facilitate normal recovery
processes in normal people who are having normal reactions to abnormal
traumatic events. Third, the CISD is designed to help the CISD team
members identify any of the group members who might be in need of
additional support or, in some rare cases, a referral for professional
assistance.
For CISD to work effectively it must be part of a comprehensive,
systematic, integrated and multi-component program of interventions. It
is not a stand alone process. Next a CISD is a small group process and
should not be used on individuals. Groups should be homogeneous NOT
heterogeneous. Their mission must be either complete or beyond the
acute stages where there is danger for the personnel. And the group
members should have had about the same level of exposure to the same
traumatic event .
Over the years I have met many Viet Nam vets. Some of them describe
small group "rap sessions" which were run by squad or platoon leaders.
The veterans I spoke with say that some of these group sessions were
helpful because they were allowed to get some things off their chest.
They said that the rap sessions helped them to feel a bit better and
that they took the edge off some of their bad experiences especially
where there were losses of colleagues. Some said that leaders sometimes
used the sessions to encourage the personnel or provide them with useful
guidance or information. They felt that someone cared for them when
these sessions occurred. Some of the veterans I met, on the other hand,
describe no such interactions with their leaders, but say they wish that
they had been given such sessions
SLA Marshall made great contributions to the history of combat
operations in the Second World War. He also inadvertently contributed
to psychological debriefings. The Israeli military depends heavily on
his work for their debriefing processes. But I have to remind everyone
that SLA Marshall was first and foremost a historian. Any psychological
benefits he uncovered by allowing soldiers to tell their stories were
accidental.
The ICISF model has a structured approach which is considerably more
structured that the Marshall debriefing. Both have a structured
introduction, both allow individuals within a group to tell their
stories and both take about 3 hours. But in the ICISF CISD model a
limited amount of detail is allowed. The CISD team introduces
themselves and the process and lays out the ground rules [phase 1].
Then the group participants are asked to state who they are, describe
their main job and briefly, using only a few sentences, describe what
happened from their perspective [phase 2]. Next the participants are
asked to express either the first or the most prominent thought they had
during the traumatic experience [phase 3]. The next step is that the
participants are asked to briefly describe the worst part of the event
or the part that left the greatest impression on them [phase 4]. After
that, the group members are asked to list some of the stress signals
they experience shortly after the traumatic event or what is left over
at the time of the CISD [phase 5]. The teaching phase is the very next
step. Team members use this phase to inform, reassure, guide and direct
participants back to adaptive behaviors, resiliency, unit cohesion and
unit performance [phase 6]. The last phase is a question answer and
summarization phase [phase 7]. Unlike the Marshall debriefing which
focuses on facts, the ICISF model encourages the participants to focus
on thoughts, emotions, signals of distress and, most importantly,
information and guidance to enhance performance, adaptation, resiliency
and recovery.
If you have not seen it already, you might want to read the book Acts of
War by Holmes. I found it to be an excellent source of a wide range of
information on human behavior in warfare.
You may publish any remarks that I have made that are useful to your
project. I hold the United States military forces in the highest
respect and believe in the overall mission. I hope that I have been
helpful.
Sincerely,
Jeffrey T. Mitchell, Ph.D., CTS
Note: Dr. Mitchell is President Emeritus of The International Critical Incident Stress Foundation (ICISF).
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