If you’re exploring research on Critical Incident Stress Management (CISM), especially the Mitchell Model (now known as the ICISF Model), there are several important considerations to keep in mind before drawing conclusions.

Limited and Frequently Misapplied Research

First, the body of rigorous research on CISM is relatively small. Even fewer studies have examined the ICISF Model when applied correctly by trained teams using proper protocols.

Many criticisms of CISM stem from the Cochrane Reviews, which are frequently cited in the literature. In fact, these reviews are often the origin point of the so-called “controversy”. However, significant issues with these reviews have since been identified (outlined below).

Understand the Timeline: Pre- and Post-2009

• If you’re reading materials published before 2009, they often reference the 2002 Cochrane Review, which has since been updated.

• In 2009, the Cochrane Library issued a clarifying statement, acknowledging limitations and misapplications in earlier reviews.

Any literature review dated 2010 or later should at least acknowledge this 2009 clarification. If it doesn’t, the researcher may have conducted an incomplete review of the available evidence.

What Exactly Was Studied?

Many studies claiming to evaluate “debriefing” or “CISM” actually did not study the ICISF Model at all — or applied it in ways that are explicitly contrary to its design. Be cautious of the following red flags:

• “Debriefing” with an individual:
  The ICISF Model (CISD) is a group intervention. It has never endorsed individual “debriefings” with primary victims.

• “Mandatory debriefing” terminology:
  The ICISF Model does not advocate mandatory participation. Participation is always voluntary. Mandatory debriefings are inconsistent with best practices and core CISM principles.

• Claims of “PTSD prevention”:
  The ICISF Model does not claim to prevent or cure PTSD. It is intended to mitigate acute stress reactions and support recovery. Referral to clinical care is central when PTSD or other conditions are suspected.

• Use of the term “single session debriefing”:
  This typically refers to a one-time clinical session, not an ICISF-style Critical Incident Stress Debriefing (CISD). In CISM, a CISD is one part of a continuum of care, not a standalone cure-all.

The Echo Chamber Effect in Literature Reviews

Many literature reviews repeat conclusions from previous flawed studies — creating a cycle of misrepresentation. If traced back, many of these reviews ultimately rely on the same limited number of studies, often involving misapplications or entirely different interventions than those defined by the ICISF.

It’s no surprise that when a model is applied incorrectly, results may be disappointing or even negative. Any evaluation of CISM should start by verifying whether the intervention studied actually followed the ICISF protocol.

For Team Leaders and Decision Makers

If you’re starting or maintaining a CISM team, it’s essential to critically evaluate the research, verify the methods used, and make informed decisions based on accurate representations of the ICISF Model.

Recommended Reading

• Recent Canadian Research
  The Canadian Institute for Public Safety Research and Treatment (CIPSRT) published a valuable article titled:
  “Assessing the Perceptions and Impacts of Critical Incident Stress Management.”
  👉 Read the study here

• Updated Systematic Review
  A more recent and well-rounded review is available from Harry Stileman and Christopher A. Jones, which discusses many of the issues raised here in a formal academic context.
  👉 Read the article here

The Cochrane Reviews are frequently referenced.  Their information is not always easy to search or to find for people who don’t have access to research libraries.  Hence I am making a copy available here.  All credit to the authors.

You will note on page 10 (page 12 of the PDF) of  Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Review) the following statements:

1. “At present the routine use of single session individual debriefing
in the aftermath of individual trauma cannot be recommended in
either military or civilian life. The practice of compulsory debriefing
should cease pending further evidence.”

 2. “We are unable to comment on the use of group debriefing, nor the
use of debriefing after mass traumas. We are also unable to make
recommendations about the use of debriefing in children.”

Regarding point #1: This is 100% consistent with the ICISF model in that there is never a “single session individual debriefing” and compulsory Critical Incident Stress Debriefings (CISD) have NEVER been a part of the ICISF model.  

Regarding point #2: It really speaks for itself.

If you are interested, I urge you to read the paper.  Download it here: Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Review)

This paper examines the Cochrane Reviews and their adherence to their own standards of research.  

Download it here:  Was Psychological Debriefing Dismissed Too Quickly? An Assessment of the 2002 Cochrane Review