Everly G S, Mitchell J T
Johns Hopkins University, 702 Severnside Ave., Severna Park, MD 21146, USA.
Int J Emerg Ment Health. 2000 Fall;2(4):211-25.
Despite a long and rich history as a specialty within applied mental health, crisis intervention has, within recent years, been the target of criticism. Singled out for specific criticism has been the intervention referred to as "debriefing." Some authors have not only challenged its effectiveness but have raised the specter that it may cause significant harm. While superficially such arguments appear to have merit, closer scrutiny reveals an antiquated interpretation of even the most fundamental of terms and concepts inextricably intertwined with research based upon applications contrary to the most recent principles, prescriptions, and protocols regarding clinical use. A review of research based upon more extant formulations reveals many crisis intervention practices, including the Critical Incident Stress Debriefing model of "debriefing" and the Critical Incident Stress Management (CISM) model of crisis intervention to be highly clinically effective, indeed. This paper will review the terms and concepts which serve as the foundation of the field of crisis intervention, while subsequently reviewing key research investigations addressing its efficacy. It may be that outcome research directed toward assessing the effectiveness of crisis intervention can prosper from following trails blazed by psychotherapy researchers. The parallels seem striking. It may be that outcome research in crisis intervention (and "debriefing") needs to now focus upon "who" does crisis intervention, to "whom," and in "what specific situations," so as to maximize outcome associated with this clinically effective tool [International Journal of Emergency Mental Health, 2000, 2(4), 211-225].
尽管危机干预作为应用心理健康领域内的一个专业有着悠久而丰富的历史，但近年来它却成为了批评的对象。被特别批评的干预方式是所谓的“心理疏导”。一些作者不仅质疑其有效性，还提出了它可能会造成重大伤害的担忧。虽然从表面上看，这些论点似乎有道理，但仔细审视就会发现，即使是对最基本的术语和概念的解释也过时了，而且与基于与最新临床使用原则、规定和协议相悖的应用研究紧密相连。对基于更现有表述的研究进行回顾后发现，许多危机干预实践，包括“心理疏导”的重大事件应激晤谈模型和危机干预的重大事件应激管理（CISM）模型，实际上在临床上非常有效。本文将回顾作为危机干预领域基础的术语和概念，随后回顾关于其有效性的关键研究调查。针对评估危机干预有效性的结果研究可能会从遵循心理治疗研究人员开辟的道路中受益。两者的相似之处似乎很明显。危机干预（和“心理疏导”）的结果研究现在可能需要关注“谁”进行危机干预、针对“谁”以及在“哪些具体情况”下进行干预，以便最大限度地提高与这一临床有效工具相关的结果[《国际紧急心理健康杂志》，2000年，2(4)，211 - 225] 。
