Experimental Evaluation: A Key Theme In REDIRECT

This is the second post reviewing Timothy Wilson’s REDIRECT.  Consider the following traumatic incident.  Two police officers responded to a house fire.  When they arrived they heard what every emergency worker dreads—screams for help from inside a house engulfed in flames.  Through a window, they could barely make out the silhouette of a man stumbling and falling, just short of escape.  By the time the police officers managed to get in, it was too late.  The man was “curled up like a baby in his mother’s womb.  That’s what someone burned to death looks like.  One of these officers knew the victim personally.  He was so haunted by seeing his friend die that he had trouble eating and sleeping.  His bosses sympathized and wanted to help, so they did what police departments do: they scheduled a Critical Incident Stress Debriefing (CISD) session for the fire.  The premised of CISD is that when people have experienced a traumatic event they should air their feelings as soon as possible, so that they don’t bottle up these feelings and develop Post Traumatic Stress disorder (PTSD).  In a typical CISD session, which lasts from three to four hours, participants are asked to describe the traumatic event from their own perspective, express their thoughts and feelings about the event, and relate any physical or psychological  symptoms they are experiencing.  A facilitator  emphasizes that it is normal to have stressful reactions to traumatic events, gives stress management advice, answers questions, and assesses whether participants need any additional services.  Numerous fire and police departments have made CISD the treatment of choice for officers who witness horrific events.  It is also widely used with civilians.  Following the September 11, 2001, terrorist attacks, more than nine thousand counselors rushed to New York City to help survivors deal with the trauma and prevent post-traumatic stress disorder, and many of theses counselors employed psychological debriefing techniques,

Now consider another approach.  Rather than asking the traumatized individual to relive the trauma, suppose we let a few weeks go by and see if he is still traumatized by the tragic event.  If so, we could ask him to complete on four consecutive nights, a simple exercise in which he writes down his deepest thoughts and emotions about the experience and how it relates to the rest of his life.  That’s it—no meetings with trained facilitators, no stress management advice, just a writing exercise done by oneself four nights in a two.  This is known as the Pennebacker method.

When CISD was tested properly, and it took a while to test it properly because so many thought it was obvious that it was beneficial.  When they did they found that not only was CISD ineffective, but it might also cause psychological problems.  People who had been treated with the CISD interventions had a significantly higher incidence of PTSD, were more anxious and depressed, and were less content with their lives than those who were not treated.  It turns out that making people undergo CISD right after trauma impedes the natural healing process and might even “freeze” memories of the event.  Harvard psychologist Richard McNally and his colleagues recommended that “for scientific and ethical reasons, professional should cease compulsory debriefing of trauma-exposed people.”  Nevertheless, in 2007 after a disturbed student at Virginia Tech University killed thirty-two students and faculty, students and emergency worker underwent stress-debriefing techniques similar to CISD.

On the other hand, dozens of experiments in which people were randomly assigned to write about personal traumas or mundane topics such as what they did that day.  In the short run, people typically find to express their feelings about traumatic experiences.  But as time goes by, those who do so are better off in a number of respects.  They show improvements in immune-system functioning, are less likely to visit physicians, get better grades in college, and miss fewer days of work.

You will find this theme throughout REDIRECT, well established programs that are highly esteemed proven worthless.  And you will find other programs that, when evaluated with properly designed experiments, are found to be effective.  You will get a sense of what works and what does not work and why.

For more on Pennebaker, go to his homepage
http://homepage.psy.utexas.edu/homepage/Faculty/Pennebaker/Home2000/WritingandHealth.html

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