Debriefing Tools and Strategies
- Rachel Smith
- 11 minutes ago
- 8 min read
Whatever area of the Maritime world that you work in, you will have experienced situations and events that affected you negatively and maybe even left a lasting memory. The same is true for the amazing medics that we work with – whatever their background, they all have a few jobs that even years later, they’d still rather not chat about.
Debriefing is an important tool that helps us learn from challenges, create plans for change, deal with future incidents more effectively, or prevent them! It aims to reduce stress and uncertainty, build trust and promote teamwork. It can also help us as individuals to recover from an adverse event or seek the help that we need to move from victim to survivor.
A ’hot’ debrief takes place ‘there and then’. Its purpose is to acknowledge what happened and the roles of those involved, to normalise the situation and make sure any immediate needs are met.
A ‘cold’ debrief happens days or even weeks after the incident and allows for more in depth discussion. Its purpose is to reflect on the event, identify areas for improvement and actions that need to be taken for this improvement.
It's good practice to get into the habit of following a structured debrief plan, and the time when you run drills onboard provide the perfect opportunity to try out different models and see which one works for your crew.
Psychological safety is key to any kind of debriefing process for both the person leading it and for the recipient. Hot or cold debriefs can be damaging for some people and it must be made clear that there is space to walk out if needed. Forcing someone to debrief if they’re struggling is never good, but everyone should be given the opportunity to seek further assistance formally or informally.
We did wonder if there is any difference depending on who does the debrief? Does it need to be someone who is liked, or respected, or senior to you? A friend, colleague or a professional? What happens if you don’t like or respect the person leading the debrief? Or you just don’t have any rapport with them? Will that affect your response and therefore your recovery?
If there are significant technical issues to debrief, a very structured debrief about the incident can be beneficial from a system learning point of view. However, if there is any bad feeling about an individual’s decisions, be cautious as it can be harmful, and cause long term conflict and anxiety for those involved.
The media currently focuses on ‘it’s good to talk’ and ‘it’s OK not to be OK. But one thing to be mindful of is the question of ‘are you ok or is everyone ok?’ This could result in a peer pressure effect, particularly in a group setting, which means you might not get the real answer. You may also be up against a fear of looking or being perceived as weak, a fear of job security, or a fear of what will happen next.
There is no right or wrong way to respond to something traumatic. Of course it’s normal to feel some distress and emotional turmoil following an incident, but how do we know when that normal distress is turning into a disorder? Well, the jury is out on this one and various sources state anything from 2 weeks to within 3 months. The NHS states post-traumatic stress disorder can develop immediately, or in any timeframe up to years later.
One of our experts is a big believer in one to one informal peer support, having found it very useful personally. Another said that the best cold debrief they attended was led by an Ambulance Service Officer who laid out a chronological timeline and facilitated excellent learning.
But we’ve heard some horror stories too. Some methods of debrief start with ‘tell me exactly what happened?’. Of course this could be damaging to the individual if they’re not willing or even unable to recount the event. Occasions when managers are so badly affected themselves that they’re in no state to debrief. A lack of training or understanding the importance of hot and cold debriefs.
Another follower told us that after working in a high pressure environment, with no debriefs or support, it took them 6 months and a lot of support to seek the right help. When they consider whether having hot debriefs would have made a difference at the time, they don’t honestly know. But debriefs of any kind certainly wouldn’t have made things any worse and may have helped over time.
As a crew, or tight knit team, you may have the advantage of being able to recognise any subtle behavioural changes in someone. Are they becoming withdrawn? Or maybe the opposite and they’re being more reactive and volatile? It’s important to ensure that everyone is looking out for these small indications in each other. If anything is spotted, directing the right person, someone they have a rapport with, to have the informal ‘walk and talk’ check in, is the next step. Debriefing is still beneficial even long after the event.
What about the environment for a debrief. This may take a bit of thought and setting up. Debriefing in sight of the aftermath of what’s just happened may not be in anyone’s best interest. People need to feel safe. Who needs to be there? Do you need to record it, or at least any outcomes, in some way? If you were involved, are you ready to lead a debrief?
Following on from that, how do you know where to signpost someone to if they need further support or specialist services? Some companies and insurers do offer this kind of support for employees, but how do those who need it get to find out about it? What level of support is needed? Do we need a psychiatrist, a psychologist, a counsellor, therapeutic support or something else? Also, is language a barrier to accessing these services?
Research shows that most people who live through traumatic events adjust well and don’t suffer any long term effects. They need reassurance, information and kindness from those around them, together with the time to adjust to what they’ve experienced.
So what is actually out there? The answer is hundreds of different tools, many based on the same or similar principles. We asked our team and LinkedIn followers for their recommendations and thoughts:
(NOTE: This list is based on personal experiences and you may need to research to find the right solution for your organisation)
Trauma Risk Management (TRiM)
Used in organisations operating in a high risk or threat location, or if staff are likely to face traumatic (or potentially traumatic) events.
TRiM involves a well-being check from a trained TRiM practitioner or manager, no more than 3 days after an incident. This can be followed by a trauma risk assessment if needed. TRiM can be useful for flagging a requirement for individual assistance and being able to signpost on for more specialist help.
In our experience, the effectiveness of TRiM can very much depend on the ability of the practitioner, but it can work really well for some people.
STOP5 – Hot Debrief Model
This model has been adopted in many healthcare settings for a quick debrief after an incident. The idea is to STOP for just 5 minutes.
Firstly thank the team and ask ‘Is everyone OK?’ – remember you’re likely to just get a yes from everyone at this stage.Tell them it’s a 5 minute debrief – to improve the quality of patient care (insert your own outcome here, such as to improve boat safety), it is not a blaming session.
Participation is welcome, but not compulsory and any information discussed during the debrief is confidential.
Summarise the case
Things that went well
Opportunities to improve
Points to action and responsibilities
Talk Foundation
The Talk Foundation offers a range of free resources to help clinical teams debrief. Though aimed at clinical teams, the principles are transferable to other industries and incidents.
Target – What shall we discuss to improve xxx? Encourage to share perspective.
Analysis – Explore your agreed target. If it’s appropriate, consider what has helped or hindered (communication, decision making, situational awareness)?
Learning Points – What can the team learn from the experience and this conversation?
Key Actions – What can we do to maintain xx? Who will take responsibility for actions? Who will follow up?
The Diamond Debrief
This works on the basis that individuals learn better as active participants, responsible for their own learning process, than as passive recipients or wisdom imparted from instructors.
Focus on the facts. What happened? Then what? Share perspective.
Transition phase – technical points and case questions
Focus on surfacing emotions and perspectives. How did you feel? Why? Reflection and understanding.
Transition phase – label the human factor for discussion
What would we do differently next time? How are you going to achieve this?
Take a gulp!
One of our followers told us they prefer a more informal chat after an incident, generally in the pub! But for times when it needs to get a bit more serious, they recommend a technique taken from the seminar ‘The Bulletproof Mind’ and talking with a bottle of water in your hand.
Every time you remember something bad, you experience an emotional response. Your heart rate increases, your respiratory rate increases and it’s unpleasant. So, at the point a memory comes back and you feel emotions heightening, together with that physical response, stop and take a big gulp of the water from the bottle.
Taking a gulp of water slows the breathing (in the same way that taking a deep breath does), and stimulates a parasympathetic nervous system response. This helps to start to separate feeling the emotion from the memory. The earlier you start with this technique the better, so it’s ideal for using during a hot debrief.
Defuse
Defusing is the process of talking it out. It allows victims and workers of a crisis situation the opportunity to vent about their related crisis memories, stresses, losses, and methods of coping, and be able to do so in a safe and supportive environment.
A defusing is usually 20-45 minutes, preferably within 1-2 hours of the incident but no longer than 8 hours.
The goals of defusing are:
Mitigate the impact of a crisis event
Speed up the recovery process
Reduce cognitive, emotional, and physiological symptoms
Assess the need for debriefings and other services
Defuse follows up with a more formal meeting that is generally held within 24-72 hours after the incident with further sessions and signposting as necessary. The aim is to improve resistance to stress, build resiliency, facilitate recovery and return to healthy functioning and it has been used successfully in some emergency services.
Cold Debriefing
While some of the above models transition from hot to cold debriefing, or lay the foundations, we have attached a guide for a cold debrief. The purpose is to gather after an event in a safe environment to help everyone understand and process what happened.
Everyone’s experience and perspective will be different and it’s an opportunity for reflection and learning. It shouldn’t be an investigation or interrogation. It shouldn’t prolong a difficult experience or apportion blame and participants must know they can leave at any time with no explanation.
The structure is important so that everyone understands the ground rules and the debrief process. The example we have provided is aimed at a clinical setting but can easily be adapted to any environment. Notes should be taken and any actions allocated. A follow up may be needed to review the actions.
In summary, there are literally hundreds of options for both hot and cold debriefing. Not all will suit everyone, so it’s a case of choosing what you think is right for you, your team, your organisation and the situation.
We’ve attached some useful guides that might help you to come up with a plan and listed some resources below. It would also be useful to find out what follow up support is already available through your employer or organisation.
As always, if you’d like any help in structuring debriefs for your team, please get in touch!
Resources
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