为什么创伤后心理疏导(CISD)已被证明无效甚至有害，心理工作者们却还继续去灾区做心理疏导？他们知道这点吗？
1. 我先讲结论，CISD不推荐在重大意外之后施行，因为无法预防PTSD，且可能阻碍自然复原力。这已经是共识，且被放进Abnormal Psychology的教科书了。
2.
刚好我有看过「Does early psychological intervention promote recovery from
posttraumatic stress?」全文。我就引用该文献第72页的结论，各位就知道作者们的立场了！该篇文章的作者将CISD简称为debriefing或psychological debriefing。
「尽管psychological debriefing被广泛使用…某些证据显示debriefing可能阻碍自然复原」(Although psychological debriefing
is widely used … Some evidence suggests that it may impede natural recovery.)「基于科学和伦理的原因，专业人员应当停止对遭遇创伤者强制实施debriefing」(For scientific and ethical reasons, professionals should cease
compulsory debriefing of trauma-exposed people.) 。(McNally等人2003原始文献p72)
3. CISD是否有害呢？1980年代就开始有发现，但大家的反应是惊讶，怎么有做比没做差！但慢慢研究多了，大家慢慢冷静下来思考与分析。若只要读一篇论文，建议找Litz et al. 2002，他们的结论是「回顾六篇随机分配个案接受CISD的治疗组或无治疗的控制组之研究，发现接受CISD的个案情况似乎更糟」。
4.
若还有人想进一步阅读，以下是推荐的文章：
McNally RJ, Bryant RA, Ehlers A. Psychol Sci Public Interest. 2. Vol. 4.
American Psychological Association; 2003. Does early psychological intervention
promote recovery from posttraumatic stress? pp. 45–79.
Rose S, Bisson J, Churchill R, Wessely S. Psychological debriefing for
preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev.
2002;(2):CD000560.
Litz, B.T., Adler, A.B., Castro, C.A., Wright, K., & Thomas, J.
& Suvak, M.K. (2004, November). A controlled trial of Group Debriefing. In
M. Friedman (Chair), Military psychiatry, then and now. Plenary session
presented at the 20th annual meeting of the International Society for Traumatic
Stress Studies, New Orleans, LA.
Litz, B.T., Gray, M.J., Bryant, R.A., and Adler, A.B. (2002). Early
intervention for trauma: Current status and future directions. Clinical Psychology:
Science and Practice, 9, 112-134.