as early as 2002 where Rose Et. al identified increased rates of PTSD one year after a psychological debriefing like those used in CISM leading to a rejection of the practice of debriefing by many US Government Agencies that year under the medical ethical principle of "do no harm". Twenty years later, the evidence against CISM/debriefing had strengthened with a January 2022 peer-reviewed evidence synthesis stating, "current evidence is consistent in not endorsing it as a form of treatment or prevention of post-traumatic symptomatology", "clinical guidelines for managing post-traumatic stress recommend not to practice psychological debriefing" and "psychological debriefing and associated interventions should be avoided in the management of acute trauma". See also Clinical psychology Incident stress Stress management Stress (medicine) References Anxiety disorders Psychological stress