Critical incident stress management (CISM) was a controversial, non-empirical, adaptive, short-term psychological helping-process that focused solely on an immediate and identifiable problem. It included pre-incident preparedness to acute crisis management through post-crisis follow-up. Its purpose was to enable people to return to their daily routine more quickly and with less likelihood of experiencing post-traumatic stress disorder (PTSD). However, after researchers linked the debriefing techniques used in CISM to increased rates of PTSD, CISM is now seldom used and has largely been replaced with immediate psychological care techniques that do not use debriefing such as those endorsed by the CDC, Red Cross, WHO, American Psychological Association and National Center for Post Traumatic Stress Disorder (NC-PTSD). Responsible practioners who still use CISM must eliminate debriefing steps in order to remain compliant with best practices and clinical guidelines. CISM was widely discredited, has not been practiced by licensed mental health professionals, and was expressly rejected by the US Government in 2002. Recent evidence-based reviews have concluded that CISM is ineffective and sometimes harmful for both primary and secondary victims, such as responding emergency services personnel. CISM was never intended to treat primary victims of trauma. An analysis of the psychological debriefing method used in CISM linked it to increased rates of PTSD one year after an event. As of 2022, peer reviewed meta-analysis specifically warn against the clinical use of CISM for all patients, primary or secondary, stating, "clinical guidelines for managing post-traumatic stress recommend not to practice psychological debriefing". Purpose CISM was designed to help people deal with their trauma one incident at a time, by allowing them to talk about the incident when it happens without judgment or criticism. The program was peer-driven (often by those with less than a week of training - and no formal mental health or counseling training or credentials) and the people conducting the interventions may have come from all walks of life, but most were first responders (Police, Fire, emergency medical services) or work in the mental health field. A major CISM training source appears to deliberately legally distance themselves from the training they provide by issuing a "certificate of attendance" and specifically stating: "We do not offer a certificate that specifically states you are CISD/CISM trained." Another training source that does offer certificates also legally distances themselves from their own training, stating that they do "not represent, warrant or guaranty that the certificant is