摘要：Critical incidents in or involving schools include shootings, stabbings, other forms of homicide, terrorist activity, suicide, road traffic accidents, major fires or natural disasters, which result or might result in death and/or serious injury to students and staff. Where crisis management plans exist, they might be based on “common sense†or clinical judgement, risking worsening rather than improving outcomes. The relevant evidence base is scattered and of very various quality. This systematic review addresses these difficulties. This second part of the review focuses on postvention (action after the incident). The beginnings of an evidence base can be seen. There is conflict between medical models of intervention and social community-based models. Intensity of exposure is a strong predictor of adverse outcomes, which may stem from primary or secondary adversity. Information is often demanded by stakeholders, but it is unclear how to provide this most effectively. A balance must be struck between reactivating painful emotions and tacitly encouraging suppression (both of which can worsen outcomes). Participation in “support†activities should be voluntary. Psychological Debriefing (under various names) and Eye Movement Desensitisation Reprocessing (EMDR) have no convincing evidence for effectiveness (although intervention definition and implementation fidelity have been problematic). Methods might be differentially effective with different groups (e.g. females). Large scale crisis management policy initiatives are not necessarily evidence-based and might worsen outcomes in some respects. Crises can have some benefits. Implications for policy, practice and future research are outlined, and summary practice guidelines for schools offered.
