Generalise the group technique known as defusing (translated as “ged rid of all emotional overload before the end of the workday to avoid taking it home and recover strength for the next shift”) may help prevent symptoms associated with emotional exhaustion and the accompanying battery of feelings, mood swings, and psychosomatic symptoms.

This type of technique is primarily used with first-line healthcare teams so they can exchange information between them and get support, to promote catharsis on emotional reactions experienced throughout the workday and relieve tensions before going home.
Defusing is done at the end of the workday to rework the events of the day, “leave the tension at work” and not carry it home. Participation is voluntary and no one should feel bad or excluded if she/he decides not to participate. It is normal to feel sceptical and not be convinced that sharing one's emotions can help the recovery process.

Explanations are given by the participants and led by a moderator (face-to-face or by using tools that facilitate the communication, such as Google Hangouts described in Resource nº 8), in which situations and emotions experienced throughout the workday and have caused major impact are shared. Each professional discloses their own personal experience and talks about his/hers fears and concerns following a series of questions and answers as described in the infogram below. There is no judgment nor criticism; no one is told what to feel, nor are emotions scrutinized to determine if they are the appropriate ones. On the contrary, these emotions should be reinterpreted based on the events, possibilities, behaviour, and attitudes surrounding us and understand that these responses are normal. Next, it is the moment to activate the sensation of team and coping mechanisms by promoting cognitive, emotional, behavioural and social potentials of each participant.

The aim is to disclose these negative emotions so the person does not repeat the experience intensely outside the workplace. Thus, the technique must be used, at least the first time, by a professional accustomed to deal with group interviews with emotional load.

You can stipulate, as a general indication and group agreement, avoid having pessimistic conversations or focused on things that have gone wrong during the workday, bearing in mind that all participants will share their lack of hope, concerns, and negative emotions during the session. Thus, the expectancy of a time for emotional ventilation, allows putting negativism aside during work time and helps avoid gloomy thoughts that affect the state of mind of the professional reducing his/her capacity for response.

During the first sessions, it may be advisable to ask separately to each participant about his or her experience, while allowing trust to be built. Once there is sense of normality with the technique, the presentation of one of the professionals may be used and alternate his or her experience with that of other participants. This will reduce the time to use the technique and help transform it into a routine to strengthen helping relationships (identification).

Closing rituals. After exhibiting their concerns and negative emotions, it is necessary to close the session by promoting positive thoughts and emotions. The group can define its own help slogans or phrases. They can also use the last minutes of the session to list the “successes” or “advances” of the workday (see positive results in the fight against the coronavirus or in the care of a non-COVID-19 patient). To congratulate oneself and colleagues for the work done, the effort that has been put in, and the dedication is not trivial, but on the contrary, it is necessary. Say goodbye with the commitment of returning the next day with the mind set on the teamwork helps dealing better with the pressure imposed by this crisis.

The duration of the session should be adapted to the needs of each group and the peculiarities of the workday (some days will be worse than others). However, to prevent losing the essence of the technique, it would be advisable that the sessions be limited to no more than 20 minutes.

Those centres that have already set up support teams for second victims may use this personnel resource to lead the interventions. It should be considered that in some cases, professionals could need individualized help (Resource nº 14).