Designed to mitigate the acute psychological distress associated with critical incidents and to mitigate and prevent the onset of posttraumatic stress disorder (PTSD), critical incident stress management (CISM) is an integrated, comprehensive, multicomponent crisis intervention approach that spans preincident training through acute care to relevant postincident response. The first published review of the CISM literature in 2000 covered publications through 1997 and included findings on individual crisis intervention procedures, single-factor psychological group debriefings and early reports of CISM approaches to assist the reader in understanding the historical roots and evolution of CISM programs. This updated literature review of CISM focuses exclusively on CISM approaches from 1997 through June 2002. The review yielded 20 papers that utilized CISM approaches and included case studies, programmatic evaluations, and controlled research efforts. The 20 papers are reviewed in this article and the strengths and weaknesses of the literature as a whole are presented with implications presented and discussed. References