Managing traumatic events in the workplace
Traumatic and critical incidents in the workplace can include events such as suicide, sudden death, robbery, actual and threatened sexual or physical violence, harassment, bullying, serious accidents, fire, bombings, shootings, murder, industrial or natural disasters, extreme isolation, involvement or exposure to warfare, as well as organisational changes such as restructuring and redundancy.
During such incidents, an individual is confronted with an extreme situation that presents a direct or perceived threat to their life, safety or wellbeing. The stress, fear, anxiety or shock which is experienced can potentially overwhelm an individual’s ability to cope, leading to physical, emotional or psychological harm and disruptive functioning. Trauma can be momentary or experienced over a prolonged or short period of time. It’s also important to consider that individuals directly or indirectly involved in a traumatic or critical incident can be impacted by these events.
Reactions to a traumatic event
Individuals will react differently to traumatic incidents, so a range of responses can be expected. Typical reactions during the first few days include shivering, confusion, disorientation, tearfulness, inability to speak, feeling helpless, fear and anger.
Over the first four weeks post-incident, reactions can include:
- Flashbacks, reliving the experience
- Recurrent thoughts about the trauma
- Avoidance of places and things which represent reminders of the incident
- Withdrawal and isolation
- Difficulties with concentration, memory, thought process
- Problems sleeping, eating, tiredness
- Headaches, nausea, dizziness
- Depression, anxiety, mood swings, anger, denial, feeling of numbness, irritability, sense of insecurity, feelings of guilt, and a sense of disbelief
It is important to recognise and acknowledge that these symptoms are a natural response to an occurrence which is atypical. During this period, individuals require time to process the experience in order to work through, manage and make sense of what has happened, enabling them to recover and return to their previous state. Most people will see a decrease in these symptoms over the first two to four weeks.
Post-traumatic stress disorder
Increased symptoms for more than four weeks following the traumatic incident can lead to a number of specific symptoms that could indicate the presence of post-traumatic stress disorder (PTSD) requiring clinical intervention or professional support. Notably, the symptoms of PTSD can start immediately or after a delay of weeks or months, but usually within six months of the traumatic event.
The clinical definition of PTSD relates to the occurrence of the following criteria:
A psychological condition that occurs after “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror”.
ESTSS from DSM IV*.DSM V American Psychological Society
PTSD symptoms include:
- Intrusive reactions: recurrent involuntary thoughts & feelings, nightmares and flashbacks;
- Avoidance of trauma associated stimuli, such as people, places, discussions, objects & situations;
- Cognitive and emotional disruption: memory loss, negative thinking and feelings, detachment, decreased: mood, interest & interaction;
- Changes in arousal & reactivity: irritability / aggression, hypervigilance, difficulties in concentration & sleep, extreme agitation / startled response, destructive behaviour such as unhealthy drug / alcohol use;
- Significant deterioration in usual functioning e.g. disruption in daily social and occupational activities.
For individuals experiencing mild PTSD symptoms for less than four weeks, a period of ‘watchful waiting’ is recommended, with a follow-up after one month. This approach is used when symptoms are likely to resolve by themselves, with self-monitoring or assessment by a medical professional helping to determine whether there is a need for further clinical treatment or intervention.
What should managers look for after a traumatic event?
It is reasonable to expect that there may initially be a level of disruption to the company’s working practice in the wake of a traumatic event. Managers are generally the first port of call in dealing with crisis situations so it is important that managers are aware of and understand the possible impact of work place traumatic events.
In doing this, there are a number of signs that managers should acknowledge in order to provide appropriate support:
- Anger and irritability possibly leading to arguments or conflicts
- Reduced work performance, due to temporary memory and concentration difficulties
- Feeling tearful, insecure & nervous
- An initial change in work atmosphere and mood of employees
- Avoiding certain areas or tasks
- Requests for time off
- Demonstrating significant difficulties over a prolonged period of six weeks or more
Helping employees to recover and return to business as usual
Managers and HR professionals are a primary point of contact in responding to employee trauma issues. The support which is made available to employees are essential for their treatment, recovery and on-going wellbeing and there are a number of effective ways for managers to engage and offer constructive support.
- Clearly acknowledge that an atypical event has taken place and that time and support is likely to be required. This will help the employee to deal with the situation and return to normal practice.
- Show empathy and understanding for those affected: listen without judgement and avoid making assumptions, ask open questions, including how are things going at the moment, what would be helpful for you right now and who would help you to feel safer or calmer?
- Maintain as normal a routine and structure as possible, making reasonable allowances for those impacted by the incident.
- Identify support options for the employees, for example, enabling them to take a break or continue with their work, or seeking medical attention.
- Provide information on the symptoms employees may expect following a traumatic event, including details on how to seek support. This can be in the form of a leaflet, intranet or your employee assistance programme contact details.
- Differentiate between what needs immediate attention and what is important. Initiate a plan and clear steps to address urgent issues
- Establish a clear Critical Incident Response Procedure (CIRP), which includes defined roles, action plans and communication processes. Train relevant staff in the CIRP and provide channels for feedback, review and adaptation.
- Maintain professional boundaries and be aware of your own needs and limitations.
- Seek advice and support from other teams and departments in your organisation, such as occupational health, human resources or your EAP provider.
Helping employees to cope with trauma in the workplace
A traumatic event can be likened to experiencing a severe shock to your core sense of being, both physically and psychologically. Such an experience takes time to comprehend, adjust and recover from its impact. To enable this, there are some positive steps that individuals can take, including:
- Engage in activities which reinforce your resilience, such as focusing on what is positive, consider how you can learn from your experience, engage in exercise, hobbies and interests and maintain a healthy diet.
- Try to maintain your usual routine and keep up communication channels with family, friends and colleagues.
- Avoid making major decisions and give yourself a break. You may blame yourself, feel guilt, shame or fear and believe that you should be stronger and should pull yourself together. Whilst these are normal reactions they can be self-defeating so allow yourself to acknowledge whatever you are feeling or thinking and then be proactive in considering what you need to move forward.
- Talk with your manager and colleagues about ways to bring employees together and establish stronger connections, such as: team building, holding an event to mark what has happened, such as fundraising or arranging a form of dedication.
How workplace culture can enable recovery from traumatic events
There are a number of elements of a company’s work culture, regardless of the organisation’s size, prominence or sector, that can constructively contribute to the recovery process following a traumatic event:
- Preparedness: an established procedure for critical incidents is in place. All relevant parties are fully aware of these procedures and, when required, responses to an incident are carried out in a clear way. Companies which avoid long delays, possess clear guidelines, make prompt assessments of a situation and react to the immediate needs of the business and its employees increase recovery and the possibility of a return to normal practice.
- Flexibility and adaptability: a company’s culture fosters flexible and creative thinking, which is practiced throughout their work and promotes the ability to develop and make changes. This enhances resilience to trauma and allows present and future demands to be met.
- Communication: the constant and speedy flow of information is one of the most important factors in managing traumatic situations. Keeping people connected, informed and providing relevant information helps them cope and promotes a sense of stability and control.
- Diversity: work cultures which have a diverse and inclusive workforce possess characteristics of respect, acceptance and understanding of different reactions. They are also able to learn and share a variety of ways of responding to and dealing with crisis.
- Empathy and commitment: expressing empathy is an important part of how you express a genuine understanding and interest in the experience and welfare of others. An employee’s positive engagement and company’s genuine commitment to the welfare of its employees, demonstrated in the acknowledgement of the situation, ongoing health and wellbeing policies and investment in its people, greatly aids in the recovery process.
- Openness to work with external support services: work cultures which function openly with external services possess the ability to connect and express their needs enabling expert services to guide and work with them in dealing with crisis.
EAP trauma services
An EAP is well placed to offer a number of support possibilities to managers or HR teams before, during or following a traumatic incident. EAPs are able to work closely with relevant professionals to determine the most helpful and appropriate support and response strategies.
Advice, support and guidance can be given on how to approach and constructively manage crisis situations in a number of ways:
- On-site trauma support psychological services: including immediate response from trauma facilitators.
- Management consultation: information and guidance from experienced trauma professionals for managers on the impact, response and appropriate resources available to deal with traumatic events.
- Short-term telephone counselling: access is available to a confidential and a free helpline staffed by trained professionals who are skilled in understanding and working with traumatic experiences and identifying clients at risk or in need of specialist support.
- Psychological assessments: some EAPs include clinical psychological assessments, which provide evaluation and detailed reports on psychological conditions such as anxiety disorders, excessive stress and PTSD.
- Face-to-face counselling: referrals can be made to specialised mental health and trauma counsellors located in the employee’s local area.
- Signposting: information can be provided for local health, social, psychological and support services.
Caroline Ribeiro-Nelson is an experienced Psychotherapist, Consultant, Coach & Trainer. She is Head of Free Choices, who provide a range of Consultancy, customized Psychological Health & Wellbeing, Professional Personal Development Training, Coaching and Mediation services for HR Employee needs and businesses
Published by The UK Employee Assistance Professionals Association is the body that represents the interests of professionals concerned with employee assistance, psychological health and wellbeing in the UK. Their mission is to promote the highest standards of practice and the continuing development of employee assistance programmes (EAPs) and services in the UK.