First responders at greater risk for post-traumatic stress

Psychological first aid and peers can mitigate effects of trauma
By Judith Plotkin and Stephen Kennedy
|Canadian HR Reporter|Last Updated: 04/19/2010

Unexpected, traumatic workplace incidents can happen anywhere, anytime. Emotional distress as a result of trauma may not be as easy to detect as a physical injury but it can be just as debilitating and painful.

Although anyone can be adversely affected by exposure to a traumatic event, first responders such as police, firefighters and emergency workers have been shown to be particularly vulnerable to the development of stress reactions as they are often exposed to traumatic events in their day-to-day work experiences. These include compassion fatigue, acute stress reaction and even post-traumatic stress disorder (PTSD).

Although training, skill and natural resiliency help inoculate first responders from the consequences of frequent traumatic circumstances, it is clear the availability of support that combines mental health specialists who understand the first responders’ culture with trained peers can be of significant benefit in helping first responders remain healthy and on the job.

Many people exposed to trauma will recover with minimal support. However, it is critical everyone affected be provided with a range of services to ensure those who may experience adverse reactions immediately following an incident (acute stress reaction) or develop reactions that last longer than 30 days (PTSD) receive the help and support they need to recover.

First responders as well as regular employees who have been exposed to a traumatic event often report reactions that include:

• new physical ailments

• compulsions to avoid anything to do with the circumstances surrounding the event

• nightmares about the trauma

• intrusive thoughts that make them feel the traumatic event is happening again

• anxiety or distress when reminded of the trauma.

The good news for those with continued reactions is counselling, and in some cases medication, can assist in helping them cope and learn skills to manage their reactions.

Detailed debriefs not best option

The science of how to treat psychological reactions to trauma continues to evolve. Research looking at the psychological aftermath of disasters and controlled studies has found not all widely practised and promoted approaches are effective in preventing long-term psychological damage.

In particular, automatically having all traumatized employees talk about the traumatic event in detail can actually hinder recovery by increasing anxiety and focusing the person’s memory on the event.

A more effective approach is to have people talk about the impact the event has had on them and how they can cope with their feelings and reactions. This is known as psychological first aid and is increasingly being used to engage natural coping and resilience skills.

EAP and first responders

Effective employee assistance programs (EAP) incorporate a range of services related to assisting diverse organizations in preparing for and responding to traumatic events. These crisis management services can include a disaster management policy and protocol development, pandemic planning, emergency preparedness and specific resilience building and training.

The approach encompasses risk-assessment activities, training for key stakeholders as well as crisis response tailored to the culture and characteristics of the event and followup.

Peer helpers

First responder organizations should also develop and maintain a network of trained peer supporters. These trained peers offer immediate assistance to employees following a traumatic event and can work collaboratively with mental health professionals in providing continued support and followup.

A peer support person is someone from the same profession as the work group who has been trained in psychological first aid and crisis management. Peers are trained listeners who have developed knowledge and skills to support those who have experienced a traumatic event.

They provide their colleagues with individual and group support and work independently as well as with EAP mental health professionals in providing helpful support following a traumatic incident.

In addition to their basic crisis management training and regular supplemental training, it is recommended these helpers receive supervision and support from a mental health professional.

For this approach to be successful, the EAP provider needs to work with the organization in developing peer support capability as well as with their own mental health professionals who will provide on-site services to ensure they understand the culture and can work collaboratively with peers.

Judith Plotkin is the Toronto-based vice-president of business development at Human Solutions, an employee assistance, disability and health management firm. She can be reached at (416) 964-1875 ext. 5210 or jplotkin@humansolutions.ca. Stephen Kennedy is director of the national capital region at Human Solutions in Ottawa. For more information, visit www.humansolutions.ca.


Traumatic incident

Emotional effects of trauma

Employees exposed to disturbing events in the workplace may exhibit a range of reactions including:

• emotional numbing

• social withdrawal

• irritability

• fearfulness

• depression

• sleep disturbances

• protracted medical problems

• substance abuse

• marital disruption

• premature job change.

For the workplace, it can mean employees are absent from work or present but distracted and unable to concentrate, which could increase the risk of accidents and reduce productivity.

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