Coming to terms with tragedy at work

A model for assisting employees after a traumatic incident.

The negative effects on employees of tragedy, crime, disaster and misfortune in the workplace can be considerable.

However, there are a growing number of employee assistance models and professionals to help people come to terms with traumatic incidents at work.

There are many issues to be raised and questions to be answered in implementing an Employee Assistance Program (EAP) that helps employees deal with traumatic events. Do you know what to look for in the certified interventionists and counsellors you hire to assist employees? How can you assist staff in an appropriate way? When should the process be enacted? Is counselling always necessary?

A model for emotional triage

There needs to be a co-ordinated approach among the four tiers of responders when a crisis manifests itself in the workplace. Each professional liaison has its place, but all parties involved must know their boundaries, mandates and roles.

Tier one: first responders — These are police, fire, EMS, military, medical and other professionals, including construction and city workers, who are called in to defuse tense situations.

Tier two: intervention responders — Once the physical situation has been stabilized, professionals are called in to educate, defuse and stabilize the victims.

Typically, they are not engaged longer than 90 to 120 hours, and are trained in intervention, crisis management, disaster psychology and trauma. They are able to intervene, debrief and defuse, assess, stabilize, and refer those who require long-term care.

Tier three: followup responders — These professionals are EAP, counsellors, mental health professionals, HR, and other long-term care providers. They are the referral source for the intervention responder because of their long-term case management styles. They are the ones who have the time and energy to maintain programs and therapies to assist the more difficult concerns that victims have.

Tier four: shielding responders — These are the family, friends, clergy, family physicians (not emergency physicians), co-workers, and others who are in a position of support, spiritual guidance and emotional care, as well as the support groups, agencies, non-profit organizations and others who serve and protect those who require it.

Recommendations for a constructive intervention

Train staff members ahead of time. When training provides employees with strategies they can take home and use, they will react better in a crisis, recover more quickly and more completely, and look after each other more appropriately.

Proactive trauma training is key and should include:

•preparing for the physical and emotional responses to trauma;

•learning how to communicate so employees know what to say and what not to say to co-workers; and

•training for HR so they know who to call in for the best possible service.

Don’t provide grief counselling right after an incident. There is no grief — yet. Employees may be in shock and just want to get home to be with their families. If counselling or response is introduced too soon, it will fall on deaf ears. Remember, intervention means giving employees the chance to make choices about themselves right after the incident. Intervention sometimes means just being with the victims, without doing anything profound or otherwise. The mistake often made is “taking over” for victims, telling them what to do, where to sit, stand, eat and so on. Victims resent strangers coming in and getting too deep, too soon.

Provide information that is factual, timely and truthful. You really don’t protect people by withholding information. At one incident where a schoolchild drowned, the family wasn’t told at the site that the child was dead; they were told only that he was missing. The family showed up at the hospital, unescorted, believing their son was in surgery. As well, the children at the site were bused away too quickly — before the student was found or before they had received word of his condition — and no one was at the school to receive the students when they arrived.

There are glaring flaws with this scenario. Anger is triggered very rapidly when there are untruths, and when the people in charge are trying to protect victims from reality. As well, you stop the healing process, because victims stay in “anger” mode longer than they should.

Provide defusing and education first. Defusing is designed to help the victim move out of “victim mode” and into a resolution- and solution-focused mode. This process is most effective if introduced two to seven days after the event. Before people can heal, they must feel pain, catalogue it and ask questions about it. If employees are having intrusive memories, developing phobias, eating disorders, severe anxiety or extreme sleep disturbances after 30 days, then formal counselling may be necessary.

The importance of “reading” the audience. While there are many different models available to help employees after a critical incident, counsellors sometimes leave little room for reading the audience, for translating the information and process to meet the audience’s understanding levels or for building a rapport with them.

In other words, a room full of steelworkers may not pour out their hearts, while a group of ambulance attendants may, simply because they want to talk about the gore and the horror. These are extremely different audiences, each with a different makeup, and each requiring a different approach.

Some inexperienced practitioners go into corporations and offices, open up emotional wounds and then don’t close them. Some employees resent the fact that these sessions are mandatory, and feel intruded upon when they believe they are coping well. Others have left the sessions feeling more angry than healed. In some cases, employees may question a process where supervisors are mixed with workers, eliminating any opportunity for spontaneous dialogue.

Review and re-think your bereavement policies to ensure they are “fluid.” For example, sometimes “Aunt Martha” is closer to the employee than his parents. Does your policy allow for this? Time frames may also need adjusting. While one worker may come back from a traumatic event and want to plunge into work, another may want to ease into it. Does the work team need to pick up the slack for a couple of weeks, or give the bereaved worker extra assignments to keep him occupied? Do the team members know what to say and do, and what not to say? A bereaved staff member may feel isolated if no one knows how to talk to him, if he is ignored, or if he doesn’t know that talking about it is ok.

Know your responder team. Intervention and therapy are not the same. Therapy must be reserved for long-term counselling that may or may not be necessary. Intervention is like the ER in a hospital: the victim is given emotional triage, stability, emotional sutures, referral to surgery (counselling), or he is sent home with an aspirin. The intervention professional must be adept at this ER doctrine, have a large knowledge base and many hours of field experience.

Therapy and intervention professionals complement each other, but each in their own time. Conversely, the intervention professional must not carry a caseload or provide long-term counselling.

Some victims may be stronger than others: use them to help their co-workers. Don’t assume that everyone is in acute trauma. Don’t conduct debriefings or defusings with multiple groups; in other words, don’t involve employees who weren’t physically there with those who experienced the traumatic event. Divide them, look after them separately, and then bring them back together at a later date.

Don’t use psychological jargon in any hand-outs. Victims should be given clear, easy-to-read printed materials they can refer to at home.

Select a critical incident response team carefully. The team should contain people who are personable, highly trained, with various skills, and who are good at building rapport rather than process. When the right people for the team are selected, the right process will assert itself in due time.

Concerns and strategies. When enacting a program first consider the front-line concerns, then the long-term strategies.

Keep in mind that your employees:

•are victims because of the incident;

•are survivors because they lived through the incident; and

•become members of the community once more, because they have prevailed.

The emotional triage model outlined in this article was developed by Donna Tona, a certified trauma specialists. She can be contacted at (780) 986-3508.

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