Restoring organizational health through critical incident stress management
An employee’s teenaged son is murdered at a house party. Fifteen bank employees, three of whom are severely injured, are terrorized and held hostage by armed robbers. A long-time employee is downsized and returns to the workplace to exact a violent revenge. A young man commits a gruesome suicide at his industrial workplace, causing tremendous grief for his family and traumatizing those with whom he worked for so many years.
How does a manager even begin to be a strong leader in the face of such a tragedy? What are the right answers to the difficult questions that arise? Even more difficult is knowing how to communicate with staff in the aftermath of a workplace crisis to help heal the emotional wounds and prevent long-term stress effects.
Critical incidents are typically sudden, powerful events outside of the range of ordinary human experiences. Events such as robberies, workplace accidents, lay offs, terminations, employee deaths, disasters and violence or terrorism are critical incidents that can affect employees, both psychologically and physically.
Critical incident management
An effective, well-organized response is a must to restore the workforce to a state of wellness, ensure continued productivity and trust in leadership and re-build a resilient organization ready to face future catastrophes. Critical incident stress management (CISM) can provide the resources organizations need to manage workplace traumas effectively, such as immediate support for employees, as well as support and consultation for managers, HR departments and business leaders. This also includes follow-up consultations, group sessions and one-on-one support.
CISM is a comprehensive, long-term and individualized response strategy and can play an important role in the preparation for, and management of, a workplace tragedy. Being able to rely on a strong support system after a traumatic event is the most important factor in helping individuals re-establish a sense of well-being and regain equilibrium.
When appropriate, CISM may include an immediate group intervention, not in the form of verbally reliving the tragedy — which can re-traumatize individuals — but rather in communing together as a natural support system.
If affected employees have been evacuated or have voluntarily left the workplace after a critical incident, the employer may need to organize an ad-hoc meeting at a community hall or hotel. A critical incident response team should lead the session, normalizing and validating the employees’ experience.
The response professionals should go over common signs and symptoms of acute stress (see sidebar “Recognizing symptoms"), then introduce coping strategies and additional resources or supports, such as one-on-one counselling, for those experiencing persistent stress symptoms.
Cost of trauma
Being involved in or witnessing a traumatic incident can be very isolating and may trigger many reactions that are unfamiliar and frightening. The long-term adverse effects of acute stress have the potential to become detrimental to employees’ health and functioning if left untreated.
Departments may experience increased absenteeism and presenteeism, higher staff turnover, morale and team functioning problems, as well as increased employee health-care costs over the months and years following a critical incident that has not been adequately addressed.
The costs of providing support to staff in terms of money, time, effort and resources, will almost certainly be saved over the long term.
Tips for leaders
An integral part of CISM is providing HR professionals and managers with information and coaching on how to respond to organizational needs and to employees affected by the incident. Managers and HR, along with company policies and practices, set the tone for workplace response to trauma and grief. Employees will inevitably look to their leaders for guidance and direction.
Bob VandePol, author of Leading Employees Through Crisis, says “how leaders respond during the first hours after a disaster offers both tremendous opportunity and serious risk for the subsequent outcomes.” He proposes the ACT model, a structured process for leaders to help facilitate individual and organizational recovery:
Acknowledge and name the trauma
•understand the facts and avoid conjecture;
•use real language that appropriately captures the experience; and
•personally acknowledge the trauma, positioning leaders as equally affected by the tragedy.
Communicate compassion and competence
•seek the support of a knowledgeable colleague, EAP consultant or critical incident response expert to help develop statements and provide coaching on subsequent steps; and
•develop a full-scale crisis plan that includes use of critical incident response professionals.
Transition
•communicate an expectation of recovery, helping to paint a picture of survivors rather than victims;
•communicate flexible and reasonable accommodations as people progress back to normalcy. Assign concrete tasks with structure and focus. Remember that extended time away can actually inhibit recovery;
•lead visibly for several days and be especially accessible; and
•de-stigmatize and encourage the use of CISM services.
Ingrid Taylor is the director of trauma services for Markham, Ont.-based employee assistance program provider Ceridian LifeWorks Services. She can be reached at [email protected]. For more information, visit www.ceridian.ca.
Recognizing symptoms
Reaction to stress varies
Typically, individuals will experience a variety of the following normal reactions to what is perceived as a critical incident. Here are some common signs of stress reactions:
Physical *
Headaches
Nausea
Vomiting
Fatigue
Dizziness
Chills
Chest pain
Constipation
Diarrhea
Fainting
Rapid heart rate
Visual difficulties
Profuse sweating
Breathing difficulties
Weakness
Thirst
Exacerbation of pre-existing medical conditions
Tremors (lips and hands)
*Any of these symptoms may indicate the need for medical evaluation. When in doubt, contact a physician.
Behavioural
Suspiciousness
Excessive silence
Inability to rest
Excessive humour
Increased alcohol consumption
Withdrawal
Antisocial acts
Change in interaction with others
Change in speech patterns
Emotional
Guilt
Fear
Anxiety
Apathy
Agitation
Denial
Wanting to hide
Panic
Depression
Tearfulness
Over sensitivity
Irritability
Feeling vulnerable and/or helpless
Anger — which may be manifested by:
scapegoating, resentment, cynicism, violent fantasies, frustration with lack of information.
Cognitive
Confusion
Disorientation of person, place or time
Difficulty with concentration
Difficulty making decisions
Difficulty calculating
Rumination
Intrusive images
Flashbacks
Blaming
Hypervigilance
Difficulty with solving problems
Distressing dreams
HR don’ts
Top 10 reminders in the aftermath of a critical incident
Do not:
•Give false reassurances or placate employees, such as expressing to them that “everything will be okay.” Use plain and simple language and talk about the reality of the situation.
•Communicate information you are unsure of or have not yet confirmed. It’s appropriate to say “We don’t know at this time, but when we have more information, we will relay it immediately.”
•Avoid talking about the event. If you are comfortable revealing your emotions, it may be helpful for employees to hear how you are doing, such as “I’m feeling sad about…”
•Respond to media or the public without having clear instructions from your public relations and/or legal department.
•Tell employees how they should be feeling, reacting or coping.
•Have unrealistic expectations for recovery and do not push staff to do more than they can.
•Permit behaviour from any staff that may be hazardous to another person, to the employee herself or to the organization.
•Assume what employees may or may not need. Ask for their input.
•Take too much on yourself or put pressure on yourself to take care of all your staff.
•Forget to continually encourage staff to access the EAP for support.
How does a manager even begin to be a strong leader in the face of such a tragedy? What are the right answers to the difficult questions that arise? Even more difficult is knowing how to communicate with staff in the aftermath of a workplace crisis to help heal the emotional wounds and prevent long-term stress effects.
Critical incidents are typically sudden, powerful events outside of the range of ordinary human experiences. Events such as robberies, workplace accidents, lay offs, terminations, employee deaths, disasters and violence or terrorism are critical incidents that can affect employees, both psychologically and physically.
Critical incident management
An effective, well-organized response is a must to restore the workforce to a state of wellness, ensure continued productivity and trust in leadership and re-build a resilient organization ready to face future catastrophes. Critical incident stress management (CISM) can provide the resources organizations need to manage workplace traumas effectively, such as immediate support for employees, as well as support and consultation for managers, HR departments and business leaders. This also includes follow-up consultations, group sessions and one-on-one support.
CISM is a comprehensive, long-term and individualized response strategy and can play an important role in the preparation for, and management of, a workplace tragedy. Being able to rely on a strong support system after a traumatic event is the most important factor in helping individuals re-establish a sense of well-being and regain equilibrium.
When appropriate, CISM may include an immediate group intervention, not in the form of verbally reliving the tragedy — which can re-traumatize individuals — but rather in communing together as a natural support system.
If affected employees have been evacuated or have voluntarily left the workplace after a critical incident, the employer may need to organize an ad-hoc meeting at a community hall or hotel. A critical incident response team should lead the session, normalizing and validating the employees’ experience.
The response professionals should go over common signs and symptoms of acute stress (see sidebar “Recognizing symptoms"), then introduce coping strategies and additional resources or supports, such as one-on-one counselling, for those experiencing persistent stress symptoms.
Cost of trauma
Being involved in or witnessing a traumatic incident can be very isolating and may trigger many reactions that are unfamiliar and frightening. The long-term adverse effects of acute stress have the potential to become detrimental to employees’ health and functioning if left untreated.
Departments may experience increased absenteeism and presenteeism, higher staff turnover, morale and team functioning problems, as well as increased employee health-care costs over the months and years following a critical incident that has not been adequately addressed.
The costs of providing support to staff in terms of money, time, effort and resources, will almost certainly be saved over the long term.
Tips for leaders
An integral part of CISM is providing HR professionals and managers with information and coaching on how to respond to organizational needs and to employees affected by the incident. Managers and HR, along with company policies and practices, set the tone for workplace response to trauma and grief. Employees will inevitably look to their leaders for guidance and direction.
Bob VandePol, author of Leading Employees Through Crisis, says “how leaders respond during the first hours after a disaster offers both tremendous opportunity and serious risk for the subsequent outcomes.” He proposes the ACT model, a structured process for leaders to help facilitate individual and organizational recovery:
Acknowledge and name the trauma
•understand the facts and avoid conjecture;
•use real language that appropriately captures the experience; and
•personally acknowledge the trauma, positioning leaders as equally affected by the tragedy.
Communicate compassion and competence
•seek the support of a knowledgeable colleague, EAP consultant or critical incident response expert to help develop statements and provide coaching on subsequent steps; and
•develop a full-scale crisis plan that includes use of critical incident response professionals.
Transition
•communicate an expectation of recovery, helping to paint a picture of survivors rather than victims;
•communicate flexible and reasonable accommodations as people progress back to normalcy. Assign concrete tasks with structure and focus. Remember that extended time away can actually inhibit recovery;
•lead visibly for several days and be especially accessible; and
•de-stigmatize and encourage the use of CISM services.
Ingrid Taylor is the director of trauma services for Markham, Ont.-based employee assistance program provider Ceridian LifeWorks Services. She can be reached at [email protected]. For more information, visit www.ceridian.ca.
Recognizing symptoms
Reaction to stress varies
Typically, individuals will experience a variety of the following normal reactions to what is perceived as a critical incident. Here are some common signs of stress reactions:
Physical *
Headaches
Nausea
Vomiting
Fatigue
Dizziness
Chills
Chest pain
Constipation
Diarrhea
Fainting
Rapid heart rate
Visual difficulties
Profuse sweating
Breathing difficulties
Weakness
Thirst
Exacerbation of pre-existing medical conditions
Tremors (lips and hands)
*Any of these symptoms may indicate the need for medical evaluation. When in doubt, contact a physician.
Behavioural
Suspiciousness
Excessive silence
Inability to rest
Excessive humour
Increased alcohol consumption
Withdrawal
Antisocial acts
Change in interaction with others
Change in speech patterns
Emotional
Guilt
Fear
Anxiety
Apathy
Agitation
Denial
Wanting to hide
Panic
Depression
Tearfulness
Over sensitivity
Irritability
Feeling vulnerable and/or helpless
Anger — which may be manifested by:
scapegoating, resentment, cynicism, violent fantasies, frustration with lack of information.
Cognitive
Confusion
Disorientation of person, place or time
Difficulty with concentration
Difficulty making decisions
Difficulty calculating
Rumination
Intrusive images
Flashbacks
Blaming
Hypervigilance
Difficulty with solving problems
Distressing dreams
HR don’ts
Top 10 reminders in the aftermath of a critical incident
Do not:
•Give false reassurances or placate employees, such as expressing to them that “everything will be okay.” Use plain and simple language and talk about the reality of the situation.
•Communicate information you are unsure of or have not yet confirmed. It’s appropriate to say “We don’t know at this time, but when we have more information, we will relay it immediately.”
•Avoid talking about the event. If you are comfortable revealing your emotions, it may be helpful for employees to hear how you are doing, such as “I’m feeling sad about…”
•Respond to media or the public without having clear instructions from your public relations and/or legal department.
•Tell employees how they should be feeling, reacting or coping.
•Have unrealistic expectations for recovery and do not push staff to do more than they can.
•Permit behaviour from any staff that may be hazardous to another person, to the employee herself or to the organization.
•Assume what employees may or may not need. Ask for their input.
•Take too much on yourself or put pressure on yourself to take care of all your staff.
•Forget to continually encourage staff to access the EAP for support.
