Power to Recover: A complete guide to managing psychological trauma at work

Power to Recover: A complete guide to managing psychological trauma at work

Liz Royle PhD and Catherine Kerr CPsychol

Copyright KRTS International Limited

First published 2016 This book is available in print at most online retailers.

Smashwords Edition

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Table of Contents

About the authors

Introduction

Chapter 1: The nature of workplace trauma

Trauma at work

A critical incident

Factors that can increase or decrease vulnerability

Chapter 2: The human survival response

Phase 1: our surveillance system

Phase 2: psychological reflex

Phase 3: physical reflex and immediate action

Chapter 3: Managing the immediate response

Immediate reactions

The guiding principles of critical incident support

The goals of early intervention

Golden rules for helping

Unhelpful interventions

Chapter 4: Helping groups in the immediate aftermath

Groups in crisis

Immediate group interventions

An interactive group process: Defusing

An informational group process: Crisis management briefing

Chapter 5: Understanding traumatic stress reactions

Early days and weeks

Regaining control through psycho-education

Simple steps to facilitate the post-trauma tasks

Chapter 6: Picking up the pieces

Support and surveillance

Group support and surveillance processes

Risk management

Rehabilitation: managing effective returns to work

Chapter 7: A death in the workplace

The impact of a death at work

Breaking the news

Remembering

Adapting to the loss

Chapter 8: Developing a proactive strategy

Step 1: assess the nature and type of risk

Step 2: create a clear rationale for intervention

Step 3: develop written policies and identify responsibilities of key people

Step 4: develop procedures and prepare resources

Step 5: train staff

Step 6: monitor and evaluate

Chapter 9: Vulnerable roles and secondary trauma

The risk of secondary trauma

Organisational strategies to manage risk

Encouraging personal resilience

Post-traumatic growth

Chapter 10: Working strategically - a case example

Step 1: information gathering

Step 2: identify those affected and their potential needs

Step 3: identify and allocate resources

Appendix 1: Strategic Management Information Gathering questions

Appendix 2: Suggested content for a Trauma Support Policy

Appendix 3: Fact sheet with basic psycho-education

Appendix 4: Information sheet for family and friends

Appendix 5: Example process for a critical incident

Appendix 6: Signs of cumulative or secondary trauma

Appendix 7: Building personal resilience

References

Acknowledgments

About the authors

Dr Liz Royle

PhD, MA, EMDR Europe Approved Consultant MBACP (Accred)

Dr Liz Royle is an international author and speaker with clinical experience of working across the full range of psychological trauma – be that responding to traumatic incidents or working therapeutically with PTSD and historical trauma. She is a psychotherapist and EMDR Europe Approved Consultant and was the lead person for the European Society for Traumatic Stress Studies (ESTSS) Managing Trauma in the Uniformed Services task force for 8 years.

She has substantial experience of the strategic management of trauma and proactive interventions for high risk organisations. Her professional experience of trauma was cemented during her time as Senior Welfare Officer for Greater Manchester Police providing psychotherapy and 24/7 critical incident interventions to police officers. In that role, she was the specialist liaison for Gold Control, firearms, Child Protection, Witness Protection Officers and the Major Armed Control Unit. She developed post-incident procedures for major incidents in the police service and managed responses to major incidents such as line of duty deaths and multiple fatalities.

Since leaving the police service in 2004, she took her skills and knowledge into the private, corporate and voluntary sectors. Dr Liz Royle has written Trauma Support policies for City Councils, Police Forces and security companies and provided strategic and crisis response support to organizations affected by the 7/7 bombings, the 2004 Tsunami and groups affected by disaster, deaths and accidents.

She co-created the early intervention programmes KRTS Power to Respond and KRTS Power to Recover and now works as a consultant to organisations that need to manage their response to traumatic events.

Catherine Kerr (CPsychol)

MSc, EMDR Europe Approved Consultant, MBACP (Snr. Accred)

Catherine is a Chartered Counselling Psychologist, a senior accredited BACP integrative psychotherapist and an EMDR Europe Approved Consultant. She has many years’ experience of working with high risk organisations and clients suffering from Post-Traumatic Stress Disorder (PTSD) and acute trauma reactions including those following serious assaults, road traffic collisions, accidents, traumatic bereavement and historical child sexual abuse.

Catherine has a Management background within the voluntary and private sector, and was involved with local NHS Primary Care Groups to help provide early preventative measures in response to mental health issues. She contributed to the creation and review of policies and procedures to ensure professional working practices.

As well as being an international author, she is the co-creator of KRTS Power to Respond and KRTS Power to Recover, early intervention programmes that support individuals following a critical incident. She now trains licensed clinical coaches to deliver them as part of a portfolio of support for organisations who need to manage workplace trauma. Catherine is part of the British Psychological Society Division of Counselling Psychology Qualification Reference Group. Ultimately her passion is to help make a difference when it really counts.

Introduction

This book is written for anyone who is involved in the management of a traumatic incident at work, whether they are responsible for preparing the organisation, responding to the crisis or facilitating the recovery of those affected. Readers may be organisational managers, leaders or personnel professionals as well as those who work in areas such as mental health, welfare, business continuity, employee assistance programmes and health & safety.

The learning is brought to life with illustrative examples and common pitfalls highlighting the mistakes that well-meaning organisations often make. Practical activities are interwoven throughout the book, helping readers to explore issues and draw up a strategic plan based on their specific context.

It should be emphasised that managing traumatic incidents is a specialised area and readers are encouraged to seek additional professional support before implementing any plan. This book does not replace professional support but will ensure you are an informed user of any such services.

Anonymity: All scenarios and individuals mentioned are based on composite case studies and any identifying details have been changed to preserve anonymity.

Caveat: As with any book or training course that relates to the subject of psychological trauma, there is a potential that readers may be reminded of their own challenging and distressing life events. This is very normal and relatively common as our brains like to associate new learning with what we already know. If you find yourself overly thinking about the past then pause, take some time out, or maybe do something pleasurable and relaxing. Appendix 7 has ideas for activities that can be calming. If your reaction is intense or doesn’t quickly settle down, then it may be an indication that there are unresolved issues for you to explore. Please take responsibility for your own well-being and seek professional advice.

Chapter 1: The nature of workplace trauma

The unthinkable has happened. You’ve just had the call – a member of staff has been seriously injured by a violent and aggressive visitor in the Housing Association office. She was stabbed before the perpetrator fled the building. Several colleagues witnessed the attack and two were directly threatened by the individual as he left. One has minor cuts. The first aider attempted to help the injured and is left pale, shocked and bloody.

The ripple effect is starting: senior management are asking questions, colleagues are distressed and angry, there are upset Housing Association tenants helplessly standing around, the telephones continue to ring with the usual business, line managers are seeking advice and direction … and everyone is looking to you.

Trauma at work

Depending on your workplace, this may or may not seem like an extreme example. Many people are at high risk of encountering psychological trauma by the very nature of their occupation – the emergency services, security and cash handling services, health and social care for example. In reality, few workplaces are immune to difficult and distressing events:

• Assaults on staff

• Sudden death or suicide of colleagues (or of members of the public in the workplace, e.g. customers)

• Serious accidents and injuries

• Robberies

High risk organisations can expect to encounter distressing and challenging events and, provided they have carefully planned how they will respond, may even find it easier to manage than the smaller or lower risk organisation that has no experience of such events.

In most cases, emergency procedures kick in to ensure that matters such as business continuity and health and safety reporting are dealt with but the human aspect is often ignored or misunderstood. Yet, without healthy employees, business would grind to a halt.

Following a traumatic event, people often suffer unnecessarily. They may not be able to function well and could even be left permanently damaged by their experience. In the early days and weeks, the organisational response, good management and peer support can make a huge difference.

However, before we can begin to manage the human aspects of a traumatic incident at work, the relevant people in the organisation must have realised that one has happened! That may sound simple but it’s not always such a clear-cut case as the earlier example!

Common pitfall: Not recognising that a critical incident has occurred

Organisations frequently compile a hit list of incidents that would trigger occupational post trauma support services. For example, a death, a serious accident, an assault.

This kind of list gives a clear indication to managers that support is required but doesn’t take into account the human experience. This can mean that resources are used where they are not necessary or not considered where they are needed. It can lead to employees feeling that procedures are simply lip-service or a box being ticked.

Managers can also be given a false sense of security that they have done all they need to, or they may feel hesitant about offering assistance following an event that falls outside the list – even when their natural instinct is to do something.

So by all means compile a list to raise awareness, but train managers to use it as a flag to consider the impact on employees.

Back to the top

A Critical Incident

Although there are many definitions of a traumatic event, what affects one person may not affect another so it’s problematic to be prescriptive. It may be better to consider the term critical incident rather than traumatic incident to reflect this. These terms will be used interchangeably throughout the book.

A critical incident is an opportunity to consider the impact of an event. After all, it is the human reaction that we are managing.

The International Critical Incident Stress Foundation (ICISF) describes a critical incident as a powerful traumatic event that initiates the crisis response (Mitchell, 2015).

Definitions of a traumatic event

Professional organisations have attempted to clarify what a traumatic event is and here are some commonly used definitions:

The American Psychiatric Association states that for an incident to be classed as traumatic the person must have been exposed to actual or threatened death, serious injury, or sexual violence (APA, 2013)

The World Health Organisation’s International Statistical Classification of Diseases and Related Health Problems (ICD-10) describes it as exposure to a stressful event or situation (either short or long lasting) of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone (WHO, 2010)

The US National Library of Medicine takes a broader and more subjective view describing a traumatic event as an experience that causes physical, emotional, psychological distress, or harm. It