Tanya Laird had only worked for Habitat for Humanity for a few weeks when she was asked to track down some images for a presentation. Browsing through the charity database, she was shocked to find graphic photographs taken in the aftermath of the 2004 tsunami.
“I was totally horrified and extremely distressed,” she says. “I just didn’t know what to make of what I’d seen.”
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When Laird told her manager what had happened, the charity realised there was a serious gap in its processes, so it restricted access to sensitive materials, and updated its induction training to prepare newcomers for potentially traumatic situations.
However, Laird says the incident definitely had lasting effect: “The images stayed with me a long time, as well as the shock,” she says. “It was definitely traumatic.”
Trauma in the workplace is a major problem, with 1.5% of all workers suffering in any given year, according to a report by the Institute for Employment Studies. Nine out of 10 people will experience a traumatic event at some point in their lives, and a third will develop trauma-related illnesses, including post-traumatic stress disorder (PTSD).
Perhaps the biggest misconception about trauma is that it only happens to police officers, doctors and bank tellers, says Keith Guy, clinical director of trauma management specialist The Red Poppy Company.
Guy deals with hundreds of employees suffering from trauma each year, and relatively few are from the sorts of jobs where trauma is expected.
Trauma can affect anyone
“Most clients have actually experienced a death at work, a serious assault or a road traffic accident,” he says. “You don’t need to be held at gunpoint to experience trauma.”
Trauma isn’t the same as being stressed, however it is a specific event that triggers an intense emotional response of helplessness, terror or horror. And an individual will usually exhibit symptoms such as flashbacks, persistent anxiety, sleep disturbance, distraction, nervousness and a desire to avoid stimuli associated with the event. But effective trauma management in the workplace can reduce staff absence and lead to better health among employees.
Trauma: support pays dividends
A study conducted by the Royal Mail Group and IT services provider Atos Origin found that companies that invest in post-trauma support for workers report lower levels of sickness absence, lower staff turnover and an increase in productivity.
And employers have a legal obligation to take the issue of trauma seriously. The Health and Safety at Work Regulations 1999 require employers to make risk assessments for employees, including their psychological health. Employers also have a common law duty to take reasonable care of employees, and so may be liable if a traumatic event could have been anticipated.
Reducing the risks
When implementing trauma policies, the best place to start is reducing the risk of trauma occurring in the first place, says Sally Wilson, a research fellow with the Institute for Employment Studies.
“Conduct thorough risk assessments using specialist help to identify vulnerable roles and individuals. You can then put in place control measures to reduce some of those risks, such as training or particular procedures,” she says.
Second, invest in trauma awareness training for line managers, advises Liz Royle, managing director of specialist provider Pathways Through Trauma.
“You should be conducting regular welfare and health checks on vulnerable people, and ensuring managers are able to see the signs of vicarious and cumulative trauma where there may not be a single event that has caused the traumatic illness – are people off sick for a long time, are they becoming cynical and easily distracted, are they performing less well than usual?”
Training can help
Training can also be helpful, particularly if it focuses on how employees might cope in a traumatic situation.
Wilson says: “Obviously, you can’t train for everything, but for bank staff, it’s worth knowing what to do during a robbery, for instance. Simply having knowledge of what to do can reduce the helplessness that can lead to trauma.”
Roleplay and workshops where staff discuss how they should react in specific situations can also be valuable.
“Sometimes, just knowing there is a procedure to follow if someone dies on a construction site, or if a client threatens to assault someone, can reduce the feelings of helplessness,” Wilson says.
Training is vital to ensure that managers can cope when traumatic events do occur – and helps reduce the risk that they will do something that may inadvertently make an employee’s trauma worse. For example, many companies run debriefing sessions or refer employees for counselling post-trauma, but research now shows this can do more harm than good.
Royle says: “Counselling and debriefing encourage people to talk about trauma in detail, which embeds the event in the brain and can re-traumatise people. Counselling is fine in some situations, but it’s fundamentally unsuited for trauma.”
NICE trauma guidelines
The latest guidelines from the National Institute for Clinical Excellence recommend that companies provide specialist trauma intervention rather than debriefing or non-directive counselling. And a growing number of trauma intervention specialists in the UK offer a range of techniques to help people recover. Some, such as TRiM (Trauma Risk Management) and SPoT (Support Post Trauma) have roots in the military, while others such as RENEW and EMDR (Eye Movement Desensitisation and Reprocessing) originated in psychotherapy.
Unlike counselling, trauma intervention is short-term (usually no more than eight sessions) and focuses on helping people manage and reduce their symptoms.
“If someone is having flashbacks, we give them a structured way of dealing with that – it’s very directive,” says Royle. “That structure and order gives someone in a trauma crisis a feeling of safety.”
Crucially, this kind of support should only be offered only if an employee is exhibiting trauma symptoms.
Wilson says: “An event is only traumatic by virtue of someone’s response to it. What triggers a stress disorder in one person might be shrugged off by someone else.”
With this in mind, managers must keep an eye on workers who are at risk, provide training if necessary, and only allocate trauma counselling to those who will benefit, she concludes.
Case study: First Group Manchester
As operations director of First Group Manchester buses, Dave Borland sees a lot of bumps. However, when a Peugeot collided head on with a bus, it was the worst accident he had seen for years.
“The driver saw the car too late to do anything, and three lads died,” he says. “It’s a tragedy, and I don’t think the driver will ever get behind the wheel again.”
The 265 drivers working for First Manchester can be exposed to some difficult situations.
“People fall on buses, they can be drunk, you might hit a person or another vehicle – it can be a fairly difficult job on occasion,” says Borland. Traditionally, bus drivers were a macho community, however, and were expected to deal with whatever might come their way.
Today, times have changed and First Manchester has invested in trauma awareness training for managers, to help support workers who experience trauma. “Some people might just need a chat, but other times, we get specialists involved very quickly, because they’re trained to help the driver make sense of their feelings and address any problems.”
Since starting to work with Pathways Through Trauma in 2004, Borland says the company has definitely seen a reduction in sickness absence following major incidents.
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“They’re great at providing people with work plans and actions plans that get them back to work, and feeling better,” he says. “Obviously, in some cases they won’t come back to work, but hopefully we have at least helped them achieve a degree of normality.”
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