A large amount of research exists on the clinical, social, and psychological effects of childhood trauma, but knowledge of how organisations can support survivors’ welfare is scant. This is an equality issue as it presents barriers to survivors. I spoke to survivors of childhood trauma about what they want from their employers, leading to recommendations on how organisations can design effective support.

Barriers affecting survivors

Childhood trauma affects one in five adults, that’s 8.5 million people aged 18 to 74 years who experienced at least one form of child abuse before the age of 16 years in the UK. The response to this trauma is often ongoing and impacts interpersonal relationships, which can negatively affect health and wellbeing throughout life.

Most managers attempt to address the causes of trauma and fail to empathise, talk confidently and actively listen to survivors

We know that survivors are the ‘experts by experience’, however, in most cases ‘experts by training’ tend to be given the strongest voice in the workplace. This is the reason why I offered survivors the opportunity to share their experiences at work. Listening to their stories, I found many barriers affecting their ability to work effectively and seek support. These include:

1. Stereotypes and bias

Survivors fear talking openly about the trauma to avoid stigmatisation and bias with work decisions. This is often due to poor organisational understanding of how to offer support, this can cause distress and re-traumatisation. They do not wish to be perceived as the ‘troublemakers’ or create the perception that their trauma prevents them from doing their work.

2. Organisational support

Survivors perceive the nature and type of support as being dysfunctional. Most managers attempt to address the causes of trauma and fail to empathise, talk confidently and actively listen to survivors. They do not create the space for survivors to receive appropriate support based on their individual needs.

3. Quality of relationships

The quality of the relationship between survivors and their managers was seen as extremely problematic due to a complete lack of trust. A major part of the issue is the lack of awareness on dealing with trauma and lack of confidence in the management processes.

4. Making a decision to disclose trauma

Non-disclosure is seen as the best approach by survivors. Past experiences have shaped their current perception in such a way that encourages survivors not to share or discuss their trauma with management to avoid re-traumatisation, stigmatisation and bias.

Lack of trust in the system and how organisations handle disclosure has been seen as a major obstacle. It is often the last resort as it is easier to leave the organisation rather than regret disclosing it.

Most organisational decisions are based on personal experience rather than on professional knowledge emerging from specific training and development

5. Knowledge to support decisions

Most organisational decisions are based on personal experience rather than on professional knowledge emerging from specific training and development activities. This creates inviable barriers negatively affecting managers’ mindsets by exacerbating symptoms and re-traumatising survivors.

Who is responsible for providing support?

To what extent is trauma something that needs to be only addressed by health professionals and/or by the organisation holistically? My study shows that there must be a collective effort to develop mechanisms that offer survivors an appropriate level of support.

We know with certainty that a more personalised approach is needed to consider individual needs but, most importantly, to design effective support methods that are appropriate for survivors. A level of support that offers the workspace, dignity and flexibility to manage trauma and achieve work objectives. 

We also know there is a societal effect of trauma and the financial impact of increased health care costs. The right support is catalytic to achieving positive health, wellbeing, and performance outcomes. If survivors can engage in a meaningful way with work, then absenteeism and presenteeism should decrease.

What do we need to do?

Talking to survivors was a powerful process and is a changing force that can reach all organisations. The underlying theme that emerged from the study was the need to continue this discussion and enable all individuals to openly talk about trauma and workplace psychological safety.

We need to go beyond the causes of trauma; we need to focus on the work experiences of survivors not linked to complicated and time-consuming solutions but simply on some basic human behaviours including understanding, trust and fairness.

However, recognising the need to support is only the very first step to developing an effective strategy. There is a need to work through a number of steps to be able to address the organisation’s moral and social obligations to offer appropriate workplace support when trauma is disclosed or symptoms are identified.

Line managers have a prime role to play like the quality of the survivor-manager relationship is a driving force to create a sense of safety

Based on the needs of the survivors I spoke to, I would recommend several ways to start the conversation around managing trauma in the workplace:

• Place trauma onto the welfare and wellbeing agenda as a strategic dimension and not a single approach under the welfare umbrella. There should not be a high reliance on HR policy.
   
• Recognise the importance of supporting trauma survivors in the workplace and create the infrastructure for an integrated, individualised and targeted approach to support.
   
• Changes should cover many areas including policy development, staff development, workload, disclosure, communication, performance and other wider employment practices.
   
• Address high levels of anxiety to talk about the trauma and whether the organisation offers balanced support.
   
• Effectively manage the line management processes to improve manager confidence in offering direct support to individuals who disclose trauma. Line managers have a prime role to play like the quality of the survivor-manager relationship is a driving force to create a sense of safety.
   
• Consider legal requirements, however, this should be followed by extensive training and development on how to support survivors at different stages. This is because legal requirements only apply to those with a diagnosis. Many survivors do not have a diagnosis but trauma manifests at work. The process should avoid re-traumatisation.
   
• Seek external support when knowledge in the area is poor and identify best practices.

The main principle here is not to add extra work for the organisations when establishing effective support for survivors but simply to understand, prepare, prevent, respond to and support employees who might need help in the workplace.

Interested in this topic? Read Mental health: The importance of person-led support for serious conditions.

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