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Mandy Rutter


Senior clinical manager

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Psychological first-aid in the workplace – responding to traumatic events


This article was written by Mandy Rutter, head of the critical incident team at wellbeing company The Validium Group.

The Boston marathon bombing has been an example of the kind of shock incident that is not only traumatic for those involved, but sends waves through networks of friends, colleagues, family and whole communities. For employees, the implications of a traumatic incident – whether work-related or not – can be far-reaching in terms of long-term health and ability to deal with a return to a ‘normal’ way of working and dealing with daily challenges.

Faced with shocked, distressed and potentially injured employees, the general focus is usually on treating physical wounds. Psychological injuries are much less often a priority – and less likely to be attended to in the right ways.

The consequence of such a “treatment-focused” approach is that standard occupational health practices can inadvertently cause individuals to maintain a state of helplessness, by being too paternalistic. Research shows that empowering staff to take a more proactive and positive approach to their own recovery is an essential part of limiting psychological damage.

In practice, empowering individuals exposed to trauma requires identifying what they need most to feel safe and supporting them to meet this need, whether it’s money for a taxi home or just access to a telephone.

The important point is that the focus on being caring and compassionate but empowering people to take whatever action is required to restore their natural resilience and day-to-day functioning; for example, encouraging affected individuals to make the call to a friend or relative themselves, instead of making the call for them.

In this sense, just as checking airways, breathing and circulation has become the established ABC of administering physical first aid, attending to basic needs with compassion is rapidly becoming the corresponding ABC of administering psychological first aid (PFA).

Delivered effectively, PFA is a systematic set of flexible, conversational, enabling actions that can be used to provide immediate support to trauma victims. The overall objective is to minimise distress in a practical, efficient and non-intrusive way, to foster short- and long-term adaptive functions.

The more you can encourage employees to take positive small steps towards retaking control, the more you can facilitate their recovery. At the most basic level, this means encouraging staff to link up with family, friends, colleagues and their managers and giving them the opportunity to talk through the impact of the trauma. It also involves educating people to understand that they are likely to experience some of the symptoms of trauma, ranging from hyper-vigilance and avoidance to poor concentration and insomnia.

Most people are resilient and will recover with the support of their personal networks. That is why, as well as encouraging empowerment and education, PFA also encourages people to connect with others for support. The more engaged and interconnected people are during the day, the more likely they are to reach out and support each other in the aftermath of a crisis.

Occupational health professionals can actively help to create those trusting support networks by facilitating group-based discussions on topics that might be distracting or distressing for employees, such as work-life balance. Employees should also be made fully aware of access to other conversational therapies, such as counselling via an employee assistance programme.

Few employers can predict exactly when or where the life of an employee might come under threat. Thorough strategic planning is therefore essential in helping those exposed to a critical incident to recover as quickly as possible.

Most recovery plans take into account practical considerations for staff, such as relocation of workspace and contacting next of kin; however, the psychological needs of employees is often omitted due to the difficulty of quantifying and identifying potential needs.

Critical incident specialists are available to deploy trained professionals to provide the appropriate psychological support in the event of an incident. However, it is the immediate response of senior professionals, occupational health practitioners, managers and colleagues on the ground that have the biggest effect on the health of employees.

Senior leaders and managers must be seen to remain calm and be compassionate and reassuring. They must be prepared to assess the fundamental, practical needs of staff and provide encouragement and information on questions such as pay, workload and absence, equipment and security.

By working with critical-incident planners, occupational health has a key role to play in ensuring the business understands the importance of the psychological dimension to the aftermath of crises – to better provide support and also reduce the costs and absence and rehabilitation.

Author Profile Picture
Mandy Rutter

Senior clinical manager

Read more from Mandy Rutter

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