CRISIS MANAGEMENT: PREPARING, SUPPORTING & RESPONDING 20 March 2018 Alexina Baldini (Psychologist) Workplace Crises • Internal? 1
Workplace Crises • External? Preparing for a Crisis Making the unpredictable able to be anticipated better 166619701538145615031061110511981508 • Know your data 988 13511048 2000 684 711 747 631 542 502 565 432 433 352 446 462 1000 • Examine your history 0 • Keep up with trends – internal and external No. of incidents • Practice your preparedness • Involve everyone in the workplace 2
Crisis Intervention Principles 1. PROXIMITY (1916) – within gunshot 2. IMMEDIACY (1919) – as soon as practical without risk 3. EXPECTANCY (1919) – those who expect to get better do so 4. BREVITY (1946) – only need to help while the person requires it 5. SIMPLICITY (1950) – often simply being present will help 6. PRAGMATISM (1972) – practical help is remembered most 7. INNOVATION (1990) – creative ways of helping Crisis Intervention Promotes Recovery Resiliency Resistance 3
Resistance The ability of an individual, group, organisation or even an entire population to RESIST manifestations of clinical distress, impairment or dysfunction associated with critical incidents, trauma, disasters Can be thought of as a form of psychological and/or behavioural immunity - built up pre-incident Resilience The ability of • An individual • A group • An organisation, or even • An entire population to RAPIDLY and EFFECTIVELY REBOUND (or bounce forward = post traumatic growth) from psychological and/or behavioural perturbations associated with critical incidents, terrorism, and even mass disasters 4
Recovery The ability to literally RECOVER the ability to adaptively function Both psychologically and behaviourally Treatment and rehabilitation programs can speed recovery Critical Incidents • A Critical Incident is ANY event that generates such intense emotional energy that it overwhelms an individual’s or a group’s ability to cope and causes impairment in work or personal activities 5
Psychological Crisis An acute RESPONSE to a trauma, disaster, or other critical incident (emergency, terrorism, catastrophe…) where: 1. Psychological homeostasis (balance) is disrupted - > increased stress 2. One’s usual coping mechanisms have failed 3. There is evidence of significant distress, impairment or dysfunction Adapted from Caplan (1964) Preventative Psychiatry What Happens First? We go into: FIGHT FLIGHT FREEZE 6
Attention Narrows High arousal narrows attention – our peripheral view diminishes Focuses concentration on the most concrete features of the environment Affects decision-making Anyone vulnerable to threat can be affected 7
Supporting those affected Sensory and/or Informational Trauma • Recognition of sensory trauma usually easier - what we see, hear, smell, feel, taste… • Informational trauma often not recognised by colleagues or managers – what we may read about, learn about… 8
Two Types of Distress Cumulative Stress Critical Incident (Burnout) (Traumatic) Normal coping Chronic Incomplete work overwhelmed physical / lateness Adaptive functioning illness Compulsive interrupted need for change Symptoms of post- Cynicism Slow erosion of traumatic distress functioning evident Responding Proactively • Psychological First Aid (PFA) as a universal first treatment of choice • Offered to all staff, irrespective of their response to an incident: • Strategies for helping meet the psychological needs of ordinary people who have experienced extraordinary events 9
Simple Model of Psychological First Aid Australian Red Cross model for volunteers: • Look • Listen • Link Victorian Ambulance – MANERS (PFA) • M inimising exposure • A cknowledge the event • N ormalising the reactions • E ducating as required • R eturning to normal function OR referring on for additional resources • S elf care (making sure the helpers look after themselves also!) 10
PFA Core Actions 1. Contact and Engagement 2. Safety and Comfort 3. Stabilisation (if needed) 4. Information Gathering – needs, concerns 5. Practical Assistance 6. Connection with Social Supports 7. Information on Coping 8. Linkage with Collaborative Services Managing Staff • Reduce length and intensity of exposure where possible • Rotate exposed staff before they are exhausted • Reduce workloads, relieve or share routine responsibilities • Support and confirm existing reporting or management arrangements • Provide active support and advice to staff • Ensure absent staff are supportively informed by manager as soon as possible 11
Crisis Leadership Know when to get help and have trusted advice available readily – legally, psychologically, organisationally Be prepared to show by example in terms of seeking support Anticipate needs and proactively provide resources to affected groups Managing the Crisis Strategic Management Best provided by people not directly affected by the crisis Need to be thinking ahead and planning for various contingency measures Operational Management Best provided by direct line managers or those responsible for the staff member’s welfare Need to be present focused and available as required 12
Information is Paramount Even if there is no new information…. Providing regular updates is vital! There is no such thing as ‘ no information ’ This Photo by Unknown Author is licensed under CC BY-SA People in crisis will fill in any gaps they perceive… This Photo by Unknown Author is licensed under CC BY-NC-SA Rumours can be rife Information management is a key strategy Minimising Risk Most individuals exposed to a traumatic event will not need formal psychological intervention beyond being provided with relevant information and guidance Focus on the individual more than the event – assess their needs – this will be an ongoing dynamic process Normalisation of the crisis response is encouraged without dismissing serious crisis reactions and getting the help needed for them 13
Voluntary is Best Crisis Intervention should be voluntary unless magnitude of the impairment means they are a threat to themselves or others Individuals should only talk about the event if they are comfortable to do so – never pressure anyone to speak Provide opportunities for staff to meet and process naturally What can go wrong • Vicarious trauma can occur if people are asked to be interactive in heterogenous groups – any group process needs to be carefully assessed by those trained in crisis response • Excessive venting, disclosure, rumination needs to be prevented – ensure you have specialist crisis intervention personnel involved • Beware of coercive peer pressure and ‘group think’ – everyone will have their individual response • Counselling is NOT recommended in the early days after a crisis – support is what is required, and often this needs to be very practical! 14
Support A sense of identification that allows enough depersonalisation to feel the trauma is not carried alone Involves: • Belonging • Understanding • Empathy • Acceptance Immediate Support • Ask staff to tell you what happened – include what they THOUGHT was happening • Assess whether they recognise their needs – prompt them to consider themselves – help them make THEIR OWN decisions • Two choices are usually better than no structure – e.g. do they need to be alone or wind down with a colleague? • Allow time for them to de-stress and react before they go home – spend time with them or allocate this to other senior staff • Avoid jokes, expressing your feelings or assuming what happened until you check their experience 15
Going Home • Ensure they have contact numbers • Check in over weekends or days off • Do they need a taxi or a colleague to get home? • Discuss notifying family members before they go home Going Home (continued) • Is home the best place to be if they live alone – are there alternatives? • Flexible return to work next day allows for extra sleep, rest or family support • Provide information and handouts to take home for staff and family members 16
Follow up the next day/s • Look for new responses • Expect delayed reactions • Consider cultural or diversity issues • Re-establish normal routines as soon as possible • Inform other staff about the situation and advise on their support roles – bearing in mind privacy and confidentiality • Monitor the situation over the next few weeks, seeking support for yourself Management Support “What goes on around you….compares little with what goes on inside you” -Ralph Waldo Emerson, 1844. Building confidence Helping understand the scope of their role 17
Strategic Planning • Themes • Threats • Target • Type • Timing • Team (International Critical Incident Stress Association (ICISF) Six T’s) 18
Employee Assistance Providers Association Recommendation: Plans should consist of a continuum of interventions: • Pre-incident training • Active response • Post incident response • Follow up • Post-incident review and plan reformulation (EAPA 2002 Disaster Response Task Force) Why have a Psychological Support Strategy? • Organisational responsibility • Legal implications • Economically expedient • Cares for your staff – the human potential of your organisation 19
Recommend
More recommend
