Our advocacy goes a step further. The types of events that can damage a company and its employees are numerous and varied. Planning to prevent psychological trauma, therefore, should be considered in a range of probabilities. The most effective trauma prevention plans are those that cover the full range of possible crises or disasters. Therefore, we will address the psychological effects of cataclysmic events that are watersheds in the history of an organization'ones that permanently change the company and its employees, as well as events that may directly affect only one employee, but still profoundly affect the organization.
To protect both employees and company, you need a centralized, unified plan that triggers the company's response to people in a traumatic incident-what is to be done, by whom, and within what time frames so that people do not fall through the cracks. As we will point out later, there is too much at stake to justify an "automatic pilot" response and simply default the people problems to human resources or assume a supervisor will refer to the EAP.
With everything that needs to be considered in the development of a disaster recovery plan, why should your organization be concerned with adding another element-the human factor?
Consider the following statistics: Stress-related illnesses cost U..S. businesses in excess of $150 billion annually for medical treatment, absenteeism, lost productivity, and retraining. These illneses can be mitigated by having in place an effective stress management and trauma treatment program. Physical injury claims are far less costly than mental, stress-related claims. By positioning your organization to deal with stressors up front, you can deflect the claims and reduce costs. Also, a program that includes the human factor in disaster recovery may enable the organization to equip its human resources with the tools they need to prevent it from becoming one of the 43 percent of U.S. businesses that never re-open after a disaster experience, or one of the 29 percent that close within two years. Other benefits follow:
- reduce the chance of human error due to stress reactions-this supports recovery activities;
- attest to the company's recognition of the seriousness of critical incidents and trauma;
- retain employees'Stress management extends job longevity and reduces turnover;
- build morale'Affirms the value of employees to the company;
- reduce likelihood of litigation and/or disability claims due to negligence;
- foster recovery through the debriefing group approach'lends a platform for later team building and growth;
- reduce long-term absenteeism, future accidents, improve productivity.
These benefits combine to create a more efficient workplace operation and maximize employee productivity.
The few crisis management or disaster recovery plans that do include a trauma prevention capability make a common mistake, and that is to limit their response to persons who are primarily exposed to the trauma or are physically injured. These plans do not take into account the shock waves that critical incidents send through the organization-the ripple effect.
The incident at Rouge Manufacturing Plant created an impact that extended well beyond plant and employees; it shook metropolitan Detroit, and was felt throughout the country. Thankfully, the vast majority of incidents will not be of the magnitude of Rouge. But if planners want to look to Rouge for a lesson, they will realize that any critical incident can affect persons who were peripherally involved, or were altogether removed from the immediate scene. It is appropriate that the most severely exposed receive the most intense intervention. But the organization will regain its feet, and then its balance, only through the efforts of the employees who are uninjured. It is they who will pick up the pieces in the immediate aftermath of the incident. A trauma response plan with a goal of returning employees and the company to normal levels of functioning as soon as possible must take into account how people recover from trauma, and know the conditions that support and accelerate that recovery.
The good news is that we do not have to search far or spend a fortune to find the resources necessary for recovery; that is, if we view the recovery effort in the context of the pre-existing social community within the organization. People who have been exposed to any ordeal have a natural bond, which is typically stronger than it was before the incident. They will talk about it on their own; this natural tendency, if organized and sanctioned by the company and directed by professionals enables them to make sense of what happened, ventilate their worst fears, and effectively clean their emotional wounds so that they may begin to properly heal.
The ripple effect extends to families who are also affected by the incident. They harbor some of the same feelings of their loved ones-is the plant safe? Will this happen again? Families have a direct tie-in to the recovery effort through their capacity to support the worker when he talks about the incident at home. When spouses understand that something is being done for the employee and are given information about how they can help, they can contribute immeasurably to recovery.
The human problems created by crises and disasters require solutions that are equally human. Too often, plans focus on the inanimate systems and exclude the human. Companies often view injuries from a purely physical standpoint where it is natural to separate "victims" from "survivors," and thereby ignore psychological trauma. This can be understandable, when we consider that approximately half of the states in the U.S. have workers' compensation programs that do not allow claims for psychological injury. In August 1998, the Ohio Supreme Court handed down a decision that has been described as a landmark for employees and a potential curse for employers. The court recognized that a psychological injury may exist without a concurrent physical injury, and should be covered under workers' compensation. Until psychological trauma is covered in Ohio, the court opined that the injured employee who is able to prove employer negligence may sue to recover damages in a civil suit.
How do you prepare and implement your disaster recovery plan so that you not only mitigate your company's liability for psychological trauma, but also create a stronger, more functional organization? By designing a plan with the flexibility to respond to both circumscribed incidents and massive disasters. You want a plan that is structured enough so that you are confident that all the bases are covered, and yet is realistically workable enough to be carried out by people who have other jobs to do.
Here is a ten-item "to do" list for establishing a trauma prevention capacity that will do all this, and yield benefits before a crisis hits:
1. Conduct a stress and trauma risk assessment
This overview gives a good picture of the organization's strengths and weaknesses, from the standpoint of quantitative data. You need to know which are the highest risk areas or departments to appreciate the scope of the problem and to construct the plan. Having hard data is also useful in getting management support for the plan; this is used to substantiate the need for an expanded plan or program, and will provide a baseline for evaluating the effectiveness of any changes you decide to make. Data may be accumulated informally, or through the use of standardized assessment instruments. In any case, you will want to obtain records of all injuries, near-misses, disability claims and illnesses (stress-related and otherwise)-not just OHSA-recordable ones. Be sure to include risk indicators such as substance abuse problems, disciplinary actions, and productivity problems, among others.
Risk categories are assigned numeric values according to type and frequency and a score is assigned, which is later used to recommend next steps. This assessment process assumes that human stress and trauma results from the interaction between person and environment. It is critical to also examine factors that apply to the workplace and, when these contribute to risk, to do what is needed to change these conditions. For example, if employees are given a course in stress reduction techniques to deal with an ineffective, inadequately trained supervisor, any good intentions are lost.
2. Assess the company's current trauma prevention / stress reduction resources
More data accumulation, but this is mostly qualitative, evaluating stress prevention activities in the company. This would include any employee stress management education, human relations training, safety programs, and employee health or EAP services. Information about the quality of these activities is best obtained through employee surveys or by conducting focus groups with employees, and sometimes even family members, suppliers, or customers. In the end, an effective stress reduction program will allow employees to devote more energy to performing their jobs and less to the problems that get in the way of their performance.
3. Compute the risk / resource formula
Regardless of the assessment tools used, this yields an appraisal, or diagnosis, as a basis for recommending and evaluating preventive stress management interventions to strengthen individuals and the organization. The recommendation is highly individualized; there can be no one approach. Interventions may run the gamut from education and training alone, to establishing a trauma response team in organizations or departments in which the risk of physical injury and psychological trauma is high.
4. Form an advisory group
How a task is accomplished will contribute greatly to a positive outcome. The end goal may be to reduce stress and prevent trauma associated with critical incidents and disasters, but it is something else to get employees to recognize a plan as something meaningful, into which they are willing to invest their energy. That it is for them is a good start, but the plan has to distinguish itself from the last "this is good for you" activity that may have turned out to be more spin than substance. The antidote to employee skepticism is an approach that asks for employee input from the outset, one that shows respect for their opinions by actually putting their good ideas into practice. Research shows that employee lack of control is strongly associated with high stress levels.
Assembling a multidisciplinary advisory group, comprised of representatives from such areas as human resources, security, health and safety, legal, public relations, and other key individuals in addition to executive management, is an important step toward gaining a 'buy-in.' This group, which may or may not include the individual(s) who performed the evaluation, has responsibility for recommending the shape of the company's response plan. They have full access to the evaluation data and the evaluator's recommendations. Ideally, this group should have a standing member someone who has been exposed to critical incident stress, and who has made a satisfactory recovery. Such an individual (or two) will be invaluable in keeping the group focused on its mission through their first-hand knowledge of trauma, especially if the company has had the good fortune of not having had a critical incident in its recent history.
5. Establish policy
Without unequivocal support from management, a trauma prevention capability will be doomed to failure. This needs to be specified in any number of policy statements and procedures for managing a crisis, in such areas as funeral leave for non-family members, transitional return to work for traumatized employees, individual counseling outside the EAP or the standard health care benefit. This is an area where prior experience in dealing with traumatic incidents is especially useful, and contingencies need to cover the range of incidents from disaster to small scale crisis.
6. Establish the Trauma Response Team (TRT)
In a critical incident, timely assessment and intervention is essential. Research shows that the optimal intervention "window of opportunity", if we are to mitigate the severity of psychological trauma, is the first 72 hours post-incident. With that time frame, trauma response cannot be an afterthought. Responsibilities should be clearly delineated, and assignments be given to individuals with requisite skills and qualifications. The following basic trauma control functions are a subset of those for general incident management and include, but are not limited to:
- controlling the immediate scene of the incident to limit further exposure;
- assessing the event with regard to its trauma impact on employees;
- evaluating the condition of exposed employees for immediate and later intervention, with ongoing evaluation in prolonged incidents;
- controlling the communication of incident details to outside authorities, the media, and within the organization;
- arranging debriefings so that all affected employees may be cared for;
- attending to basic, primary needs of personnel involved in prolonged recovery efforts (limiting overtime, proper nutrition, etc.);
- notifying families of injured employees, and providing intervention for families as appropriate;
- deciding what critical incident data will be recorded for later evaluation of the plan.
Also organization-specific, the actual TRT configuration of roles and responsibilities depends on a number of factors, such as the assessed level of risk, size of the organization, number of geographic locations, and so on.
7. Promote the program
The expanded plan will directly benefit employees. From the outset, an in-house informational campaign will let them know what is being done and what the company hopes to be accomplished. This approach can serve the following purposes:
- Sets corporate culture goals for enhancing employee health and safety, open communication, and employee participation
- Provides employees with information about general stress management
- Acknowledges company's efforts at examining intrinsic, environmental stress factors
- Shows employees that the company is concerned about them
8. Train the team, supervisors, and managers
Those individuals with the major responsibility for implementing the plan need basic skills in order to recognize and handle their own stress, and to do the same with the employees with whom they interface. This should include:
- general education about the human stress response and how it is manifested
- what can be done about it and what response is expected of them
- what internal and external resources are available to them
- how the revised plan will work-the scenarios to which it will respond
- what to expect in the aftermath of the incident-the "recovery curve"
- role plays and other "hands on" experiences to enhance learning
What good is a training session without a final exam? In the best of all worlds, in which time and money are no object, crisis and disaster scenarios are played out orally. Taking a more conservative approach, the protagonists play out their roles on paper, sitting across a table. This should be at the end of the initial training, with refreshers as needed.
10. Evaluate the plan
Any plan is a work-in-progress; it must have ongoing evaluation. This underscores the importance of constructing a plan that is based on the diagnostic assessment data discussed in steps 1 and 2, and that values employee opinion about its effectiveness.
The plan or program will have identified qualitative and quantitative goals in the form of key performance indicators that correspond to how the organization handles crises, and the effectiveness of stress reduction measures installed by the company. The responsibility for evaluation is delegated to the most appropriate member of the TRT, but the entire team should routinely review incident data and provide regular evaluation reports to management.
By following the trauma prevention plan outlined above, your organization will not only be prepared for the gamut of possible incidents it could face, but will be ready to intervene at any level to mitigate the impact of the incident and accelerate recovery of your human resources. You will know how and where to intervene in the most cost-effective manner, promote team building, reduce costs, increase productivity and improve public relations.
Michael Maly, LPCC, and Carole A. Putt, PhD, are partners in Delta Psychological Services, a consultation practice based in Cleveland, Ohio with a combined 30 years of problem-solving experience. They are experts in managing the human behavior and interpersonal issues in disaster recovery and crisis management. They can be reached at 216.671.4508, (fax) 216.671.6508, or e-mail: firstname.lastname@example.org.