Trauma in the Workplace

1. Trauma in the Workplace William Criss Lott, Ph.D. Clinical and Forensic Psychologist Ridgeland, MS Mardi F. Allen, Ph.D. Clinical Services Liaison Mississippi Department of Mental Health September 10, 2014

2. Trauma in the Workplace A traumatic event is defined as the exposure to or witnessing an extreme event that can be emotionally painful, distressful, shocking or life-threatening. Workplace Trauma may involve: Traumatic events that happen at the workplace Suicide Natural Disasters Accidents Robbery Hostage Situation Death Violence The work itself (medical/crisis response) Traumatic events that happen outside the actual workplace itself involving coworkers, families or communities that effects workplace colleagues.

3. Assessment of Traumatic Events Coping with trauma can be challenging for any workgroup, but while the event is difficult at the time, special consideration to insure emotional and physical recovery of employees is needed. Assessing the Effect: Consider • Consider how pervasive the effect is on staff, the future, productivity and safety. • Consider the signs and symptoms that linger and make it difficult to move on. • Consider coping strategies used or not being used.

4. Responses to Workplace Trauma No matter where the trauma actually occurred, few employees are totally unaffected. Common reactions employees often experience: numbness, shock, disbelief, sadness, anger, fear, denial and/or helplessness. Be Aware of Individual differences: Some employees will exhibit symptoms for days or even weeks, but most will be able to cope and return to a sense of normalcy. Others may not be able to cope. Factors such as proximity to the event, other stressors or mental health status may hinder their ability to cope.

5. How Organizations May Help • Be flexible with expectations, productivity and specific responsibilities. • Provide opportunity for open discussionsor debriefing, as needed. • Listen to staff’s concerns, ideas and strategies for coping or changes. • Encourage self nurturing at all levels. • Provide resources for support such as an Employee Assistance Program (EAP) or other professional help.

6. When Is It Time to Take Action • Symptoms continue too long. • Evidence of problems functioning in daily life. • Increase use of alcohol or other substances, including prescription drugs. • Significant effects on productivity or other work related responsibilities. • Coping strategies are not effective or not utilized. After a reasonable period of time an organization must take the next step ….. REFERRAL FOR PROFESSIONAL HELP IS NECESSARY!

7. Employee Assistance Program • Who provides EAP services? • What are the benefits of EAP services? • For the Organization • For the Employees • What should be included in an EAP contract? • How are EAPs evaluated for effectiveness?

8. Cases from the Field: Some of the most common disorder associated with Trauma are: • Post Traumatic Stress Disorder (PTSD) • Depression • Anxiety • Substance Use Disorder Employees with past traumas are at an increased risk for mental health disorders.

9. Post Traumatic Stress Disorder A person who has been exposed or witnessed a life-threatening event that results in the individual feeling intense emotional responses associated the conscious/unconscious memories of the event may be diagnosed with PTSD. Symptoms of PTSD are usually apparent within three months after the event, but for some, symptoms are not evidenced for several years afterwards. The recurrent involuntary emotional responses associated with PTSD are often intrusive and hinder an individual’s ability to carry out their personal responsibilities. A person suffering from PTSD may feel shame due to their difficulty in moving past the trauma. They may become increasingly more anxious and hyper-vigilant about their surroundings and may avoid any slight reminder in fear of flashbacks and the associated prolonged psychological distress.

10. PTSD These bouts can lead to significant changes in an individual’s personality, social interactions and mood. It can be difficult for family and friends to comprehend the internal turmoil the individual may be experiencing. Often relationships are destroyed and negative behaviors escalate. Alcohol and other substances sometimes become their treatment of choice rather than working with mental health providers.

11. Depression A diagnosis of depression is made when an individual suffers from a constellation of symptoms over a prolonged period of time. When sadness continues beyond what is typical, somewhere around two weeks, or when the sadness becomes more pervasive and interferes with day-to-day activities. Depression may start or is exacerbated by a specific event in one’s environment that initially creates the feelings of sadness. Depression is a chemical imbalance in the brain, similar to other diseases on our body. These chemical imbalances makes the depressed individual have difficulty concentrating, feeling lethargic (no energy), and usually experiencing sleep problems and eating problems. Other symptoms may include feelings of hopeless, helpless, pessimistic, guilty and/or angry. They may withdraw from activities they once enjoyed and from being around others. A depressed individual often has much more trouble making decisions they once could have made with ease. They may cry frequently and even neglect their personal hygiene and appearance. .

12. Depression • No one can just snap out of it. Research evidence supports the combination of talk therapy and medication for the best recovery from depression. Antidepressant medication can change the function of brain neurotransmitters, while talk therapy can help a depressed individual learn coping skills. By understanding that our thoughts and feelings dictate our behavior, a person can learn ways to change their thoughts and feelings which will affect behaviors including making wise decisions in the future.

13. Anxiety disorder Everyone experiences anxiety from time to time. It’s usually described as being nervous, worried, stressed or tense. A diagnosis of Anxiety is made when the physical, psychological and behavioral symptoms are too severe, last to long and interfere with the individual’s ability to carry out daily activities. Symptoms may include rapid heart rate, chest pain, shallow breathing, muscle aches, restlessness, impatience, feeling on edge, sleep disturbance, anger, decreased concentration and memory. The individual often avoids stressful situations such as crowds. He may exhibit specific phobias, have obsessive thoughts and compulsive behaviors. Destructive coping such as the use of alcohol or other substances are often present.

14. Substance Use Disorder Many people consume alcohol with little or no consequences, but for some the effects of alcohol and/or substances become deadly when consumed in large quantities. Individuals who turn to substances to numb their feeling, relieve anxiety or gain confidence are deceived into thinking it’s helpful. With time, substances have to be increased to maintain the same desired effect, resulting in increased dependency. Often confused and desperate, individuals turn to substances to self-medicate; usually with devastating results. Substance abuse greatly increases the risk of suicide.

15. Workplace Trauma • Trauma will effects all organizations. • Investing in employee’s mental and physical well are shown to have positive results in: • Improved Staff Performance • Staff Loyalty • Lower Staff Turnover