CRISIS MANAGEMENT: PREPARING, SUPPORTING & RESPONDING 20 March - - PDF document

1 Alexina Baldini (Psychologist)

20 March 2018

CRISIS MANAGEMENT: PREPARING, SUPPORTING & RESPONDING Workplace Crises

• Internal?

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Workplace Crises

• External?

Preparing for a Crisis

Making the unpredictable able to be anticipated better

• Know your data
• Examine your history
• Keep up with trends – internal and external
• Practice your preparedness
• Involve everyone in the workplace

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• No. of incidents

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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

Resistance Resiliency Recovery

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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

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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

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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

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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

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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…

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Two Types of Distress

Cumulative Stress (Burnout) Critical Incident (Traumatic) Chronic physical illness Symptoms of post- traumatic distress evident Adaptive functioning interrupted Normal coping

• verwhelmed

Cynicism Slow erosion of functioning Compulsive need for change Incomplete work / lateness

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
• rdinary people who have experienced extraordinary events

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Simple Model of Psychological First Aid

Australian Red Cross model for volunteers:

• Look
• Listen
• Link

Victorian Ambulance – MANERS (PFA)

• Minimising exposure
• Acknowledge the event
• Normalising the reactions
• Educating as required
• Returning to normal function OR referring on for additional

resources

• Self care (making sure the helpers look after themselves

also!)

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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

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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

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Information is Paramount

Even if there is no new information…. Providing regular updates is vital! There is no such thing as ‘no information’ People in crisis will fill in any gaps they perceive… Rumours can be rife Information management is a key strategy

This Photo by Unknown Author is licensed under CC BY-NC-SA This Photo by Unknown Author is licensed under CC BY-SA

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

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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!

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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

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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
• r family support
• Provide information and handouts to take home for staff and

family members

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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

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Strategic Planning

• Themes
• Threats
• Target
• Type
• Timing
• Team

(International Critical Incident Stress Association (ICISF) Six T’s)

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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

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Self Care

Physical

Social

Spiritual/ Existential

Psychological

Behavioural

Cognitive

Alexina Baldini

Psychologist 61 3 9663 9168 or 0439 300 203 alexina@enableworkplace.com.au