Good evening,
Post Traumatic Stress disorder is a widely recognised consequence of being involved in distressing or shocking incidents. Clearly certain professions are more likely to be involved in dealing with such incidents, and there are recognised techniques that can be used to help defuse or limit the long term impact of such stress. An example would be Critical Incident Debriefing.

However, the use of such techniques is clearly not written into any legislation (unless you can argue otherwise), so what business case arguments would you consider using to either introduce such a service, or save such a service from the financial cutbacks?

Thanks

I don't believe in the one size fits all to such things. Although we tend to preach 'talking about it' to everyone as a way of coping and dealing with traumatic incidents, in fact that is not everyones preferred method of coping. Some people cope better with just putting it behind them and not talking about it. So for me having a blanket approach and saying everyone neneds to face it head on may help some but may also actually make it worse for others.

Let it be known that a service is available for those that request it but don't subject everyone to facing something that they may not be want to.

On the legal aspect I would say the argument is back to Sec 2(1) HSWA74 and the focus on health, safety and welfare i.e. health and welfare affected by mental wellbeing.

Is the risk forseeable again dependant on your type of work and location, for me most definately due to the working environment.

As for the controls and services on offer, you cannot force people to use services but you can offer it and make it available, breifings on stress/PTSD etc that communicate the message.

But I do see your predicament.

And Claire's comment about not making it mandatory has just reminded me that one of the clinical concerns was around who made the decisions about relevance to any specific group, individual or incident. A one size fits all approach will be less effective and have a greater risk of harm.
Rather like going to the dentist; you may not want to go but you may need to go for your own health and well being. On the other hand there is little point in going to the dentist if you have heart problems.

Like most things it is not as simple as some providers would have you believe.

p48

Cliveg

Reactively, the constructive comments of others applies regarding monitoring and offering specialist services of support qualitiatively.

The risks of not having a coherent policy in place are non-trivial. I say this not only from experience as a counsellor of survivors of a vareity of catastropic incidents, some of them fatal and involving prosecutions, but also with particular regard for the Tracy Ann Daws (v. Intel) case.

This turned from a case of work overload (as consistently argued not only by the claimant but by her manager) into a suicide attempt after fourteen (14) claims by Daws for valid risk assessment. The senior management, OSH and HR repeatedly failed to conduct a risk assessment with due competence . The Court of Appeal backed Daws' refusal to accept counselling as a suitable and sufficient form of response to her stress (although a competent risk assessment sho, recognised she had entered the stage of trauma not later than her third in-company request).

In terms of policy development, it's worth using the White Paper on Health and Wellbeing at Work published earlier this year by the BPS Division of Occupational Psychology. It includes economic arguments and can be downloaded free from their website. With adequate accounting, the economic case for appropriately designed and managed response is usually overwhelming.

Cliveg

It occurs to me how you may need to consider how you write about the context of access to 'post-trauma' counselling in drafting a policy.

One context is where an employee is unable to make a rational decision and declines to access counselling. In such a situation, depending on the incident, a company may well have a responsibility to press an employee for assessment. I was faced with this with an manager who was a victim of a mid-air collision and later obliged to identify the corpses of his dead companions. He told me long after he had returned to robust health that he had decided how he was going to kill himself until the company's HR manager effectively obliged him to see me and he then felt positively curious about the prospect of counselling one-to-one and in a very small group of executive jobseekers, as he was unwilling and unable to return to demands of his previous job. The point is simply that on occasions the employer may have an overriding responsibility to ensure that the risk to the employee's health is controlled in a suitable and sufficient manner, even when the employee feels somewhat reluctant; this still enables the employee to decline the offer after a well-documented risk assessment by a person with the requisite competence. In this incident, had the employee carried out his intention to kill himself, the company would have been open to a hefty claim if they had failed to press him to have an assessment.

Another context is where a whole branch of a company is traumatised. This arose in an incident in which a very popular employee was killed on her way to work in a car driven by another employee (who was later prosecuted and convicted for dangerous driving). Group counselling was arranged at the start of the working day on two occasions for all interested employees; participation was on a voluntary basis.

My opinion - Leave it (them) alone. That should be the automatic fall-back choice. I have had a few (very few, fortunately) "traumatic" experiences in my life. I most certainly do not wish to bring them back to mind by "talking about it" I would much rather just forget it. Totally. I don't even wish to "deal with it".

Living over and over again a mind-scarring event can only, imho, rip open the scar and deepen the wound.

Some few people may not be able to deal with it and I agree with a previous respondant that a week or two is about right before offering counselling.

And how many of these jack-leg "counsellors" really know what they are doing ? And are not just repeating something they heard in a three-day seminar ?

Leave it.

Merv

Kieran

I don't know why you are getting on your high horse (again) with regards to Merv's comments, he is merely expressing an opinion. I may not fully agree with his comments, or others, but he is entitled to his opinion. I think you would do well to do less academic pontificating and to read other people's posts more objectively. Writing in plain English would also be advantageous to the uneducated like myself.

Good day.

The forces banned Critical Incident Stress De-briefing in 2000, as studies by top boffins showed that they had no significant value, and also could lead to psychological harm. TRiM was introduced and is now seen as a normal procedure and appears to work very well.

I have completed a Trauma Stress Management course in a previous incarnation, and attended many CISD's and I have to admit they never really did any good. Especially as most of them were carried out approx 1 hour after the incident when we were still on the emotional rollercoaster....

Further research over the weekend confirms that one size is unlikely to fit all, and NICE have published a detailed report on it all that states that they don't like critical incident debriefing - but do support other treatments. Their view was that 70% or so will recover if left to their own devices, and this potentially does add weight to the option of targetting resources at those who won't cope - if you can identify who they are.
It does appear there are going to be some situations where group debrief's of some kind are the right thing to do, such as a fatality where a number of work colleagues were involved in the incident and the aftermath (though not as part of the cause).
I'll explore Stevie40's idea, I don't know what our insurer will provide, and we certainly pay enough for their services! Thanks for that one.