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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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1000

2000684 711 747 631 542 502 565 432 433 352 446 462

16661970

153814561503106111051198

1508988

13511048

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 CrisisAn 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 overwhelmed

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

ordinary 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 Actions1. 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

or 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 AssociationRecommendation:

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