Stress in the workplace

By ANGELA McCARTHY

Traumatic work events can badly affect your job and personal life, hence the role of critical-incident stress managers.

Workplace events such as finding a colleague crushed by a crane, witnessing a bank or petrol station hold-up or a colleague committing suicide can be emotionally and physically debilitating.

Such incidents often lead to bad dreams, insomnia, irritability, jumpiness, lack of concentration, lack of appetite and tension headaches and, in the worst scenario, post-traumatic stress disorder.

Such responses to trauma can affect the physical and mental well-being of an individual and the workplace, so it is in the interests of employee and employer that such stress is dealt with quickly and effectively.

Enter critical-incident stress management (CISM) teams. These counsellors, psychologists and others try to reduce stress through defusing and debriefing.

Demand for their services is increasing as changes to health and safety and employment legislation put more onus on the employer to ensure worker safety.

The stress-management teams help people to get back on track as soon as possible, says Rod Berry, general manager of EAP Services, who has 40 CISM psychologists and counsellors around the country.

The time it takes to overcome stress depends on the personality of the victim and the severity of the event.

"Some people can move on quickly," says Berry. "Others are affected immediately but are okay in 24 hours. Others get through on the day, then days later fall apart. The idea is to prevent someone three months or one year later coming in and saying, 'I still feel affected by the robbery. I can't bear to be in the bank after 3pm or I panic whenever I see someone with shifty eyes'."

Ruth Hewlett, counsellor and manager of the Workplace Support (northern) stress-management team, says it offers psychological first aid for people exposed to potentially traumatic events to minimise long-term trauma.

Workplace Support offers an 0800 phone contact to organisations with CISM contracts, ranging from factories and industrial sites to service industries.

On average they receive four to six calls a month, but may well get two in one night.

"We make up teams depending on the incident, but usually at least two people are involved, so if someone is very distressed they can be taken out of the group situation," says Hewlett.

When a CISM team is called within two to 24 hours, they organise a "defusing". If the time lapse is longer - anything up to 72 hours - they run a debriefing. Whether defusing or debriefing, early intervention is the key, she says.

"However, some people don't want to have to talk, and if that is the case, the team pick that up and honour it."

The critical-incident manager's role is to set up a confidential, safe setting to help staff come to terms with what has happened. Ground rules are set. There is no blaming or putting down.

"We ask people how they are feeling, what they saw and what happened. We have to mediate and manage the responses so that everyone gets a turn to talk it out," says Hewlett.

She says it is important that people realise it is normal to have strong reactions such as sadness, fear, worry, guilt. It is also important to realise that an incident may trigger memories of other traumas or losses.

Groups are always given contact numbers so people can seek more help if needed.

Because debriefings are 24 to 72 hours after theincident, those involved usually have more information about the event and have had time to think. So debriefings are a bit more formal, and include discussing reactions people may be experiencing and why such reactions occur.

A stress team manager needs to be empathetic, astute and perceptive of people's body language and how they're feeling, says Hewlett.

"You also need to be unshockable, someone who has worked through issues in your own life. You can't be carrying your own grief over a past trauma."

And of course the team itself needs support, says Hewlett.

"We often see and hear horrific things, so we also have to have our own debriefing and unloading back at the office. All staff have supervision."

Organisations such as EAP Services and Workplace Support bring outside stress team expertise into organisations on request. Others, like the New Zealand Fire Service, prefer in-house stress management. Roy Warren, new clinical director of the Fire Service's CISM and West Auckland fire safety officer, says peers already know the stress of rosters and attending nasty events. "You don't have to explain all that."

The Fire Service has offered in-house stress management since the early90s. This was formally recognised last year through a comprehensive CISM programme, including national standards and training.

Newly appointed national CISM co-ordinator and firefighter Colin Littlewood became involved because of his own need to talk things through after attending emergencies.

"I was feeling horrible dealing with a dismembered body or something like that, but felt I couldn't talk about it because no one else was. It was wonderful to find out about the possibilities of CISM and get it happening in the Fire Service."

He says voluntary participation is a key.

"Some people aren't interested in something they perceive as touchy-feely and don't feel the need to talk. We recognise that, but also recognise firefighters will be affected by a critical incident at times. We know of cases where people have got sick because of the cumulative effect of what they've seen and done," says Littlewood.

He says those who have experienced stress management in his Hastings region have commented on the relief it brings to know that it is normal not to be able to cope sometimes.

"They've said things like they couldn't get something out of their head, so they turned to alcohol, or weren't sleeping, having silly arguments. It is great for them to go through the process, identify their position and normalise it."

The Fire Service in-house model includes peer to peer work. Defusings are run by trained peer supporters on return to the station from an abnormal event. Where necessary, debriefings occur later led by specialists in the service, such as Warren, who studied psychology, then trained in counselling, around his station roster. Peer supporters are chosen for their empathy and the respect they have earned from colleagues, says Warren. They offer a listening ear, but are trained to refer to outside help if they sense a more serious problem."

"The CISM strategies also include pre-interventions, such as how to recognise and manage stress on a day to day level."

The effectiveness of CISM has been questioned in international discussion, and Warren feels this is because it is difficult to show evidence of results of defusing and debriefing.

Warren also provides stress-management services to prisons, hospitals and ambulance drivers. "Their jobs are similar".

Warren's bottom line is that some events can be life-changing and cause negative behavioural changes at work and in relationships.

"So we believe this is something we can do to help. I think it is more harmful to not do anything. CISM creates a safety net. That alone has value because they know there is help if they need it."

Workplace Support
EAP Services Limited
New Zealand Fire Service