While general EAP services are designed to address personal employee challenges on a day-to-day basis, the acute needs of employees and organisations after a critical incident such as natural disaster, violence, accidents, or an employee death, are better addressed by a specialised EAP-driven Critical Incident Stress Management Programme (CISM).
Critical Incident Stress Management
Critical incidents have the potential to create significant distress and overwhelm the usual coping mechanisms, causing adverse physical, emotional and behavioural symptoms in employees as well as within management, who are usually expected to fulfil several roles in terms of overseeing an organisation’s return to normal after a traumatic event.
An EAP-driven CSIM programme is a tool in management’s ability to strike a balance in managing the workforce while assisting in preparedness and recovery, before, during and after a workplace trauma. EAP’s CISM protocols comprise a range of crisis intervention services, a continuum that typically includes pre-crisis training, individual crisis counselling, group debriefing, and post-incident referral for both primary and secondary victims.
The CISM continuum includes EAP involvement with an organisation’s pre-incident planning in the areas of assessing risk, working with human resources staff to develop policy and educating managers and employees on critical incident response and disaster preparedness.
- EAP professionals provide upfront critical incident orientation and training to employees, managers, supervisors and union representatives, which includes training in terms of resilience along with being prepared for responding to workplace critical incidents.
- EAP professionals are also in a unique position to be able to plan and develop relationships with other providers in the critical incident community, which include emergency response personnel and local hospitals. 1
Support during an incident
EAP professionals have a nominal role to play during a critical incident as the first responders are often building security or safety and emergency personnel.
- After a safe environment has been restored the EAP professional’s role is mostly one of providing coordination and guidance, including working collaboratively with management to help ensure the most appropriate response.
- EAP professionals play a critical role in working as partners or consultants with management as they strive toward workforce stabilisation and recovery.
Support in the aftermath on an incident
Following a workplace critical incident, the EAP professional typically takes on a more visible role working with management to assess the needs of employees and identifying the appropriate services to provide. These include:
- Critical Incident Stress Debriefing (CISD)
The most recognised element of CISM is the debriefing, which is a structured on-site individual or group intervention that occurs shortly after the incident, led by experienced counsellors and providing individuals with an opportunity to discuss their feelings and thoughts in a supportive and rational environment. Employees learn about stress reactions and symptoms and are provided with additional skills and resources that can help them with the healing process. 2
Within the context of CISM, debriefing is not psychotherapy but is rather a method for alleviating common stress reactions triggered by critical events. It is a precise, 7-phase, small group, supportive crisis intervention process as follows:
- Introduction: To introduce the intervention team members, explain the process and set expectations.
- Facts: To describe the traumatic event from each participant’s perspective on a cognitive, or thinking, level.
- Thoughts: To allow participants to describe cognitive reactions and to transition to emotional reactions.
- Reactions: To identify the most traumatic aspect of the event for the participants and identify emotional reactions.
- Symptoms: To identify personal symptoms of distress and transition back to a cognitive level.
- Teaching: To educate the participants regarding normal reactions and provide adaptive coping mechanisms such as stress management, providing a cognitive anchor.
- Re-entry: To clarify any ambiguities, prepare for termination and facilitate “psychological closure”
- Long-term follow-up
The CISM continuum encourages EAP professionals to provide follow-up services for employees who are more severely affected by the critical incident, including one-on-one crisis counselling, crisis interventions for families, and aftercare follow-up and referral procedures. These are designed to:
- lessen the impact of the critical incident,
- normalise instinctive reactions to the incident,
- encourage the natural recovery process,
- restore the adaptive functioning skills of the person and/or group, and
- determine the need for further supportive services or therapy.
- Post-incident evaluation
After a workplace critical incident response is over, the EAP professional’s role involves supporting research and evaluation efforts aimed at determining the overall effectiveness of the response, then consulting with management and human resources to improve the organisation’s disaster response plan.3