Coping with a Critical Incident

Traumatic events such as the recent terror attack in Nairobi, sudden death of a colleague, a workplace accident, armed robbery, a natural disaster, or other crisis situations can cause disruptions for organizations and their employees.  Such incidences can bring stress, anxiety and other issues for employees, where they may struggle to regain a sense of normalcy and safety.

Following trauma exposure, an individual may experience both physical and psychological reactions.  Some of the reactions immediately follow the critical incident, while others surface over time, developing into long term reactions.  If these reactions become chronic experiences, the individual may turn to substance abuse to cope and cover them.  Lower productivity as well as absenteeism, can increase if individuals have not been empowered with coping and management skills following the critical incident.  

Critical incident stress management provides support to assist recovery following exposure to abnormal events and is based on a series of strategies that aim at minimizing any adverse emotional reaction the person may be experiencing.  Such strategies include:

1. Preparing employees for a possible critical incident in workplace
   1. Establish contacts with professional Counselors;
   2. Provide training for managers in the provision of Psychological First Aid;
   3. Assess the work environment for the potential for critical incidents;
   4. In consultation with employees, develop procedures for responding to critical incidents
   5. Make sure that employees are familiar with these procedures

2. Demobilization – rest, information and time out

Critical incidents may trigger a wide range of physical and psychological symptoms, including increased heart rate, increased blood pressure and anxiety.  Demobilization  (rest, information and time out – RIT) is a way of calming employees following a critical incident and ensuring that their immediate needs are met.   Demobilization includes:

1. A meeting for those involved as soon as possible
2. Summarize the incident and clarify uncertainties
3. Invite questions and discuss issues of concern
4. Show care and support, including the provision of Psychological First Aid
5. Draw up a plan of action
6. Make short term arrangements for work responsibilities

3. Defusing through immediate small group support

Immediate small group support is conducted by a trained professional and is designed to bring the experience of the incident to a conclusion and provide immediate personal support.  The aim is to stabilize responses of workers involved in the incident and provide opportunity for them to express any immediate concerns.  This step should take place within 12 hours of the incident.  Strategies include: 

1. Review the event
2. Clarify questions and concerns
3. Encourage employees to talk about what happened
4. Identify current needs
5. Offer advice and information on additional support
6. Arrange debriefing and follow up sessions 

4. Debriefing through powerful event group support

Powerful event group support is usually carried out within 3-7 days of the critical incident, when workers have had enough time to take in the experience.  Debriefing is a structured, voluntary discussion aimed at pulling an abnormal event into perspective.  It offers workers clarify their experience and assists to establish a process for recovery.  Trained professionals help the employees explore and understand a range of issues, including: 

1. The sequence of events
2. The causes and consequences
3. Each person’s experience
4. Any memories triggered by the incident
5. Normal psychological reactions to critical incidents
6. Methods to manage emotional responses resulting from the critical incident

5. Follow up Support 

Responses to critical incident can develop over time and some employees may require follow-up support.  Perspectives may change after the first debriefing session and additional sessions may be needed to focus on new aspects of the incident or stress reactions.  It is also common for critical incidents to bring up a range of personal issues for workers.  Short-term counseling may be required to prevent further difficulties.  Where counseling sessions identify other or more complex needs, it may be important to refer the employee to an appropriate service for additional support