Employee assistance programmes (EAPs) work with a wide range of organisations, any of which might experience a crisis or traumatic event at any time and turn to their EAP for support. It is common for organisations well versed in crisis scenario management to run simulations to test the ‘system’ and its resilience to such events. However, when a crisis does occur and the organisation contacts its EAP, a specialist crisis consultant will need to ascertain the current crisis status, including the scale of the event, the location, whether casualties are involved and if the emergency services are present.
Initial contact supports the organisation, providing a calm and rational outside view of the situation while developing a plan. The support provided in the event of a crisis is determined by the type of event and its scale, and therefore every crisis event is individual and should be treated as such. While a relatively small event might require the presence of a single on-site counsellor after forty-eight hours, a larger one might require immediate on-site support by a specialist team at a reception centre, hospital or the event site. The EAP will work with the organisation to determine and agree the appropriate level of support. Crisis events might unfold over time, as information becomes available, and a fuller understanding of the event evolves. For this reason, EAPs have to be flexible and alert to potential shifts in the situation, and support the organisation during each stage.
Watchful waiting
It is not uncommon for an organisation to demand on-site support immediately. While this might be appropriate for a large-scale event, this is not the case for most events. Individuals may require time to process what has happened to them, or what they have witnessed, and immediate support for their physical and safety needs is far more important than providing psychological support. Counsellors on site immediately after an incident tend to provide a welfare type of approach rather than actual counselling. Frantic demands from the organisation for immediate on-site support need careful negotiation by the EAP, to alleviate anxiety. It is also important to consider how social media plays a part in visibility and reactions to a situation: sharing images, thoughts and comments has accelerated and deepened reactions to events and can impact on the decision to wait and provide support after forty-eight to seventy-two hours.
On-site support
The EAP will source affiliates who are experienced in crisis support, who are normally well known, and with whom it has worked before. Ideally, affiliates should be sourced as close to the event site as possible, to reduce travel. The EAP consultants will brief the affiliate on the event and on what is to be expected. This might be to run a group psycho-education session for employees who were directly involved, witnessed or who have been affected by the event. Group sessions should not be mandatory, but strongly encouraged, and there may be more than one session during the EAP affiliate’s attendance. Walking into a room of people, who are potentially traumatised by what might have been a horrible event, is a tough situation for any counsellor, and not suited to everyone.
Group sessions might last from forty-five minutes to a couple of hours, depending on the group, which should ideally be limited to around twelve participants. The aim is to create a calm environment, explain what might happen to people over the coming hours, days and weeks as a result of this crisis event, and the reactions and emotions that might occur. Maintaining control of a room of people is quite a skill, and experience is necessary. This can be gained by accompanying another counsellor to an event to observe directly how they work. Normalising reactions is an important part of the process and we avoid providing group debriefing sessions asking individuals to tell their story of what happened and how they felt. The general industry view is that this potentially might traumatise others and re-traumatise the story teller. However, social media is very much an uncontrolled factor to consider both now, and in the future.
Getting the basics right
Arrangements for the on-site session should have been agreed by the EAP and communicated before the event – it is important to know where to go, how to get on site and who to contact. If the affiliate is driving, for example, they may need to make arrangements for parking, and this may be difficult if the site itself is compromised. Affiliates should arrive early and prepare the room, greet attendees as they arrive, and make them feel comfortable.
Counsellors looking to get into this type of work need to gain experience in dealing with individual trauma, but also in running group sessions in very difficult situations. In the room everyone will be looking to them as the expert to know what to say and do. This responsibility at a time of crisis should be taken seriously and is an important role that affiliate counsellors can undertake when trauma strikes.
Eugene Farrell is Head of Trauma Support Services at AXA PPP healthcare. He is a board member of EAPA UK and has worked in EAP and mental health for over twenty years, with experience in planning for critical incidents and managing large- and small-scale trauma events. Email: eugene.farrell@axa-ppp.co.uk Website: www.eapa.org.uk