Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance.

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

Organisations often seek to provide some form of psychosocial intervention after a traumatic event in the workplace.Previous reviews have contraindicated particular forms of 'debriefing', however, the evidence for post-incident psychosocial interventions in the workplace has not previously been systematically reviewed.Research evidence was generally of poor quality with limited evidence of effectiveness and clinical guidelines were inconsistent with the evidence. Nevertheless, research did not demonstrate harm from most established interventions and support was valued by workers.

The psychological impact of COVID-19 on police officers.

Police officers play an important role in protecting the community. During the COVID-19 pandemic, their role has posed a serious threat to their physical and psychological health and well-being. This study was designed to assess the prevalence of anxiety, depression, PTSD and compassion fatigue in police officers and to identify the factors that predict COVID-19-related physical and mental well-being. As part of a regular health surveillance programme, 3863 police officers recorded their physical exposure to COVID-19 and the extent to which COVID-19 had affected their psychological well-being. The study provides suggestions on developing evidence-based well-being interventions for policing.

Compassion fatigue: experiences in occupational health, human resources, counselling and police.

BACKGROUND: This study examines the impact that working with distressed employees, clients and members of the public has on four caring professions: occupational health advisors (OHAs), human resource advisors (HRs), counsellors (CLs) and family liaison officers (FLOs). AIMS: To measure the levels of compassion fatigue in caring professions and to identify the mechanisms that lead to increased levels of personal growth. METHODS: Two hundred and seventy-six professionals (64 HRs, 53 OHAs, 114 CLs and 45 FLOs) completed the Carer Belief Inventory (CBI) (Tehrani, N. The cost of caring-the impact of secondary trauma on assumptions values and beliefs. Couns Psychol Q 2007;20:1-15.) and Short-Form of the Goldberg questionnaire (Goldberg D, Bridges K, Duncan-Jones P, Grayson D. Detecting anxiety and depression in a general medical setting. Br Med J 1988;297:897-899). The participants in the study were attendees at presentations or training courses on employee wellbeing. Survey involved in the study also measured sources of support and coping mechanism. RESULTS: There were few differences in the level of negative beliefs between groups, although CLs were found to experience more feelings of isolation and FLOs and CLs were more likely to believe that there was no justice in the world. OHAs, CLs and FLOs were significantly more likely to demonstrate personal growth than HRs. Reflection on the work facilitated through professional or peer supervision and a healthy lifestyle was found to be associated with higher levels of personal growth and satisfaction with their performance at work. CONCLUSIONS: The results suggest that the provision of professional or peer supervision may be helpful in increasing reflection and 'sense making' leading to personal development and growth. Other forms of support that were found to be helpful included taking exercise, healthy eating and engaging in a hobby.

Early Post-trauma Interventions in Organizations: A Scoping Review.

BACKGROUND: In some organizations, traumatic events via direct or indirect exposure are routine experiences. The National Institute for Health and Care Excellence reviews (2005; 2018) of post-traumatic stress disorder management in primary and secondary care did not address early interventions for trauma within emergency response organizations. AIMS: This scoping review was designed to identify research which evaluates the use of early interventions in emergency and other high-risk organizations following exposure to primary or secondary trauma and to report on the effectiveness of the early intervention models in common use. METHODS: A scoping review was conducted to examine early interventions for workers exposed to trauma, including emergency response, military, and humanitarian aid. Relevant data were extracted from the included studies and the outcomes were assessed using meta-ethnography. RESULTS: Fifty studies of mixed quality met the inclusion criteria for this review. A synthesis of study outcomes found that early interventions help emergency responders to manage post-incident trauma when they are delivered in a manner that (a) respects distinct organizational culture, (b) is supported by organizations and senior management, and (c) harnesses existing social cohesion and peer support systems within teams. CONCLUSION: This review demonstrates that early interventions support emergency responders following exposure to trauma when these are tailored to the needs of the population, are supported by the host organization, and harness existing social cohesion and peer support processes within a team or unit. A number of recommendations for the delivery and evaluation of early interventions for psychological trauma in emergency response organizations were made.

Workplace trauma and the law.

The law places increasing responsibilities on organizations to protect its workforce from psychological injury. This paper looks at the development of British law relating to traumatic stress and explores a growing concern of clinicians that the law and the legal processes themselves may increase the psychological injury of victims of traumatic stress. The statutory requirement for organizations to provide effective support for employees following a traumatic incident is enshrined in law. However organizations are confused by the conflicting statements on the effectiveness of debriefing and trauma counselling.