Escape, hide, fight back. Those are the suggested reactions — in order — to an active shooter situation provided to employees of one of the nation’s largest supermarket chains. In a dramatic, realistic-looking video, a man with a gun walks into a grocery store and begins shooting.
The fact that the video is part of required training for all company employees underscores the very real threat of violence in many workplaces. While employers can and should take any and all precautions to prevent violent incidents from occurring, there are still situations that arise all too often.
One thing companies can do is prevent such a situation from escalating into long term claims involving post traumatic stress disorder. Identifying and intervening early after a workplace trauma will help ensure employees recover and get back to work as quickly as possible.
Who Gets PTSD
Just about everyone will have stressful reactions to a traumatic event, such as workplace violence. But the vast majority will recover and have no symptoms within several months.
A segment of the population — around 7 to12 percent will have a more difficult time recovering. They may improve, only to see their symptoms recur with a new stressor. Some may develop a lifelong illness that affects every aspect of their lives.
Diagnosing PTSD is not an exact science, as its symptoms often mirror other conditions. Generally, experts say having the following for more than one month are clues:
- Reliving the event. Internal or external cues that resemble any aspect of the incident may cause images, perceptions, dreams, or dissociative flashback episodes.
- Avoiding certain stimuli. The employee may refuse to discuss the incident, or avoid places or people associated with it, including coworkers.
- No interest in participating in group activities.
- Feeling detached from others.
- Emotional overload. The worker may be irritable or have outbursts of anger, or trouble concentrating, and may be easily startled.
- Physical symptoms. Headaches, high blood pressure or gastrointestinal issues may be present as well.
The risk of developing PTSD depends on many factors, including the presence of psychosocial issues. Even many of those who recover slowly and are at increased risk can be helped and recover, often within 8 to 12 weeks. The key is to get them into appropriate treatment as soon as possible.
Traumatic incidents can happen in any industry, but are especially prevalent in certain ones. Employers in fields such as healthcare and retail are wise to consider implementing a post trauma crisis intervention protocol to help employees immediately after a traumatic event.
The plan should include the following elements:
- Early contact. Within 24 hours of a workplace trauma, employees should be contacted by a trained trauma specialist. That contact should continue until there is a face-to-face meeting for acute psychological intervention. Responding early shows the employer cares about the employees, which can help prevent delayed recovery and require less use of medical and mental health services.
- Face-to-face assessment. A psychologist should perform an assessment and begin trauma recovery of care. In most cases, no more than three visits will be needed before the employee can return to work.
- PTSD determination. If symptoms persist for more than one month, the psychologist should conduct a criterion-based PTSD diagnostic assessment to help determine whether the workplace trauma was the actual cause of the employee’s symptoms.
- Trauma interventions. An employee diagnosed with PTSD may find his work and daily living is disrupted. Increased absenteeism and decreased productivity may be among the results. Once a PTSD determination is made, the worker should be referred for specific treatment.
- Long, drawn-out therapies are not necessarily needed to help injured workers with PTSD. Cognitive behavioral therapy, for example, has been shown to help. It includes principles of learning and conditioning to help injured workers change their negative beliefs about themselves while gradually exposing them to the thoughts and situations they fear. Exposure/desensitization therapy is also effective in treating PTSD. This may involve imaginal exposure, where the worker is exposed to the traumatic event through mental imagery; or in vivo therapy, in which the worker confronts the actual scene or similar events associated with the trauma.
- Short term use of certain medications may be helpful, depending on the severity of the symptoms and the worker’s preference. Some antidepressants have been approved by the Food and Drug Administration to treat PTSD. However, benzodiazepines such as Valium and Klonopin should be avoided, as there is no evidence they are beneficial and can even increase the likelihood of developing PTSD when they are prescribed in the acute aftermath of trauma exposure.
Workplace trauma can take a devastating toll on all affected employees and an organization as a whole. But it does not need to result in long term disabilities.
The vast majority of people who are exposed to traumatic events recover with limited help. Of those who need further follow up, many will be able to return to work and function. Employers who are proactive about identifying and intervening can better protect their workers and their bottom lines.
Author Michael Stack, CEO Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .
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