EAP Critical Incident Response - EASNA · 4/26/2015 1 EAP Critical Incident Response OPERATIONALIZING RESILIENCE Robert Intveld, LCSW, CEAP Robert Douglas and Associates [email protected]

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EAP Critical Incident Response

OPERATIONALIZING RESILIENCE

Robert Intveld, LCSW, CEAPRobert Douglas and Associates

[email protected]

732-531-1226

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Personal Attributes

Optimism

Altruism

Moral compass

Faith and Spirituality

Humor

Role models

Social Supports

Mission in Life

750 Vietnam vets held as POWs for 6-8 years, who did not develop PTSD identified critical characteristics of resilience that were key to

their survival:

Training

Hardiness

Perseverance

Mindfulness

Problem solving

Decisiveness

Pursue meaning

Pursue growth

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Organizational Attributes

Proactive employees

Clear mission, goals, and values

Encourages opportunities to influence change

Clear communication

Nonjudgmental

Emphasizes learning

Rewards high performance

Recognition

Open communication

Supportive colleagues

Clear responsibilities

Ethical environment

Sense of control

Job security

Supportive management

Connectedness among departments

Organizational resilience = The ability for a business or industry, including its employees, to bounce back from adversity and change.

SAMHSA

Demonstrating Resilience

Vulnerability Factors Inhibiting Resilience

Protective Factors Enhancing Resilience

Facilitators of Resilience

Individual Resilience •Optimism

•Flexibility •Self-confidence •Competence •Insightfulness •Perseverance •Perspective •Self-control •Sociability

•Poor social skills •Poor problem solving •Lack of empathy •Family violence •Abuse or neglect •Divorce or partner breakup •Death or loss •Lack of social support

•Social competence •Problem-solving skills •Good coping skills •Empathy •Secure or stable family •Supportive relationships •Intellectual abilities •Self-efficacy •Communication skills

•Individuals •Parents •Grandparents •Caregivers •Children •Adolescents •Friends •Partners •Spouses •Teachers •Faith Community

SAMHSA.gov; (Kelly, 2007)

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Demonstrating Resilience

Vulnerability Factors Inhibiting Resilience

Protective Factors Enhancing Resilience

Facilitators of Resilience

Org.Resilience •Proactive

employees •Clear mission, goals, and values •Encourages opportunities to influence change •Clear communication •Nonjudgmental •Emphasizes learning •Rewards high performance

•Unclear Expectations •Conflicted expectations •Threat to job security •Lack of personal control •Hostile atmosphere •Defensive atmosphere •Unethical environment •Lack of communication

•Open communication •Supportive colleagues •Clear responsibilities •Ethical environment •Sense of control •Job security •Supportive management •Connectedness among departments •Recognition

•Employers •Managers •Directors •Employees •EAPs •Other businesses

SAMHSA.gov; (Kelly, 2007)

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Resilience Defined

According to the American Psychological Association:

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant sources of stress -- such as family and relationship problems, serious health problems, or workplace and financial stressors. It means "bouncing back" from difficult experiences.

Many studies show that the primary factor in resilience is having caring and supportive relationships within and outside the family. Relationships that create love and trust, provide role models, and offer encouragement and reassurance help bolster a person's resilience.

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Confront Adversity

Rebound Direction

Active Coping

Resilience

Activating Resilience

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EAP Critical

Incident Response

EAPEmployee

Organization

Multi-Systemic Resiliency Approach

Professional

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EAP Critical

Incident Response

EAPEmployee

Organization

Multi-Systemic Resiliency Approach

Professional

Strength Strength

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EAP CIR Strategy

Engage in a process that helps stabilize and restore connections to the organizational and individual

attributes of resilience.

Before we do anything we must assess where our guidance is needed.

“Any early intervention approach should be based on accurate and current assessment of need prior to intervention.”

(International Society for Traumatic Stress Studies, 2009)

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Pre-Incident Partnership

Seat at the table

Pre-incident Training

•Prevention

•Leadership role

•Normal Reactions

•Resiliency

•Organizational expectations

•EAP role

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Management Consultation Goals

Establish partnership (connection)

Assess impact◦ Workplace

◦ Employee

Assess ability to reestablish safety

Assess resilience

Set the stage

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Management Consultation

Organizational Assessment

•Establish Partnership with caller- Org. representative• Empower

• Compliment

• Avoid adversarial interactions

•Assess impact to workplace• Physical damage

• Product integrity

• Return to work

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Management Consultation

Organizational Assessment (Con’t)

•Actions to restore safety• Strength of contingency plan

• Leadership assembly

• Communications

•Change in the perception of safety

•Gaps

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Zero to Eight

PHYSICAL ENVIRONMENT

• Threat removed

• Security present

• First responders activated

• Visible leadership

• Communications restored

• Concrete resources added

PSYCHOLOGICAL

• Perception of safety

• Stress response deactivated/burned out

• Systemic support

• Normalize reactions- PFA

Goal: Create the conditions to restore safety

The trajectory of resilience begins from the point of safety

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Management Consultation

Employee Impact Assessment

•Medical attention

•Proximity

•Interpretation

•Progression• Time of impact

• Time of report

• Time of arrival

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Management Consultation

Resilience Assessment

•Perception of safety restored

•Visible Leadership

•Communications

•Permissions

•Collegial support

•Employee reactions to leadership (connection strength)

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EAP Interventions

Organizational Employee

• Onsite Leadership Consultation

• Messaging• Create and staff

safe locations• Corporate

Briefing• 1:1 Access• Onsite outreach

• Psychological First Aid

• Corporate Briefings

• 1:1/ 1:2 Access• Resiliency Groups• Onsite outreach• Handouts

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Educate on listening

Educate on talking points◦ Appropriate/added

resources◦ Benefits/emergency

funds◦ Optimism

Regular updates/briefings

After hours contact

Increase visibility

Visit “huddles”

Roll up sleeves

Seek volunteers for side projects

Feed them

EAP introductions

Positioning Leadership“What can I do?”

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Leadership MessagingEducate on the importance of leadership developing and delivering an effective message◦ Facts

◦ Safety

◦ Involvement of emergency or law enforcement

◦ Operational issues and restoring order, routine

◦ EAP Services (why here and how to contact) and that participation is voluntary

◦ Contact Information: leadership, HR, Benefits, EAP, relevant community resources

◦ Positive message of hope, support, safety, and expectation of recovery

◦ “We will get through this together.”

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Employee Interventions

•Entry point is one of the temporal dimensions:• Confronting adversity

•Rebound direction

•Active coping

•Solutions to their agenda• Identifying and reconnecting to resilient attributes

(our agenda)

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Screen for PFA

Dazed- constriction of the field of consciousness and narrow attention

Intrusion- spontaneous memories

Avoidance- potential triggering events

Hypervigilance/ Hyperarousal

Poor mood clarity

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Temporal Dimensions of Resilience

Confront Adversity

Rebound Direction

Active Coping

• What are we rebounding to?

• Priorities• Attribute Guides

• Purpose in life

• Spiritual• Moral

Code/Values• Optimism

• Assess for barriers• Normal

reactions• Avoidance

• Mindfulness• Mood clarity• Pursuit of

understanding• Evaluating

choices

• Healthy Appraisals

• Reframes• Engage with

significant others

• Problem solving

• Stress Mgmt.

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1:1 Access

From the Handbook of Preventative Psychiatry; Traumatic Events and PTSD Prevention, study of resilience in survivor

populations:

“The perception of personal and social resources to aid in coping in the post-trauma recovery

environment.”

(Wilson 1995)

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1:1 and Group AccessKey strategy- Reconnecting to resilient attributes

Key activity- Listening

Optimism Able to reappraise situations and their impact on them

that initially appear to be negative

Mission in life Self-assigned purpose that creates a sense of meaning

Faith/Spirituality Often religious in nature, the belief in something of

higher purpose

Humor Finding a way to laugh

Morale compass An inner guide that distinguishes right from wrong

Role Model Exhibits behavior emulated by others

Sociability Comfort in engaging and connecting to other people

Altruism Interest in helping others

Self-efficacy Belief in one’s own ability to exercise control in a

meaningful and positive way

Training External guidance that formulates roles and boundaries

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1:1 and Group Access

Hardiness A personality structure combining a sense of

commitment, control and challenge in the face of

stress.

Perseverance Maintain a course of action despite its challenging

conditions.

Mindfulness/Self-

Awareness

Living in the present. Knowing what we need, what

we don’t need, and when it’s time to reach out for

some extra help.

Problem solving Solution finding

Decisiveness Determines a course of action and commits to it.

Pursue meaning/growth Searches alternative explanations, meaning and

understanding to enhance adaptability and

outcome.

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Resiliency Group

•Voluntary

•Multidimensional Focus

• Identifies personal sources of safety

• Activities that promote resilience

• Connections

• Attributes

• Temporal dimensions

• Option to share experience

• Monitor for physical stress reactions

• Monitor group for secondary trauma reaction

• Normalization

• Work integration

• Psychoeducation

• Summary

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Takeaways

•Value of partnership

•Multi-dimensional process

•Resilience starts from the perception of safety.

•Key systems that influence safety and resilience include:• Significant others

•Workplace relations

• Community/Social

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Takeaways

•Direct influence on organizational resilience and indirect influence on the employee. (via connections)

•Foremost facilitators of reconnection to the sources of resilience vs. an actual source of individual resilience.

•Employees present to EAP in one of the three temporal dimensions.

•Interventions need to flex to the organizational culture and return to work process.

•Interventions and participation are always voluntary.

Thank you!RDA CIR Services

THE BOOKEAP CIR- A Multi-Systemic Resiliency Approach

Order online at www.eap-rda.com or Amazon.com

THE WORKSHOPLive full day trainings arranged for your staff and affiliates.

Earn the Certificate in Specialized Training.

THE LINKOnline/Fusion (live) training designed to reach all potential responders.

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Bibliography

Bonanno, G., Loss Trauma and Human Resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist. Vol. 59 No.1, 20-28, 2004.

Carver, Charles S. 1998. “Resilience and Thriving: Issues, Models, and Linkages.” Journal of Social Issues 54:245–65.

Comas-Diaz, Lillian et. al, The Road To Resilience, American Psychological Association

Lewis, G.(1994). The professional manual: the management of critical incident stress and trauma in the workplace. Framingham MA: Compass

Mallak, Larry, Putting Organizational Resilience to Work, Industrial Management; Nov- Dec. 1998.

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BibliographyMitchell, J., Everly, G.S., (1996). Critical incident stress debriefing: an operations manual for the prevention of traumatic stress among emergency services and disaster workers. Ellicott City, MD. Chevron Publishing Corp.

Reivich, K., & Shatte, A. (2003). The resiliency factor: Seven keys to finding your inner strength and overcoming life's hurdles. NY, NY: Broadway Books

Seligman, Martin, Building Resilience, Harvard Business Review, April 2011

Smith, B. Resilience as the ability to bounce back from stress: A neglected personal resource? The Journal of Positive Psychology, Vol. 5, No. 3, May 2010, 166-176.

Southwick, S.M.; Charney, D.S.,(2012) Resilience The Science of Mastering Life’s Greatest Challenges; Cambridge University Press NY.

Wilson, J.P.; (1995). Traumatic events and PTSD prevention. N B. Raphael & E. D. Barrows (Eds.), The handbook of preventative psychiatry (pp.281-296), Amsterdam, the Netherlands: Elsevier North-Holland.

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