Workplace Trauma: Concepts, Assessment and

Post-traumatic stress is a topical subject of increasing importance. Yet much of the writing on this subject so far has been on stress suffered by people exposed to serious turmoil such as war and ethnic conflict.Workplace Traumais an extremely welcome presentation of the subject of stress in the workplace. This book explores the ways that traumatic events impact the psychological well-being of organizations and the employees that work within them. Disasters, accidents, crime, injury and death are considered and the main groups of employees at risk from trauma are identified. Creation of organizationally appropriate trauma care programs tailored to meet the particular needs of organizations and individuals is discussed. Theory and the latest research together with practical advice provide essential guidance to inform organizations and practitioners on the ways they can reduce the incidence and impact of psychological trauma.

List of tables

xi

List of figures

xiii

Acknowledgements

xiv

Preface

xv

PART I Post-traumatic stress -- history and development

1

(62)

Post-traumatic stress: the history of a concept

5

(9)

Introduction

5

(1)

Trauma in literature

5

(1)

The nineteenth-century view of trauma

6

(1)

The First World War

7

(2)

Recognition of traumatic stress

9

(2)

International classification of diseases

11

(1)

Discussion

12

(2)

The psychobiology of traumatic stress

14

(10)

Introduction

14

(1)

The epidemiology of traumatic stress

15

(1)

`Normal stress'

16

(1)

Biological pathways

16

(1)

Pathway interactions

17

(1)

Traumatic stress v. normal stress

18

(1)

Post-traumatic stress and the brain

19

(3)

Discussion

22

(2)

An employee's response to trauma

24

(16)

Introduction

24

(1)

The psychological contract

24

(1)

Three phases of trauma

25

(1)

Responses to traumatic events in the workplace

26

(13)

Discussion

39

(1)

Traumatic stress in the workplace

40

(9)

Introduction

40

(1)

Major incidents in the workplace

40

(3)

Other traumatic events

43

(1)

Employees at risk

43

(4)

Organisational responsibility

47

(1)

Discussion

48

(1)

Workplace trauma and the law

49

(14)

Introduction

49

(1)

The size of the problem

49

(1)

Post-traumatic stress and the law

50

(1)

Legal recognition of psychological assessments

50

(1)

The tort of negligence

51

(1)

Duty of care

51

(1)

Employer's duty of care

52

(1)

Case law

53

(4)

Effects of litigation on traumatised employees

57

(1)

Managing trauma in the workplace

58

(1)

The future

58

(3)

Summary: Part I

61

(2)

PART II Dealing with disasters at work

63

(66)

The management of crises and disasters, and their relationship to business continuity

67

(12)

Introduction

67

(1)

Crises and disasters

67

(1)

Managing the crisis

68

(1)

Preparing for the crisis

69

(1)

Identifying the risks

70

(1)

Who might be harmed?

71

(2)

Reducing the risk of traumatic stress

73

(2)

Making the plan work

75

(1)

Dealing with the aftermath

76

(1)

Handling communications

77

(1)

Discussion

78

(1)

Post-trauma interventions: crisis management, diffusing, debriefing and trauma counselling

79

(20)

Introduction

79

(1)

The timing of trauma interventions

80

(1)

Managing a crisis

81

(2)

Diffusing or defusing?

83

(2)

Debriefing

85

(5)

Trauma therapy and counselling

90

(4)

Discussion

94

(1)

Incident support material

94

(5)

Introducing trauma care into an organisation

99

(18)

Introduction

99

(1)

Post Office Trauma Care Programme

99

(6)

Features of the Post Office Trauma Care Programme

105

(2)

Key stages of the Programme

107

(6)

Initial difficulties

113

(1)

The role of senior managers

114

(1)

Cost benefit analysis

115

(1)

Discussion

116

(1)

Choosing and managing an external provider of post-trauma support

117

(12)

Introduction

117

(1)

Selecting a provider

118

(5)

The contract

123

(1)

Auditing

123

(2)

Assessing effectiveness

125

(1)

Discussion

126

(1)

Summary: Part II

127

(2)

PART III The measurement and assessment of traumatic stress in the workplace

129

(36)

Assessing psychological trauma

133

(9)

Introduction

133

(1)

Assessment of the nature and features of a traumatic event

134

(2)

Structured clinical interviews

136

(1)

Self-report surveys

137

(2)

Psychophysiological and psychobiological assessments

139

(1)

Organisational need to measure traumatic stress

140

(1)

Discussion

140

(2)

Developing a trauma scale for organisations

142

(10)

Introduction

142

(1)

Impact of Events Scale (IES)

142

(2)

Study 1: factor analysis of IES-E data from stressful work incidents

144

(4)

Study 2: discriminative validity of the IES-E

148

(2)

Discussion

150

(2)

Difficulties of evaluating post-trauma interventions in organisations

152

(13)

Introduction

152

(1)

What is success?

152

(2)

How can success be measured?

154

(4)

Difficulties in undertaking research in organisations

158

(1)

Current research into trauma

159

(1)

A way forward

160

(1)

Discussion

161

(2)

Summary: Part III

163

(2)

PART IV Organisational research -- case studies

165

(56)

The Post Office -- identifying the causes of acute post-traumatic stress

169

(17)

Introduction

169

(4)

Method

173

(2)

Results

175

(10)

Discussion

185

(1)

Workplace bullying -- a source of chronic post-traumatic stress?

186

(11)

Introduction

186

(1)

What is workplace bullying?

186

(1)

Bullying and psychological well-being

187

(1)

Research questions

188

(1)

Method

188

(1)

Results

189

(4)

Discussion

193

(4)

The Paddington rail crash -- how to deal with a crisis

197

(10)

Introduction

197

(1)

Background

198

(1)

The rail crash

198

(1)

Interventions

199

(3)

Results

202

(3)

Discussion

205

(2)

The Manchester bomb -- trauma counselling and long-term support

207

(14)

Introduction

207

(1)

The bomb

207

(1)

Initial support

208

(2)

Dealing with chronic trauma

210

(1)

Trauma counselling

211

(2)

Results

213

(3)

Discussion

216

(1)

Postscript

216

(3)

Summary: Part IV

219

(2)

PART V Conclusions and future directions

221

(11)

Conclusions and future directions

225

(7)

Introduction

225

(1)

Practice

226

(1)

Research

227

(2)

Bringing research and practice together

229

(1)

The future

230

(2)

Appendix A: Post-incident questionnaire (CASHCO)

232

(4)

Appendix B: Bullying survey

236

(4)

References

240

(21)

Index

261

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Workplace Trauma: Concepts, Assessment and Interventions

Summary

Table of Contents

Supplemental Materials