General Stress and Critical Incident Stress Interventions

There are three types of work related stress and critical incident stress interventions:

 

Primary – Prevention at source

The key elements of primary interventions to manage workplace stress and critical incident stress include the following:

 

1. A policy on workplace stress, incorporating critical incident stress, and development of practical protocols from a risk assessment system.

 

2. A strategic plan for possible exposure of employees to work related stress and critical incidents with a view to minimising potential adverse stress reactions.

 

3. Stress management programmes for work related stress and critical incidents, focusing on stress management and resilience, to facilitate coping skills and to enhance abilities to deal with difficult emotions and stresses.

 

4. Development and training of Peer Support teams for critical incidents:

  • It is recommended that Occupational groups who have a high likelihood of being exposed to critical incidents in the course of their work should have a robust peer support system in place.
  • Ensure employees are aware of and have access to supports (e.g. Peer Support, EAP, Occupational Health, Employee Counselling).

 

5. Guidelines on how to respond to conflict include:

  • Polices for managing work-related violence and aggression.
  • Consensus on what behaviour is acceptable, and how to take steps to restrict unacceptable behaviour.
  • Appropriate policy/guidelines for working alone.

 

Secondary Post Incident Support

There are a number of secondary interventions for exposure to work related stress and critical incidents which include:

  • The availability of managerial support is crucial at such times. Management need to be committed to supporting the development and implementation of a psychosocial support system.
  • An incident-specific response, in line with the strategic plan of the service.
  • Formal assessment of the impact of stress on employees.
  • Support programme(s) for employees exposed to potential work related stress and critical incidents.

Depending on the nature and scale of the critical incident, these programmes may involve individual or group interventions. These include:

  • One-on-one (crisis) intervention or psychological support: This is an important component of an employee psychosocial model and involves the provision of psychological support throughout the full range of the crisis spectrum (including peer support).  
  • Immediate Small Group Support: A structured small group discussion should be provided within hours of an incident led by a mental health professional and a Peer Support Employee, where available, to those employees who require such immediate support for purposes of assessment, triaging, and acute symptom mitigation. Group discussions of the crisis event are designed to reduce acute stress and tension levels for first responders.
  • Post Incident Group Support: Structured group discussion/meeting, led by a mental health professional and where available, a Peer Support Employee, should be provided 1 to 10 days post-incident, and aims to mitigate acute symptoms, assess the need for follow-up, and if possible, provide a sense of post-crisis psychological closure. The provision of information about the normal responses to critical incidents is important so that those affected can better understand their own reaction to it. It is crucial that this is never undertaken as a stand-alone process, nor should it be provided outside of an integrated package of interventions provided for employees. Attendance of employees at such sessions should always be on a voluntary basis.

 

Tertiary – Incident follow up

  • Ongoing managerial support. Managers should ensure the necessary measures are in place to allow for safe, effective rehabilitation and return to work.
  • Ensure appropriate professional counselling from a mental health professional is made available, where required.
  • Investigation and analysis of incident. Refer to your local incident reporting policy for information on incident reporting and investigation.
  • Incidents reported to relevant authorities such as the State Claims Agency, the Health and Safety Authority, insurers etc. This should be carried out as per your organisation’s incident reporting policy.