Exposure to Others’ Trauma at Work: Two Case-studies of Helping Organisations to Understand the Foreseeable Risk and to Better Support Staff Health, Wellbeing and Performance.

Written by Dr Caroline Marlow, Chartered Psychologist and Director of L&M Consulting Ltd.

The potential consequence of vicarious trauma (VT) and post-traumatic stress disorder (PTSD) following exposure to others’ trauma at work is of growing concern within many professions. With research and anecdotal reports highlighting the potential negative effects of symptoms on individuals’ health, personal lives and ability to work, employers are increasingly realising the need to fulfill their legal and moral duty to understand exposure to others’ trauma as a significant and foreseeable risk to health, and to better protect and support staff.

But How Do You Best Understand the Risks and Protect Staff?

This article outlines how L&M Consulting Ltd., helped two businesses understand the health and performance consequences of their staffs’ exposure, and the current organisational practices that help and hinder staffs’ psychological wellbeing and thus their ability to; cope with exposure, flourish within their role, and contribute to the organisation’s aims. All exposed staff were highly-skilled, professionals whose roles require the viewing of graphic, multi-sensory, and typically unedited and/or user-generated material. The contrasting findings highlight the importance of gaining detailed, contextual understanding if support is to be targeted appropriately and cost-effectively.

The Two Businesses.
Team A: Part of a large global organisation, Team A has been established for over a decade and currently has 5 members. Although other individuals within the department and organisation experience occasional exposure, Team A’s main role requires daily, often highly extreme, exposure. Further, the Team has experienced substantial organisation-wide cuts and change, and are now under greater pressure to generate income within an increasingly competitive market.

Company C: Company C is newly established with 25 members across staff and management. Viewing exposure differs across roles, but the Company’s business requires all members to have knowledge of, and work with, the content. Business continuity rests on the generation of new business and maintenance of the current client base.

The Motives for Better Understanding.
Team A: The organisation’s UK-based Health Lead was concerned about the potentially negative psychological effects of the Team’s extreme exposure and wanted to ensure that the organisation was assuming its duty of care.

Company C:  The Directors wanted to develop a Company-specific Wellbeing Policy to; mitigate against the potential negative consequences of exposure, ensure staff optimal wellbeing and performance, and to gain commercial advantage with clients seeking to contract companies with strong wellbeing credentials.

How Understanding Was Achieved
L&M’s post-doctoral researchers implemented a comprehensive Psychological Wellbeing Assessment in accordance with national stress risk assessment guidelines (HSE, 2007). L&M’s assessment has been developed using the latest conceptual and work-related wellbeing research as they relate to exposure, health and performance. Further, it uses a positive, psychological approach that considers the personal attributes and relationships that help individuals buffer against the experience of stress, whilst promoting the personal resources that enables individuals and thus businesses to thrive in today’s ever-changing and demanding commercial world. 

Team A, their immediate line manager and Health Lead, and all of Company C participated in in-depth, individual interviews. These provided a detailed understanding of how the business’s culture, strategy, procedure and everyday practice affected the staffs’; experience of exposure and support, psychological wellbeing, and in turn, their health and performance. All of Company C and Team A also completed a quantitative work-related stress measure to provide a benchmark for future comparison and for tentative comparison against cross-industry averages. All appreciated the assessment’s wellbeing focus and all engaged fully with the process.

What We Came to Understand.
All members of Team A and Company C are confident in their ability to produce high quality work and are strongly motived to excel and to provide worthwhile contribution to their field. All showed a good understanding of health and most aimed to live healthy lifestyles where possible. Of importance, all rely solely on their immediate colleagues and organisation for exposure-related support. This is due to the nature of exposure preventing open discussion with others.

Team A: Team A have a strong global reputation and are frequently commended by their Department Heads for their work quality and good working practice. However, every member has experienced VT/PTSD-related signs and symptoms and all were unsure or worried about the long-term consequences of exposure. One member who gave an account of PTSD-related symptoms with sustained, life-influencing effect was immediately encouraged to attain clinical consideration. Beyond good inter-team exposure support and the vocal support of three levels of management, scant training and no formal monitoring, protection or support was available to Team A in relation to their exposure. Researchers also came to question whether higher management fully appreciated the level of severity and frequency of Team A’s exposure, and indeed, how both had escalated in recent years.

Despite the above, all Team A members highlighted the daily pressure to cope with increasing work demands and reduced resources as having the greatest negative effect on their health and wellbeing, and thus the personal resources to cope with exposure. Such work pressures reduced opportunities to limit exposure and to benefit from good business practice that could otherwise have promoted effective respite, e.g., flexible working and the ability to cover sickness absence.  With one member stating being on the verge of burnout (with increasingly serious personal consequence), all but one stated the current workload and performance levels as being unsustainable. Further, although some everyday practices that promote wellbeing were apparent, such opportunities were inconsistent, and therefore to the detriment of developing the professionally-enriching and commercially-valuable services required to enhance the Team’s flourishing, profile and financial sustainability. Questioning whether as a team and individuals they were valued by the business, and with another change on the horizon, all but one was looking for, or soon likely to seek, other employment.  

Company C: No-one at Company C reported experiencing VT/PTSD-related symptoms, with all but one reporting experiencing good health and psychological wellbeing. Many stated the company as being the best company they had worked for, with only one suggesting an intention to seek other employment due to external factors.

All staff were recruited having had exposure-related training within previous employment, whilst management were fully familiar with the material viewed and actively promoted practice that enabled appropriate exposure, work respite and good personal health. That said, when asked, all were unsure of the long-term implications of exposure and of the potential for life-changes to influence coping ability.    

Psychological wellbeing was promoted through the staffs’ affinity with the company’s aims and daily positive experiences within work practice, support and workplace civility. All staff acknowledged the managements’ informal commitment to balancing staff wellbeing with, and to the benefit of, business development and success. Despite this, the speed of the company’s growth had led to many practices not being formalised. Concerns relating to the appropriate meeting of basic health requirements and mental health support mechanisms were apparent. Further, many ways in which individual and company performance could be further improved by embedding practices that better promote psychological wellbeing within everyday activities were apparent.

 Understanding-Based Recommendations.
Beyond promoting understanding, the purpose of the assessment is to provide a broad range of recommendations that enables the business to take control and decide upon appropriate courses of action. To enable this, L&M analysed the findings in accordance with good practice for those industries with exposure to others’ trauma, and national, cross-industry standards for workplace wellbeing and performance. Recommendations were then provided for improved support in accordance with each group’s specific needs.

Team A: 38 recommendations were provided in direct relation to exposure protection and support, and to encourage the business to address its legal responsibilities and to fulfill its duty of care. These ranged across the business’s culture, procedure and systems to everyday team practice. It also included two recommendations to promote role-related physical safety and 11 to enhance recruitment and induction systems.

45 recommendations were made as to how the business could promote staffs’ coping resources and flourishing. Approximately 1/3 related to the meeting of basic health requirements, a few to the promotion of positive wellbeing, and approximately 2/3s to the development of psychological wellbeing with direct positive implication for performance.

Company C: 13 recommendations were provided in direct relation to exposure protection and support. Approximately 1/2 related to business procedure, systems and everyday practice, 1/4 to role-associated value issues, and 1/4 to role-related physical security.   

74 recommendations aimed to promote staffs’ coping resources and flourishing. Approximately; 1/10th related to the meeting of basic health requirements, 1/5th to the better development of a mental health appropriate culture, 1/10th to promoting positive wellbeing, and the remaining 2/3rds to the development of psychological wellbeing with direct positive implication for performance.

Reflecting Company C’s belief in the importance of psychological wellbeing for optimal performance, the recommendations led to the development of Company C’s Wellbeing Policy. Specifically, the policy aims to guide and encourage practice that promotes wellbeing, with the eventual aim of such practices becoming embedded within the Company’s culture.

The assessments highlighted how work-related exposure to others’ trauma can be of potential risk to staffs’ personal health, wellbeing and performance. Further, how the prioritisation of staff psychological wellbeing not only assists employers in the meeting of their legal requirements and duty of care, but also brings opportunities for enabling staff to flourish and to more fully contribute to the meeting of personal and business aims. In keeping with independent, national research (What Works Wellbeing, 2017), the staffs’ high-skill level and their perception of their role’s worthwhile nature endorses the strong potential of psychological wellbeing to act as a vehicle for driving and enabling business success.

Ultimately, the assessment and recommendations were timely for both businesses. The work completed by L&M encouraged and better enabled both to fulfil their legal duties. Further, it promoted a realisation of the often simple changes that a business can make to obtain the business benefits attainable by prioritising staff wellbeing, and provided guidance of how to embed wellbeing throughout strategic and operational practice, and ultimately, the business’s culture.

We hope that the above article has been of interest and of benefit to your organisation.

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How L&M Can Support Your Organisation
As highlighted, L&M works with organisations whose staff are exposed to others’ trauma to help them understand related threats and opportunities. L&M has a unique blend of expertise in clinical psychology, wellbeing and performance psychology. and risk management, and has experience of working with and within organisations whose staff are exposed to VT/PTSD and who work under high pressure. As stated, the assessment aims to give the organisation recommendations that are within their control and ability to instigate. However, if required, our broad expertise enables us to provide a comprehensive range of VT/PTSD specialist services that both assess risk and assist in the development of organisational cultures and practices that best protect and support individuals exposed to others’ trauma. These services can be used individually or as an integrated package, and tailored in accordance with the organisation’s specific needs.

Contact. Please contact L&M Consulting Ltd if you would like to discuss how we can support your organisation in mitigating work-related VT or PTSD.

L&M’s Other VT/PTSD-Related Blogs:
Work-Related Vicarious Trauma and PTSD: What to Know and Do.

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