The Elements of Trauma Management

There are a number of elements that contribute to effective trauma management in a work environment. This approach is derived in part from the literature on resilience.

First is the assumption of resilience ~ the natural healing process. Proactive Trauma Management encourages an approach that builds on an individuals natural resilience ~ our ability to "bounce back". We assume that people are not sick; rather shocked. They have the capacity to bounce back if provided with the resources. Our role is to create an environment that fosters resilience.

Second is the assumption that "family helping family" contributes to resilience. After a community disaster, it is family helping family that helps one move forward. With this in mind, I recommend the use of proactive workplace peers providing emotional first aid. A peer is essentially an occupational equal, and someone who is seen as "safe" to those receiving help. With community disasters, we encourage the use of community based intervenors with the "outsiders" coaching the community on recovery, and these resources coaching families on how to help themselves.

Third is the role of a "supportive community" following a tragedy. A good example of this is the Scotland plane disaster where the community leaders played a key role in keeping out intrusive helpers and media. From an organizational point of view, informed and supportive management is crucial in creating a supportive environment. The organizational culture must know the nature of the problems associated with acute stressors enabling them to actively be involved in the management of the incident.

The fourth element is the "involvement of specialized resources" . Due to the infrequency and extreme nature of tragedies and other acute stressors, communities and individuals can be shocked and confused. Communities and individuals often don’t know how to manage themselves. They need respectful guidance from trained professionals. Similarly, organizations require specialized trauma personnel to provide guidance. Since traumas tend to "bond" people, these professionals are often seen as outsiders. The best resource person, therefore, is one with whom the organization is familiar.

The fifth element is a "continuum of care". Disasters tend to have a long-term impact on both individuals and communities. Proper assistance, therefore, is that which is provided in advance, during, and following an incident. Being prepared for the worst, having an emergency response system in place that jumps into action when an incident occurs, and monitoring the impact of these events over time is key to an effective program. For example: if a serious accident occurred in the workplace, having a policy in place that held various levels of the organization accountable to its proper management ~ as we do with medical emergencies ~ is what is required. This means having first aid attendants, a safety program, emergency response protocol, referral to professionals for specialized care, a re-entry strategy for employees, monitoring of employees over time (e.g. anniversary dates), etc.

The six elements are "principles of practice" . Proactive trauma management is a coordinated, multi disciplinary, proactive set of activities designed to prepare and respond to distressing incidents occurring in the workplace or community. It is not based in one model or one approach; rather, it is designed to integrate appropriate natural healing rituals and professional pre- and post-incident activities in the promotion of resilience and recovery of all individuals and groups. The PTM principles are used when considering a trauma intervention: autonomy, beneficence, non-maleficience, justice, and the presumption of resilience.

The seventh element is "experiential training" . In order to know that a trainee embraces the principles, is aware of their own personal vulnerability to working in the field, and is competent in their knowledge and skills, PTM programs are based in experiential training ~ active involvement in the learning process.