4.33 ICF – Debriefing After Major Trauma

Prevention of traumatic responses to critical incidents:  Open Door will make special provisions for critical incidents, particularly in service areas where employees are more likely to be exposed to such incidents in the course of their work, such as ambulance or accident and emergency staff. In these services, we need to focus on making staff aware of (a) the possible impact these events may have, (b) potential ways to minimize negative effects, and (c) the supports available to them, such as Social Workers, HR department, Case managers for Employee Assistance. Open Door also encourages team working, have good arrangements for supervision and for after-shift winddowns, and use an external facilitator, where needed.

Ensure that all employees affected have access to immediate practical and social support during and immediately after the event.

Open Door will make sure there are transports home or contacting a family member; providing refreshments – tea, coffee (no alcohol); providing cover to allow for ‘down time’. This does not necessarily mean going off duty – it may be better to keep those affected together in the immediate aftermath of an incident so that they can compose themselves, talk about what has happened, and support each other.  Social support means the everyday expression of care and listening to the concerns of those affected. It is not clinical in nature and should involve:  contact with the person’s immediate manager to acknowledge what has happened, express concern, provide social and practical support and to recognize the efforts of staff, contact with colleagues, the presence of a respected and trusted colleague. Open Door will identify any staff, patients, or bystanders who may have been affected by the incident and respond appropriately to their needs.

Make employees aware of the Employee Support Services and enable them to attend if they request it.

Open Door will promote safety, calm, connectedness, self-efficacy, and help during and after a traumatic event.    

Do’s and Don’ts for Psychological First Aid for First Responders after a Trauma has occurred:

DO

• Promote Safety:  Help people meet basic needs for food and shelter, and obtain emergency medical attention. 
  • Provide repeated simple and accurate information on how to get these basic needs.
• Promote Calm:  Listen to people who wish to share their stories and emotions, and remember that there is no right or wrong way to feel.
  • Be friendly and compassionate even if people are being difficult
  • Offer accurate information about the disaster or trauma, and the relief efforts underway to help victims understand the situation.
• Promote Connectedness:  Help people contact friends and loved ones.
  • Keep families together.  Keep children with parents or other close relatives whenever possible. 
• Promote Self-Efficacy:  Give practical suggestions that steer people toward helping themselves.
• Engage people in meeting their own needs.
• Promote Help:  Find out the types and locations of government and non-government services and direct people to those services that are.
  • When they express fear or worry, remind people (if you know) that more help and services are on the way. 

DO NOT:

• Force people to share their stories with you, especially very personal details.
• Give simple reassurances like “everything will be OK” or “at least you survived.”
• Tell people what you think they should be feeling, thinking, or how they should have acted earlier.
• Tell people why you think they have suffered by alluding to the personal behaviors or beliefs of victims.
• Make promises that may not be kept. 
• Criticize existing services or relief activities in front of people in need of these services. 

Last Revised: 4/29/22