Situation Critical

This was the first weekend after Sept. 11 and Tibbo and his team, from Thornhill, Ont.-based employee assistance plan (EAP) provider FGI Canada, were there to work with eight companies whose employees were in the World Trade Center or the surrounding area. Tibbo says the residents, of a city not generally known for its warmth, amazed him.

"This is New York City. These are people who would normally not even look at a stranger," says Tibbo. "And they're stopping us and hugging us and kissing us and wanting to talk and talk and talk and talk. The mayor [of New York] has spoken at great length about how this very large city has become a small community. If you could figure out how that happens, then I think you've come up with an answer as to how it is we end up having more people in [counselling] groups after these kinds of large disaster situations."

And Tibbo, a clinical consultant, knows disaster. He has worked in disaster management for 12 years and has seen the impact that plane crashes and earthquakes have on employees. His team is holding counselling sessions in New York with groups of up to 20 employees at a time. In one 10-day period, his team counselled well over 2,500 employees.

So while most people are often reluctant to seek support for personal difficulties through an EAP under normal circumstances, after a disaster "the boundaries come down," says Tibbo. People find they need to stick together and talk about the tragic event.

Gerry Cooper, program director at the Centre for Addiction and Mental Health in Sudbury, Ont., explains that after a traumatic event, such as the terrorist attacks in the U.S., "there is a need for people to come together, to share stories, to make sense of information, and to try and resolve any kind of confusion."

A traumatic event is essentially considered "shocking to the individual," says Toby Snelgrove, trauma consultant with Easton-Snelgrove Inc. in Vancouver. They include: serious medical emergencies, such as a cardiac arrest; threatening situations, such as a hostage taking; robberies; deaths; fires; explosions; visually gripping events, such as an amputation; and situations where employees were helpless, trapped or felt that they couldn't make a difference. "Most people are simply shocked, overwhelmed, and can't believe what they saw. Very often they're left feeling guilty," says Snelgrove.

Support during traumatic situations includes defusing--group sessions normally held on the day of the crisis. The aim is to help people look after themselves over the next 24 hours, says Gerry Smith, national trauma response director at Warren Shepell Consultants in Toronto.

Anywhere from 24 hours to a week after a traumatic event, EAPs offer debriefing or critical incident stress debriefing sessions, such as those organized by Tibbo in New York. The aim of these is to allow employees to discuss what happened and what life has been like for them since the event. EAPs also offer telephone hotlines, one-on-one counselling and online counselling and information.

Martha Clarke, a senior counsellor at Personal Support Network, a non-profit agency that provides employee and family assistance plans to 30 employers in Fort McMurray, Alta., says trauma response was originally intended for emergency care workers on the frontlines of a traumatic event. Trauma response geared to employees who witness a stressful event emerged about 10 years ago. Many EAPs began offering trauma assistance between 15 and 20 years ago.

The cost of trauma assistance varies depending on the provider. In some cases, it's included in the core services ranging from $35 to $75 per employee, per year. Some providers may charge extra if EAP usage exceeds a set usage range. In other cases, an hourly fee is charged. (The cost can vary from $700 to $1,000 for a half day to service a medium-sized company.) The benefits of the service are clear, however. Employees return to work sooner. They function better and avoid developing long-term illnesses, including depression and anxiety.

How employees react during a traumatic event varies depending on how close they are to the event or to the people involved. Marjorie Shore, a principal at The Coaching Clinic in Toronto, who has two EAP contracts, says in the weeks following Sept. 11, clients came in for trauma counselling saying they were "witnesses to murder." Many had heard of the first attack on the World Trade Center and turned on a television. Some of them consequently saw the second plane hit the second tower. Shore says most people eventually saw those images throughout the day, but not many saw the event as it happened. "It's a fascinating take on it," says Shore, adding it has had a profound effect on these employees.

One issue Shore's clients have raised in light of Sept. 11 is the need "to focus on important things," such as family. In the wake of traumatic events, business suddenly doesn't seem as important to employees. "If you're a banker or an investment counsellor or a lawyer or your work is profoundly engaging, it's intellectually stimulating, your adrenaline's pumping, your phone's ringing ... it's really hard to pull yourself away from it--but these are the people who died," she says of Sept. 11. "We heard about the people at Cantor Fitzgerald and the people at Aon (two firms with offices in the World Trade Center towers), who had jobs just like people in downtown [Toronto], and they didn't get home to their husbands and wives and kids." This, she says, has caused her clients to stop, re-evaluate their priorities and ask: "what am I doing?"

The immediate side effects of trauma include interrupted sleep, loss of concentration, an inability to focus, headaches and feeling agitated or preoccupied, says Jessica Easton, a psychotherapist at Easton-Snelgrove Inc. in Vancouver, who also conducts trauma counselling for EAP providers. She adds that a traumatic event can also trigger memories of a past trauma.

Sept. 11 also had a significant impact on employees' sense of safety in the workplace. In New York, Tibbo says one of the first questions employees are asking is whether it is safe to go back to work. Canadian employees were asking the same question in the days following the attacks.

Bill Wilkerson, co-founder and chief executive officer of the Global Business and Economic Roundtable on Addiction and Mental Health in Toronto, says employees were rattled by the intensity and insecurity of the workplace well before Sept. 11. Wilkerson says the proof lies in the rise of absenteeism and stress-related disorders. "We are going to have an even more intensified society where the pace of change superimposed on this new uncertainty (brought on by the war on terrorism) is going to make it that much more likely that people are going to encounter severe stress."

Clarke of the Personal Support Network says that EAPs do try to prevent and respond to exactly these concerns. She says group debriefings or defusings right after a traumatic event are a preventative measure. The aim is to help employees deal with the event right away and avoid the need for future counselling. One disadvantage of EAPs, though, is that if employees require assistance after a crisis has passed the onus is on them to make the call. Shore says more EAPs should be proactive and suggests they offer lunch and learn sessions to employees.

How quickly employees recover from a traumatic event largely depends on the management culture within the organization. Martin Shain, senior scientist at the Centre for Addition and Mental Health in Toronto, says if the same type of hold-up occurs in two banks with different management styles, employees in the bank with the more supportive management style are likely to recover faster. "It's probably got to do with the way in which the bank is prepared for these contingencies," he says. "A more fundamental reason probably has to do with the way the bank is managed. If there's a good management climate, the odds are that any individual will have a better chance of recovery."