Handling Disruptive Events in the Workplace

by Dennis Potter Tuesday, February 9, 2016


Disruptive events are unique in specifics, but often stir up similar reactions among employees. Employees closest to the “epicenter” often have the most intense reactions, while those in circles further removed might have less intense reactions, it is likely the reactions/issues are similar. Being able to anticipate the most common reactions prepares us to provide employees the right handouts and teaching points. Experience has taught me three reactions are universal.

Three Universal Reactions


§   Guilt is usually connected to thoughts employee(s) have about what they should/could/would have done differently to alter or prevent the event. These are usually the result of “Monday Morning Quarterbacking” where the person reinterprets their actions knowing the outcome. This is particularly true after a suicide or death of a colleague. It is very destructive and usually inaccurate. A teaching point is to talk about the fact that people are in pain and “wish” the event had not happened. Understanding there is no guarantee anything they could have done differently would have altered the outcome is sometimes helpful.

§  Anger is usually connected to wanting to blame someone or something for the event. If the anger is at the perpetrator, it is probably healthy. The leadership or company is often blamed for not preventing the incident. Anger at God or their spiritual traditions are most common and should be referred back to their spiritual leadership for answers. It is outside our role as interventionists to directly address spiritual issues, except to validate them and state that they are common reactions.

§   Grief after the loss of someone they care about is easy to understand. Disruptive events can trigger a variety of intangible losses. One most common is the loss of sense of personal safety. People think this could happen to me, or my family, or my friends etc. Disruptive events happen because we have no control over them. This temporary feeling of the loss of our illusions of control and safety can be profound. The teaching points here are helping people understand their multiple losses, and that grief is a process they will move through over the next few days. Providing information on understanding they are grieving and things they can do to move through the grieving process is often helpful.

When we are aware of these universal reactions and provide teaching points for them, we help employees understand their reactions, and tap into their natural resiliency and move toward recovery.  This is the crux of helping the employees return to work and return to life.

What suggestions do you give to people to help them return to pre-incident functioning?

Dennis Potter, LMSW, CAADC, ICCS, FAAETS, serves as Manager, Consultant Relations and Training for Crisis Care Network. He is a licensed social worker and certified addiction counselor. Dennis is recognized as a Fellow, by the American Academy of Experts in Traumatic Stress. He was awarded the ICISF Excellence in Training and Educations Award at the ICISF 2011 World Congress.


Tags:

Advise | Healing | Mental Health | Self-Awareness | Self-Care | Shame | Social Work | Stress | Suicide Bereavement | Suicide Prevention | Therapeutic Relationship | Therapy | Trauma | Wisdom

What is a Critical Incident?

by Dennis Potter Sunday, November 1, 2015
I explained to someone the other day the work we do at Crisis Care Network. We respond after Critical Incidents or trauma events to help employees “bounce back”. I was asked what kind of events we handle most frequently. I responded our three most common events are death of an employee, robbery, and staff size readjustments. Again, I was asked, did these deaths happen in the workplace? Are the robberies the type we see on TV and in the movies with guns brandished and shots fired?  No, I said, they are most often natural or accidental deaths outside the workplace, and the robberies rarely involve weapons shown or anyone actually hurt in the robbery. My friend said, these are not really trauma or crisis events, but rather are events that are disruptive in the workplace!

It was then a light bulb went off over my head (if I were a cartoon character). We talk, teach about, and promote Critical Incident Response (CIR) in the Workplace as responding to a trauma event. In fact, CIR are most frequently a highly disruptive event traumatic to the families of the victims, but are far more often disruptive to the normal flow of work in the workplace due to their sudden unexpected nature.

The most common themes employees have after these unexpected events has to do with grief and loss rather than traumatic stress reactions. Employees want to know their reactions are common, but more importantly they want to know what to do about them. They want to know what to say to the families of the deceased, or to their own loved ones after the event.

Maybe we should talk about Critical Incidents as things that are disruptive to the workplace and get away from using terms like crisis or trauma so people understand better the worthwhile work we do for employees to help the workplace recover.

Dennis Potter, LMSW, CAADC, ICCS, FAAETS, serves as Manager, Consultant Relations and Training for Crisis Care Network. He is a licensed social worker and certified addiction counselor. Dennis is recognized as a Fellow, by the American Academy of Experts in Traumatic Stress. He was awarded the ICISF Excellence in Training and Educations Award at the ICISF 2011 World Congress.


Tags:

Self-Awareness | Sexual Trauma | Social Work | Suicide Bereavement | Suicide Prevention | Therapeutic Relationship | Therapy | Trauma

The Little Engine That Could

by Jeanne Blauner Monday, August 10, 2015

HelpPRO celebrates it’s 20th birthday this year. HelpPRO is not the biggest therapist finder, but we are the most comprehensive and caring, focusing single mindedly on connecting our users and their friends and families and clients to the best resources available. Many have copied the HelpPRO model over the years, but the HelpPRO search continues to be the most comprehensive and HelpPRO continues to focus on helping you, our user.

To help HelpPRO help more people please:

1. Tell us what we can do better/best.

2. Spread the word to:

• users to search www.HelpPRO.com

• therapists for free HelpPRO 3 month premium listing trial

3. Click our new counter at HelpPRO.com (top right corner) to "like" HelpPRO on Facebook and/or "follow" HelpPRO on Linkedin.

Jeanne Blauner has been helping HelpPRO build it’s caring community for over 15 years now. Jeanne cares deeply about helping people and sees in HelpPRO an organization dedicated to doing just that.

Tags:

Healing | Mental Health | Mood | Mood Booster | Suicide Prevention | Therapeutic Relationship | Therapy | Wisdom

Aftermath of Suicide: How To Help Survivors

by Dennis Potter Wednesday, November 5, 2014

Three Universal Reactions to suicide: Guilt, Anger and Grief

Guilt is usually connected to thoughts survivors have about what they should/could/would have done differently. These are usually the result of “Monday Morning Quarterbacking” where the person reinterprets their actions knowing the outcome. This is particularly true after a suicide or death of a colleague. It is very destructive and usually inaccurate. It helps to discuss that people are in pain and “wish” the suicide had not happened. There is no guarantee that had they done anything differently, it could have altered the outcome.

Anger is usually about wanting to blame someone or something for the suicide. If the anger is at the person who completed suicide, it is probably pretty healthy. Anger at God or spiritual traditions are most commonly referred back to their spiritual leadership for answers. We cannot address spiritual issues, except to validate them and state that they are common reactions. When anger is placed toward the work environment, ex’s, or family members it is generally unhealthy and unhelpful. We can acknowledge the loss of the person, and that we never really know how they might have interpreted accurately or inaccurately what others did or did not do. You might acknowledge it is too bad that the person did not confide more with others to see an alternative to suicide.

Grief after the loss of someone you care about is easy to understand. Suicide can trigger a variety of much more intangible losses. One most common is the loss of sense of personal safety. If this type of event can happen to the deceased, it can happen to me, or my family, or my friends etc. Suicides happen because we have no control over them. This temporary feeling of the loss of our illusions of control and safety can be profound. We can help people understand their multiple losses, and that grief is a process they will move through over the next few days or longer. Providing information on understanding they are grieving and things they can do to move through the grieving process is helpful.

Dennis Potter, LMSW, CAADC, ICCS, FAAETS, serves as Manager, Consultant Relations and Training for Crisis Care Network. He is a licensed social worker and certified addiction counselor. Dennis is recognized as a Fellow, by the American Academy of Experts in Traumatic Stress. He was awarded the ICISF Excellence in Training and Educations Award at the ICISF 2011 World Congress.

Tags:

Advise | Mental Health | Social Work | Stress | Suicide Bereavement | Suicide Prevention | Therapeutic Relationship | Therapy | Trauma | Wisdom

Suicide Prevention Blog Series: Clinical Tip #5

by Staff and Faculty of the QPR Institute Sunday, November 24, 2013

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.  

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc, says eighteen veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers.  According to the Centers for Disease Control and Prevention, in just one day, more then 101 of our fellow Americans will die by suicide.  Perhaps this clinical tip will save just one.

Clinical tip #5 -- Communicating Suicide Risk

The nature of modern clinical care by multiple providers requires clear communication to assure consumer safety.  Not only do prescriptions need to be clearly written, but progress notes must be legible to all providers of care.  In the root cause analysis of 400 consumers in active care who attempted or died by suicide while inpatients, communication failures ranked at the top of the list of contributory causes (National Center for Patient Safety, 2006).

To improve communications between clinicians regarding suicide risk, there is little consensus about a) how to assess immediate risk or b) how to determine its severity.  Still, risk stratification decisions and clinical judgments must be made every day as these assessments necessarily guide our interventions, monitoring levels, and frequency of contact. For a variety of reasons, suicidal consumers may not be entirely helpful in disclosing their suicidal intent, desire and plans.  If, after an assessment, you are not confident of your conclusions, it may be helpful to others on your team to add a chart note to this effect.

An explanatory note of “low confidence” would be warranted when the consumer:

·      Has been uncooperative and refused to collaborate in the assessment process

·      Has or may have psychotic symptoms, especially paranoia

·      Is or has been recently intoxicated

·      Has a history of impulsivity

·      Is faced with an uncontrollable external event, such as the serving of divorce papers or an arrest warrant 

In sum, a note of low confidence in the assessment suggests higher risk and that reassessment is indicated in the near term (not more than 24 hours), as well as the need for a second opinion, greater vigilance, and more frequent observation.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers. For more information please visit our full library of advanced courses!

Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRInstitute.com

 

Tags:

relationships, friendships | Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

Suicide Prevention Blog Series: Clinical Tip #4

by Staff and Faculty of the QPR Institute Wednesday, November 6, 2013

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc., says 22 veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers. According to the Centers for Disease Control and Prevention, in just one day, more then 105 of our fellow Americans will die by suicide. Perhaps this clinical tip will save just one.

Clinical tip #4 -- Reassessing suicide risk

 

Suicide risk changes with time and circumstances.  A single, initial assessment of suicide risk is seldom adequate for safe practice.  Suicide risk assessments should be repeated both a fixed intervals and during times of increase stress. Based on the literature and the clinical experience of several of the QPR Institute faculty, we suggest four non-exhaustive circumstances where re-evaluating suicide risk is indicated:

 

Changes in health status, e.g., diagnosis of a life-threatening illness, exposure to HIV, continued experience of chronic pain, and when the consumer is faced with significant surgery or has suffered a significant physical injury.

Stressful life-transitions, e.g., loss of a major relationship, change in living arrangements, treatment transitions (between therapists or programs), threats to housing, income or access to care.

Response to treatment, to include side effects of psychotropic medications, non-therapeutic response to medication or other intervention failures, including impasse in therapy or conflict with therapist

Substance abuse dramatically increases suicide risk.  Relapse from recovery, binge drinking or drugging, relapse of one’s sponsor, and any significant use of intoxicants, even by non-addicted consumers.

 

A number of other circumstances suggest the need for a reassessment of suicide risk.  These include reports by third parties that suicide warning signs have been observed, any report of violent behavior, the sudden loss of a loved one through death, divorce, desertion and especially suicide.  Finally, anytime a consumer of any age is facing what may be a personal and public humiliation, suicide risk may be sharply elevated.

 

Basically, suicide risk increases dramatically with multiple successive losses, co-morbidity of illnesses, acute environmental stressors, and anytime the consumer begins to feel he or she is becoming a burden on others or care providers.  If in doubt, reassess!

 

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals includingMental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers. For more information please visit our full library of advanced courses!

Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRInstitute.com

Tags:

relationships, friendships | Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

Suicide Prevention Blog Series: Clinical Tip #3

by Staff and Faculty of the QPR Institute Thursday, October 31, 2013

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc., says 22 veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers. According to the Centers for Disease Control and Prevention, in just one day, more then 105 of our fellow Americans will die by suicide. Perhaps this clinical tip will save just one.

Clinical Tip #3 -- Quick and Effective Response can Save Lives ...

The vast majority of all residential and inpatient suicides occur by hanging.  From the restrictive closure of the air passage, unconsciousness occurs in 30 seconds, death in four minutes.  Saving a life from a hanging attempt requires quick and efficient action.  Emergency rescue tools have become a standard piece of equipment for responding to such events, including the now widely used "911 rescue knife." These are specially designed knives with a hooked and protected blade that allow the victim to be cut down quickly and without injury.  Because the blade is located inside the frame of the tool it cannot be utilized as a life-threatening weapon in the hands of a potentially violent person.  Fire fighters and paramedics have used them for years to cut seat belts off trapped victims.

If you work in a residential or inpatient facility, consider securing 911 rescue knives and training staff in how to access and use them quickly.  When a consumer is found hanging, every second counts.  Once a victim is discovered any time lost trying to remove a ligature by hand - and especially if unassisted - may delay rescue and lead to a preventable injury or death.  More precious time may be lost if staff cannot locate the knife or, once in hand, they are unfamiliar with how to use it.  Good safety management practices require knowledge and practice.  If fire drills save lives, so can "cut down" drills.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers. For more information please visit our full library of advanced courses! 
Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRinstitute.com

Suicide Prevention Blog Series: Clinical Tip #2

by Staff and Faculty of the QPR Institute Saturday, October 26, 2013

 

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Releasewe bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.  

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc, says 22 veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers.  According to the Centers for Disease Control and Prevention, in just one day, more then 105 of our fellow Americans will die by suicide.  Perhaps this clinical tip will save just one.

Clinical Tip #2 -- Documenting Reasons to NOT Hospitalize

When deciding not to hospitalize a patient at risk for suicide, it is important that the clinician conduct a risk-benefit analysis.  The reasons for hospitalization may include the relative assurance of a safer, more controlled environment, a beneficial milieu, multidisciplinary staff evaluation, initiation of stabilizing medications, etc.  The reasons not to hospitalize a suicidal person might include potential loss of self-esteem, stigmatization, risk of losing a job, fostering unwanted dependency, failure to benefit from prior hospitalizations, etc.  When confronted with a possible hospitalization, the patient may also express a willingness to participate in outpatient treatment and adhere to a medication regimen. 

Whatever your reasons to not hospitalize a consumer who has expressed suicidal ideations, prior plans or suicide attempts, it is strongly recommended that the primary care provider seek consultation and/or supervision regarding the decision and to carefully document the reasons for this decision.  In a world of increasing litigation for suicide malpractice, and if a bad outcome is experienced, an uniformed jury will need to be convinced that 1) you thought the problem through, 2) you weighed the risks and benefits carefully with the patient and his or her family, and 3) you took a reasonable and prudent course of action.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers.

For more information please visit our full library of advanced courses!

 

Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRinstitute.com

 


Tags: , , , , ,

Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

Suicide Prevention Blog Series: Clinical Tip #1

by Staff and Faculty of the QPR Institute Friday, October 4, 2013

 

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five week series of clinical tips with the most up to date research and thinking on suicide prevention.

Clinical tip #1 -- So-called “No-Suicide Contracts”

Despite clinical lore there is no scientific evidence that so-called “no suicide” contracts actually save lives or prevent suicide attempts.  Despite their widespread use, specific training in their purpose, utility, and employment is largely unavailable.  

The use of a no-suicide contract as a defense against a complaint of suicide malpractice is at best dubious and at worst negligent.  However, experts generally agree that the refusal of a suicidal person to enter into a good-faith agreement to remain safe (which implies a willingness to participate in recommended treatment), suggests the risk for a suicide attempt may be higher than first assessed. 
 
Documentation of clinical status, including the results of a mental status examination, together with a detailed suicide risk assessment are the best evidence that due clinical diligence was undertaken. Care planning, level of monitoring, frequency of visits, and similar interventions hinge on the quality of the initial and subsequent reassessment of suicide risk. For the most recent literature review, please see Lisa McConnell Lewis, LCSW’s “No-Harm Contracts: A Review of What We Know, Suicide and Life-Threatening Behavior, vol. 7, #`, February, 2007.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers.

For more information please visit our full library of advanced courses!

 

  Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRinstitute.com

 


Tags:

Self-Care | Social Work | Suicide Bereavement | Suicide Prevention

A Dream Come True

by William L. Blout LICSW Monday, September 9, 2013

We founded HelpPRO on a simple dream: “Everyone should be able to find needed mental health services quickly and easily.” We believed that a dedicated group of people and technology offered the possibility that this dream could become a reality.

In1998, a few years into the development of HelpPRO, I found out about the tragic suicide of the publisher of a local newspaper.

Suffering from severe depression, Timothy Hogan tried in vain to find a therapist who could help. He called a Massachusetts professional association referral line, his insurance company and a local hospital but instead of help, he encountered frustration.

In the end, Mr. Hogan wrote in his suicide note: “My only hope is that my death will awaken the healthcare community and lives will be saved.”

Thanks to 500 HelpPRO therapists who already joined, on September 10th, Suicide Prevention Day, we will launch the first Suicide Prevention Therapist Finder.

And the staff in 160 crisis centers nationwide will use this finder as a resource for people calling the National Suicide Prevention Lifeline.

Mr. Hogan, we heard you.  


In 1995 Bill founded HelpNet, Inc. and developed HelpPRO Therapist Finder at www.HelpPRO.com. Bill is an active advocate for mental health services in his community in Lexington, MA. Bill served as chair of the Lexington Human Services Committee and was a founding member of the Lexington Youth Services Council. Bill is a founder, past president, and clinical consultant with Lexington Youth and Family Services (LYFS), a walk-in adolescent crisis counseling service that began in 2011. From 1978-1994 Bill was the Director of RePlace, Inc., a community-based,  adolescent and family counseling center in Lexington. Bill also maintains a part-time mediation and clinical practice.

 

Tags: , , , ,

Suicide Bereavement | Suicide Prevention

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