The United Kingdom: Practical Support and Expert Assessment

By Nowlan, Kate | The Journal of Employee Assistance, May 2006 | Go to article overview

The United Kingdom: Practical Support and Expert Assessment


Nowlan, Kate, The Journal of Employee Assistance


In 2005, Britain's leading authority on best medical practice issued general guidelines on the most effective approaches to treating post-traumatic stress disorder. The guidelines were released in the wake of research that had been less than positive toward a widely used debriefing model.

The National Institute of Clinical Excellence (NICE) now recommends "watchful waiting" where symptoms are mild and have been present for less than four weeks and warns that systematic provision of brief, single-session interventions (often referred to as debriefing) focusing on the traumatic incident should not be routine practice. Trauma-focused psychological treatment (e.g., cognitive behavioral therapy) and eye movement desensitization and reprocessing (EMDR) are recommended for those with severe post-traumatic symptoms or PTSD; for those at risk of developing PTSD, there should be routine use of a brief screening instrument.

These clinical guidelines have influenced current practice in the management of EAP trauma services throughout the United Kingdom. Managing workplace trauma is a central and pivotal component of the employee assistance product, whether the trauma is of an individual nature (as in the case of a sudden death, suicide, or traffic accident), affects a team (such as in a bank robbery, assault, or fire), or has implications for the larger company (via terrorist attacks or natural disasters).

As a result of the guidelines, EAPs in the United Kingdom no longer typically offer a single-session debriefing immediately after an event; instead, they combine various approaches that might include "defusing" or "psychological first aid" as an initial intervention. Practical support and a calm, expert assessment of the situation are seen as the proper initial responses and reflect the "watchful waiting" recommended by NICE.

Rather than rushing to a site within hours of an incident, EAPs today will probably e-mail their clients to remind them of the 24-hour telephone line. Human resources managers, health and safety personnel, and business continuity departments will be encouraged to use telephone support in the first hours after an incident. Both individuals and groups affected by the incident will be treated by skilled professionals in cases where protocols have been negotiated with the company Fact sheets or CDs often will be distributed as a matter of course. Onsite visits and face-to-face counseling will be offered as needed, and other psychological treatments of choice (EMDR and CBT) will be made available at a later date.

EAP providers use terms such as "education," "normalization," "stabilization," and "psychological inoculation" when describing aspects of their trauma services. …

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