Center for the Study of Traumatic Stress

Workplace Preparedness
for Terrorism
Report of Findings to
Alfred P. Sloan Foundation

Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
4301 Jones Bridge Road
Bethesda, MD 20814-4799
T: 301-295-2470 F: 301-319-6965
www.usuhs.mil/csts | www.centerforthestudyoftraumaticstress.org

Workplace Preparedness
for Terrorism
Report of Findings to
Alfred P. Sloan Foundation

Robert J. Ursano, M.D.
Principal Investigator

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University School of Medicine
4301 Jones Bridge Road
Bethesda, Maryland 20814

Table of Contents
Executive Summary ................................................................................................1
Findings ...............................................................................................................2
Recommendations..............................................................................................4
Proposed Initiatives............................................................................................5
Introduction .............................................................................................................7
Site Visits .............................................................................................................9Barriers and Opportunities to Employee Preparedness and Human
Continuity ..............................................................................................................12
Threat Awareness, Threat Perception and Threat Assessment ...................12
Corporate Security as an Emerging Voice in Preparedness........................17
Organizational Structure, Functional Areas, and Corporate Culture .......18
Disaster Paradigms ...........................................................................................22
Communication for Preparedness, Response and Recovery ......................22
Summary: Barriers and Opportunities ..........................................................24
Conclusions and Future Steps..............................................................................28
References ...............................................................................................................31
Appendix A: Study Team ......................................................................................35
Appendix B: Study Procedures ............................................................................40
Preliminary Interviews ....................................................................................40
Procedures .........................................................................................................42
Site Visits ...........................................................................................................44
Appendix C: Topics Identiﬁed for Study of Corporate Preparedness ............46
Appendix D: Model of Corporate Preparedness ...............................................47

WORKPLACE PREPAREDNESS FOR TERRORISM

Executive Summary
Comprehensive workplace
preparedness for terrorism
must address and integrate
the psychological andbehavioral aspects of terrorism
preparedness and response
in order to address issues ofhuman continuity.

Comprehensive workplace preparedness for terrorism must address and integrate the psychological and behavioral aspects of terrorism preparedness andresponse in order to address issues of human continuity. Recognizing the beliefs and attitudes that inﬂuence behavior and drive behavioral change is essential if organizations are to eﬀectively commit time to educate employees about
preparedness and to practice preparedness behaviors. Understanding humancontinuity issues must also inform development of the interventions that canprotect, sustain, and foster the recovery of individuals and facilitate resumptionof work and performance. Human continuity factors in preparedness encompass a range of issues that can contribute to a corporation’s threat assessment,
its employee preparedness, the health and performance of employees, and therole of leadership in fostering organizational resilience to the impact of disasterand terrorism.
In the United States the workplace has been the primary target of terrorism. Signiﬁcant negative impact on the nation’s economy, infrastructure, andhealth can be accomplished through workplace disruption. Many workplaces—
including the mass transportation systems upon which Americans rely to reach
work—are relatively unprotected. These factors suggest that the workplace willcontinue to be an ideal target for international terrorists. Despite this, recent
studies have demonstrated a lack of preparedness and a perceived lack of employer emphasis on workplace preparedness for terrorism. After observing thewide-scale destruction of events such as the September 11th terrorist attacks
some corporations have focused increased attention on business continuity
plans and physical security. However, the extent to which corporations havetaken measures to protect human continuity through training and educationaleﬀorts aimed at altering disaster (or terrorism) behavior are less clear.
With the research support of the Alfred P. Sloan Foundation, Center for
the Study of Traumatic Stress (CSTS) of the Uniformed Services University undertook a study of several large U.S. corporations to systematically explore thepresent status of human terrorism preparedness in the workplace. Through thisstudy, we identiﬁed the functions and structures critical to corporate humancontinuity preparedness and identify barriers to, and opportunities for improving corporate workplace terrorism preparedness.
Through a series of preliminary interviews with leaders of and consultants
to several US corporations, members of CSTS identiﬁed corporate divisions
WORKPLACE PREPAREDNESS FOR TERRORISM • 1

The corporate security oﬃce
emerged as the most critical
corporate voice in identifying
preparedness vulnerabilities
to leadership, transmitting themessage of security awarenessand practices (behavior)and personnel instrumental to terrorism preparedness in the corporate workplace. These informants provided initial perspectives on preparedness eﬀorts,
perceived challenges, and potential areas for increased attention from within
their own corporations and others with which they had ﬁrst-hand knowledge
or experience. The interviews formed the basis for the development of thesemi-structured survey instrument created by the CSTS for more systematic
examination. After institutional review board approval, the CSTS engaged a diverse sample of US Corporations and conducted site visits and semi-structured
interviews of corporate leaders including Presidents and CEOs, and Directorsof Corporate Security, Employee Assistance, Corporate Health/Medical, andHuman Resources divisions, as well as product line managers. In the analysis ofthese interviews the CSTS made no attempt to compare or contrast the relative
preparedness of sampled corporations. Interview data and observations weresynthesized to identify commonalities between corporations. Through this iterative process, the CSTS established recommendations applicable to corporate
workplaces as areas for action and further study.
Findings
1.

The corporate security oﬃce emerged as the most critical corporate voice
in identifying preparedness vulnerabilities to leadership, transmitting themessage of security awareness and practices (behavior) to corporate employees, and promoting a culture of anticipation of future disasters. As oneof our interviewees said, “Good security is good business.” Security is at
the core of human continuity preparedness only when corporations recognize the value and need to foster a “community of safety” rather thanmerely protect buildings. When security is not focused on individual employee behaviors, day-to-day and in response and recovery from a disasteror terrorist event, human continuity preparedness—and therefore citizen
preparedness—is less eﬀective.

2.

Preparedness, at the “macro” level, and for the individual employee, ismotivated by threat awareness, threat assessment, and threat perception.
Deﬁning events—a corporation’s historical experience with crises and understanding of past responses—shape the identiﬁcation of potential future
threats and eﬀorts to prepare for these events. Other factors inﬂuencing
threat identiﬁcation include geographical location (particularly the location of corporate headquarters) and degree to which the corporate “brand”
is perceived as a potential terrorist target. Points of failure (e.g. as criticalnodes for material supply, vulnerable geographic locations, or relatively
unsecured or unprotected corporate functions or processes) are organizing principles upon which corporations based concerns about future business disruption and hence, preparedness eﬀorts.

3.

In addition to corporate security, the divisions of employee assistance,
personnel/human resources, occupational health (medical and Employee
Assistance Program (EAP)), and senior corporate leadership (e.g. President/CEO) served primary functions in establishing a corporate cultureof preparedness. Coordination between these oﬃces appeared crucial tocomprehensive preparedness planning and response (e.g. translating thisculture into a “climate” in which individuals altered their planning andbehaviors to protect themselves and their families and, therefore, the corporation. The degree to which all of these divisions were involved in theto corporate employees,
and promoting a culture of
anticipation of future disasters.

2 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

planning and response processes varied across corporations as did theirintegration in the preparedness process. The extent to which these service divisions (particularly occupational health) were internal versus outsourced to venders substantially aﬀected the level of attention given to anddegree of participation in preparedness eﬀorts. This aﬀected both knowledge of present corporate needs and planning for internal and external (i.e.
contracted for) services critical to human preparedness.
4.

In general, protection of physical plants and corporate business functions
rather than personnel forms the basis of response plans. Such planningwas consistent with an emphasis on traditional business continuity plans
and traditional models of points of failure. The degree to which humancontinuity was prioritized or measures to protect this had been initiated
was variable across corporations.

5.

Corporate leaders noted that communicating to employees a recognitionof their value to the corporation—of instilling in employees the idea thatthey “mattered”—was important to preservation of function in times ofcrises. Speciﬁc programs, as well as physical and monetary resources arenecessary to communicate this message. Communication systems withincorporations (e.g. corporate websites or intranet) that may currently serve
as a mechanism for accountability of personnel after disaster may also be
used to amplify the message of concern to many, but not all, employees.

6.

Eﬃcient information ﬂow within corporations, between corporations, andbetween corporations and local and federal government agencies regarding
threat analysis, preparedness, and terrorism response facilitate integrated
community response. On a national level it appears eﬀorts to create these
integrated systems of communication have been limited to date. Notable
exceptions are present.

7.

Corporations exist within larger “communities” of related enterprises, suppliers and traditional communities of towns or cities where business operations occur. Interdependence is the norm for safety (ﬁre, police, emergency response) as well as for eﬀective product delivery. Loss of suppliers,transportation or community support can disrupt corporate continuity. Effective corporate response to terrorists attack may require assistance from
related corporations as well as local, state, and federal governments andinstitutions. Likewise, corporate resources and the integration of resourcesfrom multiple corporations may be necessary for eﬀective community responses to large scale attack. Integrated personal relationships across theseboundaries are critical to sustaining actions post a terrorist event.

8.

Threat awareness, assessment, and perception drive the allocation of security resources and assignment of priorities. Corporations, faced with ﬁnite resources for response planning and security eﬀorts allocate resources
based on past experience and in so doing may not apportion protective
measures and related safety/security awareness training evenly across all
personnel. This can create discontent and rifts in corporate function acrossdivisions/departments/locations.

9.

Corporations assess their individual risk speciﬁcally for a terrorist attack
variably and allocate according to these assessments. However, corpora-Preparedness, at the “macro”
level, and for the individual
employee, is motivated by threatawareness, threat assessment,
and threat perception.

WORKPLACE PREPAREDNESS FOR TERRORISM • 3

tions universally identiﬁed hazards to business operations (e.g. disasters(natural and human made) and accidents) and to varying degrees established training in response to these phenomena. Corporations tended toembrace an “all hazards” response plan based on “deﬁning event” disasters
that their corporation had previously experienced rather than emphasizing preparedness speciﬁcally for terrorism.

Deﬁning events arecentral to the manner inwhich preparedness is
integrated into or absent
from corporate humancontinuity preparedness.

10. Corporate “culture” and corporate values inﬂuence both the content of disaster preparedness plans and the eﬀectiveness with which plans and training were communicated throughout a corporation. For example, if safety
is a widely recognized corporate value, then preparedness training may
be eﬀectively embedded in corporate safety training. The extent to which
employees are “invested” in the corporate values inﬂuences the degree towhich they respond to messages delivered in this context. When employees have experienced corporate values and culture as guiding principles
during “deﬁning events” this experience inﬂuences the eﬀectiveness of preparedness initiatives framed within corporate culture and values.
Recommendations
1.

Corporate security should be positioned, and should have the knowledge
and interest for a leadership role for human continuity preparedness. Education of this group regarding the means to building “a community ofsafety” will enhance their ability to perform in this capacity and build avision of this role.

2.

Medical Directors and Occupational Health Divisions are under-identiﬁed as a critical component of corporate human continuity. Their distancefrom corporate decision making should be reduced as it currently limits
their contribution to assessing threat of, planning for, and responding to
the health implications of terrorism—especially bioterrorism and infectious disease outbreaks with population-health implications (e.g. SARS,
Avian ﬂu).

3.

Employee Assistance Programs and Occupational Health require knowledge of evidence-based and evidence-informed interventions to mitigate,
respond to and foster recovery from disasters.

4.

Integration, collaboration and cross functionality of roles within corporations in human continuity planning is critical for, responding to and recovery from terrorism to include corporate security, employee assistance,
medical, human resources, and corporate communications. Preparedness
initiatives must promote this integration.

5.

Deﬁning events are central to the manner in which preparedness is integrated into or absent from corporate human continuity preparedness.
Changing preparedness and response behavior must build upon the experience, lessons, and language of deﬁning events. Finding uniﬁed concepts,
operations, and cultural supports that resonate with existing corporate disaster paradigms for each corporation as well as language that addresses
human continuity aspects of disaster response is needed. In general, talking about “terrorism preparedness” per se is not easily understood in thecorporate world, nor easily implemented. In order for terrorism prepared-

4 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

ness to be understood and implemented it requires “translation” into thedeﬁning event language of a speciﬁc corporation’s history experience witha disaster or critical event.
6.

Initiate targeted knowledge
dissemination programs for a)
corporate leadership, and b)

Since corporations are part of communities in which they conduct operations around the globe they are components of local, state, federal andprivate networks. Coordination at the local level across these boundaries isnecessary for human continuity planning for terrorism, disasters and critical incidents. From ﬁre planning to daycare and inoculation for biological events (inﬂuenza to bioterrorist agents) the boundaries of corporations
and their communities are porous and require resourcing and planning tomeet human continuity and preparedness objectives. Education on the issues of community planning and response are particularly needed for thecore preparedness functions (e.g. security, employee assistance, medical,
human resources and communication)

corporate functional leaders(e.g. security, occupational
health (medical and EAP),
human resources andProposed Initiatives
1.

communication).

Initiate targeted knowledge dissemination programs for a) corporate leadership, and b) corporate functional leaders (e.g. security, occupational
health (medical and EAP), human resources and communication). Educational programs should foster integrated disaster planning for human continuity. Such a program needs to include knowledge about organizationaland behavioral responses to terrorism, interventions and scenario training.
Scenario based education in particular using 9/11 and hurricane Katrina
as case studies for planning and response to complex catastrophic events
which include loss of infrastructure can yield increased knowledge andpreparedness. Writing useable scenarios that can teach human continuity requires expertise in terrorism preparedness, disaster response, humanbehavior and teaching/education. The Center for the Study of TraumaticStress (CSTS) is uniquely positioned and skilled in this task.
In addition, the CSTS is presently seeking partners to join in support offunding received from SAMSHA for the ﬁrst knowledge dissemination
conference for corporate preparedness. This meeting will be a major stepin both educating for human continuity and bringing together various corporate functions, across various industries, to share knowledge and practice and identify gaps in terrorism preparedness for human continuity.

2.

Develop educational materials for corporate human continuity preparedness and response. A model for this is the “Courage to Care” health education program of the CSTS. The CSTS has initiated an extremely successful
health education campaign that is now distributed around the nation andthe globe. Directed to medical providers and others who reach the public“Courage to Care” is based on ﬁnding “teachable moments. It has been
distributed with information on preparing for inﬂuenza, helping families
think about evacuation, and training families and health care providers in
psychological ﬁrst aid. This program is a model of what is needed for the
corporate functions of security, human resources, and occupational health(medical and EAP),

3.

Provide real time knowledge dissemination/consultation to corporate disaster/critical incidents to foster human continuity. This is a model the
WORKPLACE PREPAREDNESS FOR TERRORISM • 5

CSTS has used for many years to develop rapid information and disseminate it in response to real time questions. For example, recently the CSTS
provided corporate consultation and knowledge materials for human continuity for the Katrina hurricane, addressing the issues of “continuous operations” required for business recovery.
4.

Develop lessons learned from corporate experience with Hurricane Katrina as an event that can teach about response and recovery for weapons of mass destruction. The CSTS has consistently held lessons learned
meetings for issues of bioterrorism, and other weapons of mass destruction, yielding important recommendations for use by public and private
agencies. The development of a three day conference of security, humanresource and occupational health corporate leaders, in conjunction withacademic and operators, to think together on the present barriers to preparedness and needed programs could yield highly valuable input often notdeveloped in ways that are useable. The CSTS had a record of successful
Lessons Learned meetings that have inﬂuenced federal, state and private
agencies. Such a meeting can also identify regulatory and legal agendas for
preparedness response.

5.

Expand the present study to a survey based approach of various groups(e.g. security, EAP) to increase knowledge of barrier and opportunities for
preparedness across a wide range of corporations. Additional knowledge
is needed. Systematic information collected now with the assistance ofpartnerships with the corporations and individuals who participated inour study—nearly all of whom volunteered to be resources in the future—
could yield corporate study of corporate preparedness backed by the skills
and knowledge of the CSTS.

Develop lessons learned from
corporate experience with
Hurricane Katrina as an eventthat can teach about response
and recovery for weapons ofmass destruction.

6 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Introduction
In the United States, theworkplace has been the
primary target of terrorism.

In the United States, the workplace has been the primary target of terrorism. The events of 9/11 that targeted the World Trade Center and the Pentagon,
the 2001 anthrax attacks on the U.S. Postal Service, Congress and media outlets, the 1995 Oklahoma City bombing of the Alfred P. Murrah Federal Building and the 1993 World Trade Center bombing each demonstrate the vulnerability of occupational settings to terrorist attack (Stith et al., 2003). Recently,
public transportation systems—themselves workplaces for many—have been
the target of international terrorism. The 2004 Madrid train bombings (Galea,2005) and London’s transportation terror (Rubin et al., 2005) exacted much of
their devastation by disruption of systems that many rely on for transportation
to and from work. As terrorists will continue to focus their eﬀorts on vulnerable targets with the greatest potential for impact on society, the workplace islikely to continue to be the site of future attacks.
The negative impact of such violence on the nation’s economy, infrastructure, and the health of citizens and communities created by workplace disruption is one of the major goals of terrorism (Ursano et al., 2004b, Schouten etal., 2004). Terrorists seek to destabilize trust in public institutions, to change
people’s beliefs, sense of safety, and behaviors (Holloway et al., 1997). Terrorismis the most extreme form of workplace violence (Bowie et al., 2005) furthering
the imperative for disaster consequence management in industry (Vineburgh
et al., 2005a,b,c).
Terrorism is associated with a greater negative impact on mental healththan other disasters because of its malicious intent (Ursano et al., 2003; Stithet al., 2003). People exposed to terrorism, whether in close proximity to or far
from the aﬀected site, are at increased risk for a range of health-related responses. These include distress as well as mental illness and changes in behaviors thathave health and community and corporate economic consequences. Following
terrorist events a number of mental health problems have been found: sleep
disturbance, post traumatic stress disorder, depression, generalized anxiety disorder and panic disorder, as well as elevated health risks such as increased use ofalcohol, tobacco, and other drugs, especially for those with pre-existing alcoholabuse or other psychiatric diﬃculties (North et al, 1999; Fullerton et al., 2003;
Pfeﬀerbaum & Doughty, 2001; Galea et al., 2002; Vlahov et al., 2002; Ursano
et al., 2003). In addition, changes in perceived safety can lead to unwillingness
to travel or unwillingness to come to work. Similarly altered trust in leadershipand disrupted work performance due to depression or family concerns are only
a few of potentially costly workplace responses that can be anticipated.
The health consequences of terrorism have been documented to haveshort-term and long-term eﬀects on the workplace and on workers. A signiﬁcant population experiencing persistent distress two months after 9/11 reported
WORKPLACE PREPAREDNESS FOR TERRORISM • 7

Because most acts of terrorism in
the U.S. have occurred where andwhen people work, and because
corporations and the workplace
are identiﬁed high value targets
of international terrorism, it isessential that interventions for
preparedness, response andrecovery occur in occupationalsettings(Stein et al., 2003) that the distress disrupted work (65% reported accomplishing less), social life (24% avoided public places) and led to increased healthrisks (38% using alcohol, medication or other drugs to relax, sleep and reduce
terrorism-related worries). A study of Pentagon employees thirteen months
following 9/11 found those with acute stress disorder, depression and increased
rates of alcohol use also had decreased sense of safety at home and in travel(Grieger et al., 2003). A study of this same population conducted a year later
found that there were persisting eﬀects of distress and mental disorder (Grieger
et al., 2005).
Because most acts of terrorism in the U.S. have occurred where and whenpeople work, and because corporations and the workplace are identiﬁed highvalue targets of international terrorism, it is essential that interventions for preparedness, response and recovery occur in occupational settings (Fullerton etal., 2003; Ursano et al., 2004b; Vineburgh, 2004). Studies, however, indicate awidespread lack of workplace preparedness, and a perceived lack of employer
emphasis on preparedness for terrorism. A National Center for Disaster Preparedness study (2003) found a majority of Americans (76%) expressed concern
about terrorism, but lacked awareness of emergency plans in their children’s
schools and in their workplace. Another survey found only 36% of citizens familiar with emergency plans in their workplace, yet citizens reported interestin having their workplace update their plans and practice drills (Council for
Excellence in Government, 2004).
Sustaining our workforce –its organizational health and the well being ofworkers—sustains our communities and important national resources and services (Fullerton et al., 2003; Ursano et al., 2004b). Yet, nearly half of U.S. workers felt their employer was not prepared for a terrorist attack; and of those, 9%said it did not matter because they believed their company will never be aﬀected(Comp Psych Survey, 2004). These perspectives, often counter-intuitive, may
be attributable to concern amongst employers that preparedness could raise
undue anxiety (Ursano & Vineburgh, 2003); lack of knowledge and training on
how to educate employees (Stith et al., 2003); and complacency of employees
who do not take drills seriously (Fink & Mathias, 2002).
Human continuity is the critical element of corporate continuity. Humancontinuity is deﬁned as the process or concept of sustaining the health, safety
and the ability to perform of individuals in a corporation, organization, groupor community after a critical incident, disaster or terrorist attack (Vineburgh
et al., 2004a,b,c). However rather than human continuity, sustaining the workplace in the face of disaster has tended to focus on more general concepts ofoperational preparedness and business continuity focusing to protecting buildings, property and product ﬁrst (Mankin & Perry, 2004; Cavanagh, 2003). Several studies have found that less than 50% of U.S. corporations surveyed had
any disaster plans in place, and those that did focused on natural disasters (hurricane, ﬂood, ﬁres) or safety issues related to industrial accidents versus terrorism planning and its impact on employees (Mankin & Perry, 2004). Less isknown and written about preparedness in the context of human behavior andhuman continuity. Moreover, few studies have addressed the human continuity
aspects of disaster preparedness in the private sector (Tierney et al., 2001).
Employee (and citizen) knowledge, beliefs and attitudes as well as training
and expectations inﬂuence disaster and terrorism preparedness response andrecovery. Despite what may be best for safety, in general individuals will not
move toward smoke after a disaster even if safety is in that direction, they willseek out groups and only evacuate with a group and often only after leadershipis present (Gershon, 2005). Knowledge of such behaviors is a necessary part

8 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

A classic study (Weisaeth, 1989)
which identiﬁed the concept ofdisaster behavior in the context
of a workplace critical incident,
found that an individual’slevel of preparedness was
the strongest predictor of an
optimal disaster behavior.

of corporate preparedness planning at all levels. Recent studies of the WTC
employees who survived the 9/11 tragedy showed that nearly 25% believed theroof could be used for evacuation and only 10% had ever entered a stairwell aspart of a ﬁre drill (Gershon, 2005). Therefore, preparing people and organizations for terrorism and disaster response and recovery requires understanding
such disaster behaviors (Ursano et al., 2004c; Ursano and Vineburgh, 2004;
Ursano and Vineburgh, 2005). Disaster behaviors include evacuation, shelterin-place and quarantine, and these are often overlooked as important humancontinuity issues and health interventions in occupational settings, yet they are
central to organizational resilience (Fullerton et al. 2003; Hall et al 2003; Ursano et al. 2003; Ursano and Norwood, 2003). Studies conducted after the 1993
World Trade Center Explosion found that 32% of employees had not begun
to evacuate by over one hour and 30% decided not to evacuate (Aguirre et al.,1998). Other ﬁndings were that large groups (N>20) take 6.7 minutes longer toinitiate evacuation; the higher the location, the greater the delay; the more people are known to one another, the longer the group takes to initiate evacuation(Aguirre et al 1998). In a terrorist attack or major disaster requiring evacuation,
the behaviors described above could be the diﬀerence between life and death.
A classic study (Weisaeth, 1989) which identiﬁed the concept of disasterbehavior in the context of a workplace critical incident, found that an individual’s level of preparedness was the strongest predictor of an optimal disasterbehavior. Employees without prior training did not fare well after a workplace
explosion. Morgan Stanley’s response to 9/11 supports this ﬁnding. Soon after
the 1993 WTC bombings, Morgan Stanley launched a preparedness program
involving serious evacuation drills. The employee preparedness program wassupervised by corporate security Vice President, Rick Rescorla. One minuteafter the North Tower was struck on 9/11, Rescorla instructed Morgan Stanley’s
employees to evacuate the South Tower immediately, to stay calm and follow
their well-practiced drills resulting in a loss of only seven of its 2,700 employees. Unfortunately, Rescorla, a celebrated Viet Nam veteran, was among theseven. His successful employee preparedness training has been attributed to themilitary discipline he brought to this task (Coutu, 2002).
The Nation’s security is dependent on military, economic and communication infrastructure. In recent times, it has become clear that the health of thenation and its workforce is also a critical factor in national security (Ursano,
2002; Ursano et al., 2004b). The health of the workforce is critical to corporate
continuity and preparedness. A corporation protects: (a) the nation (throughsafe products and services); (b) corporate life and interests, and; (c) the corporation’s employees.
Focusing preparedness on protection of buildings, property and productrather than on employee health and behavior may put corporations at risk of
disruption and break down. The events of 9/11 demonstrated to the nation as
articulated by leadership of a number of aﬀected corporations that an organization’s most valuable asset is its people and that the crisis to be dealt with in
its immediate aftermath was not industry-speciﬁc, but one deﬁned as a humancrisis (Greenberg, 2002; Argenti, 2002). Understanding the barriers and opportunities for preparing the workforce- and in this way the citizens of the nation— is a critical step in protecting our workforce and corporate continuity.
Site Visits
The Center for the Study of Traumatic Stress (CSTS) undertook a study ofseveral large U.S. corporations to examine corporate human continuity preWORKPLACE PREPAREDNESS FOR TERRORISM • 9Rather, our aims were to identify
barriers and opportunities forcorporate human continuity
preparedness (across a range
of industries) and to identify
potential avenues to establish
greater terrorism preparednessof US citizens through corporate
preparedness.

paredness. Importantly, the goal of our study was not to compare the levels ofterrorism preparedness or types of preparedness programs in participating corporations. Nor was it to evaluate or rate the level of preparedness of individualcompanies, or to generalize from this sample about the levels of preparednessof various industries. Rather, our aims were to identify barriers and opportunities for corporate human continuity preparedness (across a range of industries)
and to identify potential avenues to establish greater terrorism preparedness of
US citizens through corporate preparedness.
Observations on the corporations’ overall view of and approach to terrorism and disaster preparedness were collected. In addition, data on emotionaland behavioral functioning, role of security operations in corporate culture,human resource planning, employee assistance organization, ﬁnancial and insurance aspects of preparedness, medical protective measures and planning,
worksite safety, organizational structure and the role of corporate values ininﬂuencing workplace and community preparedness behaviors were collected
and analyzed for barriers and opportunities for workplace human continuity
preparedness. This information was collected from senior leadership in eachcorporation and leaders of the speciﬁc areas of interest.
For our preliminary interviews, we met with management and leadershippersonnel from four organizations in New York City to obtain backgroundinformation regarding their perceptions of barriers to, and opportunities foreducating employees and corporations on terrorism preparedness to ensure
human continuity and employee preparedness. These organizations included:
1) a prominent, private consulting ﬁrm specializing in consultation to national and international leadership on homeland security; 2) two multi-national
corporations, and 3) an academic center for emergency preparedness. Each ofthese had been involved in New York City’s response to 9/11. In these meetings,
interviewees identiﬁed topics that formed the basis for the semi-structured interviews utilized in phase three of this project.

Interviewees
Corporate Operations
CEO
Vice Presidents/ Presidents of subsidiaries

1
7

Corporate Management
Vice President/Director/Asst Director Human Resources
Vice President/Directors Employee Assistance
External EAP/Consultants
Corporate Medical Directors/Asst Director

5
3
2
3

Corporate Global Security
Directors/ Deputy Directors
Senior Partners/Consultants Private Security
External Security Analyst

7
3
1

Academic Centers
Faculty/staﬀ

10

10 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Threat awareness (knowledgeof threats) and assessment(determination of risk) are thedrivers of corporate decisions
on terrorism preparedness andresponse as well as the resources
it assembles and deploys in

For our core study interviews, we selected four multinational Fortune 500
corporations as candidates for formal study participation. Three of these corporations agreed to participate in the study. The participating corporations, headquartered in the Midwest, Northeast, and Mid-Atlantic regions, represented
food processing, chemical manufacturing, and ﬁnancial services. The fourth
corporation was still considering participation in the study when our data collection phase ended.
We conducted 20 in person, key informant interviews at the headquartersof the three Fortune 500 corporations that joined the study. Each corporation
selected interviewees who were knowledgeable about and/or involved in thecorporation’s crisis management. The study team suggested potential key-informant positions to an identiﬁed point of contact at each corporation, but theultimate selection of participants for interview was left to the discretion of thecorporate point of contact. All prospective participants were told that they did
not have to consent to the interviews and that if they did not, no one would
be told of their refusal. We met with executives and senior level individuals
whose functions included: CEO, global security, human resources, corporate
communications, employee relations, senior line management, and occupational health services including medical, health promotion and wellness, andemployee assistance.

responding to its perceived andactual risk environment.

WORKPLACE PREPAREDNESS FOR TERRORISM • 11

Threat perception — in contrast
to assessment and awareness— is largely a psychological andbehavioral process based on
perception and belief.

Barriers and Opportunities to
Employee Preparedness andHuman Continuity
The results from our interviews are summarized into areas for corporate
crisis management response and impact on the human continuity of organizations. These areas indicate barriers as well as opportunities to enhance businessand employee/citizen preparedness.

Barriers and Opportunities to Employee Preparednessand Human Continuity
Threat Awareness, Threat Perception and Threat Assessment
Corporate Security as an Emerging Voice in Preparedness
Organizational Structure, Functional Areas, and Corporate Culture
Disaster Paradigms
Communication: Preparedness, Response and Recovery

Threat Awareness, Threat Perception and Threat Assessment
Threat awareness (knowledge of threats) and assessment (determinationof risk) are the drivers of corporate decisions on terrorism preparedness andresponse as well as the resources it assembles and deploys in responding to
its perceived and actual risk environment. In our interviews, terrorism was
the organizing event for preparedness only in organizations that had a direct,
meaningful experience with terrorism. In the absence of such direct exposure
to terrorism, the history of the organization and its business directed the vast
majority of threat assessment to expected events: e.g., catastrophic accidents,
workplace safety, internal threats of employee stealing or tampering, kidnapping, travel security, disgruntled employees, product contamination. These relatively more expectable events organized the preparedness for terrorism. The“all hazards” approach this reﬂects was only occasionally reﬂected in a plan that
explicitly included terrorism per se. At times there was little knowledge thatthe planning that was being done in these areas, was the same as required forspeciﬁc terrorist threats.
Threat perception — in contrast to assessment and awareness — is largely
a psychological and behavioral process based on perception and belief. Threatawareness and assessment have largely been analyzed and conceived of in an
12 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

operational context. The recognition of threat perception as an additional levelof planning is necessary to human/employee preparedness and planning. When
this was not recognized, interviewees told us that they had observed that some
employees had a “why do they do that?” approach to fears and concerns that did
not match the threat awareness and assessments of the organization. A numberof factors inﬂuenced terrorist threat awareness, assessment and perception:

A corporation’s location, its
corporate headquarters,
its national presence andits international presence,inﬂuenced its assessmentof the threat of terrorism.

Threat Awareness, Threat Perception and Threat Assessment
Geography
Brand
Points of Failure
Human Continuity as Business Continuity
Critical Event Preparedness
Corporate-Community Cooperation and the Public-Private Interface
Training
Cost
Fear of Increasing Anxiety

Geography: A corporation’s location, its corporate headquarters, its national presence and its international presence, inﬂuenced its assessment of thethreat of terrorism. Proximity to sites of previous terrorist events heightened
the sense of vulnerability. The actual physical facilities of a company also inﬂuenced perception of threat. One company, because of its geographical location (e.g. the location of its headquarters and of the majority of its global
operations), did not feel that it was or would be a target for terrorists. However
the corporation was headquartered in the midst of industrial plants with potential for explosions, so that became the focus of their threat assessment andresponse. Another corporation could secure its own building, but could not exercise control of its outside environment, so directed considerable eﬀort at detecting perturbations in the outside environment while preparing its employees
to shelter within in the event of attack.
Geographical barriers to preparedness include operations in rural and remote settings, as well as international sites where local regulations may prohibit
protective measures such as employment screening. Further, in some foreign
locations, local aﬃliates of a U.S. corporation may assess threat diﬀerently fromthe local government with which it is conducting business. A United States corporation doing business abroad that requires the importation of goods may see
product contamination as their major risk, while the threat assessment of thelocal government might be focused on drug smuggling, or the use of transport
vehicles themselves as weapons of terrorist destruction.
Brand: Interviewees consistently drew attention to their “brand”, in thecontext of threat assessment. For corporate response planners, “brand” had arange of meanings including speciﬁc product or product line, a service, or eventhe reputation of the company. In all instances, brand was an important element of corporate identity. A corporation’s perception and beliefs about theirbrand was a major factor in how they protected, planned for, responded to, andrecovered from disaster. Brand is a core part of an enterprise that has broad
meaning to people both within and outside of the corporation. Brand is a set of
attitudes and characteristics that deﬁnes the corporation in people’s minds andserves as a point of reference. Threat assessment often focused to the value of
this emotional aspect of brand.
WORKPLACE PREPAREDNESS FOR TERRORISM • 13

In some instances, thethreat assessment based oninterpretation of “brand” led toa lowered perception of threat,
while in others, the corporate
brand was seen as a potential
reason for attack.

In some instances, the threat assessment based on interpretation of “brand”
led to a lowered perception of threat, while in others, the corporate brand wasseen as a potential reason for attack. The interpretation of “brand” was an organizing principle that determined the steps corporations took to prepare foradverse events including natural or industrial disasters or anticipated acts ofterrorism. One corporation believed that their brand was recognized (within
their own industry) as being synonymous with a particularly high level of carefor their employees. This company devoted considerable energy to providing
individual employees with evacuation kits and personal protective equipment.
This activity was not merely a symbolic gesture, but evidence of the extent towhich corporate leadership was invested in the idea that their brand meant carefor employees. As one security director remarked, “Good security is good business. Good security protects the brand.”Another corporation assessed their threat for terrorist attack as low because they regarded their brand as not widely recognized. They felt that manyof the corporations they supplied were more vulnerable because their products
had greater (American) brand recognition. Thus, the company that perceived
its brand as unfamiliar centered its concerns on product contamination in thecontext of day-to-day business more than the likelihood of a major terrorist
attack on their products. Another corporation recognized that its name, while
not that of a product, was still a recognized brand, and removed signage containing its corporate logos from its plants in vulnerable, foreign locations.
Brand can represent multiple threats for a corporation, and even itself be
the object of attack. The threat assessment of one company was heightened by
two concerns. First, that its name could create a focus of attack as a result ofspeciﬁc ethnic associations, and, second, the company considers its ability to
conduct business without interruption as fundamental to its brand, i.e., to thatcompany brand meant a reputation for business continuity, even under duress,
so any disruption would damage the reputation of the company .
Points of Failure: Corporations tended to organize their threat assessment
and preparedness planning around the concept of potential points of failure— critical points of business supply, function or vulnerability to disruption.
For example, critical transportation nodes, outsourced functions, remote andinternational sites with questionable security protection were all cited as vulnerabilities in their risk environment. Businesses diﬀered on the number andtypes of points of failure they identiﬁed. Preparedness from this vantage can be
only as good as an organization’s imagination as to what the actual potential
points of failure might be. Little attention was given to additional human/employee preparedness at these points of failure although they were agreed uponvulnerabilities to traditional business continuity.
Human Continuity as Business Continuity: The traditional view of business continuity has been focused on the infrastructure of an enterprise, i.e., its
facilities and hardware. Some but not all of our interviewees described an expansion of the concept of business continuity to incorporate the organization’ssocial capital— its human continuity. Corporate communications, security, human resources, occupational health services, and leadership attitudes were seen
as vital in protecting and sustaining the human continuity of a corporation.
Interviewees at several participating corporations told us there was a shift
in priorities from business continuity to human continuity after the attacks of
9/11. Corporations undertook a number of measures to support this. Examples
include the creation of backup work sites, redundant information systems, useof virtual oﬃces, having a disaster communication plan, and expanded useof communication technology, such as Blackberries, web-based company in-

14 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Several corporations pointed out
the need to rely on community
resources and to respond tocommunity needs.

tranets, and maintaining frequently updated personnel lists (both hard copy
and electronic) which managers carried with them when not at the oﬃce.
Critical Event Preparedness: Another challenge to human continuity is
anticipating what types of events to prepare employees for. Furthermore, whenan event occurs, it is often hard to get information about exactly what has happened. Thus, employees and managers go through a period in which criticaldecisions must be made, but they do not have complete information about thenature of the event. Corporate leaders interviewed noted that in the aftermathof corporate disasters they needed to rapidly develop plans for making quick
decisions with incomplete information—and not letting the lack of information
prevent them from taking some form necessary action in a timely manner.
This observation has been reported in other threat situations as well. In a
recent incident in which a small plane encroached on restricted airspace in the
Washington, DC, area, oﬃcials did not know whether to respond to the threat
as a potential bomb/explosive event or a chemical/biological attack.
Even when programs have been put in place to ensure or improve humancontinuity, several described the problem that it is diﬃcult to know until an
event occurs whether the right programs have been put in place and whether
they have worked. As one security manager put it “How does one know if one’s
people have been appropriately hardened? What are the metrics?”
Corporate-Community Cooperation and the Public-Private Interface:
No corporation is an island. Several corporations pointed out the need to rely
on community resources and to respond to community needs. Terrorism preparedness and response requires coordination and cooperation between the
public and private sectors including a company’s community or communities,
as well as state and Federal agencies. Public/private interface around terrorism
preparedness can range from issues of research, to sharing and interpretation of
threat information, to the role and resources of a business in response to a major disaster and to the local ﬁre department and law enforcement in responding
to corporate needs.
Corporations discussed numerous barriers to eﬀective public/private interface. One barrier is the perception that Federal Government will take care ofdisaster preparedness and response. This discourages self-initiatives and allocation of resources at the individual, company, and corporate levels.
Federal regulations about full disclosure of research procedures and outcomes were seen as a barrier to a corporation’s participation in studies thatmight beneﬁt terrorism preparedness. One issue for the corporations was thepotential that proprietary information would become available to their competitors. In addition, there was a reluctance to shoulder the ﬁnancial costs of research, especially when that research might beneﬁt competitors. Doing “good”
for the nation, while valued by corporations, is not always good for business,and corporate leaders interviewed recognized their ﬁduciary responsibility tostockholders. The same factors that discourage joint public/private research endeavors also discouraged research collaboration among corporations.
Training: Discussion with corporations following questions speciﬁc totheir terrorism preparedness training programs invariably became more general discussions about safety, health, leadership, and communication. Each ofthese areas and topics involve trainable skills, especially in relation to a disasteror terrorist attack. Corporations varied in what exercises they had conducted.
Some had active programs including table top exercises with senior management; others had not held exercises for over a year. While some key-informants
could not identify any training or measures designed speciﬁcally to prepare forterrorism, all key-informants interviewed recognized an all-hazards response
WORKPLACE PREPAREDNESS FOR TERRORISM • 15

Expense is a barrier to more
extensive training for speciﬁc
terrorism preparedness.

to anticipated corporate disasters.
In some companies, training focused on the safety of everyday operations
and was conducted regularly. In these companies, there was very little training
speciﬁcally geared to terrorist events. Many of the skills taught in safety training are applicable to terrorism preparedness, but this was not necessarily recognized by the study groups. At times for some of the corporate participants,
safety training and ﬁre drills were used as an opportunity for small group presentations, or mini-town hall meetings at which terrorism preparedness was, or
could be, discussed.
Cost: Expense is a barrier to more extensive training for speciﬁc terrorism preparedness. Some corporations have the money to implement expensive
tabletop exercises and to secure the services of outside consultants who candevelop, conduct, and evaluate sophisticated exercises. However, these exercises are for senior management who strategize from the top down, and are notintended for employee preparedness. Drills devoted to employee preparedness,such as evacuation drills, are not uniform and frequently are not taken seriously by the employees themselves. When preparedness is optional the issuesof cost, and therefore aﬀects on the bottom line, are substantial. If mandatory
or required by regulation this competitive loss is equalized across and industry.
Evacuation drills will be mandatory in New York City in 2006.
Fear of Increasing Anxiety: Some managers fear that training for terrorist
events can raise employee’s anxiety. However, the informants interviewed by
the study team were not able to identify any speciﬁc examples of this having
occurred. In contrast to this view, corporations that directly experienced 9/11
believed that conducting regular drills and communicating openly about preparedness issues empowered employees and made them less fearful. Furthermore, security leadership in these corporations that were aﬀected recognizedthat training builds behavior that will maximize positive outcomes in the eventof a terrorist attack or a disaster. Preparedness is not instinctive; rather, it is aset of learned skills and behaviors.

Corporate Terorism Preparedness
Integration across Community & Public-Private Interfaces
Local Government

Industry Groups

Community Resources

Corporation

Suppliers, Distributions,Markets

16 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Federal/State
Government
Local Corporations

Corporate Security as an Emerging Voice in Preparedness
The corporate security directors we interviewed were highly knowledgeable and immensely articulate about terrorism preparedness. They expressedinterest in advancing this knowledge directly to management and employees.
They saw themselves and their profession as going beyond the traditional corporate security functions of “gates, guns, and guards.” They prided themselvesin their role in the continuity of the corporation’s people as well as its operations and brand.

The corporate security directors
we interviewed were highly
knowledgeable and immensely
articulate about terrorism

Corporate Security as an Emerging Voice in Preparedness
Security Priorities
Corporate Security as Critical to building “A Community of Safety”
Security Information Sharing Among Corporations and Local, Stateand Federal Oﬃcials

preparedness.

Security Priorities: Allocation of security resources to speciﬁc threats may
be economically or emotionally disproportionate to the actual preparedness
needs of the employees. Corporations may choose to allocate resources to a few
people in high-risk locations or to focus their attention on one or more locations they consider most vulnerable (e.g. at identiﬁed points of failure) to the
exclusion of other areas of the company. An example of allocation of resources
to a few people in high-risk locations is training in evasive driving and renting arace track to conduct the exercises for personnel traveling to places where kidnapping is a known threat. This represents a sophisticated assessment and intervention; however, it is available to only a few employees. Corporations might
consider some basic education for all employees, even those in areas perceived
as not high risk, in certain personal security measures, since all may encounter
terrorism outside the normal work setting, e.g., on vacation or on corporate
travel even if their worksite does not place them at highest risk for identiﬁed
corporate threats.
Terrorism insurance is another area of resource allocation that requires
evaluation of security priorities. One corporation described its dilemma at having to renew its risk insurance policies immediately after 9/11 when insurance
prices dramatically escalated. This is an instance in which leadership must prioritize both its infrastructure protection and its human continuity needs.
Corporate Security as Critical to building “A Community of Safety”. The
security directors understood that preparedness is about human behavior. One
security director remarked, “We can teach people about security to build behavior. I love to build behavior!” Remarking on the diﬀerence in dealing withhuman continuity versus operational continuity, one security team said, “We
don’t buy products, we buy “self-resilience and self-suﬃciency.”
A primary objective of security was the development of a culture and community of safety. To achieve this, security collaborated with occupational healthin the form of employee assistance, human resources and corporate communication.
One security director felt that a barrier to building behavior in the formof employee preparedness is a sense often shared by leadership, management
and employees that the federal government will take care of homeland security
issues relieving them of the personal responsibility of preparing. On the other hand, this director felt that an opportunity for preparedness was that theirworkforce was very patriotic.
WORKPLACE PREPAREDNESS FOR TERRORISM • 17

Interpreting threat information
provided to corporate security
programs from all levels ofgovernment was a commonly
expressed concern and barrier tocorporate preparedness.

A common theme amongst each security professional was how they had
established trust in their workplace. Some established their visibility and trust
by useful interactions. These ranged from the mundane — such as assistingwith traﬃc safety enforcement on corporate property — to the more serious
events such as consultation around workplace and domestic violence. After
9/11, corporate security personnel in one corporation made themselves visible and available to answer questions by roaming the halls and talking with
employees at their workstations. Several referred to this approach as “security
transparency”, which they viewed as essential in their strategy to engage employee’s attention. In one company aﬀected by 9/11, security collaborated with
EAP counselors to encourage employees to interact with the bomb dogs as away to humanize heightened security.
Each security interviewee was highly skilled in management, had broad
experience including having worked in the Federal sector, and was immensely
articulate. The security directors believed that direct access to the CEO wascritical to their success in protecting the corporation. They also were often theircorporation’s point of contact with Federal, state, local, and global security andintelligence resources.
Security Information Sharing Among Corporations and Local, State andFederal Oﬃcials: Interpreting threat information provided to corporate security programs from all levels of government was a commonly expressed concern
and barrier to corporate preparedness. One highly knowledgeable individual
asked, “How do you get people or organizations to prepare when they don’tknow how to interpret the threat?” All of the corporations in our study desired
usable (“actionable”) intelligence from the government, that is, information
they can act on. Color-coded threat levels were cited as a prime example ofinformation that gave little or no guidance for action and was, in its ambiguity, viewed as possibly damaging. In addition to the ambiguity of color codes
for corporate security interpretation, program managers struggled to identify
mechanisms to address the increased concern threat level changes caused employees. Corporations want information that leads to speciﬁc precautions andresponses, not generalities.
Threat Assessment requires information, expertise, and information sharedby local, state and federal security and police oﬃcials. Perceived deﬁciencies inthe types and quality of information that ﬂows from public sector to the private
sector were noted by security oﬃcials. Government agencies were perceived as
frequently not sharing information with corporate security. For example, one
security director described an incident in which critical information, which
he should have received, was communicated to a source at the wrong corporation. A Federal agency had informed the corporation who owned the building,but failed to inform this corporation’s security director whose employees werethe major tenants of the building. Despite these barriers, each corporation expressed a desire for increased eﬀective public-private partnership.
Organizational Structure, Functional Areas, and Corporate Culture
Organizational structure, functional areas, and corporate culture aﬀected
preparedness planning and its position in each corporation. The functional areas that were represented on the crisis management team, and how they interacted with one another appeared to be extremely important in determining
what information was considered in corporate planning. The organization’s
culture can facilitate or impede crisis management team objectives, as well as
individual employee behavior before, during, and after a terrorist event. Ourinterviewees identiﬁed several important organizational, functional and cultural factors that enhanced or impaired crisis response.

18 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Organizational Structure, Functional Areas, and Corporate Culture
Corporate Culture and Values
Integration, Collaboration and Cross-functionality
Occupational HealthOutsourcing

Corporate culture and values
set the context in which anorganization functions, andtherefore are important aspectsof corporate and employee
preparedness.

Corporate culture and values: Corporate culture and values set the context in which an organization functions, and therefore are important aspects ofcorporate and employee preparedness. Safety was so embedded in the cultureof one corporation that it became a value intrinsic to its brand. Interviewees
remarked that employees were proud of their safety consciousness and often
inculcated this value and its practices into their daily work routine, family lifeand community activities.
Preparedness values were also a product of shared experience – experienceand therefore personal relevance. Corporations aﬀected by 9/11 expressed a
sense that values articulated by the corporation were exempliﬁed during thepost-disaster community building period, and this led to a greater sense oftrust amongst leaders. Values are galvanized by shared experience which canfacilitate a more universal commitment to preparedness.
Many sub-cultures existed in the interviewed corporations. These wereformed by diﬀering ethnic groups, diverse work environments, varying worktasks and varying geographic locations. In addition, acquisitions and changes
in management philosophy created cultural variation (and at times tensions)in which corporate procedures including safety were aﬀected. In one company,
long-time employees (generally older) had more accidents than newer employees who were more receptive to the new procedures. In such environments,
language, trust, or sense of safety may vary and create barriers to preparedness
policies, implementation and communication.
Integration, Collaboration and Cross-functionality: Corporations described eﬀective crisis management as requiring cross-functionality and teamwork. Many functions formerly operating in silos were experiencing new collaborations. For example, collaboration between corporate security, corporate
communications, and occupational health services strengthened employee
outreach, education, and training for terrorism. The collaboration between human resources, EAP, and security is essential to address back-to-work policies
and programs following critical incidents. The collaboration between security,
medical, and human resources appeared critical in order to address bioterrorism and pandemic threats
Occupational Health: In corporations where medical directors were integrated within the crisis management team, there was more planning aroundhealth issues in the aftermath of disaster or attack. The participation of the corporate medical director in crisis management appeared to highlight planningfor normal epidemics (e.g., inﬂuenza), created opportunities for better response
to other health threats, such as the recent SARS outbreak, incorporated ideas
about certain types of product contamination, and brought bioterrorism to thetable.
The particular role of occupational health services in terrorism responses
has been recognized by the National Academy of Sciences, Institute of Medicine (Stith et. al., 2003). This was supported by the prominence of occupational
health in some of the corporations where planning for epidemics as well as bioterrorism were present. The health consequences of bioterrorism or pandemic
WORKPLACE PREPAREDNESS FOR TERRORISM • 19

threats provide models for planning for bioterrorism attacks. The individuals
most knowledgeable about these issues within the corporation are normally the
medical directors.
Outsourcing of corporate medical services appeared to represent a potentially serious barrier to corporate preparedness. One outsourced medical director noted that he was not involved in corporate crisis planning and expressed
an interest in being included. The reasons for this may have been attributable toa corporate lack of awareness that medical expertise and assessment could enhance overall threat assessment and/or lack of communication between medical and crisis management leadership. Integration of the medical director may
facilitate adherence to preventive measures such as inoculation and treatment.
Global disease threats (e.g., SARS) also highlighted the presence or absenceof an integrated medical function. When an integrated medical function was
not present, the medical focus was primarily on contract services, travel needs
and employee health beneﬁts. Corporate downsizing was one reason given forthe decreased the number of full-time, corporate medical directors.
The trend to outsourcing of medical is also prevalent in employee assistance. Employee assistance programs (EAP) are the locus of health promotion,assessment, and sometimes treatment for a range of employee psychologicaland behavioral health problems including workplace stress, substance abuse,mental disorders, and domestic violence. Most companies outsource their EAP
services. After 9/11, one corporation hired their outsourced EAP as a full-time

Outsourcing of corporate
medical services appeared
to represent a potentiallyserious barrier to corporate
preparedness.

Integration, Collaboration and Cross-functionality
for Corporate Preparedness and Response■■■■

SafetyProtection
Emergency Response
Risk/ThreatCommunication

Security
Human Resources

■
■
■
■

Policies
TravelSupervision
Communication

20 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

EAP &Medical Care

■
■
■
■

Medical Care
Behavioral HealthWellness
Health SurveillanceInternal EAP Directors that theteam interviewed believed that
their existing health promotion
activities could be expanded toinclude employee preparedness
for terrorism and bioterrorism.

employee of the corporation recognizing the long-term implications of this terrorist event might result in an escalation of psychological and behavioral healthproblems. The occupational health program found their caseload divided into
two groups. The larger group was experiencing short-term traumatic stress withconcerns about continuing to work in this environment. The second group hada prior history of trauma and anxiety that was reawakened as a result of 9/11.
Alcohol use increased, as did tobacco use. There were family problems as many
spouses were upset about the other spouse returning to work. Comments like,“My spouse doesn’t get it. We’re not on the same page,” prompted home mailings to reassure families.
Debrieﬁng was found to increase re-experiencing of the event and was disbanded. In its place, a resilience model was instituted that focused on managing
one’s stress (not disaster speciﬁc) and preparedness for recovery. Occupational
health and security collaborated and thought outside the box. “Counselors
wandered the halls and bomb dogs became therapy dogs.”
Some corporations that utilized outsourced resources and were pleased
with their response to 9/11 commented that, “vendors need to be the best inclass.” Corporations are responsible for ensuring the best quality and deliveryof services and require close monitoring. It was commented that the contracted
role was primarily to respond to crisis, not to educate employees about preparedness. The tendency to utilize outsourced Employee Assistance Programs(EAPs) and subcontracted crisis management ﬁrms may represent a barrier to
employee preparedness as it is not a proﬁtable activity for the vendor and thecorporation may overlook this need as their responsibility.
In addition several of the outsourced EAPs noted past use of, and plans to
use Critical Incident Stress Debrieﬁng in the aftermath of disaster or attack.
Recent studies of this procedure suggest that it may be a potentially harmfulintervention and in particular will not prevent development of post-traumaticstress disorder. This lack of knowledge of evidenced based interventions wasprominent in this area.
Internal EAP Directors that the team interviewed believed that their existing health promotion activities could be expanded to include employee preparedness for terrorism and bioterrorism.
Outsourcing: Outsourcing is a core component of corporate structure
to limit costs, expand opportunities and meet regulatory requirements. Corporations reliant on transportation networks recognized the vulnerability ofoutsourced services such as trucking, rail transport, barges, and aircraft. The
preparation and reliability of a contractor is not in the control of the primary
corporation. (Similarly, corporate oﬃces that are outside of owned facilities arevulnerable to the planning, drills and threat vulnerability planning of the building owners). Contracted seasonal workers were also less integrated into thecorporate planning. When these created corporate costs, extensive programs
were arranged to educate and supervise to limit dangers and costs. They weremore diﬃcult to prepare because of their limited availability for training. Outsourcing of occupational health functions has been discussed above. Thus outsourcing, in general, may be a barrier to preparedness and can even compromise corporate security.

WORKPLACE PREPAREDNESS FOR TERRORISM • 21

Disaster Paradigms

Disaster Paradigms
Deﬁning Event
Resiliency

Each corporation that the
study team interviewed had
experienced a deﬁning event or
events that became a template
for their approach in preparing
for and responding to workplacecrises and traumatic events.

Deﬁning event: Each corporation that the study team interviewed had experienced a deﬁning event or events that became a template for their approachin preparing for and responding to workplace crises and traumatic events. Weview these as establishing a corporate disaster paradigm. Deﬁning events included industrial accidents, workplace violence, acts of disgruntled employees,
natural disasters, and the experience of 9/11. A corporation’s crisis management philosophy, team, and training were often organized around one or moreof these deﬁning events, which became their disaster paradigms.
We observed that interviewees responded to questions about bioterrorism
and their corporations’ preparedness by referring to their recollections of thesedeﬁning events, and the lessons learned. It was easier for interviewees to discuss
real events than hypothetical threats and concepts of preparedness. Interviewees’ descriptions of disaster events included descriptions of the development ofshared meaning within various leaders of each corporation, and the need forleadership to be visible and on the spot when a critical incident occurs.
Resiliency: These deﬁning events become a resiliency benchmark. Positive responses to previous corporate disasters set the standard for what leadersthought resiliency should be in their respective organizations, and provided
belief that they are capable of recovery from adverse events. This benchmark
and belief became a critical basis of their preparedness posture.
One company remarked that they have, “the gold standard of preparedness.”
This standard was described as multi-pronged. It encompassed the health, wellbeing and safety of employees, communication, having actual preparedness
and response plans in place and ongoing, creative reminders to sustain threatawareness amongst employees.
We do not have any reason to believe that this was a conscious or deliberate
process. Rather, disaster paradigms seem to develop spontaneously as a resultof the shared experience of corporate responders to these signiﬁcant corporate
events.
Communication for Preparedness, Response and Recovery
The importance of information, provided on a consistent and reliable basis
in disaster events was heard repeatedly. Whether this was a clearly designatedresponsibility that was valued varied. The role of human resources was usually
critical and central to the communication planning. In many ways communication was a function of the Human Resources Division.
Communication for Preparedness, Response and Recovery
Mattering
Communicating Preparedness, Response and Recovery

22 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Interviewees described theimportant role of corporate
communications in crisis
management and response.

Mattering Preparedness measures to support human continuity served
Mattering:
several functions, including practical help for maintaining work and contact,
but also, and reported by several interviewees as important, communicating
to employees that they mattered. In each of the corporations the study teamvisited, oﬃcials emphasized the importance of creating a sense of mattering.
This appeared to be more eﬀectively implemented in some but not other corporations and divisions. Successful implementation was done by many means,including in addition to enhanced communications measures noted above, encouraging health and ﬁtness through special programs such as immunizations
and ﬁtness centers, supplying individual disaster kits for every employee, andproviding an assurance of job security in the aftermath of adverse events. For
example, one corporation cited the morale beneﬁt to employees when the CEOannounced the day after 9/11 that employees would all have jobs despite disruption of their business.
Instilling in employees the sense that they matter involved not only communication and good intentions, but also required resources and management
actions that demonstrated a sense of mattering. In a recent large-scale evacuation, an organization whose individuals worked in separate sites experienced
a disparity in employee protection. Upon evacuating, this organization’s employees, whose evacuation gear was limited, observed that employees of otherorganizations whose buildings they shared evacuated with sophisticated kits
including protective masks. This created a drop in employee morale and a sensethat they did not matter. (Ursano, Vineburgh 2005)
Communicating Preparedness, Response and Recovery. Interviewees described the important role of corporate communications in crisis management
and response. Since 9/11, many corporations realized the need for ongoing employee information updates and having some positive mechanism for ensuring
the updates really occur. The latter requires having ways to communicate with
employees who are not at the oﬃce and means that contact lists must be current. One corporation created a system that caused employee ID cards (necessary for entrance to the building) to fail if their contact information had notbeen updated within thirty days.
A corporation’s employee website was also reported as a valuable tool in
disaster communication. One corporation aﬀected by 9/11 had launched its
company employee website on September 10. The site served as a critical tool
to keep employees informed throughout the recovery process. The site continues to be central to the organization’s employee education and communication
about threat and preparedness. Their experience and that of other corporations
using the Web for employee communications supported the value of this approach, but also highlighted some problem areas. First, the site only worked
for people with access to the communication net. Hourly employees and contractors were often harder to reach, as were any employees without regular access to a computer. Communication required sensitivity to the diversity of theworkplace, and had to include information in diﬀerent languages, be accessible
to special populations such as the disabled, and be easily comprehensible.
Other technologies, some older, were also important in corporate communications. In immediate response to 9/11, public address systems were the mostaccessible and useful forms of communication (Argenti, 2002). Since 9/11,
some corporations have also made more extensive use of Blackberries and cell
phones. One corporation expanded its PA system into buildings remote fromthe main headquarters building and in spaces shared by more than one ﬁrm.
Other forms of communication include 800 numbers for updates and phonetrees.
WORKPLACE PREPAREDNESS FOR TERRORISM • 23

Corporate communications also responded to the wide variety of othersources of information — and misinformation. With the Internet and real time
television, disaster information was usually received in real time and often
events were viewed as they were occurring. Therefore, corporate communication design required rapid response if it were to inform employees and allay
concerns. Another critical challenge was ﬁnding the balance between providing too little information and too much information. Corporate communication also had a responsibility to deal externally with customers and the media.
Summary
Corporate leadership must
champion the importance ofterrorism preparedness in orderfor management to facilitate
preparedness activities.

Barriers and Opportunities
Corporate leadership
Critical role for corporate security as leader in human continuity
preparedness
Critical role of occupational health (medical and EAP) in planning,
response and recovery
Integration and collaboration of security, human resources andoccupational health (medical and EAP)
Corporate communication
Education and training

Corporate Leadership
In the corporations which were the most successful in preparedness, leadership was felt to be dedicated to protecting and preparing their people. Corporate leadership must champion the importance of terrorism preparedness
in order for management to facilitate preparedness activities. A corporationthat provides preparedness education sends a message that it cares, and thiscan counter-balance a corporation’s fear that undertaking such activities runs
the risk of fear mongering or increasing employee anxiety. Leadership can undermine or reinforce a corporation’s historical values. Either way, the morale
and trust of employees are aﬀected and these impact response to training andcompliance with recommendations critical to response and recovery in crises.
Certain corporate cultures may make people feel they matter more (or less)than others. Policies and leadership behavior must maximize people’s sensethat they matter, and be informed by the idea that best-practices for training or
preparing one sub-culture within a corporation may not be as eﬀective in othersub-culture populations.
Critical Role for Corporate Security as Leader in Human Continuity
Preparedness
As a result of 9/11, a number of corporate functions, including as seen
here, have begun to step beyond their formerly prescribed functions and roles(Greenberg, 2002; Argenti, 2002) to assume necessary leadership of preparedness. Corporate security, traditionally tasked with guarding the perimeter, hasmore than before moved to deal with the human continuity aspects of preparedness (Conference Board, 2003; Burill, 2005). Working with communications, occupational health and human resources, security is ideally positioned
to educate employees about preparedness and develop and sustain a corporate
culture of safety. This professional group has the resources and skills to educate
24 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

employees about preparing and life-saving behaviors in the face of disaster andterrorism (Ursano, 2003).

The role of occupational
health providers is essential
to disaster planning andresponse…

Critical Role of Occupational Health (Medical and EAP) in Planning,
Response and Recovery
The role of occupational health providers is essential to disaster planningand response (Ursano RJ, Fullerton, CS, Norwood AE, 2004a; Stith et al 2003;
Guidotti, 2005). Marginalizing medical services, a result of downsizing and outsourcing, may have contributed to corporate crisis management overlooking
major threats especially ones related to the health consequences of terrorism— particularly bioterrorism and the important on-going role of the medical
director and medical care planning in this response and preparation. The Avian
ﬂu concerns also illustrate this at present. However, many occupational healthprofessionals also lack training in disaster health and mental health (Stith etal, 2003). Occupational health nurses are knowledgeable about the health effects of hazardous and toxic substances, especially in manufacturing industries
involving chemicals where they assess exposure and injuries (Guidotti, 2005).
Bioterrorism preparedness requires this established platform of knowledge andoutreach. Corporate medical directors play a critical role in workplace risk assessment around the threat or actuality of bioterrorism, infectious disease andpandemics.
Corporations must also be alert to management of occupational healthservices in the aftermath of disasters because of the potential liability aroundpost-disaster care (Tehrani, 2002). The burden of disease from depression, anxiety, alcohol misuse and abuse—all associated with disaster exposure—is costly
in terms of healthcare expenditures, lost productivity and impact on morale(Birnbaum et al., 2000; Stewart et al., 2003; Mangione et al., 1998).
Similarly, as part of occupational health, internal EAPs have greater understanding of their corporation’s culture than do contracted providers and canuse this for planning and response as well as advising leadership. The loss of
this internal knowledge of employee life can aﬀect disaster planning and recovery unless this is recognized. Corporations must be vigilant and conscientious
in setting expectations for outsourced services that relate to employee security
or preparedness. Some corporations in this study made special eﬀorts to get toknow their vendors and to establish relationships to ensure that the vendors
were “part of the team” and would be responsive to the corporation’s culture
and values. It is unlikely such will occur widely without regulatory requirements since this aspect of preparedness will substantially increase costs.
Employee assistance providers (EAPs) are also a resource for education as
well as mental health care in disaster preparedness. EAPs gained great visibility
as a ﬁrst responder in the workplace after 9/11 (Greenberg, 2002). In addition to oﬀering assessment and referral for issues aﬀecting employee mental
health and performance, EAPS disseminate preventive health information.
This role is central to disaster preparedness (Vineburgh, 2004; Vineburgh et al.,2005a,b,c.).
Integration and Collaboration of Security, Human Resources andOccupational Health (Medical and EAP)
Integration and cross-functionality of workplace functions is critical toachieving crisis management objectives around human continuity (Shaw andHarrald, 2004; Vineburgh et al., 2005a,b,c; Ursano and Vineburgh, 2004; Ursano and Vineburgh, 2005). Collaboration between corporate security and EAP
can reinforce the health implications of employee preparedness, an approach
WORKPLACE PREPAREDNESS FOR TERRORISM • 25

that can personalize activities like drills, which many employees regard as operational and therefore not their responsibility. Findings on human preparedness
around engaging and inﬂuencing public action suggest that personalizing risks
motivates behavior change (Tierney, 2001). Corporate security, occupational
health (medical and EAP functions), human resources and corporate communications must work together in this process that encompasses three phases:
pre-event, event and post-event.

Integration and cross-functionalityof workplace functions is criticalto achieving crisis management
objectives around humancontinuity

Corporate Communication
Often communication within the corporation is a function of both humanresources/personnel and a communications department. Corporate communications is essential to work with corporate leadership and human resourcesin post terrorism response and recovery. In addition to what we found in thisstudy, two case studies on corporate responses to 9/11 in the Harvard Business Review (Argenti, 2002; Greenberg, 2002) underscore the importance ofcommunications and communication strategies in the immediate aftermath ofworkplace disasters, and how communication fosters organizational recovery
and resilience. Accounting for employees, maintaining contact, setting work
policies for return, absence and travel, disability policy, assisting employee return to work, reassuring families and providing ongoing information arounddisasters is a critical function driven by good communication and communication resources, i.e. telephone trees, employee websites, PA systems, client andmedia interface).
Communication is particularly important from leadership to employees
and from employees and management to leadership after a disaster. Terrorism opens the fault lines of a society revealing its vulnerabilities and divisive
tendencies along racial, ethnic and religious lines (Ursano, 2002). This can result in scapegoating. and discrimination against ethnicities perceived as akinto the terrorists, as well as fallout around perceived inequities in disaster treatment responses. In the aftermath of the anthrax attacks of 2001, U. S. postal
workers perceived their medical treatment as inferior to that given to employees on Capital Hill. This perception rooted around the fault lines of race andethnicity in the United States, resulted in serious and persistent mistrust that
undermined the cohesion of the postal service workplace including legal ramiﬁcations (Holloway and Waldrep, 2004; Steury et al., 2004). These behavioral
consequences of terrorism, which were evidenced in Hurricane Katrina, haveimportant implications for the human capital and continuity of organizations.
Human resource personnel must be knowledgeable about the potential of fallout and plan to mitigate its occurrence.
Education and Training
Deﬁning events oﬀer opportunities for preparedness learning and training.
The challenge is, to quote a prominent public spokesperson on national preparedness and threat awareness, to transpose these stories into a public education campaign around workplace preparedness. The opportunity, however, liesin the recognition that corporations appear to identify more readily with an allhazards approach based on previous corporate experience than to hypotheticalmodels of potential attacks.
New knowledge is needed in evidence based and evidence informed interventions for post disaster recovery. For example, critical incident stress debrieﬁng (CISD) has become a staple in the arsenal of corporate response todisasters (Tehrani, 2002). Many outsourced EAPs subcontract to crisis management ﬁrms that specialize in this approach. However, a number of studies

26 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Corporations are communities
unto themselves with their own
culture and values. Intrinsic tothe culture of a corporation is
its own experience with disaster,which shapes its beliefs, threat
assessment and responses
to critical incidents and their
management.

have shown this method to be ineﬀectual and even detrimental (Schouten etal., 2004; McNally et al., 2003; Rose et al., 1999; Rose et al., 2001; Raphael, B
2004).
In developing training or education programs for employee preparedness,
it is also essential to recognize various subcultures within the company. Subcultures may represent workers within diﬀerent divisions in a corporation,seasonal vs. full-time employees, employees of diﬀerent ages, or of diﬀerent
ethnicities. For example, older, more tenured, employees may be resistant toadopting new safety practices because they feel comfortable with procedures
they’ve utilized successfully for long periods of time and do not feel the necessity to change them.
Because each corporation’s perception of threat diﬀers based upon suchfactors as location, industry, disaster history, organizational structure and values, an educational approach to employee preparedness must identify elements
which have universal appeal for organizations and workforces. Seizing on the
more readily identiﬁable all-hazards approach rather than models based on hypothetical (and at times unimaginable) threats may be a reasonable starting
point. However programs must then be tailored such to meet individual corporate needs based on speciﬁc corporate factors such as threat perception, brandperception, corporate culture and values, corporate resources and priorities,
perceived (and actual) points of failure, and identiﬁable needs and characteristics of corporate subculture populations
Each corporation’s unique characteristics, priorities, values, and resources
will pose barriers to preparedness if these unique factors are not incorporated
into preparedness programs or training. However, the correct identiﬁcation ofa corporate “language” — sensitive to corporate culture, priorities and uniquecharacteristics — and the development of programs and training informed anddelivered in this “language’, can assist in overcoming this barrier. In addition,
this strategy can provide an opportunity to enhance leadership support forand employee participation in terrorism preparedness. Behavioral research on
crowd behavior (Mawson, 2005; Aguirre, 2005) has important implications for
employee training. Corporate leadership needs to be aware of such ﬁndings toprovide the most eﬀective training.

WORKPLACE PREPAREDNESS FOR TERRORISM • 27

Corporations must have an
integrated crisis management
team with cross-functionality.

Conclusions and Future Steps
Corporations are communities unto themselves with their own culture
and values. Intrinsic to the culture of a corporation is its own experience withdisaster, which shapes its beliefs, threat assessment and responses to criticalincidents and their management. While corporations depend on the federal
government for threat assessment information, industry is better positioned toprepare employees and to provide post-disaster interventions.
Employed individuals spend more than a third of their day at work (IOM,
2003), and work is most often the source of one’s health beneﬁts. There is increasing evidence that workplace health promotion activities and programs canchange behavior and psychosocial risk factors for individual employees and thecollective risk proﬁle of the employee population (IOM, 2003b; Mangione etal. 1998). Two times as many individuals experiencing persistent distress after
9/11 accessed information at work rather than from a medical practitioner, andover three times as many sought information and counseling at work rather
than from a mental health provider assumedly in a community setting (Stein etal. 2003).
This study revealed a number of barriers and opportunities for human continuity preparedness. These areas require both organizational changes and education of key corporate function leaders. Corporations must have an integrated
crisis management team with cross-functionality. Educational programs andmaterials to encourage corporations to undertake employee preparedness andpractice of preparedness behaviors are needed. Education should take place inways that foster integration of the critical incident team and include didactic
and practical instruction. The opportunity to develop lessons learned from pastor future disaster events can also bring together corporations to share and develop new human continuity planning and response needs.
Workplace preparedness for disaster and terrorism is essential to protect
and sustain our nation’s security, defense and public health in the 21st century.
Workplace preparedness is critical to citizen preparedness. Educating employees about terrorism and bioterrorism and response behaviors helps individuals
educate and prepare their families, their communities and our nation. Regardless of their location or locations, all employees are subject to threat exposure
or actual terrorist events through their own travel, travel of family members,changes in workplace environment or through an attack of weapons of mass
destruction or pandemic outbreak, which would aﬀect large areas of the country. Natural disasters such as the recent hurricanes and ﬂoods, terrorism andbioterrorism such as 9/11 and the anthrax attacks, and pandemic threats fromSARS and Avian Flu require an informed and resilient workplace and workforce.

28 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Although Hurricane Katrina occurred after this study was completed
observations of the response eﬀort reinforce corporate interviewee concerns
calling for coordination of eﬀorts between the private sector and all levels ofgovernment. This natural disaster, with its far-reaching eﬀects, provides opportunities to develop lessons learned for the public/private sector coordinationthat would be required after an attack with weapons of mass destruction.
The CSTS project demonstrated the willingness of corporations to engage
in an exploration of their human continuity terrorism preparedness with external academic institutions. This willingness appears to be predicated on an
institutional approach that capitalizes on previously established relationships,
engages corporations with a study question of interest to the corporation itself,
and takes speciﬁc measures to protect the conﬁdentiality of information andinformants and to direct inquiries in a manner not viewed as threatening tocompetitive proprietary interests or corporate security practices.
Deﬁning Future Steps
Based on this study the following are needed:
1. Initiate targeted knowledge dissemination programs for a) corporate leadership, and b) corporate functional leaders (e.g. security, occupational
health (medical and EAP), human resources and communication). Educational programs should foster integrated disaster planning for human continuity. Such a program needs to include knowledge about organizationaland behavioral responses to terrorism, interventions and scenario training.
Scenario based education in particular using 9/11 and hurricane Katrina
as case studies for planning and response to complex catastrophic events
which include loss of infrastructure can yield increased knowledge andpreparedness. Writing useable scenarios that can teach human continuity requires expertise in terrorism preparedness, disaster response, humanbehavior and teaching/education. The Center for the Study of TraumaticStress (CSTS) is uniquely positioned and skilled in this task.
In addition, the CSTS is presently seeking partners to join in support offunding received from SAMSHA for the ﬁrst knowledge dissemination
conference for corporate preparedness. This meeting will be a major stepin both educating for human continuity and bringing together various corporate functions, across various industries, to share knowledge and practice and identify gaps in terrorism preparedness for human continuity.
2.

Develop educational materials for corporate human continuity preparedness and response. A model for this is the “Courage to Care” health education program of the CSTS. The CSTS has initiated an extremely successful
health education campaign that is now distributed around the nation andthe globe. Directed to medical providers and others who reach the public“Courage to Care” is based on ﬁnding “teachable moments. It has been
distributed with information on preparing for inﬂuenza, helping families
think about evacuation, and training families and health care providers in
psychological ﬁrst aid. This program is a model of what is needed for the
corporate functions of security, human resources, and occupational health(medical and EAP),

3.

Provide real time knowledge dissemination/consultation to corporate disaster/critical incidents to foster human continuity. This is a model the
WORKPLACE PREPAREDNESS FOR TERRORISM • 29

CSTS has used for many years to develop rapid information and disseminate it in response to real time questions. For example, recently the CSTS
provided corporate consultation and knowledge materials for human continuity for the Katrina hurricane, addressing the issues of “continuous operations” required for recovery.
4.

Develop lessons learned from corporate experience with Hurricane Katrina as an event that can teach about response and recovery for weapons of mass destruction. The CSTS has consistently held lessons learned
meetings for issues of bioterrorism, and other weapons of mass destruction, yielding important recommendations for use by public and private
agencies. The development of a three day conference of security, humanresource and occupational health corporate leaders, in conjunction withacademic and operators, to think together on the present barriers to preparedness and needed programs could yield highly valuable input often notdeveloped in ways that are useable. The CSTS had a record of successful
Lessons Learned meetings that have inﬂuenced federal, state and private
agencies. Such a meeting can also identify regulatory and legal agendas for
preparedness response.

5.

Expand the present study to a survey based approach of various groups(e.g. security, EAP) to increase knowledge of barrier and opportunities for
preparedness across a wide range of corporations. Additional knowledge
is needed. Systematic information collected now with the assistance ofpartnerships with the corporations and individuals who participated inour study—nearly all of whom volunteered to be resources in the future—
could yield corporate study of corporate preparedness backed by the skills
and knowledge of the CSTS.

Initiate targeted knowledge
dissemination programs for a)
corporate leadership, and b)
corporate functional leaders (e.g.
security, occupational health(medical and EAP), humanresources and communication).

30 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

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34 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Appendix A
Study Team
Robert J. Ursano, M.D.
Robert J. Ursano, M.D. is Professor of Psychiatry and Neuroscience andChairman of the Department of Psychiatry at the Uniformed Services University of the Health Sciences, Bethesda, Maryland. He is Director of the Centerfor the Study of Traumatic Stress which has over six million dollars in researchfunding. In addition, Dr. Ursano is Editor of Psychiatry, the distinguished journal of interpersonal and biological processes, founded by Harry Stack Sullivan.
Dr. Ursano was educated at the University of Notre Dame and Yale University School of Medicine and did his psychiatric training at Wilford Hall USAF
Medical Center and Yale University. Dr. Ursano graduated from the Washington Psychoanalytic Institute in 1986 and is a member of the teaching faculty of
the Institute. Dr. Ursano served as the Department of Defense representative
to the National Advisory Mental Health Council of the National Institute of
Mental Health and is a past member of the Veterans Aﬀairs Mental HealthStudy Section and the National Institute of Mental Health Rapid Trauma andDisaster Grant Review Section. He is a Fellow in the American Psychiatric Association, the American College of Psychiatrists, and the American College of
Psychoanalysts and is listed in Who’s Who, Who’s Who in America and Who’s
Who in Medicine and Health Care.
Dr. Ursano was the ﬁrst Chairman of the American Psychiatric Association’s Committee on Psychiatric Dimensions of Disaster. Through his workwith the Committee, the American Psychiatric Association established a collaborative relationship with the Red Cross, the Bruno Lima Award to recognize
contributors to psychiatric care in times of disaster, and the Eric Lindemann
Grant to support disaster services. This work greatly aided the integration of
psychiatry and public health in times of disaster and terrorism. Dr. Ursano
was an invited participant to the White House Mental Health Conference in
1999. He has received the Department of Defense Humanitarian Service Awardand the highest award of the International Traumatic Stress Society, The Lifetime Achievement Award, for “outstanding and fundamental contributions tounderstanding traumatic stress.” He is the recipient of the William C. Porter
Award from the Association of Military Surgeons of the United States.
Dr Ursano is a member of the Advisory Board of the National Partnershipfor Workplace Mental Health (American Psychiatric Association); the White
Paper Panel on Bioterrorism and Health Care, Joint Commission on AccreditaWORKPLACE PREPAREDNESS FOR TERRORISM • 35

tion of Health Care Organizations; the Scientiﬁc Advisory Board on Bioterrorism of SAMSHA (HHS), Center for Mental Health Services; the Advisory Boardof the Center on Terrorism of the University of Oklahoma School of Medicine;
the National Academies of Science, Institute of Medicine, Committee on Psychological Responses to Terrorism; and the National Institute of Mental Health
Task Force on Mental Health Surveillance After Terrorist Attack.
Dr. Ursano has over 200 publications. He is co-author or editor of sevenbooks. His publications include the widely cited and referenced “PsychiatricDimensions of Disaster: Patient Care, Community Consultation, and Preventive Medicine” in the Harvard Review of Psychiatry and the internationally recognized volume Individual and Community Responses to Trauma and Disaster: The Structure of Human Chaos. (Cambridge University Press.) His bookson psychotherapy have been translated and published in Russia, Turkey, China
and Japan.
Dr. Ursano is widely published in the areas of Post-Traumatic Stress Disorder and the psychological eﬀects of terrorism, bioterrorism, traumatic eventsand disasters and combat. He and his team have served as consultants andcompleted studies on numerous disasters, disaster rescue workers, motor vehicle accident victims, family violence, and Viet Nam, Desert Storm and Gulf
War veterans. His research group completed the follow-up studies of the USAF
Vietnam era prisoners of war, identifying the critical role of degree of exposure
to outcome, resiliency, and the development of psychiatric disease in those withno known risk factors. More recently, he was part of the design of the repatriation of the Desert Storm prisoners of war. His work on disaster ﬁrst responders
is noted for the focus on public health needs. His group has studied the psychiatric responses of individuals to disasters and to small-scale traumatic events
including motor vehicle collisions in order to better understand the humantrauma response and its mechanisms of disease and recovery.
Dr. Ursano and his group are at the forefront of public health policy planning for terrorism, and bioterrorism in particular. Their work has been widely
cited in government planning and Institute of Medicine, National Academiesof Sciences reports addressing these issues. He was a national consultant forplanning clinical care responses and research programs following the September 11th terrorist attacks, providing consultation to New York State Governor’sOﬃce, New York City Mayor’s Oﬃce, Department of HHS, National Capital
response teams and the Department of Defense Pentagon response groups. His
group developed educational materials that were some of the most widely disseminated throughout the nation to assist populations exposed to the September 11 attack.
Dr. Ursano’s research has been funded by the National Institute of Mental Health, SAMSHA, CDC, NIOSH, the Sloan Foundation, the United States
Army, the United States Air Force, and other national foundations and agencies.
Nancy T. Vineburgh, M.A.
Nancy T. Vineburgh, M.A. is Assistant Professor in the Department of Psychiatry at The Uniformed Services University of the Health Sciences in Bethesda, Maryland. She serves as the Director of the Oﬃce of Public Education andPreparedness at the Center for the Study of Traumatic Stress (CSTS).
Ms. Vineburgh is an expert in health communication, health marketingand public education with a focus on the workplace. She has created numerous, high proﬁle public education campaigns that have generated national andinternational attention: Fight the Bite, the nation’s ﬁrst health campaign for
36 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Lyme Disease awareness; Courage to Care, an electronic campaign addressing the well-being of deployed soldiers and their families; Can a Depressed
Parent Be a Good Parent, You Bet, the nation’s ﬁrst campaign on parental depression sponsored by Children’s Hospital Boston; Where to Draw the Line, athree year campaign for National Alcohol Screening Day sponsored by NIAAA
and SAMHSA; Our Nation’s Resilience: Paintings, Public Education and Preparedness for Terrorism, an art exhibit to educate the nation about terrorism
preparedness on display in the Rotunda of the Russell Senate Oﬃce Building,
Washington, D.C throughout the week of September 11, 2005.
She is Co-Principal Investigator of a research study, Workplace Preparedness for Terrorism, funded by the Alfred P. Sloan Foundation. Her publishedpaper, The Power of the Pink Ribbon: Raising Awareness of the Mental Health
Implications of Terrorism in the Journal Psychiatry inﬂuenced public policy
and led to Maryland’s proclamation of National Resiliency Day on September
11, 2004, an oﬃcial event to be held annually.
Her work has earned numerous awards including Woman of the Future by
Hartford Woman Newspaper in recognition for her broadcasting on women’s
health; The Combined Health Appeal Media Award and Connecticut’s Arthritis Foundation Public Education Award for her work related to Lyme Diseaseeducation.
Ms. Vineburgh received her B.A. from Connecticut College in New London, Connecticut, her M.A. in counseling from St. Joseph College, West Hartford, Connecticut, and attended Harvard University Graduate School of Education. She is a member of the Washington School of Psychiatry, the American
Public Health Association, the Employee Assistance Professionals Associationand Employee Assistance Society of North America.
Dr. Robert K. Giﬀord, Ph.D.
Robert K. Giﬀord, Ph.D., is a senior scientist in the Center for the Studyof Traumatic Stress at the Uniformed Services University of the Health Sciences, specializing in the study of traumatic stress in the workplace, particularly combat stress, operational stress, accidents, and the aftermath of workplace
incidents. His advanced degrees include Doctor of Philosophy and Master ofPhilosophy degrees, both in psychology, from Yale University, and a Master of
Science in clinical psychology from Saint Mary’s University in San Antonio,
Texas. Dr. Giﬀord served in the United States Army for thirty years, retiring as
a colonel. While in the Army, he conducted psychological research in the ﬁeld
in the Persian Gulf War (Operation Desert Shield/Storm), in Somalia, and in
Bosnia as well as at ﬁeld sites in Germany and the United States. He served as
Research Psychology Consultant to The Army Surgeon General and later as the
Army Medical Service Corps’ Assistant Chief for Medical Allied Sciences.
Dr. Giﬀord’s research interests include creating resiliency in organizations;the role of group, organizational, and community factors in facilitating a return to normal function after disaster or traumatic loss; and grief leadership— the eﬀect of leaders’ behavior and communication on group recovery. He
has extensive experience with both interview research at multiple levels withinorganizations, and survey questionnaires for larger populations. He has also
been active in education about traumatic stress and developing resiliency inorganizations and individuals, having lectured on the topic both in the UnitedStates and in Europe. His publications include the entry on “War and Conﬂict:
Eﬀects on Military Personnel” for the Encyclopedia of Psychology, published by
the American Psychological Association and Oxford University Press.

WORKPLACE PREPAREDNESS FOR TERRORISM • 37

David M. Benedek, M.D., LTC, MC, U.S.A.
Dr. Benedek received his B.A. from the University of Virginia in 1986 andhis M.D. from the Uniformed Services University School of medicine in 1991.
After Internship and Residency in Psychiatry at Walter Reed Army Medical
Center, he was assigned as Division Psychiatrist, First Armor Division, Germany. From there, he deployed to the former Yugoslavia and delivered mental
health support to U.S. and NATO Troops for Operation Joint Endeavor (1996).
He returned to Walter Reed to complete forensic psychiatry fellowship training
in 1998 and then served as the Assistant Chief of Inpatient Psychiatry, Walter
Reed Army Medical Center. In 1999 he became Chief, Forensic Psychiatry Service, and Director, National Capital Consortium Military Forensic Psychiatry
Fellowship Program at Walter Reed, and he remained in those positions until
joining the USUHS/CSTS faculty in 2004. Dr. Benedek’s awards include theMeritorious Service (20LC) and Army Commendation (3OLC) Medals for his
work at Walter Reed and in Bosnia, the LTG Claire Chennault Award for Outstanding Military Psychiatry Faculty Member, and the American Psychiatric
Association’s Nancy C.A. Roeske Award for Excellence in Medical Student Education. In 2002 he received the U.S. Army Surgeon General’s “A” Proﬁciency
Designator. He has authored or co-authored over 30 scientiﬁc publications, andhas presented on numerous aspects of military, disaster, and forensic psychiatry at regional, national, and international professional conferences. His studies include ﬁrst responders to the December 2004 tsunami and he has written
extensively on traumatic death and grief recovery. In addition, he was a major
contributor to the development of Rapid Knowledge Dissemination Programfor Hurricane Katrina national and local responders. Dr Benedek serves on theAmerican Psychiatric Association’s Committee on Conﬁdentiality was a consultant to the Association’s Practice Guideline for the treatment of Acute Stress
Disorder and Posttraumatic Stress Disorder work-group in the development of
its recently published practice guideline.
Dr. Benedek is an Associate Professor of Psychiatry and Scientist at theCenter for the Study of Traumatic Stress, Uniformed Services University of the
Health Sciences. He is a Past President of the Society of Uniformed Service
Psychiatrists—the Military District Branch of the American Psychiatric Association. He was recently selected as a Distinguished Fellow of the American
Psychiatric Association. In addition to his operational experience in Bosnia
and Croatia Dr. Benedek has deployed to Cuba, Iraq and Kuwait in conjunction
with the Global War on Terrorism. In 2004 he was appointed Consultant to the
U.S. Army Surgeon General for Forensic Psychiatry. He has been married since1991 to Cindy Bierman of Bowie, MD and he and his wife reside in Clarksville
Maryland with their four children.
Carol S. Fullerton, Ph.D.
Carol S. Fullerton, Ph.D. is Research Professor in the Department of Psychiatry at the Uniformed Services University of the Health Sciences School of
Medicine (USUHS), Bethesda, Maryland. She is the Scientiﬁc Director of theCenter for the Study of Traumatic Stress (CSTS), an interdisciplinary Centerwith an established an International reputation for research, education andconsultation on the eﬀects of terrorism, bioterrorism, trauma, disasters, andwar on individuals, communities and groups.
Dr Fullerton was educated at Alfred University, New York, and did her
graduate work in Psychology at the University of Maryland. Dr. Fullerton’s research and consultation to disaster populations was recognized by the awarding of the Department of Defense Meritorious Service Medal in 1990, and the
38 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

USUHS Exceptional Service Medal in 1993. Dr. Fullerton is the 2005 recipientof the James Leonard Award for Excellence in Clinical Research, USUHS. Dr.
Fullerton’s research on the acute and long term eﬀects of trauma exposure on
disaster workers was selected as the feature article for the August 2004 volumeof one of the most prestigious journals in psychiatry, the American Journal of
Psychiatry.
Dr. Fullerton and her group established the Military and Disaster Psychiatry Fellowship, an International program to train psychiatrists and other mental health providers. Under her leadership the Department of Psychiatry alsoestablished the Clinical Scientist Training Program in Disaster Psychiatry at
USUHS.
Dr. Fullerton is widely published in the areas of post-traumatic stress disorder and the behavioral and psychological eﬀects of terrorism, bioterrorism,
traumatic events and disasters, and combat. Dr. Fullerton has over 100 publications. She is editor or co-author on 5 books: Bioterrorism: Psychological andPublic Health Interventions (Cambridge University Press, 2004); Terrorism
and Disaster: Individual and Community Mental Health Interventions (Cambridge University Press, 2003); Mental Health and Mass Violence: Evidence
Based Early Psychological Intervention for Victims/Survivors of Mass Violence(National Institute of Health Publication No. 02-5138, 2002); PosttraumaticStress Disorder: Acute and Chronic (American Psychiatric Association Press,
1997); and Individual and Community Responses to Trauma and Disaster: The
Structure of Human Chaos (Cambridge University Press, 1994). Dr. Fullerton’s
articles are frequently cited because of the contributions to developing response
capabilities to terrorism, bioterrorism, disaster, and war.
Dr. Fullerton Co-directed two International conferences that resulted in
two published monographs that were widely circulated in congress and served
as the basis for congressional recommendations for the nation’s security: Planning for Bioterrorism: Behavior & Mental Health Responses to Weapons ofMass Weapons of Mass Destruction & Mass Disruption (DTIC: 142, 2000); andResponses to Terrorism & Infectious Disease Outbreaks: Planning for Biological Events (2001).
Dr. Fullerton has conducted empirical investigations and provided consultation to the following disaster and traumatic events: Ramstein Air Force
Base air show crash; Norton Air Force Base cargo plane crash; USS Iowa gun
turret explosion; United Flight 232 DC-10 crash, Sioux City, Iowa; Armenianearthquake; Operation Desert Storm; the USNS Comfort Desert Storm deployments; Typhoon Ohmar; Hurricane Andrew; dentists following Waco disaster;
9/11 Pentagon personnel; USNS Comfort 9/11 deployment; DC Sniper attacks;
motor vehicle accidents; eﬀect of terrorism on State Department Oﬃcers andfamilies; the eﬀects of the 2004 Florida hurricanes on the FL Department of
Health; and the 2004 South East Asia Tsunami.
Dr. Fullerton and her group are at the forefront of public health policy
planning for terrorism, and bioterrorism. Her work has been widely cited ingovernment planning and Institute of Medicine, National Academies of Sciences reports addressing these issues. She was a national consultant for planningresearch programs following the September 11th terrorist attacks. Dr. Fullerton
and her group developed educational materials that were some of the mostwidely disseminated throughout the nation to assist populations exposed to the
September 11th attacks.
Dr. Fullerton’s research has been funded by the National Institute of Mental
Health, the United States Army, the United States Air Force, CDC, SAMSHA,NIOSH and other national foundations and agencies.
WORKPLACE PREPAREDNESS FOR TERRORISM • 39

Appendix B
Study Procedures
Preliminary Interviews
The Center for the Study of Traumatic Stress (CSTS) undertook a study ofseveral, large U.S. corporations to examine corporate human continuity preparedness. Importantly, the goal of our study was not to compare the levels ofterrorism preparedness or types of preparedness programs in participating corporations. Nor was it to evaluate or rate the level of preparedness of individualcompanies, or to generalize from this sample about the levels of preparednessof various industries. Rather, our aims were to identify barriers and opportunities for corporate human continuity preparedness (across a range of industries)
and to identify potential avenues to establish greater terrorism preparedness of
US citizens through corporate preparedness.
Observations on the corporations’ overall view of and approach to terrorism and disaster preparedness were collected. In addition, data on emotionaland behavioral functioning, role of security operations in corporate culture,human resource planning, employee assistance organization, ﬁnancial and insurance aspects of preparedness, medical protective measures and planning,
worksite safety, organizational structure and the role of corporate values ininﬂuencing workplace and community preparedness behaviors were collected
and analyzed for barriers and opportunities for workplace human continuity
preparedness.. This information was collected from senior leadership in eachcorporation and leaders of the speciﬁc areas of interest.
We met with management and leadership personnel from four organizations in New York City to obtain background information regarding their perceptions of barriers to, and opportunities for educating employees and corporations on terrorism preparedness to ensure human continuity and employee
preparedness. These organizations included: 1) a prominent, private consulting
ﬁrm specializing in consultation to national and international leadership on
homeland security; 2) two multi-national corporations, and 3) an academic
center for emergency preparedness. Each of these had been involved in New
York City’s response to 9/11. In these meetings, interviewees identiﬁed topics
that formed the basis for the semi-structured interviews utilized in phase threeof this project.
Our discussions at the consulting ﬁrm identiﬁed threat assessment andthreat awareness, both creating and sustaining it, as primary concerns for human preparedness. Both of these concepts were described as prerequisites forterrorism preparedness. One partner in the ﬁrm expressed his opinion that the
40 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

greatest barrier to preparedness is the confusion experienced by the public andthe corporate sector to interpret threat. He referred to Homeland Security’scolor code as an example of this ambiguity. “The problem is how you get people
and organizations to plan when they don’t know how to interpret a threat.” Healso pointed out the ﬁne line between “fear mongering and threat reality,” asrequiring important and diﬃcult decisions in all organizations and city, stateand federal planning for communication about critical incidents.
According to this interviewee, a threat becomes real to people when it ispart of a “story” e.g. an event with meaning and relevance to the people — suchas 9/11 in New York City., An event that is relevant and meaningful becomes astory which can be incorporated into an individual’s psyche and/or the cultureof an organization. The challenge, he stated, was in transposing a story intochanging behaviors and sustaining these changes through public education
campaigns and other vehicles. He indicated that schools are also very important vehicles of public education for preparedness. When we educate children,
we educate parents, families and the community.
Another partner emphasized that the public is also educated about threat
assessment, awareness and preparedness through establishing a particular relationship between the individuals of the community and the ﬁrst responders.
In particular ﬁre departments play an important role in this process because
they are seen as part of the community and as “friendly rescuers”, not always
true of law enforcement. The open doors of the ﬁre house, literally and ﬁguratively, can provide ongoing threat knowledge, awareness and preparedness.
A ﬁre department that is open to its community raises community awarenessand fosters cohesion. He pointed out that human nature is another barrier tothreat awareness and preparedness as we want to forget, and often those who
remember become isolated and seen as out of main stream. “We love to put evilbehind us.”
At one corporate interview, the role of occupational health services inprotecting and ensuring a corporation’s security, continuity of business andemployee wellbeing was the focus. We conducted a joint interview with theorganization’s Director of Health Promotion, EAP and Lifeworks and the assistant medical director in charge of primary care, international regulatory compliance and travel health. The corporation had experienced a number of post
9/11 threats including the anthrax scare, SARS, being an identiﬁed workplacetarget of Al Qaeda, and heightened security around the Republican convention
in 2004. The primary response group of the corporation was the crisis management team. This team included the functions of business continuity, security,
corporate real estate, the medical director, human resources, and corporate
communications addressed issues around the implications of these threats on
employee health and performance.
Our interviewees underscored the importance of collaboration within occupational health services. Those tasked with responsibilities for the psychological and behavioral needs of employees and those tasked with the medical
needed to work together. Both health and mental health had to be considered
and coordinated in disaster, terrorism and bioterrorism preparedness, response,
and recovery. This included planning for behavioral issues such as ﬂu shots andthe rates of participation in these programs; to evacuation for drills and real
events – how people participated or not — and observed spikes in counselingneeds post 9/11. Despite coordinated eﬀorts, one of the interviewees commented, “There is no single policy that will address a Mary or a John’s fear about
coming to work.” The roll of cell phones as providing connectedness was alsomentioned and the wish after 9/11 to “stay at home” rather than travel.
WORKPLACE PREPAREDNESS FOR TERRORISM • 41

This company identiﬁed three other factors that can be barriers or opportunities for workplace preparedness. These factors involve a corporation’s culture
and values, the role of corporate communications, and the interface between
internal and external resources and vendors
We met with the crisis management team at a corporation considered byexperts as having very well developed terrorism preparedness. The crisis teamnarrated their individual experiences and the experiences of their corporation
around 9/11 in which they were active participants in the event as well as lessons learned and preparedness solutions.
Among the lessons learned was the importance of accounting for theirpeople and communicating that their people matter. Leadership communicated this from the moment of impact. Corporate communications and the active
communication of security with employees, referred to as security transparency, supports this corporate value and culture. Achieving this transparency
is a process in which corporate security takes a leadership role in employee
education around disaster and terrorism preparedness. The process involves
close working relationships with employee assistance, human resources andcorporate communications. This trend and process of corporate security transparency and its link to employee education and creating a culture of safety isborne out by our key informant interviews.
At an academic center for preparedness, we discussed the issues of thebusiness case for preparedness in the private sector and the importance of providing training in regulatory and insurance issues. (see Appendix C for a list ofmajor topic areas identiﬁed for study)
Procedures
Based on the concepts and issues identiﬁed as germane to employee preparedness in our back-ground interviews, our Center’s scholarship and consultative involvement around psychological, behavioral and health consequencesof terrorism and their impact on organizational responses and recovery, a literature review (see Introduction), we developed a semi-structured interview.
In addition to the interview form we developed an interviewer’s guide which
identiﬁed interview techniques for expanding and clarifying responses elicitedfrom key informants to initial questions. We also developed procedures forprotecting the rights and conﬁdentiality of study participants and their organizations. Following review and approval by the Uniformed Services Universityof the Health Sciences (USUHS) Institutional Review Board, we initiated contact with corporations to solicit their participation in the formal study.
The semi-structured interview aﬀorded the opportunity to listen to the nuances, the language and the examples of disaster events and critical incidents
that interviewees shared in describing their corporation’s experience aroundhuman preparedness The ability to be present, to listen to, and talk with individuals tasked with corporate strategic level crisis management planning andresponse, provided an opportunity to expand and clarify initial answers and aquality that may be lost in mailed surveys or web-based questionnaires.
Center investigators selected four multinational Fortune 500 corporations
as candidates for formal study participation. Three of these corporations agreed
to participate in the study. The participating corporations, headquartered in
the Midwest, Northeast, and Mid-Atlantic regions, represented food processing, chemical manufacturing, and ﬁnancial services. The fourth corporation
was still considering participation in the study when our data collection phase
ended.
We conducted 20 in person, key informant interviews at the headquarters
42 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

of the three Fortune 500 corporations that joined the study. Each corporation
selected interviewees who were knowledgeable about and/or involved in thecorporation’s crisis management. The study team suggested potential key-informant positions to an identiﬁed point of contact at each corporation, but theultimate selection of participants for interview was left to the discretion of thecorporate point of contact. All prospective participants were told that they did
not have to consent to the interviews and that if they did not, no one would
be told of their refusal. We met with executives and senior level individuals
whose functions included: CEO, global security, human resources, corporate
communications, employee relations, senior line management, and occupational health services including medical, health promotion and wellness, andemployee assistance.

TABLE: Study Interviewees
Corporate Operations
CEO
Vice Presidents/ Presidents of subsidiaries

1
7

Corporate Management
Vice President/Director/Asst Director Human Resources
Vice President/Directors Employee Assistance
External EAP/Consultants
Corporate Medical Directors/Asst Director

5
3
2
3

Corporate Global Security
Directors/ Deputy Directors
Senior Partners/Consultants Private Security
External Security Analyst

7
3
1

Academic Centers
Faculty/staﬀ

10

The majority of interviewees were employees of the corporation, but someinterviewees were vendors that provided contracted services to the corporations. As noted above, interviewees were informed that participation was optional. In the only instance where a corporate employee refused to participate,
his objections appeared to be over the requirement to sign an informed consent
document (without opportunity for his attorney to review it) rather than any
objections to the format or content of the proposed interview per se. This individual was not interviewed and his data are not included in this report.
The Center’s interview team consisted of four members: the Center’s Director and three Center scientists with diverse backgrounds and work experience.
Two team members were psychiatrists whose expertise in military and disaster psychiatry involved clinical, academic and consultative work. One member was a Ph.D. in psychology whose scientiﬁc research areas involved social
psychology, traumatic stress, and organizational responses to critical incidents.
The fourth member, an M.A. in counseling and human behavior, had extensive
experience developing and marketing health promotion programs and educational materials used by Fortune 500 corporations, federal, state and local agenWORKPLACE PREPAREDNESS FOR TERRORISM • 43

cies. All members have provided education and consultation to corporate andnational leadership, and leading federal, state and local agencies.
Before each site visit, the team sent participating corporations a list of thequestions we would ask and a copy of the informed consent document (including the nondisclosure agreement). These documents were reviewed and approved by corporate legal staﬀ prior to site visits and interviews.
We had conceptualized an interview format in which two Center teammembers would conduct one key informant interview. While the ﬁrst two
would write up or expand any notes from one interview session, two otherteam members would then conduct the next interview session. We did not adhere to this plan because our point of contact at each site had scheduled theinterviews in a manner that enabled our entire team to be present for the majority of the 20 interviews. Interviews began with introductions after which
one team member explained the purpose and procedures of the interview, as
outlined in the informed consent document. Participant concerns or questions
were addressed before consent documents were signed and witnessed and theformal interviews commenced. The interviews, originally intended to be one
hour, actually lasted 75–90 minutes, because participants became engaged in
the process and gave more detailed discussion than anticipated.
Site Visits
Corporation One is in agricultural and food processing. With operationsin the U.S., Canada, Latin America, Europe, Asia and the Paciﬁc Rim, the company interfaces with farming communities and food companies. The company
relies upon its own extensive transportation resources and contracted global
transportation networks of rail, highways and rivers.
The study team met with corporate line managers, President of the transportation company, head of insurance and global risk, chief global security ofﬁcer, chief human resource oﬃcer, director of wellness and EAP, medical director, and the CEO.
Corporation Two, a leader in industrial services, operates in more than 70
countries. The corporation provides products and services for diverse markets
in food and nutrition, health care, apparel, safety and security, construction,
electronics and transportation. The corporate culture and operating principles
are deeply embedded in workplace safety.
This corporation scheduled ﬁve key-informant interviews for the study
team with senior management. We conducted only four, as one of the identiﬁed
interviewees was sick. We met with the company’s manager of crisis operations,director of global security, chief medical oﬃcer and EAP global regional director.
Corporation Three is a leading global ﬁnance company serving corporations, governments and municipalities, institutions, and private citizens. Its
services include securities trading, research, investment banking, private investment management, asset management and private equity. The corporation
operates worldwide. The study team interviewed 5 senior level oﬃcers: one representative each from security, human resources, employee relations and communications, and employee assistance.
The process of gaining access to corporations was complex and time intensive. Each site visit required twenty to thirty hours of preliminary coordination. In all instances prior relationships greatly facilitated access to the key
informants who were interviewed during the formal study. Indeed, the corporate individuals who ultimately facilitated our entrée into their companies
44 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

communicated their high regard for the Center, its Director and members of
our team. We responded in a timely manner to all follow up requests from corporations. This often involved multiple conference calls with each corporation
to explain the project to the point of contact’s crisis management colleagues orteam, emailing of materials explaining the project and its goals, and letters tolegal departments whose approval was key in several instances for participationin the study. .
Our focus on psychological and behavioral issues appeared to facilitate
corporations’ willingness to participate in the study. This focus, on an area thatparticipant corporations recognized as an aspect of preparedness that they had
not themselves fully developed appears not to have threatened their perception of the proprietary nature of their own security issues or programs, nor
to have concerned corporate leaders as an area of investigation that might infringe upon or compromise existing corporate security. This focus—according to interviewees—provided corporations with a sense that they might havesomething to gain and something to learn by participating in an independent
exploration into the “uncharted waters,” of psychological and behavioral issues
of workplace preparedness.

WORKPLACE PREPAREDNESS FOR TERRORISM • 45

Appendix C
Topics Identiﬁed for Study ofCorporate Preparedness
Awareness versus Fear
Changing Behavior
Sustaining Preparedness
Threat Awareness — how to create and sustain
Threat Perception — inﬂuenced by a deﬁning event
Threat Assessment — requires information, expertise, and shared
information
Deﬁning Event — present or absent
Collaboration of corporations with local resources — police,
ﬁreﬁghters, etc.
Corporate integration and collaboration across security, occupational
health (medical and EAP), human resources
Practice regular preparedness, e.g., ﬂu shots, evacuation drills
Post event: return to work vs. stay at home
Corporate communication to employees: cell phones, web, memos, people
to people, leadership to employees, employees to leadership
Corporate culture: a community of safety/”people ﬁrst”
Internal versus external corporate resources for employee healthand wellness
Suppliers, distributors and markets
Leadership Communication in Crisis
Leadership role of security
Business case for preparedness is required
Costs of preparedness include: insurance, training, response to regulations,time loss, legal costs

46 • Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine

Appendix D
Model of Corporate Preparedness:
Event, Response and Recovery
Corporate Preparedness and Human Continuity
Terrorist Event/
CRITICAL INCIDENT
Severity of Incident

Nature of Incident
Human Made
Accident

Terrorist
AttackNaturalDisaster▼RESPONSE MEDIATORS
Corporate History
Deﬁning Events
Loss/Destruction Corp. Resources
Availability/Loss Key Personnel
Integration of Security/HR/Occ HealthTraining
Disaster Plan
Communications
Leadership Characteristics
Community Integration▼

HUMAN CONTINUITY OUTCOMES
Organizational

Behavioral

PsychologicalBehavioral▼
Resilience

Distress

Illness

Function

Risk Behaviors

WORKPLACE PREPAREDNESS FOR TERRORISM • 47