Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Helping Military Personnel Who
Experience Work-Related Trauma Exposure:
Recommendations for Military Leaders
Many people are exposed toand distractibility may also occur.
The
recommendations…
describe
actions
trauma at some time in their life.
Prolonged and more severe
Service members (SMs) may be
responses can include psychologicalmilitary leaders can take to help personnel
repeatedly exposed to trauma in bothdisorders, such as depression,before, during, and after occupational
combat and non-combat settings.
anxiety, PTSD, and complicatedexposure to trauma.
Their exposure may be throughgrief.
directly witnessing an event, such
The military has a culture ofas the death of a unit member, or
pride in being able to withstandby hearing someone re-tell distressing events. It may also
trauma exposure and not seek support, which can delay
occur through exposure to the media, such as photographs,
recovery. Military leaders can help by debunking myths
audio, or video, or a combination of these. More distressing
and encouraging support at all levels, while maintaining
trauma of longer duration and repeated exposure canperformance and accountability, to promote health andincrease the risk for adverse effects, which negatively impact operational readiness.
interpersonal relationships and operational readiness.
Leaders can help SMs who are repeatedly exposed
Adverse effects of occupational exposure to trauma
to occupational trauma through education, training,
include distress reactions (insomnia, anger, guilt,modeling, and support using evidence-based early
scapegoating, anxiety, decreased perception of safety)
interventions. The recommendations below describe
and risky behaviors (increased alcohol and tobacco,actions military leaders can take to help personnel before,social isolation and restricted activities, reduced self-careduring, and after occupational exposure to trauma.
behaviors). In the unit, lost productivity, absenteeism,BEFORE
Being prepared (mental, physical, equipment) helps SMs
focus on the task at hand.
1. Obtain information about anticipated trauma exposures(risk analysis).
2. Provide adequate protective equipment and ensure SMs
understand their purpose and proper use.
3. Determine minimum required exposure to performessential tasks.
4. Train SMs about expected trauma exposure and normal
reactions: insomnia, anger, boredom, decreased feelingsof safety, guilt, helplessness.
5. Educate SMs to monitor for difficulties and when to get
help: persistent difficulty with sleep, increased problems
at home or work, reduced self-care, thoughts of harming
self or others.

DURING
Efforts to limit the intensity and duration of exposureto trauma decrease adverse effects. Identifying problems
early and providing prompt and effective interventions canprotect operational performance and overall readiness.
1. Foster “buddy care” where SMs support and regularly
check-in with one another.
2. Model self-care, including adequate sleep, hydration,nutrition, stress management, and exercise.
3. Encourage help-seeking, such as taking a break ortalking to someone.
4. Monitor and adhere to exposure limits. Reduce
exposure or temporarily remove those showing
significant adverse effects from further exposure.
5. Conduct team check-ins to enhance cohesion, discusschallenges, dispel misconceptions, and informally assess
personnel.

6. Use breaks or brief team huddles to facilitate peer
support.
7. Directly encourage and facilitate help-seeking for SMs
having persistent or increasing difficulties at work.
8. When particularly shocking or disturbing exposuresoccur, anticipate, validate, and respond supportively togrief and other distress reactions.
9. Use effective communication strategies: say what isknown and unknown, commit to getting answers when
there is uncertainty, follow through and keep promises,
avoid false reassurances, always tell the truth. Good
communication builds trust and decreases rumors.
AFTER
Adverse effects of trauma exposure may not be seen
until after the stress of operations are over. Self- and buddycare are important first-line interventions. Screening andreferral are helpful for those with significant problems orimpairment.
1. Remind personnel about normal and expectable
reactions to trauma as well as common patterns ofrecovery.

2. Communicate the value and benefits of buddy care inmaintaining well-being and recovery.
3. Ensure personnel have access to resources (healthcare,family support, financial assistance).
4. Continue informal check-ins with SMs. If concerns
arise, seeking additional information, when possible,from unit members, family, or friends may help inunderstanding.
5. Create opportunities for informal social interactions(coffee and donuts, etc); these can strengthen unit
cohesion and promote informal buddy care.
6. Engage support programs or other resources for moreformal assessment measures to help SMs struggling
in silence. Offering leadership support and referral totreatment can encourage personnel to seek assistance
who might otherwise feel stigmatized.
ADDITIONAL RESOURCES
Fact sheets to help leaders prepare for and respond tocrisis and disaster events:
https://www.cstsonline.org/fact-sheet-menu/leadershipCenter for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org