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 Personnel Who Experience
Work-Related Trauma Exposure:
Recommendations for Supervisors
absenteeism, and distractibility
Many people are exposed toSupervisors
canassistpersonnel
repeatedly
may also occur. Prolonged andtrauma at some time in their life.
Personnel in certain occupations
more severe responses can include
exposed to occupational trauma throughpsychological disorders, such as
may be repeatedly exposed to trauma
education, training, modeling, and support
depression, anxiety, PTSD, andin the course of their work duties.
using evidence-based early interventions.
complicated grief.
Such fields include law enforcement,
Some occupations have a culture
healthcare, public health emergency,of pride in being able to withstandand intelligence, among others.
trauma exposure and not seek support. Supervisors canTheir exposure may be through directly witnessing or byhelp by debunking myths and encouraging support at all
hearing someone re-tell distressing events. It may alsolevels, while maintaining performance and accountability,
occur through exposure to the media, such as photographs,audio, or video, or a combination of these. More distressing
to promote a healthy organization. Supervisors can help
personnel repeatedly exposed to occupational trauma
trauma of longer duration and repeated exposure canthrough education, training, modeling, and support using
increase the risk for adverse effects, which negatively
evidence-based early interventions. These interventions,
impact interpersonal relationships and work performance.
called Psychological First Aid (PFA), include enhancing a
Adverse effects of occupational exposure to trauma
sense of: 1) safety, 2) calming, 3) self- and group efficacy,include distress reactions (insomnia, anger, guilt,
4) social/unit cohesion, and 5) hope/optimism.
scapegoating, anxiety, and decreased perception of safety)
The recommendations below, based on PFA principles,and risky behaviors (increased alcohol and tobacco use,
describe actions supervisors can take to help personnelsocial isolation and restricted activities, and reduced
before, during, and after occupational exposure to trauma.
self-care behaviors). In the workplace, lost productivity,BEFORE
Being prepared (mental, physical, and equipment) helps
personnel 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 personnel about expected trauma exposure andnormal reactions: insomnia, anger, boredom, decreased
feelings of safety, guilt, and helplessness.
5. Educate personnel to monitor for difficulties and whento get help: persistent difficulty with sleep, increased
problems at home or work, reduced self-care, andthoughts of harming self or others.

DURING
Efforts to limit the intensity and duration of exposure
to trauma decrease adverse effects. Identifying problems
early and providing prompt and effective interventions canprotect performance.
1. Foster peer support where employees support andregularly 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 forpersonnel having persistent or increasing difficulties atwork.
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, and 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-careand peer support are important first-line interventions.
Screening and referral are helpful for those with significant
problems or impairment.
1. Remind personnel about normal and expectable
reactions to trauma as well as common patterns ofrecovery.

2. Communicate the value and benefits of peer support inmaintaining well-being and recovery.
3. Ensure personnel have access to resources (healthcare,family support, and financial assistance).
4. Continue informal check-ins with personnel. If
concerns arise, seeking additional information, whenpossible, from co-workers, family, or friends may helpin understanding.
5. Create opportunities for informal social interactions(coffee and donuts, etc); these can strengthen cohesion
and promote informal peer support.
6. Engage Employee Assistance programs or otherresources for more formal assessment measures to help
workers struggling in silence. Offering compassionate
and confidential screening and referral to treatment
can encourage employees to seek assistance who mightotherwise 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