Analysis by the Health and Safety Executive estimated that 17.1 million working days were lost due to work-related stress, depression or anxiety in 2022/23.  Certain occupations, such as health and social care work, blue light services, military and security services are at particularly high risk of exposure to stress and work-related trauma. In comparison to the general population, rates of post-traumatic health conditions in these occupational groups are well documented (e.g. Brewin et al., 2020; Scott et al., 2023; Stevelink et al., 2018). The challenge of how to specifically respond to workplace trauma and mitigate potentially lasting outcomes is a priority as both a health and occupational effectiveness challenge.

Exposure to trauma in the workplace is not uncommon, nor is it limited to high-risk occupations.  Accidents, suicides and bullying in the workplace may also be considered index traumatic events and as such, how to respond and support workers in the aftermath is of broad importance.  As the occupational landscape continues to change post-COVID, so too does the context in which workplace trauma can take place and how post-incident support can and may be delivered.

Despite the demonstrated lack of effectiveness on PTS symptoms in most of the research, workers do value being offered some kind of support by their employers after a traumatic incident at work. This highlights a current dilemma for employers to do something, but also to do no harm.
– Billings et al. (2023)

According to Professor Jo Billings, Professor of Psychological Trauma and Workplace Mental Health at UCL, there is a pressing need to understand how best to mitigate the impact of workplace trauma as a unique stressor.

“Workplace trauma differs from other trauma exposures in that certain jobs may have an increased risk, frequency and length of exposure.  These workers may also anticipate exposure as part of their job, and exposure to these events occurs in a group context that is different to life outside work.”

In a systematic review published in the European Journal of Psychotraumatology, Professor Billings and her team examined 80 studies of post-incident psychological interventions offered within one month of an index traumatic event. Interventions included Trauma Risk Management (TRiM), Psychological First Aid, EMDR, CBT-based interventions, and various forms of debriefing.  They also appraised 11 different clinical practice guidelines on support after workplace trauma published globally.

There is an urgent need for good quality, robust research in the field to better understand what may work for whom and when.
– Prof Jo Billings

Whilst the review did not show that any of the studied interventions delivered in a workplace context demonstrated any harmful outcomes, quantitative research did not conclusively demonstrate benefits either.  Notably, the team found that most of the guidelines recommended interventions which were not adequately supported by the empirical research, as well as interventions which were not defined and have yet to be empirically evaluated. Nevertheless, qualitative research indicated that such interventions were valued by workers.

“We found that the quality of most of the evidence was weak which makes it very difficult to ascertain whether these interventions are any more effective than the natural recovery after trauma which might be expected over time,” Billings said.  “There is an urgent need for good quality, robust research in the field to better understand what may work for whom and when.”

The team are now looking for participants for the next stage of their research: the development of clinical best practice guidelines for support following traumatic incidents in the workplace. They want to hear from workers who have received a psychosocial intervention after a workplace trauma, as well as providers of post-incident psychosocial interventions and managers/commissioners of services.  Once these interviews have been completed, the team will also be inviting participants to take part in an expert Delphi study towards the latter half of this year.

Those interested in taking part are asked to email Helen Nicholls (helen.nicholls.20@ucl.ac.uk) or Jane Curley (janey12@icloud.com) for further information.