1. The Role of the Employee Assistance Program (EAP) Before and After a Traumatic Event Presented by May 8, 2013 1

2.  Incident or series of events that cause moderate to severe stress reactions.  Characterized by sense of horror, helplessness, serious injury or threat of serious injury or death.  Affects survivors, rescue workers, friends and relatives of victims who have been directly involved.  May affect witnesses who have seen the event first hand or on television.  Stress reactions immediately following an event are common. Duration is dependent upon a number of factors. 2Proprietary to New Avenues, Inc.

3. 3 Workplace Violence: Some Preventative Measures

4. Know who is working for you and how your employees feel about their work environment.  Do they feel safe?  Do they feel like they are being harassed or bullied?  Do they believe the company takes their safety seriously?  Do they know the plan in the event a serious incident occurs? 4Proprietary to New Avenues, Inc.

5.  Include behavioral health section in your employee health risk assessments.  Share results with your EAP and Occupational Health Provider so that they are aware the kind of problems your employees are having.  EAP can target training and other interventions to address these issues. 5Proprietary to New Avenues, Inc.

6. Supervisors should be trained:  To recognize behavioral warning signals and to know what to do.  To manage/diffuse a volatile situation until assistance arrives.  In company policies and the importance of applying policies and the need for accountability.  In clear and effective documentation.  In the company safety plan and procedures and kept updated. 6Proprietary to New Avenues, Inc.

7. Be Alert

8.  Unusual behavior changes.  Making false, malicious or unfounded statements against co-workers, supervisors, or subordinates which tend to damage their reputations or undermine their authority.  Inappropriate remarks, delusional statements.  Escalating anxiety and irritability.  Verbal threats to inflict bodily harm, including vague or veiled threats.  Disorderly conduct, shouting, throwing or pushing objects, punching walls, and slamming doors. 8 Proprietary Material of New Avenues, Inc.

9. Where an individual is exhibiting threatening or intimidating behavior 9 Managing a Behavioral Crisis in the Workplace

10.  Ask colleague to monitor or call for assistance.  Project calmness.  Maintain a relaxed posture.  Speak privately, if possible, but do not take aggressive person to an isolated location.  Encourage person to talk.  Acknowledge person’s feelings.  Offer choices.  Avoid sudden moves.  Be mindful of office layout/exit strategy. 10 Proprietary Material of New Avenues, Inc.

12. Management Referrals – 3 Types 12  Concerned Supervisor Referral  Management Referral*  Fitness-For-Duty Evaluation* * Clinical Case Management Proprietary Material of New Avenues, Inc.

13.  Performed by Psychiatrist or Psychologist  No guarantees, but important to get professional opinion and any treatment/ employment recommendations 13  History of prior violent behavior  Current symptoms, functioning, belief systems  Motivation  Emotional control  Probability of violence Proprietary Material of New Avenues, Inc.

14.  Conflict Resolution and Mediation Services  Critical Incident Stress Management (CISM)  Counseling for Targets/Victims of Violence  HR and Supervisory Consultations  Training 14 Proprietary Material of New Avenues, Inc.

15.  Provide strong leadership.  Physical safety comes first.  Ask for support from higher management.  Don’t “keep a stiff upper lip” or advise anybody else to do so.  Share information with your employees as soon as you have it available. 15Proprietary to New Avenues, Inc.

16.  Build on the strengths of the group.  Rely on your work group’s prior planning.  Be aware of the healing value of work.  Try to return to the daily routine as soon as possible.  Encourage employees to talk about their experiences (Follow-up with them in a week, 2 weeks).  Ask for support from your EAP. 16Proprietary to New Avenues, Inc.

17.  Mental health professionals trained in trauma come on-site.  Triage – Provide Psychological First Aid.  Meet with victims after the event preferably as a group.  Listen and encourage members of the group to talk about their reactions when they feel ready.  Validate the emotional reactions of the individuals. (Intense painful reactions are common responses to a traumatic event).  Explain that their symptoms may be normal.  Encourage individuals to keep to their usual routines, find ways to relax, face situations that remind them of the event, reach out to their support systems, talk about their experiences and feelings. 17Proprietary to New Avenues, Inc.

18.  Advise survivors to anticipate symptoms that are uncomfortable or scary to them.  Refer individuals needing ongoing care to mental health professionals with experience in treating the needs of survivors of traumatic events.  Provide education to help people identify symptoms of anxiety, depression, and PTSD (Post Traumatic Stress Disorder).  Offer clinical follow-up when appropriate. 18Proprietary to New Avenues, Inc.

19.  Cognitive – confusion, disorientation, memory loss, poor concentration, difficulty making decisions.  Emotional – shock, numbness, fear, sense of being overwhelmed, depression, intrusive images, volatile emotions, anger.  Physical – nausea, light headedness, dizziness, gastro- intestinal problems, rapid heart rate, headaches, sleep disturbances, grinding of teeth, jumpiness.  Behavioral – Irritability, withdrawal, apathy, suspicion, excessive silence, arguments with loved ones, inappropriate humor, change in eating habits, change in sexual desire and functioning, increased smoking, substance abuse. 19Proprietary to New Avenues, Inc.

20.  Those with closer exposure to actual event  Multiple stressors  History of trauma  Meaning of the event in relation to past stressors (May activate unresolved fears or frightening memories)  Persons with chronic medical illness or psychological disorders. 20Proprietary to New Avenues, Inc.

21.  Be aware of the warning signs of violence  Don’t ignore behavioral changes  Mentally prepare for “what if” situations  Take all threats seriously  Seek help for threatening domestic issues  Foster respect in the workplace/model the behavior you expect. 21 Proprietary Material of New Avenues, Inc.

22. For confidential assistance, call New Avenues: 574-232-2131 or 800-731-6501 www.NewAvenuesOnline.com