An armed raid or industrial accident may leave invisible scars that employers can help to heal. Peter Hodgkinson explains how Mike was scalded by super-heated vapour while investigating a problem with one of the manufacturing factory's industrial ovens. His workmates did what they could to help him before the ambulance came. However, he died three days later in hospital ­ 90% burns left him little chance of survival. Mike's colleagues were left with traumatic images of his injuries. They grew preoccupied with how the accident could have been avoided and were reluctant to go near the oven where it occurred. Jill was stacking shelves at midnight in a convenience store when she saw balaclava-clad men about to smash down the entrance door. The glass shattered and she and her colleagues ran in fright. Seven nights later the store was raided again. Jill was filling up the cigarettes which were the crooks' target. This time she fled through a side door with colleagues and didn't stop running until they were a quarter of a mile away. Jill and her colleagues felt jinxed because both raids had happened on their shift. They felt frightened, and they felt ashamed that they had run away. Most significantly, they were certain there would be another raid and Jill did not want to go back on the night-shift. Her negative feelings grew and she thought the best thing was to leave work altogether. In both these cases, the companies intervened ­ staff faced their difficulties and settled back to work. But often workers' psychological needs in the aftermath of trauma are overlooked. If staff are back at work they may be presumed to be "all right". However, trauma and resentment about management inaction will fester. Post-traumatic reactions follow a predictable pattern. First, staff re-experience the incident with flashbacks or nightmares and even agonise about what did, or what might have happened. Although victims might survive without even a scratch, they can be traumatised by thinking that things might have turned out worse. Second, they can have avoidance reactions. These may include attempts to push the incident from their mind, or avoid the place where it happened (or places like it). The latter has ramifications for getting staff back to work. Third, staff can experience symptoms of emotional numbing. These include diminished interest in work and leisure, detachment or estrangement from colleagues or family, and a reduced ability to experience feelings. These may have clear negative effects on general motivation and work relationships. Lastly, there are a range of reactions resulting from increased arousal which include sleep difficulties, hypervigilance, irritability, exaggerated startle and poor concentration. Even without considering the arguments surrounding duty of care, businesses should understand that prompt action saves money by promoting recovery. And prompt action is only possible with preparation, which requires policy, procedures and trained personnel to be put in place. All organisations need a policy for proactive psychological intervention and procedures that facilitate a range of responses. After the incident itself, a second trauma for staff involved is their treatment by managers, and this can have far reaching effects. Therefore a group of managers must be trained to defuse (contain) the initial emotional responses to the trauma. They must monitor staff and be able to recognise the signs of problematic reactions. A simple intervention would be as follows: - Trained managers reach the affected location to defuse the immediate emotional reactions of staff. - Between 48 to 72 hours later, a group psychological debriefing takes place, led by suitable experts. All staff are encouraged to attend. - Over the next week or two, the defusing manager returns to visit staff, who have continuous access to professional help via the telephone. - After three weeks, a group follow-up to the debriefing takes place, at which point staff who continue to suffer would receive individual help. These interventions can prevent avoidable over-reactions, allow staff to make a confident return to work and give them the sense that their employer cares in a practical and purposeful way which bolsters their general morale. What benefits the employee, in this case, should most definitely benefit the business. - Peter Hodgkinson is a clinical psychologist at the Centre for Crisis Psychology {{MANAGEMENT FEATURE }}