This section is designed to provide you some tips on how to accommodate workers who have PTSD. Research has found that PTSD does have an impact on impaired occupational functioning, particularly as it relates to reduced productivity, presenteeism and absenteeism. This is not an exhaustive list of accommodations, there may be other ideas or options you may wish to use.
Questions to Consider when Accommodating Work
When considering how to accommodate a worker you may what to identify the specific circumstances related to that worker, some questions include:
- What is the worker experiencing (signs and symptoms) and what are the limitations?
- How will these limitations impact the work that the worker needs to do?
- Are there specific job tasks that will be problematic as a result of these limitations?
- What accommodations can help address or eliminate these limitations?
- Has the worker been asked about possible accommodations, can they help identify specifically how the organization can assist?
- In order to facilitate a successful return to work what training should be provided to the leadership team, supervisor or other workers who work with worker?
- Is the worker currently receiving care or treatment and if so are they continuing to follow a treatment plan (if this is known)?
Potential Individual Accommodations
There are a range of treatment options for Workers suffering from PTSD. All treatment options should be in line with emerging best practices that are known to be effective and delivered by individuals trained in addressing PTSD including psychologists and psychiatrists. These potential individual accommodations can be used to support workers so that they can stay at work or return to work.
|Signs and Symptoms||What this could look like at work||Impact on job tasks||Potential Accommodations|
Supportive Management Techniques
When you are planning how to manage recovery and return to work for your workers, it is important that you are support the managers and supervisors so that they can utilize effective techniques which help keep the worker on track to recovery. Below are a list of tips that may help supervisors and managers implement an individual return to work plan:
- Be prepared to provide day to day guidance and feedback, focused on tasks.
- Provide written and verbal instructions.
- Provide positive praise and reinforcement.
- Recognize when the worker is experiencing hyper-arousal symptoms, stress or withdraw and provide support and remind them of mechanisms they can use such as utilizing quiet space, strategies to deal with conflict.
- Establish long term and short term goals, breaking down complex tasks.
- Provide clear expectations of responsibilities and outline the consequences of not meeting those performance standards.
- Plan how to evaluate the effectiveness of the accommodations.
Triggers in the Workplace
“Trigger” is a stimulus that activates the fight-or-flight response because it reminds one of something traumatic and/or anxiety-provoking. There may be many triggers in the workplace that don’t appear directly related to traumas even if they worked with these things for many years. It is important for the Return to work plans to consider potential triggers and incorporate systematic in-vivo exposures to them. For example – exposure to flashing lights and sirens.
Avoidance of triggers does not give a chance to learn stimuli is usually safe. Exposing ourselves to feared situations will in turn show us that we can handle it. With repeated exposures, severity and duration of anxiety decreases. It is crucial this process happens gradually.
Modified duties can incorporate time & opportunities for controlled exposures such as setting minimum 20 minutes on each shift dedicated to exposure.
Example of Gradual Exposure for a Paramedic employee returning to work
- Photos/videos of: ambulance/ truck/car, members in uniform
- Stand outside station
- Visit inside of station (Rehearse what to say to colleagues/management – assertive communication)
- Wear uniform at home
- Look at outside, then insides of stationary ambulance/truck/car
- Sit in passenger seat
- Sit in back (if ambulance)
- Work with equipment (e.g., in simulation labs)/run through protocols
- Ride as passenger in moving ambulance/truck/car (no sirens/lights)
- Ride in back of ambulance/truck/car (no sirens/lights)
- Ride as passenger with lights & sirens
- Drive (not in service) with driver trainer/peer support member
- Ride as third person – observation only
- Ride as third person – increasing responsibility (not primary) – days, then nights
- Ride as third person – primary responsibility for some calls – days, then nights
- Trial two-person teams (day time only)
- As progress, trial two-person teams (nights)
Assessing your Program:
When evaluating your return to work program, some key metrics to monitor are a decrease in both short and long term disability related to PTSD and mental health injury, an increased utilization in the employee assistance program (EAP) and an increase in benefits for psychological support. Indirect metrics may include improved job satisfaction, reduced turnover in important operational roles, reduced stigma related to modified duties, and reduced employee complaints. In addition to outlined return to work practices and modifications, voluntary assessments should be completed to address barriers to recovery and return to work for workers with PTSD.
Broader family and community members should also be engaged to support recovery and return to work. This will allow for a quicker return to work and help the first responder move back into their routine. Moreover, engagement with friends and families of workers who are suffering from PTSD increases awareness to PTSD, reduces the stigma, and allows for a community of support. Some examples of how friends and/or family are engaged include:
- Open houses, BBQ, family night and other social events, which also provide information about PTSD
- Providing family-based peer support that allows family members and caregivers to speak to others who have had similar experiences, in an effort to support themselves and their loved one through recovery.
- Offering and funding for time-limited family counselling if required. This can be made available by the employer as part of an insurance benefits package, though an EAP or under circumstances which it is deemed necessary for the well-being and recovery of the worker and their family.