Organizational Crisis Management: The Human Factor

(A fully edited version of this article is published in it entirety in the International Journal of Emergency Mental Health (IJEMH) vol 7, No. 3, 2005)

The Past

As the Employee Assistance Program (EAP) field has developed, so too have the services provided. From the early days with the alcohol-centric focus through the transition to a more broad-brush application. From an assessment and referral orientation focused primarily on the individual employee to the more consultative paradigm looking at the total organization. This has been quite an evolution in a little over 20 years.

Similarly, the professions of psychology, psychiatry, social work, occupational health, and others have amalgamated under the heading of behavioral health. Vast advances in psychopharmacological treatment along with cognitive behavioral approaches and other methodology (i.e. EMDR, hypnosis) have broadened the array of treatments and strategies. Add to this the boom in alternative health services such as acupuncture, massage, aromatherapy, art, music, and pet therapy. And there is the current blending of traditional services with self-help service, twelve step programs, and spirituality. All of the aforementioned have contributed to the provision of services to mitigate psychological distress in a much more mainstream genre. 

Another sphere of EAP that has seen dramatic expansion is the area of organizational crisis management. This author remembers the late 1980s and early 1990s, when there was a bit of a hesitation among EA professionals to embrace the provision of “critical incident debriefings.” Some worried that the EA professional could loose status as a confidential resource to troubled individuals. Others were concerned that it placed the EAP in the domain of a management tool. Yet others weren’t sure if they had the training and skill set to handle such interventions. Perhaps, because it first emerged out of emergency service professions, such as police and fire, some EA professionals thought that it was too minimalist and overly structured for the workplace. Since then, the EAP field has seen both the emergency service professions as well as the private sector integrate the concept and practice of critical incident debriefings, trauma debriefings, crisis interventions, psychological first aid, resiliency meetings, and a range of other supportive interventions for a wide range of workplace crises.

The efficacy of crisis intervention

The well-established conceptualization of crisis intervention has been around for at least the last 60 years. Lindemann (1944), and his work with the victims of the Coconut Grove Club fire in Boston, Massachusetts in the early 1940s, is considered the modern day father of crisis intervention. During World War II, Kardiner (1947) developed a crisis intervention model working with soldiers still involved in combat, referred to as the PIE model (Proximity to the front; Immediacy; with the Expectation of returning to duty). Later, Kardiner added “B” for brevity of intervention. With these, as well as other more recent events such as the terrorist attacks on September 11, 2001, earthquakes, and hurricanes there has always been an understanding that victims need immediate emotional services in the aftermath of such tragic events. Yet, there was for a while, a growing controversy surrounding the efficacy of psychological debriefings. It is the opinion of this author that this was partially as a result of three factors: 1) Early on, one or two session debriefings were touted as being able to “prevent PTSD,” an overstated concept; (Mitchell, 1995); 2) Poor training of facilitators resulted in poor interventions; and 3) A misunderstanding that a one-shot intervention of any type can resolve problems for people who have been seriously impacted by trauma. For a more detailed summary of the controversy, read Lewis (2002; 2004).

The Present

This article will discuss the emergent role of social and psychological intervention as the EAP field continues to move forward. Currently, there is a merging of two critical aspects of emergency response in work organizations. The first is described by a number of labels such as: business continuity, organizational continuity, consequence management, and disaster management. These all refer to the pre-incident planning and post-incident response to events that may potentially disrupt operational functions. Until recently, the priority in the workplace has been on information systems, security, and infrastructure. For individuals who may not be familiar with this, the most well known example of this type of situation was the preparation for and response to the Y2K problem. Most were concerned about the potential disruption that this computer glitch may have had on our computer dependent society. Predictions of data loss, financial institutions closing, communication systems interruption, and national security disruption were rampant. Since September 11, 2001, natural disasters, power outages, Enron-like collapses, the concern about continuity disruptions has spread to include a wide range of other more dramatic and far reaching events. However, the focus has remained on technology and infrastructure as well as fiscal compliance. 

The second critical aspect of emergency response in work organizations is the growing understanding that these types of events may dramatically impact the workforce as well as workplace infrastructure. Since September 11, 2001 and other recent traumatic events, EAPs and business have discovered that it may be easier to get the computers, phones, and security systems back on line than to get the workers back on line. Or, put another way: It is easier to recover the IT (information technology) than the HT (human technology). Recognizing that most work organizations in this country are service and information providers and are therefore quite dependent upon the workforce, there is a compelling need to “recover” the employees and that often, this is not recognized or highly prioritized.

The Future

This confluence is an excellent opportunity for the EAP field, specifically and the behavioral health field in general. It is an opportunity for the EA professional to sit at the table with the rest of the business continuity planning team, usually comprised of IT, security, legal, operations, and management. It is an opportunity for the EAP to be seen as a viable and valuable component to this critically essential effort to which most organizations are now devoting time and resources. It is an opportunity for the EAP to be more visible to the total organization at a time of economic tenuousness and questioning of the need for an EAP. And most importantly, it is a time to expand EA services beyond the concept of one-shot debriefings to a more comprehensive array of interventions that may be delivered over the “life cycle” of the workplace recovery. For people in behavioral health professions, it is an opportunity to apply their knowledge and skills outside of the clinical office or health center.

The Need for Assessment

Two of the key components of any Business Continuity Plan (BCP) or Disaster Management Plan (DMP) are to: 1) assess the potential likelihood of an event occurring; and 2) estimate the type and level of disruption that it may cause. After this Business Impact Assessment (BIA) has been completed, the goal is to develop strategies to either prevent the incident from occurring or to mitigate the potential impact should it occur. While there are many methods to do this assessment, one model developed by Fink (2002) suggests asking five questions and then assigning a 1-10 rating for each. One (1) indicates no or limited likelihood and ten (10) indicates a high level of likelihood of impact. While this is not a “test” nor is it a statistically valid instrument, it does provide a subjective estimate of impact that can be used for assessment purposes.

The five questions include: 

1) If there were an incident, is there a likelihood of escalation?
2) Are there media, government, and regulatory scrutiny?
3) Does the incident cause interference with normal operations?
4) Is there or could there be negative impact on public image?
5) Could the incident cause damage to organization’s bottom line?

After rating each question using Fink’s scale from 1-10, add responses and divide the total by five to derive the Crisis Impact Value (CIV).

Fink’s model (2002) then suggests estimating a Probability Factor (PF) (0-100%), by approximating the likelihood that this event may, in fact, occur. Finally, plot the different types of events on a table similar to the one drawn in Table 1.

So, as an example, a hurricane in Florida may be estimated as having a high PF (75%) and with CIV of around 7. Therefore, it would be placed in the high likelihood and high impact quadrant. (See ‘X’ as noted on Table 1).

Table 1: Probability Table for Workplace Traumatic Event not included in this draft version, but is basically a two axis graph with 4 quadrants.

Similarly, a power outage in Florida may receive a PF of about 20% and a CIV of about 3, thus placing this type of event in the low impact and low likelihood quadrant. (See ‘Y’ as noted on Table 1). Planners would then prioritize and address in order those events with high scores over those with lower ones.

Human Impact Assessment Tool

This author has developed a similar assessment “tool” that may enable a planner to think about the social and emotional impact on personnel. Similar to Fink’s methodology (2000), this is not a statistical instrument or an exact scientifically derived measure, but rather an estimate of potential social and psychological impact.  The Human Impact Assessment Tool (HIAT) basically looks at five types of events as well as ten factors of assessment. First, an effort is made to determine the type of incident by placing it into one of five types of events:

1. Manmade 1: criminal events caused by a single perpetrator. 

2. Manmade 2: larger criminal events such as the terrorist attacks on September 11, 2001, and other terrorist actions. 

3. Natural Disaster: events such as hurricanes, earthquakes, and fires. 

4. Organizational Transitions: events such as lay-offs, relocations, mergers, etc. 

5. Infrastructure Disruptions: events such as power outages, computer hacking, and computer viruses.

Then, ten factors are assessed to determine the potential impact on the workforce. The ten factors include:

1. Locus of Impact – Was this an event that impacted a single department, building, city, region, or nation?

2. Warning vs. Sudden Event - Did this event occur without warning or did people and the workplace have time to prepare?

3. Contained vs. Ongoing Event - Is the incident over or is an on-going incident that could continue to escalate?

4. Impact on Operations - How did the incident impact operations at the workplace?

5. Injury to Personnel - Did anyone get hurt or killed during or as a result of the incident? 

6. Damage to Workplace Premise - Was there damage to the workplace to an extent that people may have to be reassigned?

7. Damage to Employees’ Personal Property - While the workplace may be functional and not impacted by an incident such as a hurricane, the employees’ homes or other personal property may have sustained significant damage.

8. Damage to Reputation - Another “damage” issue is the potential liability to the organization as well as the damage to its reputation. 

9. Impact on Social Structure - While many crises may not result in death, damage, or destruction beyond a specific area, there are situations in which the social structure of the larger community may be impacted. Hurricanes and floods may knock out communication, utilities, ATMs, transportation, etc.

10. Concurrent Stressors - Whether it is humans or a work organization, stress is considered cumulative. Issues and events such as: labor-management relationships, financial stability, and recent changes in demographics are some examples of events considered concurrent stressors. When a crisis hits an organization it can exacerbate these “chronic” or on-going stressors. Or, if the preexisting stress level of an organization is relatively high, when a crisis hits it can negatively impact the reactions to and recovery from the crisis. Therefore, it is important to evaluate the level of concurrent stressors in an organization and assess the effects of cumulative stress.

This type of an assessment may help to generate which types of services and interventions may be required and in what order. For example, after a flood that has damaged peoples’ homes, counseling may not be the most appropriate response. Rather, people are dealing with survival concerns and may need food, clothing, medicine, a borrowed cell phone to call family, etc. Cumulative scores of more than 50 would be considered as having a significant impact on the personnel. The following table may be utilized.

For a more comprehensive explanation of how to use the HIAT please see Lewis (2006).

The Life Cycle of a Crisis

The life cycle of any crisis continues to evolve over time, generating different difficulties and requiring different types of services and interventions. If one were to consider any type of crisis, be it a surgical procedure, a divorce, a lay off, or the terrorist attacks of September 11, 2001, all of these experiences take people and their body/family/culture/nation through a dramatic transition and a rediscovery of a new identity. Therefore, when working with individuals or groups it is essential to remember that this is an evolutional process that goes through stages and phases. While others such as Kubler-Ross (1974) have developed a stage paradigm for life crises, this author has selected to utilize the following labels and concepts, briefly described below. These stages or phases are not time specific. In addition, they coincide with Abraham Maslow’s theory of need satisfaction.

Survival - 0-48 hours. The primary need during this time is for food, clothing, shelter, absence of pain, and connection with family.

Support - Days 2-14. The primary need is for social and emotional support. This is where crisis or trauma debriefings and other forms of psychological first aid can be helpful. However, debriefings and first aid alone are not enough.

Adjustment - Next 2-3 months. Unfortunately, this is where support tends to drop off and most people begin to experience serious adjustment problems. For an individual going through a personal crisis or an organization going through a large event, often there is a lapse in service and intervention. 

Resolution - First year or so. People are beginning to establish new resources and relationships. Holidays, anniversaries, and seasons have been transited. 

Re(dis)covery - 2+ years. It is not recovery that connotes a return to a previous state, but rather re(dis)covery of a new identity and life style. Regardless of the type of crisis, trauma, whether it is an individual or an organization, one must think in terms of two years for the new identity to take formation.

What to do?

The EAP field has learned that there is much greater need for services and interventions than just debriefings and individual counseling. The following section will highlight some of the services and interventions that are used by EAPs to respond to workplace critical incidents.

1. Provision of Information. Early on, information is the lifeblood for surviving a crisis of any type. The old adage often applies, “The first information is often inaccurate information.” Information systems must have consistency, redundancy, frequency, circularity, and continuity. Consistency is just that, being sure that all information going out has a certain degree of constancy of message. Information must be repeated frequently through different modalities even if it seems redundant. The communication system must have a feedback loop to allow people to ask questions and provide more information to each other. Finally, communication must have continuity over an extended period of time.
2. Availability of “higher ups”. Whether they are parents, principals, presidents, CEOs, or captains, people need to see the leaders of a family or community. It taps a very primitive need that most have to see leadership at the helm.
3. Supervisory training. Give first and second level supervisors support. They, more than the “higher ups”, will be dealing directly with the workforce and its reactions. They are often in the unenviable position of having little information or decision-making power, yet a great deal of responsibility.
4. On-going, on-site stress management services. These include meditation, exercise, brief massage, time out rooms, educational seminars, etc. The EA professional knows that people tend to do well initially after an event, but may begin experiencing difficulties two to three months after the event. This is a time when “softer” services can be extremely useful to employees.
5. Debriefings and other psychological first aid interventions. Most EAPs are quite proficient at providing immediate as well as longer-term services for a wide range of workplace disruptions. While there is currently some controversy surrounding the efficacy of the debriefing process, this author believes that there is value to the service. 
6. Alternative health care. What has been discerned in recent years is that victims of crisis and trauma benefit from a wide range of treatment and other modalities. Often, we may think of counseling as the only “treatment of choice.” However, massage, yoga, acupuncture, spiritual/religious counseling, and expressive therapies (such as music, art, and dance), are all viable and valuable options to assist individuals. 
7. Temporary family support services. In the case of a natural disaster, people may initially need temporary placement or shelter, day care, and clothing more than psychological counseling services.
8. Short term no or low interest financial loans. After an incident such as a flood, or storm, ATMs may not be in service and people may need immediate cash to cover basic necessities. An EAP may be the confidential source to manage a small amount of “banking” for the company’s employees who are in need.
9. Help with insurance forms. Once again, after a large-scale incident, people may need help filing claim forms. In one situation where the author was involved, the insurance company set up a mini-office at the workplace to help employees with form completion. In other situations, the EAP and Human Resources departments helped the employees with claims.
10. Flexible schedules. Once again, in the case of a large-scale event, schools and day care programs may be temporarily closed. An employee may have children at home, have no means of transportation, and/or have an elderly parent who needs assistance.
11. Focus groups for employees to provide feedback to management. Two to three months after an event is often a critical time for employees and the overall workplace. It is a time when the “softer” interventions, often offered or facilitated by the EAP, can be helpful. Rather than guess as to what services could be helpful, focus groups of employees could meet with an outside consultant to give feedback to upper management regarding morale, concerns, and service requests. This model was utilized by the US Postal Service to help facilitate the return of employees to the facility that had been attacked with Anthrax.

In closing, unfortunately, there will be more events that will cause trauma and tragedy, catastrophe and chaos, and operational and emotional disruption to the workplace. The EAP field will have ample opportunities to continue to learn from experience and, perhaps, to provide solace and support.

References

Fink, S. (2002). Crisis management: Planning for the Inevitable. NE: Universe, Inc. Kardiner, A. (1947). War, stress and neurotic illness. New York: Hoeber. Kubler-Ross, E. (1974).

On death and dying. New York: Touch Stone Publishers. Lewis, G. (2002). Post-crisis stress debriefings: More harm than good?. Behavioral Health Management, 22(4), 22-25. Lewis, G. (2004).

Thoughts on psychological debriefings. Journal of Employee Assistance, 10-12. Lewis, G. (2005).

Organizational crisis management: The human factor. Lindemann, E. (1944).

Symptomatology and management of acute grief. The American Journal of Psychiatry, 101, 141-148.

This article briefly covers some of the key concepts in a book entitled, Organizational crisis management: The human factor by Gerald Lewis, to be published March 2006.