An AfterAssault Staff Intervention Hope Community Resources The Story Hope has led a staff wellness initiative for over 15 years Wellness Seminars Employee Assistance Program Wellness Staff June 2015 ID: 650557
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Slide1
Doing the Right Thing for Those Who Support Others
An After-Assault Staff Intervention
Hope Community ResourcesSlide2
The Story
Hope has led a staff wellness initiative for over 15 years.
Wellness Seminars
Employee Assistance Program
Wellness Staff
June 2015
Regular Critical Incident follow-up meeting
“Do we do anything supportive with a staff person after an incident of aggression?”
“Do we try to ensure that the staff person can still be truly caring and supportive with that person after the incident?”Slide3
Statistics at Hope
From 2005 to
2015
Census 900-1000
765 total altercations/aggression episodes on
staff (broad definition of aggression)
70 per year
One
or two per weekSlide4
Research
Review
of literature on workplace violence and trauma
intervention
Organizations – Eight interviews and site visits
Other DD agencies
Hospitals
Mental health hospitals
Public schoolsSlide5
Preliminary Conclusions
A consistent protocol to support
a staff person after
an assault is needed.
After research and careful consideration, we will apply the
“Mitchell Model” of Critical Incident Stress
Management; it is the most-referenced in the (mixed) literature, and it seems to fit
Hope’s
situation and needs best.
We need to be trained
in this model before we proceed.Slide6
Training
January 2016
“Three-Day
Combined”
Training
International
Critical Incident Stress Foundation (the Mitchell /CISM model
)
Alaska
Trauma Center
R
etired
Anchorage Police Department
chaplain
13
contact hours in Assisting Individuals in
Crisis
14
hours in Group Crisis
Intervention
This
training was by far the most relevant and helpful to our situation at Hope.Slide7
Pilot Project Design
Notification of assault incident by Internal Incident Report
Telephone call explaining the intervention
The interventionSlide8
The Telephone Call
Introduction
of the interventionist
“I understand you were harmed by someone you support. I would like to just pause and take a moment to get with you and check to be sure you’re okay.”
Purposes: to touch base, for personal support , to provide a safe place to talk
freely
The
purpose is not to investigate the incident or find fault with the staff person.
“It will probably only take about 30 minutes.”
“I have some materials I want to give you to help you.”
Explanation of confidentiality (except anything illegal or dangerous to anyone)
“Your participation is voluntary but I encourage you to talk for your own benefit.”
If the staff
person
refuses the intervention, offer contact information.Slide9
The Intervention – The Incident
A
one-on-one
conversation
A location
with some
privacy
Brief review of the telephone conversation
“Tell me a little about what happened.”
“What was the worst part about what happened?”
Discuss physical injuries, medical treatment, and
possible
workman’s compensation claim.
If
the interventionist suspects the staff
person
was at fault or may have actually caused the assault, the procedure is to say nothing during the intervention, and then later advise the agency’s In-House Counsel to review the Internal Incident Report again.Slide10
The Intervention – Impacts of the Incident
“How is this incident affecting you now
?”
Sleep
– exhaustion, or
sleeplessness
Memories
Feelings
of
anger
Feelings
of
fear
Numb
Reminding
you of other experiences in your
life
Using
drugs or
alcohol
Affects
in your family or other relationships
“Your feelings and responses are all normal responses to an abnormal situation.”Slide11
The Intervention - Two Hand-Outs
“Doing the Right Thing for Yourself”
“Doing the Right Thing for the Person You Support”Slide12
“Doing the Right Thing for Yourself”
A
list of
strategies
for self-care and stress relief after a traumatic
incident,
a
dapted with permission from the ICISF
“
Self-Care and Stress Management Do’s and
Don’ts,” adapted
with permission from Providence Alaska Medical
Center
Applying these strategies soon may reduce post-traumatic stress symptoms almost completely. Slide13
2. “Doing the Right Thing for the Person You Support”
“Thank you for your work at Hope. We know you were drawn to this work for many personal reasons – mainly because you care. Based on your caring heart, please do some
‘soul-searching’
about what happened. Take some quiet time and honestly reflect on these questions:
Slide14
2. “Doing the Right Thing for the Person You Support”
“How much has your relationship with the support recipient been affected by what happened?
Can you go back to work prepared to care – in a way that will continue good services for that person?
Do you think it would be better for another staff person to work with that person?”
Explanation how a transfer within the agency worksSlide15
The Intervention – Wrap-up
Ask
“Do you have any questions for me?”
(Ask yourself
“Are we done here
?”)
Contact
information for the
Employee
Assistance Program
Contact information for the
interventionist
Follow-up phone call from Human Resources about a week
laterSlide16
Two Follow-up Questions from HR
“On a 1-to-10 scale, how glad are you that we reached out to you (with 1 being not glad at all and 10 being very glad)?”
“On
a 1-to-10 scale, how helpful were these conversations to you (with 1 being not helpful at all and 10 being most helpful)?”Slide17
Pilot Project – Approved by Executive Leadership
Parameters
July-October 2016
Three months (100 days)
Only
in the Anchorage region
Only incidents of physical assault – hits, kicks, slaps, bites
Only one
interventionist
Data points
Total
number of interventions
How soon after assault incident?
Staff
refusals of the intervention
Time spent on each intervention
Transfer requests
Any unhealthy coping mechanisms?
Impacts on the
interventionist
Answers to follow-up questionsSlide18
Pilot Project Results
Total Internal Incident Reports scanned
377
26 per week average
Total interventions
22
6% of
total Internal
Incident Reports
One or two
interventions per week
16 women, 6 men
Refusals – Only one staff
person
did not return the phone call
.Slide19
Pilot Project Results
Intervention locations
Group homes – 12
Main administrative building – 3
Mental Health waiting room
Public park
Family home
Agency art studioSlide20
Pilot Project Results
Telephone contact how soon after incident – almost always the same day the Internal Incident Report was posted
Intervention how soon after incident
From 12 hours up to
seven
days
Two
days average
How much time spent per intervention
From 30 minutes up to
three
hours
One
hour averageSlide21
Pilot Project Results
Transfer requests after intervention
There were no transfer requests specifically based on the incident and intervention.
Two
people did leave the agency since the incidents (for other
reasons?).
Coping responses/denials – There were some (“it comes with the territory”).
Staff
were very open to reviewing incidents, to learn how to do it better next time.
Staff consistently
showed good self-care, a professional perspective on the incident, and sincere concern for the person who assaulted them.Slide22
Pilot Project Results
Impacts on interventionist – After scanning many Internal Incident Reports and doing several interventions in one
week, woke
up from a dream of being assaulted in a group home. R
eviewed
and applied strategies from “Doing the Right Thing for Yourself.”
“How glad are you that we reached out to you?” – 9.3 out of 10
“How helpful were these conversations to you?” – 9.2 out of 10Slide23
Staff Comments During Pilot Project
“Thank you for the follow-up. I think it’s wonderful that you are doing this.”
“…makes you feel that someone cares”
“…if I were really struggling, it would be really nice to know that I have people that care and are here to support me.”
“…having the handouts to really look over, read and think about what was saying really made me think about some things. I really appreciated that.”
“It is really comforting to know that you are out there.”
“
I can see how it would be helpful for others who might need it. I really have been just doing this for so long that I know what to expect.”
“I think it is such a wonderful thing to know that your agency has your back. This is going to be an amazing thing for current and future employees
.”Slide24
Protocol
The After-Assault
Staff Intervention was approved
as
an official protocol of Hope Community Resources.
The
protocol is now expanded to all the other regions of Alaska, by means of telephone interventions.
T
he
definition of “assault” remains the same – physical assaults only.
We
will continue to capture data on interventions for one year
.
In
the future we will
train
more interventionists
to form
an intervention team.
We are happy to share what we are learning at Hope!Slide25
Doing the Right Thing for Those Who Support Others
rbenjamin@hopealaska.org
(907)433-4707