Trauma and Counselling Services Policy and Procedure

Not Protected Trauma and Counselling Services Policy and Procedure Reference No. P29:2004 Implementation date 2004 Version Number 2.5 Reference No: Name. Linked documents P30:2003 Post Incident Procedure P22:2004 Health and Safety Policy and Procedure P27:2003 Health & Wellbeing Procedure Absence Management and Wellbeing Strategy 2012-15 Policy Section Procedure Section Suitable for Publication Yes Yes Protective Marking Not Protectively Marked PRINTED VERSIONS SHOULD NOT BE RELIED UPON. THE MOST UP TO DATE VERSION CAN BE FOUND ON THE FORCE INTRANET POLICIES SITE. 1

Table of Contents 1 Policy Section... 3 1.1 Statement of Intent Aim and Rationale... 3 1.2 Our Visions and Values... 3 1.3 People, Confidence and Equality... 4 2 Standards... 4 2.1 Legal Basis... 4 2.2 People, Confidence and Equality Impact Assessment... 5 2.3 Any Other Standards... 5 2.4 Monitoring / Feedback... 5 3 Procedure Section... 6 3.1 Introduction... 6 3.2 Definitions and Guidance... 6 3.3 Post-Traumatic Stress... 6 3.4 Defusing... 7 3.5 Trauma Risk Management (TRiM)... 8 3.6 What Is A Traumatic Incident?... 8 3.7 Who Might Be Affected?... 9 3.8 Counselling Services... 9 3.9 Psychological Health Monitoring For High Risk Roles... 9 3.10 Responsibilities... 10 4 Consultation and Authorisation... 13 4.1 Consultation... 13 4.2 Authorisation of this Version... 13 5 Version Control... 13 5.1 Review... 13 5.2 Version History... 13 5.3 Related Forms... 14 5.4 Document History... 14 Appendix A... 15 DEFUSION PROCESS... 15 Appendix B Where to find Professional Help... 16 Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 2

1 Policy Section 1.1 Statement of Intent Aim and Rationale The work of police officers and police staff routinely exposes them to the sorts of traumatic events that the general population would rarely encounter e.g. violent assaults, sudden fatalities, road accidents, murder, body recovery etc, as well as the regular tensions and confrontations inherent in operational policing. The organisation relies heavily on the resilience of the personnel who continue to attend the workplace regularly and perform effectively despite the sometimes traumatic nature of their work activity. This policy has been developed to provide guidance to managers and staff regarding the Trauma and Counselling Services that provide specialist support and expertise to the organisation, its staff and managers. These services aim to assist in maintaining the emotional well-being and resilience of the workforce and to protect, as far as possible, all personnel from psychological harm. These services can be divided into 3 main areas:- The provision of a confidential counselling service; Specialist trauma support (TRiM) following involvement in potentially disturbing incidents; Pro-active psychological support for specialist roles. This policy/procedure applies to all Police Staff employed by both the Chief Constable and the Police and Crime Commissioner. Therefore, there may be occasions when the Police and Crime Commissioner requires access to specialist HR resources/skills employed by the Chief Constable to support the agreed processes. 1.2 Our Visions and Values Dorset Police is committed to the principles of One Team, One Vision A Safer Dorset for You Our strategic priority is to achieve two clear objectives: To make Dorset safer To make Dorset feel safer In doing this we will act in accordance with our values of: Integrity Professionalism Fairness and Respect National Decision Model The National Decision Model (NDM) is the primary decision-making model used in Dorset Police. The NDM is inherently flexible and is applied to the development and review of all policy, procedure, strategy, project, plan or guidance. Understanding, using and measuring the NDM Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 3

ensures that we are able to make ethical (see Code of Ethics), proportionate and defensible decisions in relation to policy, procedure, strategy, project, plan or guidance. Code of Ethics The Code of Ethics underpins every day policy, procedures, decision and action in policing today. The Code of Ethics is an everyday business consideration. This document has been developed with the Code of Ethics at the heart ensuring consideration of the 9 Policing principles and the 10 standards of professional behaviour. Monitoring is carried out through the Equality Impact Assessment process which has been designed to specifically include the Code of Ethics. 1.3 People, Confidence and Equality This document seeks to achieve the priority to make Dorset feel safer by securing trust and confidence. Research identifies that this is achieved through delivering services which: 1. Address individual needs and expectations 2. Improve perceptions of order and community cohesion 3. Focus on community priorities 4. Demonstrate professionalism 5. Express Force values 6. Instil confidence in staff This document also recognises that some people will be part of many communities defined by different characteristics. It is probable that all people share common needs and expectations whilst at the same time everyone is different. Comprehensive consultation and surveying has identified a common need and expectation for communities in Dorset to be:- Listened to Kept informed Protected, and Supported 2 Standards 2.1 Legal Basis Whilst there is no legal basis for this policy Dorset Police is committed to protecting the health, safety and welfare of all staff in compliance with the Force Health and Safety Policy and Procedure. Modern policing can sometimes be extremely challenging and staff can be exposed to events that most members of the public would not ordinarily experience. Therefore, it is vitally important that effective control measures are put in place to identify such events and for the Force to provide specialist support where appropriate, particularly in the area of post-traumatic stress. Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 4

2.2 People, Confidence and Equality Impact Assessment During the creation of this document, this business area is subject to an assessment process entitled People, Confidence and Equality Impact Assessment (EIA). Its aim is to establish the impact of the business area on all people and to also ensure that it complies with the requirements imposed by a range of legislation. 2.3 Any Other Standards This policy is subject to an assessment process to establish its impact in relation to the requirements imposed by a range of legislation that might be affected by its implementation. The Health Safety and Welfare at Work Act 1974 places a duty on employers, so far as is reasonably practicable, to safeguard the health, safety and welfare of their employees while they are at work; This policy complies with NICE (National Institute for Clinical Excellence) Guideline 26 The management of PTSD (Post Traumatic Stress Disorder) in adults and children in primary and secondary care. When fully completed, a record of the impact assessment is retained within the Corporate Development Department. A summary of this assessment is then published on the Dorset Police website. 2.4 Monitoring / Feedback The Force s general sickness reporting measures are set out in the Health and Wellbeing Procedure. Specific work-related stress data is included in the Human Resources quarterly performance measures, which is reported to the Health Safety and Wellbeing Group and overseen by the Strategic People Board. This policy will largely be reviewed against the National Institute for Clinical Excellence guidelines on the Management of Post Traumatic Stress in adults and children in primary and secondary care and the Force s established TRiM procedures attached at Appendix C. However, it also references the Force s Employee Assistance Programme provider and psychological health monitoring arrangements. Feedback relating to this document can be made in writing or by e-mail to: Address: E-mail: Mr J Nickson, Welfare Officer, Winfrith, Dorchester, Dorset. DT2 8DZ jon.nickson@dorset.pnn.police.uk Telephone: 01305 223880 Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 5

3 Procedure Section 3.1 Introduction Not Protectively Marked 3.1.1 Post-Traumatic Stress (PTS) is both an organisational risk and a significant health issue. It is therefore important to identify and manage potentially traumatic incidents. Managers have a clear duty of care to consider carefully the balance between the welfare of the individual and the needs of the organisation, its stakeholders and customers. 3.1.2 When the duties of police officers and police staff involve them in potentially traumatic incidents, supervisors and managers must be aware of, and must utilise the guidance and support provided to assist them with their duty of care to their staff. This includes individuals who have been exposed to prolonged or repeated exposure to potentially traumatic incidents or material. 3.1.3 Individuals who may be vulnerable or have been exposed to primary and secondary traumatisation have a responsibility to co-operate with any support measures put in place by their managers, the Welfare and Counselling Unit or Occupational Health. 3.1.4 The overall aim of the policy is to provide guidance to ensure an effective supportive service for the benefit of the organisation and individual. It identifies responsibilities for a proactive approach to ensure safe systems of work, minimising the risk of PTS and providing early intervention in cases where a reaction to a situation has the potential to become problematic. 3.1.5 This policy supports the Personnel Services Strategy 2013/16 to reduce the number of days lost to sickness as a result of major psychological illness. 3.1.6 Early recognition, effective and ongoing support is known to reduce the onset of a post traumatic reaction. The welfare of our staff is an important aspect of line management responsibility. Giving priority and attention to post incident support will improve the resilience, health and wellbeing of our staff resulting in regular and reliable attendance and longer term health benefits which in turn will help to maximise operational efficiency. 3.2 Definitions and Guidance 3.2.1 A traumatic incident is an event that is considered to be outside that of an individual s usual experience and may surpass their usual coping mechanisms; it has the potential to cause physical, emotional or psychological harm. This could include the mistreatment, injury, or death of members of the public or of a colleague. 3.3 Post-Traumatic Stress 3.3.1 Up to 30% of people who witness a traumatic event then go on to experience some of the symptoms of PTS. These symptoms can vary widely between individuals, and are not unique to any protected group or community but can surface more from certain incidents. Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 6

3.3.2 Post-Traumatic Stress Disorder (PTSD) may emerge months or sometimes years after a traumatic experience has taken place, affecting an individual s health, resilience and lifestyle. 3.3.3 The term PTSD or post-traumatic stress syndrome is used to name a range of symptoms that may develop in response to experiencing a traumatic event. It is normal to experience a stress reaction to an abnormal event. Symptoms may be experienced physically, psychologically or through changes in behaviour. 3.4 Defusing 3.4.1 Defusing is an informal process carried out by a supervisor or manager, after an incident and ideally before the end of the working day/shift. It involves a brief, initial discussion about how an individual experienced a recent incident, how an individual is feeling and advice is given regarding the possible impact of the first few hours and days following the incident. It is an informal process and can be undertaken either on a one to one basis, or in a group of approximately 6-8 people. The process can usually be completed in less than 15 minutes. Please see appendix A. 3.4.2 Individuals who prefer not to participate should not be put under any pressure to do so. Individuals have different styles and coping mechanisms and may not wish or need to participate in the defusing technique. If concerns exist additional supervisory advice can be provided by the Welfare and Counselling Unit. 3.4.3 Disclosure rules mean that supervisors must exercise their duty of care whilst at the same time ensuring that defusing is not used to rehearse factual events prior to making a statement. Disclosure should never be used as a reason not to defuse staff. 3.4.4 Defusing should follow a set pattern:- Opening remarks to explain the purpose of the meeting; Allowing individuals to talk about the incident; Allowing ventilation of feelings; Allowing individuals to gain a perspective; Checking and closing, and who to contact for further advice. 3.4.5 Listed below are some additional areas for supervisors to consider:- Be aware of those most affected. Reassure individuals that you want to support them; Be aware of home support (or lack of it.) Discuss what their plan is following the defusing process and the importance of keeping a balance with work and home life and the potential benefit of gentle exercise; Be aware of those with recent involvement in other incidents and make a note to monitor further exposure and general wellbeing; Be available for a follow up meeting. If appropriate arrange a time for a further brief meeting; Refer to the TRiM Coordinator or to the Welfare and Counselling Unit, TRiM sharepoint page or.trim email box if concerned Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 7

3.5 Trauma Risk Management (TRiM) 3.5.1 The Force provides support for personnel by identifying potentially traumatic operational incidents and by providing appropriate trauma or counselling support when needed. TRiM, which stands for Trauma Risk Management, is derived from the Royal Marines and involves a buddy system delivered by trained colleagues which focuses on education and risk assessment. 3.5.2 The objectives of TRiM are:- To ensure supervisors and managers have guidance for the ongoing management and support of staff in trauma management; To enable managers and supervisors to identify an incident which may require a TRiM intervention; To provide TRiM trained practitioners across the Force to enable them to provide support to their colleagues; To address, under Health and Safety legislation the duty of care to all staff in identifying hazards and minimising risks; To identify and refer when professional intervention is required resulting in a positive impact on sickness absence; For the TRiM practitioner to listen to the experiences of officers and staff and to offer practical advice and assistance; The role of the TRiM practitioner is not one of counsellor or therapist. If counselling support is required a referral will be made by the TRiM practitioner to the Welfare and Counselling Unit. 3.5.3 Details of the full TRiM service and accompanying promotional literature are maintained on the Force intranet. 3.6 What Is A Traumatic Incident? 3.6.1 In most cases supervisors will be aware that the more serious the incident, then the more likely it would be that some form of support could be needed. Supervisors also need to understand the potential impact of accumulative stress; exposure to a number of incidents over time, and that officers working in rural locations, could be as vulnerable as their colleagues working in the conurbation. At times individuals will be less resilient; this could be due to either additional work related or personal problems. If this is the case particular care should be taken. Listed below are the types of incident that would most likely fall into the definition of a potentially traumatic incident:- Serious injury or death of a police officer or police staff member in the line of duty; Serious injury or death of a member of the public as a result of police operations. Some examples of these would be a shooting by a police officer (where a well defined Post Incident Policy already exists), death caused by the collision of a police vehicle or death in police custody; A fatal road traffic collision involving a child or vulnerable person, particularly if injury or death is caused by fire. Any incident involving a baby, child or young person e.g. sudden death of an infant, child abuse or neglect; Unusual sudden deaths, suicides, murders or near misses; Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 8

Any incident considered to be a serious physical or psychological threat, particularly in situations of extreme violence, or where life threatening risk has been taken; An incident where an individual believes that more could have been done to prevent death or serious injury. Any situation where staff are trapped and/or in danger of a hostage situation. 3.7 Who Might Be Affected? 3.7.1 The list is not exhaustive; many of those who could be affected will not just be confined to those at the scene who dealt directly with the incident. Supervisors must also consider other staff such as:- Control Room or Police Enquiry Centre (PEC) staff who will have been involved in dealing with the incident; Police Community Support Officers; Special Constables; Crime Scene Investigators; Coroners Officers. 3.7.2 Some of the above groups will already be included in the Force Psychological Health Monitoring programme. 3.8 Counselling Services 3.8.1 The Welfare and Counselling Unit can provide a comprehensive range of counselling services, including specialist trauma counselling. The purpose of counselling is to support individuals and the organisation by providing confidential counselling interventions that will help to prevent ill health and facilitate effectiveness at work. 3.8.2 Anyone who works or undertakes voluntary work for Dorset Police is able to access counselling support to address work-related or domestic issues. 3.8.3 Counselling can be provided by the Force s Employee Assistance Programme provider, or by specialist external therapists, or by specialist external therapists. Consideration is also given to appropriate community based alternatives via the NHS. 3.8.4 In the case of trauma support individuals may be referred for either psychiatric and psychological assessment and care, or both. As with most work based counselling programmes an assessment is undertaken and a limited number of agreed sessions can be arranged. 3.9 Psychological Health Monitoring For High Risk Roles 3.9.1 Certain roles within the police service have been identified either nationally and/or locally as having the potential for an increased or high risk of psychological harm or distress. Listed below are the groups within the Force that are included in this programme:- Operational Support Unit; Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 9

Safeguarding Referral Unit; Witness Care; Road Policing Officers; Coroners Officers; Foundation Undercover Officers; Imaging Unit; Road Death File Preparation Unit; Family Liaison Officers, Traffic and CID; Child Abuse Investigation Team, POLIT & CSE; Disaster Victim Recovery staff; Marine Section Officers; Specialist Trained Officers; Force Negotiators; Hi Tech Crime Unit & Imaging Unit TRiM Practitioners; Witness Protection Unit. Domestic Abuse Officers MOPI Review Officers Traffic Officers Crime Scene Investigators 3.9.2 Officers and staff working in these roles are offered customised support via the Welfare and Counselling Unit. The purpose of the programme is to provide individuals working in foreseeable high risk roles with enhanced support to maintain their emotional resilience. 3.9.3 A health monitoring consultation would normally encourage reflection on the role and responsibilities to identify aspects of the work that may be particularly challenging as well as those that are fulfilling and rewarding. Time would also be spent on self care through diet and exercise, maintaining boundaries between work and home, managing expectations and exit strategies. 3.9.4 The programme is regularly reviewed for effectiveness and managers involved in the management of teams included in the programme can expect to meet with the Force Welfare Officer at least once in a 12 month period. 3.10 Responsibilities 3.10.1 Dorset Police will:- Acknowledge that PTS can be a normal reaction to the specific nature of police work and not an indication that an individual is in some way weak or a failure; Assist individuals to feel able to discuss their reactions to traumatic events by aiming to promulgate cultural change to remove the perception of stigma associated with traumatic stress; Ensure that the psychological health monitoring programme is utilised appropriately to those groups of staff who could be most affected by the effects of trauma; Seek to ensure that when appropriate the service provided by TRiM practitioners is available to staff and acknowledge the necessity for, and the effectiveness of, post incident support; Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 10

The Welfare and Counselling Unit will where necessary provide training and awareness for line managers and supervisors in good management practices to minimise PTS; The Welfare and Counselling service will provide confidential psychological support for staff affected by PTS to assist with their recovery and return to duty; Provide adequate opportunities for line managers to implement the Trauma and Counselling Services Policy and Procedure thus increasing the psychological resilience of the workforce; Monitor and update guidance in line with the latest information on PTS to continue to develop and achieve good practice. 3.10.2 Line Managers will:- Consider the use of trauma support as a necessary and important management tool; Ensure that defusing interventions are used appropriately and competently; Contact the Welfare and Counselling Unit for advice and/or support in respect of potentially traumatic incidents; Be vigilant to potentially traumatic incidents, provide defusing when considered appropriate and offer additional support by way of a referral to the Welfare and Counselling Unit to staff who may be experiencing PTS; All managers should ensure that trauma support is utilised so that the appropriate duty of care is exercised and the psychological health of staff is protected; Seek advice from the TRiM coordinator and if appropriate make a referral for a TRiM intervention; Play a valuable part acting as a role model by supporting a culture which does not stigmatise the needs that Dorset Police and individuals have, to address stress related issues. The management style adopted on these occasions such as hot debrief, defusing at or after a potentially traumatic incidents can do much to demonstrate the seriousness that line managers attach to the Dorset Police s duty of care, health, safety and welfare of the staff under their supervision; A Guide for Managers Working Together to Reduce Stress is available to Managers on the Force TRiM intranet page. 3.10.3 The Welfare and Counselling Service will:- Give guidance to line managers on the Trauma and Counselling policy and procedure; Provide proactive initiatives for staff in potentially vulnerable roles (psychological health monitoring); Provide specialist advice and awareness training on PTS; Provide training in defusing techniques; Assist with the development and ongoing maintenance of the TRiM programme; Provide appropriate psychological interventions and support to individuals experiencing PTS. Where the individual has been on certificated leave due to PTS, assist and support them during their absence and return to work; Advise and organise referrals to external specialists as required; Inform the Health Safety and Wellbeing Group of any concerns and developments in the field of PTS. 3.10.4 A booklet entitled Potential Reactions to Working at the Scene of a Major Disaster or other Critical Event is available from the Welfare and Counselling Unit. A copy should be given to all involved in such an incident. The booklet can also be accessed from the Welfare and Counselling intranet site. Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 11

3.10.5 Officers and Staff will:- Take responsibility for the care of their own health, safety and psychological wellbeing and that of others; Raise issues of concern regarding PTS or other health issues with line managers, the welfare and counselling service, trade union or staff associations at the earliest opportunity; As directed, take part in any training events or awareness sessions related to post incident resilience and wellbeing; Co-operate with the advice and interventions offered by the Dorset Police in managing PTS including specific measures for vulnerable roles as reflected in the role risk assessments. 3.10.6 A document entitled Be Strong In Stress is available to individuals on the Force TRiM intranet page. Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 12

4 Consultation and Authorisation 4.1 Consultation Version No: Name Signature Date Police & Crime Commissioner Police Federation Superintendents Association UNISON Other Relevant Partners (if applicable) 4.2 Authorisation of this Version Version No: 2.4 Prepared: Quality assured: Authorised: Approved: Name Signature Date Mrs L Tong 03/02/15 Mr J Nickson Jon Nickson 04/03/16 Mr P Channon Pete Channon 9/2/15 Mr P Channon Pete Channon 21.3.16 5 Version Control 5.1 Review Date of next scheduled review Date: 6/4/17 5.2 Version History Version Date Reason for Change Created / Amended by 1.0 May 2004 Initial Document Chief Supt Summers 1.1 July 2004 Following Consultation Chief Supt Summers 1.2 Aug 2004 Further Consultation Chief Supt Summers 1.3 Sept 2010 To incorporate new procedures and Mrs J Hayter working practices 2.0 June 2012 To incorporate new TRiM Mrs J Hayter Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 13

procedures, latest N.I.C.E guidance on PTSD etc into revised policy and procedure format 2.1 November Replacement of references to Police 2012 Authority for arrival of PCC. No other reviewing or changes made. 2.2 March Insertion of stage 2 paragraph into 2014 section 1.1. Change of designation 7/4/14. no review conducted and no further changes made 2.3 28/11/14 The policy has been reviewed in preparation for NICHE implementation (April 2015), no changes necessary 2.4 3/2/14 TRiM guidance added to Appendix C. Fit for purpose review carried out. Minor amendments made to designations and roles 2.5 4/3/16 Fit for purpose review carried out. Minor amendments made. Appendix C - TRiM guidance removed and details inserted at paragraph 3.4.5 re access to current TRiM guidance. Kate Berchem Force Policy Coordinator Policy Coordinator Policy Co-ordinator (6362) Mrs L Tong Mrs L Tong 5.3 Related Forms Force Ref. No. Title / Name Version No. Review Date 5.4 Document History Present Portfolio Holder Director of Human Resources Present Document Owner Lynn Tong Present Owning Department HR Wellbeing and Engagement Details only required for version 1.0 and any major amendment ie 2.0 or 3.0: Name of Board: Date Approved: Chief Officer Approving: Template version January 2013 Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 14

DEFUSION PROCESS Appendix A INCIDENT When possible prepare staff for what they might see/ hear/ smell/ experience Supervisors MUST defuse staff after the incident using a common sense approach approach Decide on individual or group defusion Go to safe location away from scene Set a max time limit of 60 minutes. Talk about event Stress confidentiality Acknowledge that it is normal to feel affected Discuss facts and fill in missing details Discuss impact on individual Discuss normal stress reactions Advise of support available Record:- Name of defuser Date Time Location Attended/ declined TRiM Yes/ No Considerations: Are they safe to drive home? Are they expressing any thoughts of harm to themselves or others? Are they due to go on annual leave or rest days? Check progress over the next few days Not appropriate Consider TRiM referral Considered appropriate See TRiM referral flowchart If problems or difficulty coping Consider referral to Welfare and Counselling Unit Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 15

Appendix B Where to find Professional Help 1. Welfare and Counselling Unit 01305 22 3880 or 700 3880 2. Employees Assistance Programme 24 hour helpline 0800243458 3. TRiM Coordinator - see +SPR on force-wide system 4. Occupational Health - 01305 363800 - normal office hours 5. Local General Practitioner 6. Police Federation 01305 22 3732 7. UNISON 01305 22 3691 Trauma and Counselling Services Policy and Procedure P29:2004 v2.5 16