PTSD: National Center for PTSD

For Leaders: Supporting Your Staff During the Coronavirus (COVID-19) Pandemic

Supporting your staff in a work setting strongly impacted by the coronavirus (COVID-19) outbreak should involve some key adaptations to your routine. Leaders are in a position to provide accurate and timely information about the pandemic, link employees with polices that may rapidly change, foster peer support, and offer resources to help manage stress and coping.

Early Efforts

Managers have an important role in establishing order, predictability, and direction in large scale disasters. As the national and organizational response unfolds, your own sense of calm, focus, and self-assurance will play a significant role in easing the stress of those you work with. Because this is an extended, infrequent event, it may be helpful to remember that organizational strategies must change. This means establishing both order and reassurance early on. Plan your approach before you respond. First, gather and prepare accurate and up-to-date information, determine the impact on your staff carefully, and organize your own thoughts. Convey that the organization will prioritize the safety of all staff, work with them to understand their questions and needs, and explain any policies or regulations.

Your next priority should be to inform staff how you will communicate and operate to ensure their care—especially those who request leave. Let them know that even when policies and plans change in response to the evolving outbreak, you will communicate those changes as efficiently as possible. Give your staff resources—such as the Employee Assistance Program (EAP)—options for work relief, and how to get peer support, if it is available. These efforts to normalize anticipated stress reactions will let staff know that what they are experiencing is understandable. Let them know you will check in regularly to see how they are doing. It is important to remember that in the intermediate and long-term phases of a public health crisis, increased communication and willingness to put new organizational strategies and policies in place—based on leader vision and regular input from employees—is essential for organizational and employee health.

Five Essential Elements: A Framework for Support

Research has identified five essential elements related to better recovery from adverse ongoing experiences after the initial response. These elements—Cover, Calm, Connect, Competence and Confidence—have been captured in the Stress First Aid (SFA) peer support model. You can organize your ongoing support of employees by ensuring these elements are in place for them. Here are some sample questions, statements, and actions relevant to impact of the outbreak that map onto the five SFA elements. You can choose those that best fit the context, changing them to suit the situation and your style of interacting:

Cover

• Questions: "How has the pandemic affected your sense of safety? If it has, what can we do to help?"
• Statements: "We are committed to our employees' health and wellbeing. Here is what we're doing to keep you all safe."
• Actions: Give your best understanding of timelines and any variables.

Calm

• Questions: "How are you doing? What changes have you experienced regarding sleep, feelings of being on edge, or ability to stay calm? If you're having trouble staying calm, is there anything we can do to help?"
• Statements: "There are no set rules for working through something like this. Be patient with yourself."
• Actions: Allow employees to speak frankly about the event, their reactions, and their concerns. Discuss the importance of being more disciplined in self-care. More information about self-care is included in the Managing Stress Associated with the Coronavirus (COVID-19) Outbreak article.

Connect

• Questions: "Has there been an impact on how you talk with each other, work morale, or connecting with family and friends? Is there someone you feel comfortable talking with about this? Has anyone you know done or said something that really helped? Do you feel the need for practical support right now?"
• Statements: "We'll make it through this together. We value you and the work you do. Be sensitive to those around you. Talk when you need to; listen when you can."
• Actions: Encourage employees to consider staying in touch with coworkers via email, text, or videoconferencing, both to continue collaborating on projects if that is part of their work, and to be sources of support and connection.

Competence

• Questions: "Do you have any concerns about being able to handle what's going on in your life, deal with your stress reactions, or do your work? What are some things that you have done to cope that have been helpful in the past, or have been helpful recently? What else could we do that would help?"
• Statements: "If you've found a coping strategy that works for you, consider sharing it with your coworkers. Here are resources to help you through (e.g., a workplace peer, chaplain, and/or an EAP counselor)."
• Actions: Offer the resources available at your organization. Encourage use of resources.

Confidence

• Questions: "Have you noticed any change in your confidence in your ability to do your job the same way as before the outbreak or your confidence in leadership? Are you feeling guilty or wish you could do something differently? Does the outbreak hold special meaning or connect with other experiences in any way? What else could help?"
• Statements: "Try to take things one day at a time. The situation is unprecedented and ever-changing, and we're all doing the best we can under challenging circumstances. Remember to be patient with yourself and others. Don't let the worst elements of the situation overshadow your belief in yourself or your commitment to what you do. Help is there whenever you need it."
• Actions: Check in regularly. Share optimistic news. Increase positive encouragement, reinforcement, and gratitude for employees' contributions.

Extended Efforts

The workplace is often a place where people turn to others for help when they are dealing with problems. However, stress reactions can affect everything we value at work: control, growth, productivity, connections. As a part of the COVID-19 response, work variables will vary widely in different work settings so there is no way to prescribe specific actions that will fit for every work setting. Given the many variables that occur at work in relation to a pandemic response, as a manager or leader if you can build a relationship of trust with teams and individuals who are experiencing intense stress reactions, you can support and help employees recover more quickly. Strong time off policies, flexibility, and open conversations make a big difference. Here are a few potential ways to help:

• Be flexible. Employees affected by stressful circumstances can experience both progressions and regressions in focus and productivity, especially if the stressor lasts a long time or is complex. Acknowledging the multiple stressors and making fewer demands during less productive periods helps. If possible, allow flexible adaptations from time to time, such as remote working, a shift to a less demanding role, or flexible work hours. Check in periodically to discuss how the person is coping and whether further accommodations are needed. Flexibility helps people benefit from the structure of work in stressful times, without being overwhelmed.
• Show support. In stressful work conditions, many employees are touched by simple gestures on the part of leaders. Your demonstration of support is a signal that the workplace cares. This can be done in the most fitting way for you, your organizational culture, and your workers.
• Ask questions. Follow the employee's lead regarding the kind of support, assistance, time off, and mentoring they prefer.
• Inform. Be open with staff about work policies and how flexible they are. Clarity around work policies and options can give structure and routine in a time when a person is feeling out of control. There is no formula for making allowances for employee stress reactions; it depends on your work policies and requirements. If existing policies do not seem sufficient, consider supplementing them with strategies like leave sharing options that allow employees to donate vacation time to those in need. But ultimately, patience and support are what make the difference.

Helping Those Who Need Additional Support

For employees who have a strong negative impact from the outbreak (e.g., those with close exposure to loss, illness, moral distress, or long-term wear and tear), here are a few additional recommendations:

• Be patient. Stress reactions for those most strongly impacted by the COVID-19 outbreak can remain intense for some time. Fluctuations may occur in how well they are able to engage in work. They may function fine at work sometimes, and at other times feel like they can't function well. It may take time for them to "return to normal," and at times feel discouraged. If you share that these reactions are to be expected, they are a valued employee, and that you can work together to move forward, you can reduce a good deal of misunderstanding and conflict.
• Believe in the person. People are often very self-critical when dealing with intense stress, especially those who have previously been very successful at work. They will benefit if you continue to believe in them while not putting too much pressure on them. It requires the capacity to listen and give permission to be both a functioning employee and a human being who is experiencing intense stress. It can be a relief for the employee to see that you hold them in the same regard as before but can tailor your expectations as needed.
• Be a role model. When an employee is dealing with significant stressors and needs time off or other adaptations, you can play an important role by respecting confidentiality. That means taking a long-term perspective and not engaging in speculation or negative conversations about people when they are not present.
• Advise and refer. If an employee indicates they are seriously struggling, it will be helpful to assist them in identifying specific concerns and issues that warrant additional support or require mental health treatment. Common reactions likely to affect mental, emotional, social, and physical functioning can be identified by the most appropriate person (e.g., supervisor, EAP provider, HR, etc.) An inability to sustain regular work duties in the months after the crisis has passed may be a symptom of complicated or prolonged stress-related illness. There are effective, evidence-based treatments that can reduce suffering and speed up recovery.

Proceeding in the Aftermath of the Outbreak

Experiencing an extended, intensely stressful public health crisis like the COVID-19 pandemic can have positive as well as negative effects. For instance, it can lead to deeper connections with others. It can inspire greater authenticity, a shift in values, the realizations that one is stronger by enduring through complex, threatening circumstances, and that life is worth living. You can support employees through this process by demonstrating your interest in what they might be discovering about their changes in life and work. If an employee is feeling guilt about new ways of feeling and seeing life, listen and support them as they craft a new way forward, speak about your own experiences with adversity or loss, or ask about their experiences over time.

Your actions as a manager can help employees feel supported as they work towards recovery, have a ripple effect on other employees who see the care you take with the most affected individuals, help employees remain in their roles, and bring out their best in the long run. In this sense, any crisis becomes a potential opportunity to make a lasting impact on the lives of those you lead.

Practicing Self-Care as a Manager

Your leadership during the COVID-19 pandemic is vital to the organization and your own wellbeing is a paramount consideration if you are to do your job safely and well. Your example as a role model can have a profound effect on how your staff values their own self-care. Remember to use the core principles of Stress First Aid to care for yourself as well. Be clear with family and friends about how they can support you at this time. Should you need additional assistance, consider reaching out to a peer or mentor who may have had experience with similar situations, or consider using Employee Assistance Program (EAP) or other available support as needed.

Example of Communication from Leadership to Staff Conveying Support

This is an example of communication to staff that can be adapted as needed to fit your communication style and workplace settings.

To All Staff:

Everyone who works here is proud of what we do and how we do it. We have earned a reputation for excellence, and it is the consistent hard work we do here that has made this happen.

This has been a difficult time for everyone in the organization. It may be some time before we know what will happen with any certainty. As questions swirl and people in many quarters speculate, we all struggle to sort through our own feelings and reactions.

We are committed to your safety. Our pride in the work every employee contributes has never been greater and will never waiver.

We will likely face some trying moments in the context of this pandemic, and we need to be prepared to work through any difficulties we encounter. Below are a few suggestions that may help you along the way:

• There are no set rules for working through something like this. No two people experience the situation in quite the same way, nor will they share the same reactions. None of us will navigate it quite the same way either. The range of normal reactions is extremely broad—it's the situation that's abnormal, not you or your reactions to it.
• Be patient with yourself. Expect your stress reactions to come and go—sometimes when you're least expecting it, often when it's least convenient. When you can, let yourself react. If you need to step away for a couple of minutes or take a moment by yourself, do what you need to do. But try to come back and complete whatever you were doing as soon as you feel able—that's how we regain control.
• Be sensitive to those around you, especially the people closest to you. We tend to turn inward when processing a major life disruption and this can sometimes lead us to pull away from others right when we need them the most. A simple check in when someone else is having a tough moment or saying, "I'll be okay," to someone concerned for your wellbeing can help more than you may know.
• Talk when you need to; listen when you can. It's really that basic in the long run. The real work of adapting to situations like this happens one person at a time, one person to another. Don't try to go it all alone. Pick the people, places, and times that work the best for you.
• You don't have to talk when you don't need to. It's important not to run away from your reactions but you also need to let yourself have some distance from the event and its impacts. Lots of people will have comments, questions, or suggestions. Some may be welcome but others—though well-intentioned—may seem intrusive, calloused, or clumsy. It's perfectly acceptable to say, "I'd really rather talk about something else right now," and take it in another direction.
• Don't let the worst elements of the situation overshadow your pride in what you do. As difficult as this event is for all of us, we will emerge stronger, safer, and more committed than ever to the work we do. Every one of us is crucial in helping us move ahead.
• One day at a time. It takes time to work through something this big and some days will be much better than others. Try to take each day as a fresh challenge and don't be too distracted by an occasional false start or seeming setback.
• If it works for you, pass it on. We become stronger when we work through things together. Catastrophic events can seem like overwhelming obstacles but there is real strength in getting through them intact and together. This pandemic is no exception. We've all mastered other difficulties in our lives, and we will master this, too. Share your strength with others.
• Help is there whenever you need it. Don't wait to reach out for help. Our EAP is ready to provide confidential help 24/7. If it's a concern to you, it's worth a call or visit. You could also list other resources for employees.

Materials Adapted From

Gist, R. (2015). Working together through troubling times. Amtrak Employee Assistance Program Publication.

Gist, R. (2015). First contact first aid. Amtrak Employee Assistance Program Publication.

Hannah, S. T., Uhl-Bien, M., Avolio, B. J., & Cavarretta, F. L. (2009). A framework for examining leadership in extreme contexts. The Leadership Quarterly, 20(6), 897-919. http://doi.org/10.1016/j.leaqua.2009.09.006

Snowden, D. (2005). Strategy in the context of uncertainty. Handbook of Business Strategy, 6(1), 47-54. http://doi.org/10.1108/089443195195568955

Snowden, D. J., & Boone, M. E. (2007). A leader's framework for decision making. Harvard Business Review, 85(11), 68.

Watson, P., Gist, R., Taylor, V. Evlander, E., Leto, F., Martin, R., Vaught, D., Nash, W.P., Westphal, R., & Litz, B. (2013). Stress First Aid for firefighters and emergency services personnel. National Fallen Firefighters Foundation.

Watson, P.J., & Gist, R. (2015). Amtrak employee assistance program. Assessment toolkit. Amtrak Employee Assistance Program Publication.