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Updated September 11, 2020

COVID-19 Guidance for Building Resilience in

the Workplace

Purpose

This document provides guidance for building resilience in the workplace. The information is for all organizations and businesses throughout Washington. This includes nongovernmental organizations, healthcare agencies, and non-profits.

This guidance covers:

 The behavioral health impacts in the workplace because of the COVID-19 pandemic.

 Tips and ideas for developing resilience at the organizational, leadership, and individual levels.

It is important for organizations and employers to be aware of the toll that the COVID-19 pandemic is having on the workforce, and take action to reduce harmful effects.

Expected Behavioral Health Impacts in the Workplace

There are major impacts on the behavioral health and wellness of employees due to the COVID- 19 pandemic. The most common concerns are burnout, compassion fatigue, and moral injury.

 Burnout: Tiredness of body and mind, and lower motivation because of work stress or frustration that does not end. Burnout occurs when there is an unequal balance between the demands of the job and the coping resources that an employee has.

 Compassion fatigue: Emotional and physical tiredness leading to a decreased ability to empathize or feel compassion for others. It is also described as secondary traumatic stress.

 Moral injury: Strong feelings of guilt, shame, and anger about the frustration that comes from not giving the kind of care or service that an employee (often a healthcare worker) wants and expects to provide.1

The best way to address these common concerns is to develop resilience and resilience factors.

 Resilience: The process of adapting well during hard times, trauma, tragedy, threats, or major sources of stress. It involves changing behaviors, thoughts, and actions.2

 Resilience factors: Conditions that help a person survive and recover from a crisis or trauma. These can include flexibility and adaptability, connection to others, purpose, and hope.3

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Increase Resilience to Support Your Teams

To build resilience in the workplace, identify and put into practice the four resilience factors or ingredients on both organizational and individual levels:

1. Be able to adapt and be mentally flexible.

2. Focus on developing social connections, both big and small.

3. Develop a shared sense of purpose.

4. Focus on hope.

If your organization employs or supports those in higher risk occupations, such as healthcare, behavioral health, law enforcement, education, etc., see the COVID-19 Behavioral Health Group Impact Reference Guide. This guide explains occupation-specific behavioral health concerns, risk factors, and support strategies.

For more information about the phases of disaster, the behavioral health impacts related to each phase, and information on additional groups, visit DOH's Behavioral Health Resources & Recommendations webpage.

Organizational, Leadership, and Individual Resilience

Organizational Level

Organizational resilience depends on:4,5

 Developing shared trust and interdependence among employers and employees.

 The organization’s ability to learn and adapt to lessons learned.

 Human Resources flexibility for work schedules and boundaries, time off, and job roles.

 Open, two-way communication among leadership and staff at all levels about expectations and goals.

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A resilient organizational culture:

 Supports flexibility and adaptability in a changing environment.

 Encourages setting healthy boundaries and models those healthy boundaries, which must start with leadership. Boundaries can include work time limits, job expectations, and job availability (i.e., being off work means not available for work activities).

 Prioritizes workforce wellness as a way to achieve the mission of the organization or company.

Tips to increase organizational resilience:

 Keep workgroups or project teams together for the rest of the pandemic (or for as long as possible) to increase work connection for employees.

 Encourage and support work-life balance.*

o Limit work hours to no more than 12 hours per day.

o Limit work schedule to no more than two weeks without a break of at least 36 to 48 hours.

 Develop work plans and set clear expectations about productivity given the problems caused by the pandemic.6

 Develop communication guidelines that are responsive and clear.

o Set boundaries around communication, noting the changes in workflow due to COVID-19.6

o Consider “offline” days that allow employees to work without having to be responsive to digital communication.

 Rotate employees between high and low stress work or job tasks if possible.

 Encourage the use of the organizational Employee Assistance Program (EAP) when available, as well as other outside support trainings or resources.

 Encourage employees to keep track of and talk about their exposure to very high stress events when possible.

 Encourage employees to develop personal coping plans to follow during times of high stress.

 Develop clear definitions of roles because duties and workflows may have changed as a result of the pandemic.6

 When offering feedback, comment on positives before giving criticism.6

 Encourage employees to stay in touch with their close social supports, such as family and friends. Communicate the importance of having connection with others during times of stress.

 Provide the opportunity for, but do not require, employees to share their experiences with each other and with leadership throughout the pandemic.

* https://hbr.org/2019/08/better-work-life-balance-starts-with-managers

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 Educate employees about the rise of substance use during the pandemic. Clearly communicate the preventative measures available in the workplace and the support offered through EAP when available.

 Keep track of the workplace for signs of harmful substance use. Refer to the tip sheet for help identifying substance misuse from the Substance Abuse and Mental Health Services Administration (SAMHSA).† Signs may include showing up at work with alcohol on breath or being impaired or hungover, or employee reports of increased drinking or cannabis use.

o If substance use issues may be widespread in the workplace, think about doing a workplace assessment for substance misuse problems.‡

Leadership Level

Leadership resilience depends on:

 Understanding the many factors that add stress for yourself and your employees during this time.

 Creating a culture where people know that mistakes may lead to positive results. Understanding that everyone will make mistakes, and mistakes offer learning opportunities.6

 Developing an awareness of behavioral and emotional reactions to stress and burnout. These can include emotional outbursts, having trouble concentrating, withdrawal from others, loss of interest in the job, and trouble completing tasks.

 Being aware that during a pandemic, there is pressure to get work done fast, be productive, and available to do work.

 Understanding the need to create and sustain an environment where employees know they are valued, and they feel appreciated.

Tips to increase resilience among leadership and supervisors:

 Create a system for recognizing employee efforts and accomplishments during team or one-on-one meetings.

 Promote fairness and work balance when giving out assignments, projects, and tasks, especially in higher stress roles.

 Make sure everyone understands their level of responsibility and authority in the organization.6

 Help create a team culture where it is okay to say “no” to requests that can’t be taken. Model this practice for your team.

† https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4874.pdf ‡ https://www.samhsa.gov/workplace/toolkit/assess-workplace

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 Encourage healthy work-life balance by modeling healthy boundaries around time spent working and time off. For example, build breaks into your work schedule, remind team members to take breaks, and don’t do work tasks while off work.7,8,9,10,11,12,13

 Model problem solving from a variety of viewpoints. Encourage team members to do the same.

 Manage anger and reduce conflict between team members. Seek training on this for support or more information in this area.

 Provide the opportunity for, but do not require, team members to check in regularly with their lead and colleagues to share how they are feeling about their work. One way to do this is to have regular, short (e.g., 15 minute) team meetings for team members to check in on how they are feeling, report on what went well, share lessons learned, and suggest changes.14,15

 Share your own feelings and experiences as a leader.

 Watch employees for signs of too much stress. Warning signs may be physical and behavioral, such as headaches, stomachaches, tiredness, irritability, and trouble focusing and finishing tasks.

 Secondhand or vicarious trauma occurs when exposure to high stress events creates a psychological trauma response, even when someone isn’t directly exposed to the trauma. It can occur as a result of exposure to the experiences of others.

o The signs of vicarious trauma may look the same as if being directly exposed, and can be just as harmful.

o Following the recommendations outlined throughout this document (see individual level tips in the next section) can help manage vicarious trauma exposure in yourself and team members.

 Create a culture of non-judgment. Set clear expectations that when someone appears to be struggling, the organizational policy guides leadership and colleagues to reach out to discuss and offer support. Clearly communicate a reporting tool for employees to follow. Having concern while ignoring or not discussing the issue is unfair to the individual and to the organization.11,13,16

 Keep track of employees for signs of harmful substance use. Refer to SAMHSA’s tip sheet for help identifying substance misuse. Signs may include showing up at work with alcohol on breath or being impaired or hungover, or employee reports of increased drinking or cannabis use.

Individual Level

Individual resilience depends on:

1. Flexibility and Adaptability: Practice viewing changes as opportunities and challenges, rather than as threats. If you view something as a threat, even if it isn’t, you are more likely to experience a sense of fear. Fear prevents us from challenging ourselves, enjoying new things, and growing.

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2. Purpose: Purpose comes from knowing your core values, such as honesty, gratitude, and courage, and working in a way that is consistent with them. Personal core values are different for everyone. No two people have the same sense of purpose based on their life experiences. Anything that motivates you is an example of something that gives you purpose.

3. Connection: Develop and keep connection by increasing the strength, quality, or number of healthy relationships in your life. A greater number of relationships isn’t necessarily better. The quality of your connections is what makes the biggest difference. Friends, family, cultural and social groups, pets, and higher powers are all examples of relationships that increase your sense of connection and decrease feelings of isolation and loneliness. Connection is even more important during pandemics, and may require getting creative in how we build and keep our connections with others.

4. Hope: Having a positive outlook is a powerful tool. Spend time thinking about all the possible and likely outcomes of a situation, not just the negative things that may happen. It is okay to think about negative possibilities, but it is important to also give attention to the positive possibilities. This practice increases hope.

Tips to increase individual resilience:

 Define and work on developing your core values. Decide how you can live and work every day in a way that is consistent with your best self, even if those steps are very small.

 Live in congruence. This means the ways in which you think, feel, and act agree with your core values.

 Work on developing healthy boundaries.

o This means taking responsibility for your own thoughts, feelings, and behaviors, and not blaming other people or a situation.

o This also means not taking responsibility for other people’s thoughts, feelings, and behavior, and giving them the respect of allowing them to manage those things for themselves.

 Develop a self-care plan§ to follow when you are feeling high stress. Engage in self-care in order to reduce stress as soon as possible.

REST Model to increase personal resilience:17

It can be hard to do your job well and help others if your own need for rest is ignored. The REST Model is a simple tool to help increase your resilience. This model helps support healthy boundaries and the development of resilience through purpose, connection, and hope.

§ https://csun.edu/sites/default/files/SUN-Self-care-Plan.pdf

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REST Model

Reward

Reward yourself for a job well done. Build supports into your work. For example, give yourself a break from the patterns and issues you deal with often. Take some time off or even just 15 minutes to do something you enjoy, such as watching a short video, going for a walk, or spending a few minutes doing a mindfulness exercise. Try to avoid rewards that include alcohol or drug use, as this can make job and personal stressors worse.

Establish

Set or establish healthy boundaries. Focus on keeping work at work and leaving it there. When you are off work, stick to that boundary. Do not bring work into your personal time or space. For example, for those who are working at home, this may mean moving work materials into another room or space. Say “no” to a request that conflicts with your boundaries, such as an expectation that you will answer work emails when off duty. Respectfully but firmly stick to set boundaries.

Share

Share your feelings, concerns, and stories. Do not hold things in. Participate in support and professional consultation groups. Consultation groups can provide opportunities to talk about work matters and offer social connection, which improves workplace resilience. Do not avoid talking about things that bother you. Enjoy the small things in life by focusing on spending time with your family or social group. Make time for connections and activities in your life.

Trust

Trust your support network and reach out as needed. Refer people elsewhere if you are too tired or emotionally unable to offer support. Trust that others are willing to help. If the issues seem larger or more serious, reach out for professional consultation and help. Keep a referral list of professional resources, such as your EAP and behavioral health professionals that you can go to when needed.

Resilience Resources

 SAMHSA:

o Tip sheet for help identifying substance misuse

o Assess your workplace for potential substance misuse issues

 Reach Out: Developing a self-care plan

 California State University: How to Create an Individualized Self-Care Plan**

** https://csun.edu/sites/default/files/SUN-Self-care-Plan.pdf

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 University of Buffalo:

o Self-care assessment††

o Lifestyle behaviors checklist – Is your lifestyle causing you stress?‡‡

o Maintenance self-care plan worksheet§§

 Harvard Business Review: Developing better work-life balance article

Acknowledgements

This document was developed by the Washington State Department of Health’s Behavioral Health Strike Team for the COVID-19 response. It was written by Kira Mauseth, Ph.D, Tona McGuire, Ph.D, and Matt Brickell, Psy.D., with support from a Seattle University student research group.

More COVID-19 Information and Resources

Stay up-to-date on the current COVID-19 situation in Washington, Governor Inslee’s proclamations, symptoms, how it spreads, and how and when people should get tested. See our Frequently Asked Questions for more information.

A person’s race/ethnicity or nationality does not, itself, put them at greater risk of COVID-19. However, data are revealing that communities of color are being disproportionately impacted by COVID-19- this is due to the effects of racism, and in particular, structural racism, that leaves some groups with fewer opportunities to protect themselves and their communities. Stigma will not help to fight the illness. Share accurate information with others to keep rumors and misinformation from spreading.

 WA State Department of Health 2019 Novel Coronavirus Outbreak (COVID-19)

 WA State Coronavirus Response (COVID-19)

 Find Your Local Health Department or District

 CDC Coronavirus (COVID-19)

 Stigma Reduction Resources

Have more questions about COVID-19? Call our hotline: 1-800-525-0127, Monday – Friday, 6 a.m. to 10 p.m., Weekends: 8 a.m. to 6 p.m. For interpretative services, press # when they answer and say your language. For questions about your own health, COVID-19 testing, or testing results, please contact a health care provider.

To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email [email protected].

†† http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/self-care-assessment.pdf ‡‡ http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/lifestyle-behaviors.pdf §§ http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/my-maintenance-self-care- worksheet.pdf

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References

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3. Sarkar, M., & Fletcher, D. (2014). Ordinary Magic, Extraordinary Performance: Psychological Resilience and Thriving in High Achievers. Sport, Exercise and Performance Psychology, 3(1), 46-60.

4. Gittell, J. H., Cameron, K., Lim, S., & Rivas, V. (2006). Relationships, Layoffs, and Organizational Resilience Airline Industry Responses to September 11. The Journal of Applied Behavioral Science, 42(3), 300-324.

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12. Langelaan, S., Bakker, A. B., Schaufeli, W. B., Rhenen, W. Van, & Doornen, L. J. van. (2006). Do burned-out and work-engaged employees differ in the functioning of the hypothalamic-pituitary- adrenal axis? Scandinavian Journal of Work Environment Health, 32, 339-348.

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14. SAMHSA. (n.d.). Understanding Compassion Fatigue. SAMHSA. https://store.samhsa.gov/product/Understanding-Compassion-Fatigue/sma14- 4869?referer=from_search_result

15. SAMHSA. (n.d.). First Responders and Disaster Responders Resource Portal. SAMHSA. https://www.samhsa.gov/dtac/disaster-responders

16. Harrison, R. L., & Westwood, M. J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy Theory, Research, Practice, Training, 46, 203-219.

17. Mauseth, K., Ph. D. (n.d.). REST Model. Health Support Team. http://healthsupportteam.org/