Accommodating Employees with PTSD: Understanding Function in the Workplace

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that has a profound effect on the lives of those who suffer from it. Experiencing a trauma can result in physical, emotional, or psychological harm that can interfere with an individual’s ability to cope and engage in meaningful activity. As responsible employers, it is essential to foster inclusive environments for employees. Taking steps to accommodate employees with PTSD can promote overall wellbeing and help employees stay at work after experiencing trauma.

What is PTSD?

PTSD is characterized by psychologically reexperiencing the initial traumatic event, avoiding people or places that may trigger symptoms, acting in aggressive or reckless ways, and experiencing negative cognitions and mood.

The most common traumas that could result in a diagnosis of PTSD include the following:

• Sexual assault.
• Physical assault.
• Sudden or violent death of a loved one.
• Witnessing or being exposed to situations involving trauma on a repeated basis for an extended period such as Personal Safety Personnel (Paramedics, Firefighters, Police officers), or veterans who have been exposed to combat.
• Brewin et al in 2000 also found associations between PTSD and preexisting psychiatric or personality disorders, race (minority status), lack of education, socioeconomic status, family psychiatric history and gender.
• Women are twice as likely as men to develop PTSD. This may be due to women’s increased exposure to sexually motivated violence coupled with a higher prevalence of psychiatric disorders among women.

Impact of PTSD on Function in the Workplace

PTSD can have a significant impact on an individual's functioning in the workplace. The symptoms associated with PTSD can affect various aspects of an employee's performance, productivity, and overall well-being. The impact of PTSD on work function can vary from person to person, depending on the severity of their symptoms and individual coping mechanisms, but here are some of the effects employees may experience:

Cognitive Functioning: PTSD can impair cognitive abilities, such as memory, concentration, and decision-making. Employees with PTSD may experience difficulty focusing on tasks, retaining information, or making sound judgments. This can result in decreased productivity and errors in work.

Emotional Regulation: PTSD often involves intense emotional reactions, including anxiety, fear, irritability, and anger. Employees may struggle to regulate their emotions, leading to mood swings, emotional outbursts, or difficulty coping with stressors in the workplace. Emotional instability can affect work relationships and overall team dynamics.

Interpersonal Challenges: PTSD can impact an individual's ability to interact effectively with colleagues and supervisors. Hypervigilance and a heightened startle response can make it challenging to feel comfortable and safe in social situations. This may result in difficulties forming and maintaining relationships, collaborating on projects, or participating in team activities.

Triggers and Flashbacks: Certain triggers in the workplace may remind individuals of their traumatic experiences, leading to intrusive thoughts, flashbacks, or panic attacks. Triggers can vary for each person, but they can include specific sounds, smells, sights, or even certain work-related tasks. These symptoms can be distressing and disruptive to daily work routines.

Sleep Disturbances: Many individuals with PTSD experience sleep disturbances, such as insomnia, nightmares, or night sweats. Sleep deprivation can significantly impact an employee's energy levels, concentration, and overall well-being, leading to reduced productivity and increased absenteeism.

Avoidance Behavior: Individuals with PTSD may engage in avoidance behaviors as a coping mechanism. This can involve avoiding certain work-related tasks, situations, or even colleagues that remind them of their trauma. Avoidance behaviors can hinder professional growth, limit career opportunities, and create challenges in fulfilling job responsibilities.

Increased Absenteeism: Employees with PTSD may require time off work for therapy sessions, medical appointments, or to manage their symptoms during periods of heightened distress. Frequent or prolonged absences can disrupt workflow, place additional stress on coworkers, and impact team productivity.

Accommodations in the Workplace

Employers have an obligation to make every reasonable effort to accommodate workers with disabilities, including PTSD. Employees experiencing PTSD may need various accommodations in the workplace to continue to do their job. Some individuals may need permanent accommodations, but many who experience symptoms of PTSD will only need temporary measures to help ease back into work following evidence-based treatment for their condition and symptoms. 

Ideally, the process for implementing accommodations to address symptoms of PTSD should be a collaborative effort between the employee, manager, human resources representative, and the employee’s treatment provider. The employee does not need to disclose the details of their diagnosis to their employer, but instead can explain their specific needs and functional limitations that affect them at work.

Reasonable Workplace Accommodations for PTSD

Reasonable accommodations are those that do not provide an “undue hardship” to the employer. There is no set formula to determine what is “undue hardship,” and this is considered on a case-by-case basis.

Below are some examples of common accommodations for PTSD symptoms that are typically easy to implement in the workplace:

• Modifying break schedules
• Noise cancelling devices
• Repositioning of the desk, cubicle, or office location
• Flexible scheduling
• Regularly scheduled supervision/feedback
• Allowing assistance animals
• Written instructions and requests
• Modifying workplace lighting
• Allowing for phone calls to a support person during the work day
• Disability awareness training for staff
• Time management training
• Allowing music or headsets
• Organizational tools
• Consistent shift scheduling
• Remote work

In addition to the strategies listed above, there may be instances where an employee is unable to return to work with a certain individual within the organization or to a certain location. An employee with PTSD symptoms may also struggle to work with a certain population, with certain tools/objects, or within certain environments. These accommodation needs should be taken seriously and may accompany a permanent or temporary medical restriction that has been assigned by the employee’s treatment provider.  Every reasonable effort should be made to accommodate the employee with permanent medical restrictions due to PTSD such that they can continue to perform the essential functions of their job. 

How Can Gowan Consulting Help?

Gowan Consulting’s Occupational Therapists’ unique occupational lens and focus on empowerment and promotion of health and well-being makes them ideally placed to work with persons with PTSD as they work to regain control over their lives. Our team of OTs have the clinical expertise to treat the symptoms and functional limitations of PTSD and provide assistance with identifying reasonable and individualized accommodations to meet the specific needs of the employee. OTs can assist with monitoring a RTW plan and can provide support to the manager through the accommodation process. Make a referral to get your employee the support they need.

We can also offer training to managers, employers, HR, and disability management professionals on how to accommodate for PTSD. View our current training workshops and webinars at https://www.gowanhealth.com/store or contact us to learn about our customized training options.