The Leeds Teaching Hospitals NHS Trust

Critical Incident Counselling Service

Critical Incident Counselling Support

 The Critical Incident Counselling Service within the Leeds Teaching Hospitals NHS Trust is a service that provides a timely response to individual staff or staff groups that have been involved in a critical incident at work.

The service is part of the department of Clinical and Health Psychology and is staffed by two professionally qualified and experienced staff counsellors, who are members of BACP and abide by the BACP Ethical Framework.


A critical incident may be defined as an event that is extraordinary and produces significant reactions for the affected person. It may be so unusual that it overwhelms the natural abilities that people have to cope with difficult situations. Critical incident stress is often the natural reaction of a normal person to an extremely abnormal situation. It may manifest itself as a physical, cognitive and/or emotional response that may be experienced almost immediately or may be delayed days, weeks or months.

Examples of critical incidents which can occur while at work may include:-

  • Witnessing the traumatic death or injury of patients/clients and/or members of staff/co-workers
  • Witnessing an event where anyone on NHS premises seriously harms himself/herself/others or attempts/completes suicide while in NHS care or employment
  • Being threatened by someone
  • A very stressful incident extending over a long period of time
  • Death of a child under unusual circumstances
  • Physical/Sexual Assault
  • Threat to physical health e.g. the danger of being exposed to a contagious illness and/or chemical hazards or any other unusual sights, sound or smells out of normal working circumstances for that person.
  • Events which occur outside work could also be included which have an impact on staff e.g. the traumatic death of a colleague that affects the members of staff in a department.


Common reactions may include:












Muscle tremors

Blaming someone



Difficult to make decisions or concentrate







Emotional outbursts


Rapid heart rate

Aches and pains




Increased use of alcohol

Inability to relax


Visual difficulties



Shock symptoms


Heightened alertness


Poor problem solving

Loss of emotional control


Feeling overwhelmed

Intense anger


Startle response


Difficulty sleeping

Avoidance of situations/ people/ objects







How can I help myself or others to overcome these difficulties?

  • Take time out to get sufficient sleep, rest and relax, eat regularly and healthily.
  • Tell people what you need. Talk to people you trust.
  • Take care when driving or riding or at home, accidents are more common after a traumatic event.
  • Try to take time in a safe and calm place to go over what has happened, if the feelings are too strong don’t force yourself though.
  • Try to reduce outside demands on you and don’t take on extra responsibilities for the time being.
  • Don’t forget that many colleagues are likely to have similar feelings and letting your feelings show is not a sign of weakness. They are normal reactions to a very stressful event.


Why might I come for counselling?

If you notice your ability to function at home or at work or sometimes both is being affected.

Frequently we find our own ways of coping or enlist the support of family and friends. However, there may be times when our difficulties feel more intense and help from a counsellor is more appropriate, especially if it has been more than four weeks and you are experiencing any of the reactions below with no sign of improvement:

  • You want to talk about what happened and feel you don’t have anyone to share your feelings with
  • You find that you are easily startled and agitated.
  • You experience vivid images of what you saw and have intense emotional reactions to them.
  • You have disturbed sleep, disturbing thoughts preventing you sleeping or dreams and nightmares.
  • You are experiencing overwhelming emotions that you feel unable to cope with or changes in mood for no obvious reason.
  • You experience tiredness, loss of memory, palpitations, dizziness, shaking, aching muscles, nausea and diarrhoea, loss of concentration, breathing difficulties or a choking, tight feeling in your throat and chest.
  • You are worried about your alcohol or drug use since the event.
  • Your performance at work has suffered since the event and / or your relationships.
  • Someone close to you tells you they are concerned about you.


 What happens during counselling?

Counsellors aim to create an environment where you feel safe enough to be open, reflective and able to talk about your feelings and experiences, especially how the critical incident has affected you. We offer a psychological first aid approach to help staff to understand how they may be feeling following a critical incident.

Talking through a problem with a trained counsellor can lead to greater clarification of the issues and discovery of your own resources and coping mechanisms.

The staff counselling service offers one to one face to face counselling sessions  using a 2+1 model and offers up to 2 initial sessions to help you explore any difficulties you may be having at work, in your life outside work, or both following the critical incident.

We offer a follow up review appointment, usually about 3 months after the first appointment for you to discuss if any further support is needed at this time.

We can also help signpost you to other services for support, if this is necessary.

The Critical Incident Service also offers small group support to staff teams in their work location at their request following a critical incident. Further information is available on request by calling 0113 2065515 and asking to speak to one of the counsellors or emailing your enquiry to


What Happens when we first meet?

Initially you will be invited to meet one of the counsellors, where you will be offered time to talk through whatever is on your mind and explore what counselling might involve. Some people feel anxious about this initial meeting, the counsellor will be sensitive to this and do what they can to help.

They will also be open to any questions you have. Sometimes counselling is not the best form of help. The counsellor will enable you to explore other options or offer guidance/suggestions should this be the case.



A fundamental principle of counselling is that it should be confidential. There are some exceptional situations when confidentiality cannot be guaranteed and these will be explained at your first session, but otherwise counselling takes place under strict conditions of confidentiality and nothing you discuss will be disclosed.

Much of what is said in sessions is very personal and it is natural to be concerned about what is happening to this information.

The Critical Incident Service employs trained and experienced counsellors who are all members of the British Association of Counselling and Psychotherapy (BACP) and who abide by its Ethical Framework. We wish to offer the highest level of confidentiality consistent with the Law and with the ethical framework and guidelines of the BACP.

If you give information to your counsellor which leads her to believe that you may harm yourself or someone else, then your counsellor will discuss with you the need to minimise any risk. In the rare circumstance that a way forward cannot be agreed between us, your counsellor will inform you where possible of the requirement to breach confidentiality. This breach of confidentiality includes matters of Public Interest, Acts of terrorism and Child Protection.

All records and files are kept private and confidential. Neither your manager nor anyone else will be told you have used the service. We do not routinely contact GPs, however, we do require the name and address of your GP to allow us to fulfil our duty of care should medical support ever be necessary with regard to risk issues.

Statistical information will be collected and is kept in an anonymous format, so that individuals are not identifiable. 


How to access our service

We are a self-referral service. Your manager will not be able to refer you - or discover from us whether you are or have been using our service.

The Staff Counselling Service is located at SJUH (Fielding House).

The service is managed by the Department of Clinical & health Psychology


If you wish to access counselling you may do so by;

Telephoning 0113 2065515 to request a Critical Incident self-referral form, or email a Critical Incident form can then be emailed or posted to you.


Where staff teams feel a small group psychological first aid support session would be helpful a named person can contact the critical incident service by phone or email to discuss the support available.

If we are not available you may wish to leave your name and contact details on the confidential answer phone and we will return your call asap (we don’t work weekends or evenings)

Please note that we do not offer a 24/7 immediate response service. Any staff in need of immediate support regarding suicidal thoughts, feelings or risk to themselves should contact

A & E or other appropriate services, more information on this link . Once these issues have been resolved they can then access the critical incident counselling service for support.



Other Support


Self Help leaflets

Northumberland, Tyne and Wear NHS Foundation Trust Leaflets

This website hosts a number of well written self-help leaflets on topics such as anxiety, depression, health anxiety, panic, etc.



Further Support