Caring for Those Who Give Care in the Wake of the October 7th War: The Effect of Trauma Exposure on Healthcare Professionals and Coping With It on a Personal, Professional, and Systemic Level

A roundtable discussion was organized by the Prime Minister’s Office within the framework of the Multi-Sector Emergency Roundtable with the participation of health sector researchers and focused on the challenges faced by professionals in therapeutic fields such as mental health, medicine, emergency and rescue services, and various professions in health, education, and welfare. The central theme of the discussion was the difficulty of coping with the effects of trauma exposure in general, and particularly in the current period, with the October 7 war serving as a key case study.

The discussions highlighted the need for a literature review and the formulation of recommendations on how to provide support for those who offer assistance. This document was co-authored by researchers from the Taub Center, researchers from the universities of Haifa, Tel Aviv, and Ben-Gurion, and researchers from the Forum for Promoting a Trauma-Adapted Healthcare System, the Shlomot Association, and other organizations that specialize in trauma care.

The events of October 7 thrust Israeli citizens into an unprecedented reality not experienced since the establishment of the State. It is estimated that in the initial months, over 30% of the Jewish population suffered from post-traumatic symptoms. In addition to those who experienced the traumatic events directly or faced the evacuation of entire communities, there is an increasing number of individuals who have been indirectly exposed to these events. Health professionals, who are on the front lines of trauma care, share the traumatic reality with the victims and experience the consequences of the disaster alongside them.

Numerous studies point to the risks of care providers being exposed to traumatic content, including compassion fatigue, secondary traumatization, moral distress, burnout, and more. In Israel and around the world, programs and methods have been developed to mitigate the traumatic impact on care staff and help them cope with it. These programs have formulated strategies for developing both individual and organizational coping capacities to deal with exposure to traumatic content and events, both during emergencies and in routine times. When faced with complex cases, staff should arrive equipped with emotional resilience and the psychological resources necessary to provide professional responses based on their skills and experience, as expected of them.

Strategies for developing individual coping capacity: These methods include personal treatment such as mindfulness, cognitive-behavioral therapy, sports and maintaining a healthy lifestyle, spending time in nature, increasing self-awareness, and dedicated personal time. Additional strategies involve seeking social support, setting boundaries between personal life and work, continuing education, and developing professional skills. However, beyond the existing methods, it is crucial to invest in developing two additional abilities that can contribute to individual coping:

• Vicarious resilience: The ability to draw strength from witnessing patients’ successful coping with trauma, leading to a positive change in the caregiver’s inner world.
• Self-control and balanced empathy regulation: Developing awareness among care providers of their attitudes and emotions towards patients, along with finding a balance between the emotional detachment necessary for professional functioning during a disaster and fostering empathy towards patients in a way that allows them to function without becoming overwhelmed.

Strategies for developing organizational coping capacity: In organizations that provide social services to the public — from health funds, educational institutions, to local authorities — it is essential to develop a comprehensive support system for employee caregivers. Key organizational strategies include:

• Promoting trauma-informed organizational leadership: Primarily, the well-being of caregivers benefits patients as well. Creating an organizational culture that is aware of the broad impact of trauma and responds at all levels — including responding to secondary trauma among caregivers, and creating safe and healing spaces for patients to prevent re-traumatization — is a crucial step in empowering and protecting staff during difficult times. Therefore, organizations should work to create mutually supportive relationships and take practical steps, such as encouraging employees to take breaks for mental relief, organizing team-building days, promoting healthy nutrition, monitoring stress levels, maintaining two-way communication that includes explanations and rationalization of guidelines, and more.
• Employee well-being and psycho-social risk management: A set of guidelines for implementing an occupational safety and health management system at the organizational level aims to identify psycho-social risk factors that threaten the health and well-being of employees. These risk factors are related to the organizational structure, social factors at work, and aspects of the work environment, such as the equipment used by employees and the tasks required of them, which can negatively impact both physical and mental health as well as economic costs for the organization. An organization’s commitment to employee health and well-being entails assessing the risks present in the work environment and preparing accordingly.
• Appointment of a well-being officer: Designating a senior role responsible for overseeing employee resilience within the organization and ensuring its implementation across the organizational structure. The well-being officer is tasked with identifying sources of anxiety among employees, establishing support infrastructures for those experiencing difficulties, evaluating employees’ well-being, and promoting systemic initiatives to improve it. This role focuses solely on promoting resilience, health, and well-being among the organization’s employees and should maintain direct communication with the organization’s management.

In light of the October 7 events and their impact on care providers, a systemic rebuilding and planning process is required to improve existing support infrastructures. In the short and medium term, planning should address the experiences of caregivers in response to the October 7 events, and in the long term, efforts should be made to prevent — or at least reduce — the harm and traumatic impact on caregivers during both routine and future crisis situations.