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Recognizing and Accommodating Employees with PTSD: The Intersection of Human Resource Development, Rehabilitation, and Psychology

New Horizons in Adult Education & Human Resource Development 28(2), 27-39

Claretha Hughes1 Stephanie L. Lusk2 Stephanie Strause3 Abstract All employees within the workplace must be treated fairly and equitably including those with disabilities who may require accommodations that serve to increase access to and maintenance of competitive employment. Human Resource Development (HRD) researchers and practitioners have experience in accommodating employees with disabilities but are now increasingly faced with disorders with which they are not as familiar. One of these disorders is Post-Traumatic Stress Disorder (PTSD). This article provides detailed information on how to detect PTSD in the workplace and implement solutions, including appropriate accommodations, for employees with this disorder. Integration of the Jobs Accommodations Network (JAN) Areas and Considerations with HRD principles is a suggested starting point in an effort to meet the employment needs of these employees.

Key Words: Post-traumatic stress disorder, human resource development, rehabilitation, psychology Employees enter the workforce with personal experiences that can have either a positive and negative impact on their job performance. The past decade of wars in which the United States’ military has engaged has produced employees who are dealing with disorders that are negatively influencing their behavior in the workplace (Friedman, 2006; Lang, Rodgers, Laffaye, Satz, Dresselhaus, & Stein, 2003). One specific disorder is Post-Traumatic Stress Disorder (PTSD). This disorder is generally associated with combat and military personnel and has received increased exposure due to the large number of returning service members who have been diagnosed with the condition (Smith, Ryan, Wingard, Slymen, Sallis, & KritzSilverstein, 2008). Service members with PTSD may remain in the military, but many are returning to civilian life and engaging in mainstream careers. There have been numerous initiatives that support the recruiting and hiring of these individuals, and as a result, Human Resource Development (HRD) researchers

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University of Arkansas University of Arkansas 3 Collective Bias Corresponding Author: Claretha Hughes, University of Arkansas-RHRC, 255 GRAD COECHP Fayetteville, Arkansas 72703 Author Email: [email protected] 2

Copyright © 2016 Wiley Periodicals, Inc., A Wiley Company

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New Horizons in Adult Education & Human Resource Development, 28(2)

and practitioners must be prepared to interact with them and make available accommodations that support the accessing and maintaining of competitive employment. HRD professionals are usually involved in the onboarding of these employees through orientation, training and development, skill development, career development, and organizational development activities. As a result, they have numerous opportunities in which to assess, interact, and put into place accommodations that help to ensure overall job success and tenure. It was not until 1980 that the American Psychiatric Association (APA) in its third edition of the Diagnostic and Statistical Manual (DSM -III) denoted a collective set of symptoms as PTSD. Although not always known by its current clinical name or diagnosed using research-based criteria, PTSD has been a part of human existence since the beginning of time; however, the first time this disorder was associated with military combat occurred shortly after World War I (Friedman, 2014). This was the first time “in history when ‘modern’ warfare coincided with a ‘scientific’ psychiatry that endeavored to define diagnostic entities as we understand them today” (Crocq & Crocq, 2000, p. 49). War strain, war neurosis, and shellshock, as it was initially called, was used to describe a set of symptoms and characteristics exhibited by men who engaged in military combat. Symptoms included “loss of memory, insomnia, terrifying dreams, pains, emotional instability, diminution of self-confidence and self-control, attacks of unconsciousness or of changed consciousness sometimes accompanied by convulsive movements resembling those characteristic of epileptic fits, incapacity to understand any but the simplest matters, obsessive thoughts, usually of the gloomiest and most painful kind, even in some cases hallucinations and incipient delusions…” (Smith & Pear, 1918, pp. 12-13). Because the disorder was not well understood and men exhibiting symptoms were considered weak, if treatment was received, it was often brief and ineffective (Crocq & Crocq, 2000). These men generally returned to the battlefield and eventually to their homes where no further assistance was made available. A traumatic event can be a difficult situation for anyone to experience, and thankfully, for the majority of people, the effect goes away once the experience is over. However, for approximately 6.8% of the population, stress reactions last long after the trauma has ended (Durand & Barlow, 2010). PTSD develops as the result of “exposure to extreme traumatic stressors involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or threat to the physical integrity of another person, or learning about unexpected violent death, serious harm, or threat of death or injury experienced by a family member or other close associate” (APA, 2000, p. 463). War veterans and victims of sexual abuse are common victims of PTSD. Exposure to other events such as natural disasters, violent crimes, or serious accidents can serve as the impetus for this disorder as well. Although symptoms only need be consistently present for at least one month for a diagnosis of PTSD, it is generally six months or later of the individual actively experiencing symptoms before an actual diagnosis occurs (US Department of Veterans Affairs, 2013a). Estimates of individuals plagued by this disorder range from 5.2 million to 7.7 million (Anxiety and Depression Association of America [ADAA], 2013; US Department of Veterans Affairs, 2013a). It tends to be more common among women, those who have experienced prolonged or extremely severe trauma, individuals with a co-occurring mental health problem such as depression or alcohol and drug use, those who are poorly educated, or among individuals who are younger (Bulut, 2009; Ditlevsen & Elklit, 2010; Kline et al., 2013; Litt, 2013; US Department of Veterans Affairs, 2013b). While not all traumas lead to PTSD, it is important to understand the severity of the disorder and the effects that it can have on everyday life. Many individuals who currently have the disorder struggle to cope with common processes that might seem simple to those without the disorder. These individuals may be functionally impaired because of symptom-related distress causing a person's work life and home life to become drastically affected. Knowledge is a powerful weapon in the war of reintegrating these individuals into the fabric of daily life. Employees use the HRD department for mandatory annual training services and use the HR services for other employer provided benefits including compensation and medical insurance. Therefore, the probability is high that the HRD professional will interact with the employees who suffer from mental and emotional disabilities. Not wanting to deal with the employees’ disabilities because they are not a trained professional in a mental health field is not an option for HRD professionals when there is a high probability that workers know someone who has PTSD or experiencing the symptoms themselves. Workers who survived the 9/11 attack, the Iraq and Afghanistan wars, drive by shootings, school shootings, and horrific accidents can all be victims of PTSD and are within our workplaces (Friedman, 2014).

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Uninformed, unexposed and/or close-minded HRD professionals cannot help their organizations grow if they are not open to hiring and developing all qualified employees who may have a mental or emotional disability. Furthermore, employees with PTSD are in a protected class under the American with Disabilities Act (ADA) and the HRD professionals who are discriminating against employees who suffer from PTSD may be violating federal statutes. This article provides the HRD researchers and professionals an opportunity to change their thought processes about mental and emotional health. HRD professionals ask employee supervisors to coach and counsel employees regarding their work performance at least annually during performance reviews. Yet, they may not be adequately aware of the mental disabilities influencing the employees’ performance. The supervisor is focused on the technical and/or physical performance of the employee. They are interested in obtaining and evaluating job outcomes. HRD professionals should not ask supervisors to interact with employees and not recognize the mental disabilities, when they have not acknowledged the disabilities themselves. This article is hopefully providing information to HRD professionals about employees with PTSD, and bringing awareness to the fact that employees cannot separate who they are mentally and emotionally from how they perform their job tasks. Presented in this article are: 1. The identification of PTSD, with a summary of guidelines provided in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), a guide used by professionals in the mental and emotional health fields to identify mental disorders. Eight criteria are given in order that HRD professionals are aware of the diagnostic framework being used by mental health professionals. 2. Comorbidity, the existence of two or more disorders is discussed with emphasis on substance abuse and mood disorders, two predominant disorders that co-occur with PTSD. 3. The implications for management’s role and responsibilities in recognizing and integrating employees with PTSD are presented. Of critical importance are the legal issues organizations must understand and with which they must comply; this can be facilitated with knowledgeable HR and HRD staff. 4. From adequate understanding of PTSD and recognition of management’s responsibility for addressing the needs of employees with PTSD, guidelines are provided for accommodating these employees. The Jobs Accommodations Network (JAN) has developed specific recommendations for dealing with the many PTSD symptoms and behavior.

Identification of PTSD DSM-V Diagnostic Criteria New diagnostic criteria for PTSD were recently released by the APA in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). These criteria are intended to inform HRD professionals about what the changes are within the mental and emotional health fields. HRD professionals are not to skilled or trained to make clinical judgments. These eight criteria are used to assist the clinician in determining whether the disorder is present. The criteria are as follows: 1. Criterion A: Stressors - A person must have been exposed to either death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence; 2. Criterion B: Intrusion Symptoms – The individual continues to re-experience the traumatic experience in at least one of the following ways: (a) recurrent, involuntary, and intrusive memories; (b) traumatic nightmares; (c) dissociative reactions (flashbacks); (d) intense or prolonged distress after exposure to traumatic reminders; and (e) marked physiologic reactivity after exposure to trauma-related stimuli; 3. Criterion C: Avoidance – The individual displays an effortful avoidance of distressing trauma-related stimuli after the event including thoughts and feelings or external reminders (e.g. people, places, situations) of the traumatic event; 4. Criterion D: Negative Alterations in Cognitions and Mood – The individual generally experiences a

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New Horizons in Adult Education & Human Resource Development, 28(2) worsening of mood symptoms after the occurrence of the traumatic event in at least two of the following ways: (a) dissociative amnesia or the inability to recall important features of the traumatic event; (b) distorted negative beliefs and expectations about self and the world; (c) distorted blame of self and others for causing the traumatic event; (d) consistent negative emotions related to the traumatic event; (e) diminished interest in activities once deemed important; (f) feelings of alienation and detachment from others; and (g) the inability to experience positive emotions; 5. Criterion E: Alterations in Arousal and Reactivity – A change in one’s arousal and reactivity worsen after the traumatic event is presents itself in at least two of the following ways: (a) aggressive or irritable behavior; (b) self-destructive and reckless behavior; (c) hypervigilance; (d) exaggerated startle response; (e) problems concentrating; and (f) problems sleeping; 6. Criterion F: Duration – symptoms in Criteria B, C, D, and E persist for more than one month; 7. Criterion G: Functional Significance – symptoms cause significant distress or functional impairment (e.g. problems maintaining a job); and 8. Criterion H: Exclusion – symptoms are not caused by substance use, medication, or other illness (APA, 2013, pp. 271-272).

PTSD can be further differentiated by the use of specifiers, which serve to assist clinicians in designing and implementing appropriate treatment plans. The specifiers are: 1) preschool, which denotes PTSD in children younger than six year old; 2) dissociative, which signifies experiences of depersonalization and/or derealization; and 3) delayed expression, which indicates full criteria were not met until six months or more after the traumatic event (APA, 2013). Since PTSD is classified as an anxiety disorder, the symptoms are very similar to what is common for most anxiety disorders. Individuals with PTSD often experience fear when no adverse stimulant is present and are generally apprehensive about the future (Durand & Barlow, 2010). Panic can also erupt where the experience of intense fear is coupled with physical symptoms. A person will physically tense up and progress quickly into a fight or flight state of being. All of this happens without actually being exposed to any real source of danger, much like an anxiety disorder. It is important to note that in an individual with PTSD, the symptoms or disturbances are not caused by any outside source such as medication, substance use, or another illness. It is therefore important to tease out all of the underlying problems and diagnose accordingly.

Comorbidity Comorbidity exists when an individual is diagnosed with two or more disorders. Comorbidity is a common issue among individuals with PTSD, and approximately 80% of those with this disorder meet the criteria for at least one other disorder while nearly 50% meet the criteria for three or more additional diagnoses (Nunes, Selzer, Levounis, & Davies, 2010). In the United States alone, approximately 20% of the population has some form of mental illness (Substance Abuse and Mental Health Services Administration [SAMHSA], 2010); however, it is not uncommon for people to have more than one.

Substance Use Disorders One common group of disorders that often co-occurs with PTSD is substance use disorders (SUDs). The prevalence rate of SUDs is approximately 50% higher for individuals with an anxiety disorder, such as PTSD, as compared to those without (Ham, Connolly, Milner, Lovett, & Feldner, 2013). Experiencing a traumatic event serves to increase the likelihood that an individual will develop an SUD as stress seems to be a compounding factor for the development of an addiction (Nunes, Selzer, Levounis, & Davies, 2010). Researchers have also noted that the lifetime prevalence of PTSD is between 36 to 50% among individuals with a SUD (Jacobsen, Southwick, & Kosten, 2001). While PTSD alone can have damaging effects on an individual's life, a person who experiences comorbid PTSD and SUDs faces even more turmoil. These individuals often experience greater emotional difficulties and have a smaller support system than those with only one disorder (Lalonde & Nadeau, 2012). There are also increased incidences of suicidal ideation and attempts among those with these comorbid disorders. Because comorbidity tends to increase the overall complexity and course of the disorders, treatment and recovery is complicated and requires additional time and resources (Lalonde & Nadeau, 2012).

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Mood Disorders Mood disorders, also known as affective disorders, oftentimes co-occur with PTSD as well (Nunes et al., 2010). This group of disorders is characterized by inappropriate mood states that involve periods of depression and/or mania. Disorders within this category include major depressive disorder (unipolar depression), dysthymia (chronically depressed mood state that occurs most of the day for the majority of the day for at least two years), bipolar I disorder (mood episodes cycling between mania and depression), bipolar II disorder (mood episodes cycling between hypomania and depression), and cyclothymia (a fluctuating mood disturbance involving periods of hypomania and low grade depression). Major Depressive Disorder (MDD) is considered one of the most prevalent mental illnesses in the United States affecting 5 to 10% of the general population (Nunes et al., 2010). It is also considered to be the leading cause of disability in the United States (National Institute of Mental Health [NIMH], n.d.) and results in major impairment across all areas of one’s life. MDD and associated suicidal ideation are both highly correlated with PTSD (Panagioti, Gooding, Tarrier, 2012; Panagioti, Gooding, & Tarrier, 2009; Krysinska & Lester, 2010). Angkaw et al. ((2013) also found that individuals diagnosed with PTSD and co-occurring depression were at an increased risk for committing aggressive acts against others. MDD is also often likely to co-occur with SUDs as well, and this serves to create a potential cycle where one disorder is exacerbated by the other (Nunes et al., 2010).

Implications for Management With the relatively high prevalence rates of PTSD, it is not surprising that many individuals living with the disorder also attempt to have normal, functional lives, which includes gainful employment. Therefore, it is very important that people in management positions be well versed in the disorder(s). If researchers and practitioners in the HRD understand the prevalence of these types of disorders and the impact on all employees, they will be better able to integrate these individuals into the workplace. Recognizing the symptoms, understanding the cause, and knowing the different treatment and accommodation options will allow those in HRD to help these employees successfully transition into the workplace. It is also very important that management see their employees with PTSD as people. Once the stigma from the disorder attaches itself onto the individual and the situation becomes a "problem", it will be more difficult for the employee to trust management, get treatment, and reintegrate themselves into their workplace again (Friedman, 2006). In today's world, the majority of the population has some type of disorder, whether big or small, and it is essential for organizations to create a caring environment that promotes psychological safety as well as physical safety (Penk, Drebing, & Schutt, 2002). Since PTSD is a disorder that makes its victims feel vulnerable and out of control, building trust in the workplace is extremely important in the hopes of treating it.

Recognition The first priority of those in HRD is to successfully recognize symptoms of PTSD. PTSD in the workplace often manifests itself in specific symptoms such as difficulty sleeping, loss of a sense of future, and anger (Penk et al., 2002). Many assessment tools are available to assist in properly identifying individuals with PTSD so that appropriate referrals, treatment, and work accommodations can be obtained. HRD professionals can work with mental health clinicians to properly accommodate individuals diagnosed with PTSD. The clinicians are the experts that HRD professionals must build collaborative alliances. Working together can be very helpful in determining the prevalence of PTSD in the workplace since, oftentimes; employees with PTSD do not want to admit to their disorder because of the negative stigma attached to it (Ham et al., 2013). Many employees consider themselves to be less marketable once they have been labeled as an individual with PTSD. This is another reason why it is essential to always treat the employee as a person and not strictly a disorder. Treatment and appropriate accommodations cannot take place if the disorder is being hidden. While many people feel as if work may be a contributing factor to the stress experienced by individuals with PTSD, an emerging train of thought suggests that work might act in a way to relieve the stress associated with the disorder (Larson, Highfill-McRoy, & Booth-Kewley, 2008; Penk et al., 2002). Allowing these individuals to gain control over an aspect of their lives addresses an important characteristic of the disorder (Penk et al., 2002). Individuals with PTSD often experience forms of learned helplessness, and contributing in a work environment gives them a sense of purpose and mastery. Rather than being seen as a cause of the problem, work

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can be viewed as a therapeutic solution. However, in many situations, work is not enough to treat the individual completely (Penk et al., 2002). While some think that exposure therapy is risky, in that it exposes the person to stressors that may cause distress, there have been several studies that support that treatment option (Ham et al., 2013). By modifying the individual's perceptions, the treatment allows for the fear to become more manageable. Successful employment is highly correlated with successful treatment. Smith, Schnurr, and Rosenheck (2005) note that even modest decreases in PTSD symptoms lead to overall gains in employment.

Reintegration and Integration When working with an employee with PTSD, there are several important points that should be considered when developing and managing workplace accommodations. When assisting in the reintegration of individuals with PTSD into the employment setting, Penk et al. (2002) suggest the following: (a) employers should implement a "performance only" identification strategy where actions are taken only when performance problems exist on the job; (b) consultations from experts should be provided by employers and only a "constructive confrontation" should take place; (c) referrals between the employee and treatment services should be readily available and organizational linkages should exist between the workplace and the service providers, with a monitoring system included; and (d) employers should emphasize the importance of human capital in the workplace and checks and balances should be put in place to ensure that the employee's welfares are being cared for. Knowing how to identify the symptoms, establish meaningful connections with professional help, and create a support system in the work environment are all-important steps in the process of employee reintegration (Ham et al., 2013). According to ADA guidelines, employees with PTSD are under no obligation to share their diagnosis with coworkers (US Equal Employment Opportunity Commission, n.d.); however, in doing so, all individuals may benefit in a myriad of ways. First and foremost, employees with PTSD can serve as advocates for themselves and others with the diagnosis. This allows them the opportunity to educate co-workers about PTSD, thus addressing some of the assumptions and stigma associated with the disorder. Employees with PTSD can also enlist co-workers or peers in the development of a social network that provides additional support for themselves and others (Greden et al., 2010). In helping co-workers better understand the nature of PTSD and the supports needed, those with the diagnosis may be better able to complete work tasks, which ensures their ability to meet expectations and maintain employment (Davis et al., 2012). By engaging in these tasks, employees with PTSD, along with their co-workers, can create a work environment that facilitates open communication and learning, and this can lead to increased growth and productivity.

Legal Issues Because of the United States Equal Employment Opportunity Commission (EEOC; n.d.) put in place in 1978, employees with PTSD are protected against discrimination and unfair employment practices under EEOC laws (Gutman, Koppes, & Vodanovich, 2011). One of those laws in particular is the Americans with Disabilities Act (ADA) of 1990 and its subsequent amendment in 2008. The ADA protects individuals with a "physical or mental impairment that substantially limits a major life activity" (Gutman et al., 2011, p. 385). “Substantially limits” is defined by the EEOC as impairment-related limitation that last several months or more. The EEOC noted that this term should be applied broadly in an effort to expand coverage and protection (USEEOC, n.d.). Major life activities include, but are not limited to walking, standing, sitting, talking, concentrating, speaking, working, etc. Although the ADA does not provide a specific list of disabilities protected, “given its inherent nature, PTSD will almost always be found to substantially limit the major life activity of brain function” (EEOC, 2011 as cited by The Jobs Accommodation Network, 2013, para. 11). The law states that the individual with a disability must be able to perform all essential work tasks "with or without a reasonable accommodation" (Gutman, et al., 2011, p. 386); therefore, if the employees can perform their job with reasonable accommodations, they are protected in the organization. This means that individuals with PTSD cannot be terminated strictly based on their disability. However, because of the high comorbidity rates between PTSD, substance use, and mood disorders, termination of employment is often plausible. Organizations have a legal right to terminate an employee for "egregious or criminal conduct" (Gutman, et al., 2011, p. 423), and that type of behavior often accompanies substance use. While PTSD is a mental disability that is legally protected under the ADA, it is important for those in HRD to be aware of the limits of the law. Again, knowledge is the key in serving both the organization and the employees. Additionally, EEOC laws exist that assist the family members of individuals with PTSD as well. The Family

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Medical Leave Act (FMLA) allows for employees to take up to 12 weeks of unpaid leave per year for a family member with a serious medical condition when a company houses more than 50 employees (Gutman et al., 2011). While this law is most commonly used during pregnancies, it can also be an important tool in the treatment of PTSD. One of the most important tools during treatment is a strong support system, and the FMLA allows family members to be present in the time of need. This law is beneficial in the undertaking of making the workplace a caring and supportive environment. Flexible employers can greatly influence an individual's psychological health.

Accommodating Individuals with PTSD An accommodation “means modifying a job, job site, or the way in which a job is done so that a person with a disability can have equal access to all aspects of work” (Work Without Limits, 2013, para. 3). Accommodations help to ensure not only one’s ability to apply for, gain access to, and successfully perform a job, but the definition also includes the ability to fully integrate into the working environment. This means that the individual has access to the entire work environment (e.g., break rooms, meeting rooms, and restrooms) and can fully participate in all activities that take place therein. In order to ensure full participation and access, when working with individuals with PTSD, the employer should keep in mind that symptoms and degree of severity varies among individuals with this disorder, and while some individuals may require accommodations to complete the essential functions of their jobs, not all individuals will. Table 1 lists the Jobs Accommodations Network’s (JAN) 15 symptoms of PTSD and the recommended areas and considerations when developing and implementing accommodations for individuals with PTSD.

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Table 1. continued

All of these areas and considerations are critical to understand and accommodate for HRD researchers and professionals. Table 2 shows the interaction between the three HRD concentration areas: training and development, organization development, and career development and the JAN areas and considerations and its implications for employees in the workplace.

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Training and development is particularly impacted by JAN areas and considerations 1 to 5 and 9 to 15. If employees lack memory concentration, and time management; does not complete tasks; are disorganized; and cannot cope with stress, it will be virtually impossible for them to be trained to implement critical job functions. From an organization development perspective, JAN items 6-8 and 11-15 are essential for HRD professionals to understand and address so that affected employees can best be taught to interact with peers and superiors within the workplace. All 15 of the JAN items will influence the employees’ career development potential and inclusion within career management systems such as skill and performance-based pay.

Discussion and Conclusions HRD professionals have a tendency to subjectively determine who is worthy of their help. It is not their job to determine worthiness of employee access to HRD services. All employees must be developed to the extent possible to achieve organizational goals. Subjective selectivity of who is worthy to be trained and developed must end. HRD professionals must understand that they do not know what an employee is dealing with emotionally or mentally when they come to work. Subconsciously and sometimes consciously, we are making judgments about employees’ mental state. In this article, we are not asking the HRD professionals to become psychologists, psychiatrists, or vocational rehabilitation counselors. We are asking them to attain the basic skills to recognize observable symptoms because they are possibly the only employees who have direct contact with all the employees within the organization during some point within the course of the employees’ employment. Understanding PTSD is essential for HRD professionals so that they can effectively communicate with rehabilitation and psychological professionals as they attempt to accommodate employees within the workplace (Brailey, Vasterling, Proctor, Constans, & Friedman, 2007). Many organizations use Employee Assistance Programs (EAPs) to aid employees, assure confidentially, and implement proper support services (Nimon, Philibert, & Allen, 2008). However, unless the employee self-discloses and contacts EAP on his own, accommodations are not offered (Friedman, 2004). HRD professionals must be trained to recognize symptoms and objectively make employees aware of the EAP services available. This training includes working with rehabilitation counselors and placement specialists who are specifically trained to assist individuals with all types of disabilities, including PTSD, to reintegrate into the workforce and create ways to integrate the appropriate principles and practices from the respective fields to better develop employees in the workplace (Smith, Piercy, & Lutz, 1982). HRD professionals must be actively involved in the organization’s procedures related to the recognition, treatment, reintegration, and legal issues associated with accommodating employees with PTSD disabilities in the workplace. Learning how training and development, organizational development, and career development within HRD can be used to better accommodate employees with PTSD is paramount. Awareness of the needs of all employees within the workplace is essential, but some employees warrant more attention than others in order to resolve specific developmental issues (Wilson & Gielissen, 2004). With regards to PTSD and cooccurring disorders, there is a clear need for the interaction between HRD and mental health, researchers and practitioners. HRD professionals usually conduct needs analyses to ensure that workplace problems be correctly identified and defined. Knowing that there is a problem with meeting the needs of employees with PTSD disabilities provides an opportunity for HRD researchers and professionals to strengthen their relationships with other fields to maximize the potential for positive outcomes for these employees and their organizations. Many organizations have EAP programs to address the psychological issues but there is very little in the way of licensed counselors, rehabilitation specialists, and/or psychologists providing human resource support in many organizations (Smith, Piercy, & Lutz, 1982; Pitt-Catsouphes, Matz-Costa, & MacDermid, 2007). The full extent and the methods of addressing the needs of employees with PTSD disabilities have not been completely explored within this study. The interaction of HRD and JAN provides a benchmark upon which to begin exploring ways to communicate amongst the fields and conduct empirical studies to determine effective solutions for employees who are dealing with the specific symptoms of PTSD.

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Implications for Human Resource Development HRD researchers and professionals can begin to work more closely with mental health professionals to develop ways to integrate principles from each field that can be used to better develop employees in the workplace. HRD professionals and practitioners must understand how utilizing resources, such as the Jobs Accommodations Network (JAN), serves to strengthen the HRD researcher and professional’s ability to accommodate employees with PTSD. Empirical studies can also be conducted to determine other methods or to improve upon current methods for accommodating employees with PTSD and other co-occurring disorders.

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