Beyond the process: Navigating the emotional landscape of workplace investigations
BACP Workplace, October 2026

Therapists working in organisational settings inevitably encounter clients who are undergoing workplace investigations and this remains one of the most demanding areas of practice, even for experienced clinicians. At Northumbria Healthcare NHS Foundation Trust, the Staff Psychology and Counselling Service (SPCS) is a well-established in house provision employing six therapists who work with staff across a large acute trust. We hold a unique dual position as both therapists within the service and as employees of the organisation which informs the way we support our clients through these investigations, offering a space where the human impact can be understood and held.

In this article, our focus is not on the procedural mechanics of investigations, which are rightly the responsibility of our HR colleagues, but on the lived experience of the individuals who must navigate them.¹ We outline our experiences of the emotional impact of disciplinary processes on employees, the ways therapists can best support staff during these periods and the relational complexities that arise when working clinically with cases of this nature. We also consider how our experience of closer collaboration with HR may help to reduce avoidable harm by bringing employees’ lived experience into clearer view.

Our intention is to share the emotional and relational insights gained from our work with staff undergoing workplace investigations, offering reflections that may support both affiliates and employed therapists who encounter similar presentations in their own work.

Trauma-informed responses

The significance of this topic within therapeutic practice is underscored by increasing attention to governance, accountability and regulatory oversight within contemporary healthcare systems, alongside ongoing concerns regarding workforce pressures, staff retention and occupational wellbeing across the NHS.

These developments situate disciplinary procedures within a wider structural context characterised by heightened scrutiny of clinical practice and organisational performance. Disciplinary procedures may have far reaching implications beyond procedural outcomes, influencing emotional functioning, professional confidence, and perceptions of organisational justice among healthcare professionals. Therefore, understanding these dynamics is essential in informing trauma informed and contextually responsive therapeutic approaches, as well as contributing to a more comprehensive appreciation of how systemic healthcare pressures shape individual psychological experiences.

As a stark reminder, the independent investigation ordered after the death by suicide of nurse Amin Abdullah² in 2016 serves to highlight the significant emotional risks when staff experience investigative processes without adequate support, alongside limited organisational understanding of the psychological impact such procedures can have on individuals.

Understanding the impact of disciplinary procedures on individual employees may assist therapists in contextualising clients’ experiences of stress, shame, professional vulnerability and related trauma. Workplace investigations are designed to ensure fairness, accountability and safety. However, for the employee involved, they can also represent a profound psychological challenge. Investigations may unsettle a person’s sense of identity, belonging and psychological safety. For healthcare professionals, in particular, professional identity is often deeply connected to competence, trust, care and moral purpose. Therefore, when concerns are raised at work, individuals may experience the process not simply as an organisational procedure, but as a threat to how they understand themselves and a fear of how they may be perceived by others.³

The emotional impact of investigations is often underestimated within organisations because much of it remains unseen. While employees may continue attending work, privately they are often struggling with shame, fear, uncertainty or emotional overwhelm. As therapists, a person-centred and trauma-informed approach helps us recognise and respond to these experiences with greater sensitivity and care.⁴

Impact on employee wellbeing

For many employees, the first indication that concerns have been raised comes during an exploratory meeting and even when handled carefully, this moment can feel shocking and disorientating. Individuals frequently describe a sense of unreality, as though the ground beneath them has shifted without warning. Anxiety, confusion and fear about the future can emerge rapidly. Others feel numb, or report becoming overwhelmed by shame or a sense of reputational threat. Many report disrupted sleep, difficulty concentrating and heightened emotional distress in the days and weeks that follow.⁵

From a person-centred perspective, these reactions are understandable. An investigation can challenge the core aspects of a person’s sense of self and create a painful incongruence between how an individual sees themselves and how they perceive others view them. Indeed, employees may feel isolated, scrutinised or uncertain about whether they still belong in the organisation.⁶

Among the many emotional responses that arise, shame is often one of the most powerful and corrosive. Unlike guilt, which relates to specific actions, shame speaks to a far deeper fear of judgment, criticism and censure. Employees may worry that they are no longer perceived as competent, trustworthy or valued. Shame can lead to withdrawal, hopelessness and intense self-criticism, and in some cases may contribute to a significant mental health risk.⁷

Many behaviours presented during the initial assessment with a therapist can be understood as attempts to cope with overwhelming distress.⁸ Rumination may represent an effort to regain control or make sense of events, and withdrawal may function as a form of protection against shame or perceived judgment. Often, anger may conceal fear or humiliation, while denial may temporarily prevent emotional collapse. Viewing these responses through a compassionate and psychologically informed lens can help the therapist support the client in a considerate, respectful and empathetic manner.⁹

Understanding reactions

A trauma-informed approach may help the therapist to understand an employee’s responses to formal disciplinary investigations, because such processes can evoke experiences of fear, vulnerability, shame and a loss of professional security. Understanding disciplinary investigations through a trauma-informed lens may assist therapists in responding more effectively to the complex emotional, cognitive and relational impacts associated with organisational scrutiny during disciplinary hearings. Of course, trauma-informed practice does not assume that an investigation is traumatic, nor that it causes trauma. Rather, it recognises that people bring their own histories, vulnerabilities and stress responses into challenging situations.¹⁰ Sudden change, uncertainty, perceived scrutiny and temporary loss of control can activate strong stress responses, particularly when an individual’s identity is closely tied to their professional role.¹¹

Northumbria Healthcare NHS Foundation Trust is developing trauma-informed approaches across the organisation, and as an early adopter is exploring how these principles can be embedded not only in clinical care but also in formal processes such as investigations. This reflects an understanding that while investigations are necessary and not intended to cause harm, organisations can still reduce avoidable distress by recognising how people respond under stress. Trauma-informed approaches can also strengthen psychological safety, improve communication and help staff feel supported throughout emotionally demanding processes.¹²

Role of the therapeutic relationship

Employees frequently describe counselling as the only place where they can speak openly about what is happening. The therapeutic relationship becomes an experience that is counter to the scrutiny, uncertainty and objectification that investigations can evoke. Within therapy, the individual is not reduced to an allegation or procedural category; they are met as a whole person whose emotions, fears and hopes matter.¹³

One of the most important therapeutic contributions is the provision of containment. Anxiety, shame, anger and fear can be explored safely rather than suppressed or acted out elsewhere. Through empathic understanding and relational safety, employees begin to make sense of their emotional responses and reconnect with their own values and sense of identity.¹

Unconditional positive regard is particularly important in this context. If employees feel exposed or judged, the therapist’s consistent acceptance offers a powerful counter experience. This does not mean minimising concerns or aligning unquestioningly with the client’s perspective. Rather, it communicates that the individual remains worthy of dignity and care regardless of the outcome of the investigation. In many cases, this helps reduce the internal fragmentation created by shame and supports the rebuilding of self-efficacy and psychological steadiness.¹⁴

Ways of coping

A central part of our work involves supporting adaptive coping and helping employees maintain a sense of coherence – the feeling that experiences are understandable, manageable and meaningful. Strengthening this sense of coherence can improve stability under pressure and help people navigate difficult situations more effectively. Drawing on transactional models of stress and coping,¹⁵ therapists may support individuals to organise information, prepare for meetings, regulate their emotions and identify practical means of support. Although person-centred therapy is fundamentally non-directive, contemporary practice often incorporates gentle psychoeducation and stabilisation strategies where appropriate; for example, grounding techniques, emotional regulation skills, sleep support and preparation for difficult meetings can all be integrated without compromising core therapeutic principles. The aim is not to increase compliance with organisational expectations, but to help individuals remain psychologically coherent and emotionally safe during a period of uncertainty.¹⁶

Investigations at work can heighten vulnerability, particularly when shame, isolation and identity threat converge, and therefore, counselling also plays an important safeguarding role. Risk assessment forms an essential part of the therapeutic work and when concerns arise, therapists may collaborate appropriately with occupational health, HR or external mental health services to ensure that individuals receive timely and proportionate support.¹⁷

Complexities and challenges

Therapists working in-house occupy a unique and sometimes delicate position. They face dilemmas that are not necessarily created by HR colleagues or organisational shortcomings, but arise from the emotional intensity of investigations, and from the therapist’s dual role as both an employee of the organisation and a confidential support to the individual.

Clients may wonder whether a counsellor employed by the same organisation can truly be independent. They may test the boundaries of confidentiality or look for signs of organisational allegiance. Therapists must hold these concerns with openness and transparency, acknowledging the complexity without becoming defensive. There is also the ever-present risk of collusion. When someone is distressed, ashamed or frightened, it is easy for a therapist to overidentify with their narrative, to avoid gently challenging the client or to slip into a rescuer role. Conversely, there is a subtler risk of aligning too closely with organisational perspectives, minimising systemic factors or encouraging compliance rather than authentic exploration. Navigating these tensions requires reflective practice, supportive supervision and a commitment to relational safety.

For therapists, these dynamics can be further complicated by experiences of moral injury, the discomfort that arises when organisational processes appear to conflict with personal and therapeutic values of care, client autonomy and compassion. This can be amplified when therapist and client are employed by the same organisation. Clinical supervision provides a vital space to explore these tensions, helping therapists recognise when moral distress may be shaping their responses, and supporting them to re-centre themselves in an ethically balanced, non-collusive stance. Through supervisory reflection, therapists can examine organisational pull, check for overidentification, strengthen boundary clarity and maintain the neutrality required to keep the therapeutic relationship safe, attuned and grounded.

Holding boundaries

One of the most challenging questions in our collective experience as in-house therapists arises when clients ask whether we can accompany them to a formal hearing or panel. Two of the authors, Teresa Rogers and Dr Simon Pestell, have each, at various points in their professional careers, been asked to attend such meetings, often by individuals who feel profoundly alone in the process. Some are not members of a union, while others have no trusted colleague, friend, or family member who can attend with them. We have each felt compelled to step in and help, which is partly an expression of empathy and care, as well as a desire to protect someone who is frightened or overwhelmed. Yet this is precisely the moment when holding the boundaries of the therapeutic relationship is of most importance.

As authors, we have reflected on the role of therapists in investigatory meetings and outcome panels based on our experiences, and our current position is that this involvement sits outside our professional remit. While we acknowledge the pull that each of us has felt at various times, our reasoning is that the therapist’s role is to offer emotional support, containment and psychological understanding, and not to act as an advocate, representative or witness. Crossing into these functions can subtly but powerfully alter the therapeutic dynamic. The client may begin to experience the therapist as someone who is ‘on their side’ in a procedural sense, rather than someone who is holding their emotional world with neutrality and care. This shift may compromise the safety and openness of the therapeutic space, and inadvertently create expectations that the therapist cannot ethically meet.

Although the NHS does not always use the term ‘Employee Assistance Programme’, its staff wellbeing services meet the core definitional criteria used in occupational health and counselling literature. As such, the ethical tensions associated with dual-role practice in EAPs are equally relevant to NHS counselling services. The UK Employee Assistance Professionals Association (UK EAPA)¹⁸ Code of Ethics and BACP’s guidance on dual roles within the counselling professions¹⁹ highlight the ethical tensions and explicitly identify conflicts of interest, role confusion and the risk of exploitation or harm when counsellors must serve both employee and employer interests. Both organisations highlight the central importance of the counsellor being seen as impartial, and able to clarify and maintain professional boundaries to minimise confusion of roles and outcomes.

Therefore, we propose that our most meaningful contribution during an investigation lies in strengthening employees’ self efficacy and empowerment. In a context where individuals often feel stripped of control, the therapeutic space becomes a place where they can reconnect with their own capacity to think, choose and act. Supporting clients to prepare for meetings, articulate their needs, regulate their emotions and make informed decisions fosters a sense of agency that is far more protective and enduring than any form of procedural advocacy we might be tempted to provide. In fact, stepping into roles outside the therapeutic frame can inadvertently undermine this process. If the therapist becomes the person who ‘steps in’ or ‘speaks’ for the client, the opportunity for the client to experience their own competence and resilience is diminished. By staying firmly within the client-therapist role, we help individuals discover that they can navigate complexity themselves and this, ultimately, is one of the most powerful therapeutic outcomes we can hope to facilitate.

Fostering resilience within healthcare

Accessible in-house psychological support can play an important role within organisations during workplace investigations. As noted already, employees often experience investigations as highly isolating and emotionally destabilising, and therefore ensuring that support is available within the organisation communicates to staff that wellbeing matters, alongside procedural fairness and organisational accountability.²⁰

As an in-house service, we can also provide continuity of care before, during and after an investigation. Therapeutic support does not end once an outcome is reached, as many individuals continue to experience anxiety, shame, uncertainty or difficulties reintegrating into teams, long after formal processes conclude. Counselling can help staff process what has happened, rebuild confidence and re-establish a sense of professional identity and belonging.¹

From an organisational perspective, providing timely psychological support also reflects a broader duty of care. Investigations inevitably place strain on staff wellbeing and organisations have a responsibility to consider how emotional support is made available throughout these processes. This is particularly relevant in healthcare settings where staff are already working within demanding and emotionally intense environments.²¹

Close collaboration between counselling services, HR and occupational health can strengthen this support further, with each discipline bringing a different but complementary perspective. Our HR colleagues maintain responsibility for fairness, legal compliance and patient safety, while therapists focus on the emotional and psychological impact on staff. Occupational health provides both health and work focused advice to employees, as well as managers, and plays a significant role in supporting staff safety and wellbeing. Our experience is that when these roles work collaboratively, employees are more likely to experience the organisation as coherent, compassionate and psychologically safe.²⁰

Helping to shape NHS disciplinary investigations

In-house counselling services may also contribute valuable psychological insights into how investigations are designed and experienced at an organisational level. Therapists are often in a unique position to observe recurring themes in how staff respond emotionally to investigations, including experiences of shame, uncertainty, isolation and perceived loss of control.²²

This knowledge can help organisations think more carefully about how processes are communicated and implemented. A trauma-informed approach does not mean avoiding accountability or weakening investigative standards, but it does involve recognising that the way procedures are conducted can either reduce or inadvertently intensify avoidable distress.²³ For example, organisations may consider how information is communicated, how uncertainty is managed, how staff are supported during periods of suspension or restricted duties, and how reintegration is approached following the conclusion of an investigation. By making small relational and procedural adjustments, organisations can significantly influence whether individuals experience the process as containing and fair, or psychologically overwhelming.²⁰

As organisations increasingly adopt trauma-informed approaches, there is growing recognition that psychological safety should not sit separately from procedural integrity. Trauma-informed thinking can help investigations remain robust while also reducing unnecessary harm and preserving dignity.²⁴

The above echoes recommendations issued by NHS England to all trusts following shared learning from the death by suicide of nurse Amin Abdullah, emphasising the need for compassionate, well supported and psychologically safe investigative processes.²⁵

Final reflections

Workplace investigations are necessary organisational processes, yet they can also become deeply challenging emotional experiences for the individuals involved. Therapists working alongside staff during these periods occupy a valuable position. Through empathic understanding, unconditional positive regard and psychologically informed support, counselling can help individuals maintain coherence, regulate overwhelming emotions and navigate uncertainty with greater dignity and agency.¹⁴

At the same time, therapists must remain mindful of the complexities that are inherent when working in-house, including maintaining boundaries, avoiding collusion and protecting the integrity of the therapeutic relationship, all while working collaboratively with wider organisational systems.²⁵

Ultimately, organisations that integrate trauma-informed thinking with accessible psychological support will create conditions that not only uphold accountability and fairness, but also reduce avoidable distress and strengthen trust. In doing so, they recognise an important truth: workplace investigations are not experienced solely as processes but as profoundly human events.¹⁴