Psychological First Aid

What is Psychological First Aid?

Psychological First Aid is an approach to help children, adolescents, adults, and families in the immediate aftermath of a personal crisis,  disaster and terrorism. Psychological First Aid is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping.

 

Who is Psychological First Aid For?

Psychological First Aid can be for children, adolescents, parents/caretakers, families, and adults exposed to a personal crisis, emotional crisis, disaster or terrorism.

 

When Should Psychological First Aid Be Used?

Psychological First Aid is a supportive intervention for use in the immediate aftermath of personal crisis, emotional crisis, disasters and terrorism

 

Basic Objectives of Psychological First Aid:

  • Establish a human connection in a non-intrusive, compassionate manner.
  • Enhance immediate and ongoing safety, and provide physical and emotional comfort.
  • Calm and orient emotionally overwhelmed or distraught affected person.
  • Help affected person to tell you specifically what their immediate needs and concerns are and gather additional information as appropriate.
  • Offer practical assistance and information to help affected person address their immediate needs and concerns.
  • Connect affected person as soon as possible to social support networks, including family members, friends, neighbours, and community helping resources.
  • Support adaptive coping, acknowledge coping efforts and strengths, and empower affected person:; encourage adults, children, and families to take an active role in their recovery.
  • Provide information that may help affected person cope effectively with the psychological impact of disasters.
  • Be clear about your availability, and (when appropriate) link the survivor to another member of a disaster response team or to local recovery systems, mental health services, public-sector services, and organisations.

 

Guidelines for Delivering Psychological First Aid:

  • Politely observe first; don’t intrude. Then ask simple respectful questions to determine how you may help.
  • Often, the best way to make contact is to provide practical assistance (food, water, blankets).
  • Initiate contact only after you have observed the situation and the person or family, and have determined that contact is not likely to be intrusive or disruptive.
  • Be prepared that affected person will either avoid you or flood you with contact.
  • Speak calmly. Be patient, responsive, and sensitive.
  • Speak slowly, in simple concrete terms; don’t use acronyms or jargon.
  • If affected person wants to talk, be prepared to listen. When you listen, focus on hearing what they want to tell you, and how you can be of help.
  • Acknowledge the positive features of what the survivor has done to keep safe.
  • Give information that directly addresses the survivor’s immediate goals and clarifies answers repeatedly as needed.
  • Give information that is accurate and age-appropriate for your audience.
  • When communicating through a translator or interpreter, look at and talk to the person you are addressing, not at the translator or interpreter.
  • Remember that the goal of Psychological First Aid is to reduce distress, assist with current needs, and promote adaptive functioning, not to elicit details of traumatic experiences and losses.

 

Some Behaviours to Avoid:

  • Do not make assumptions about what affected person are experiencing or what they have been through.
  • Do not assume that everyone exposed to a disaster will be traumatised.
  • Do not pathologize. Most acute reactions are understandable and expectable given what people exposed to the disaster have experienced. Do not label reactions as “symptoms,” or speak in terms of “diagnoses,” “conditions,” “pathologies,” or “disorders.”
  • Do not talk down to or patronise the survivor, or focus on his/her helplessness, weaknesses, mistakes, or disability. Focus instead on what the person has done that is effective or may have contributed to helping others in need, both during the disaster and in the present setting.
  • Do not assume that all affected person want to talk or need to talk to you. Often, being physically present in a supportive and calm way helps affected people feel safer and more able to cope.
  • Do not “debrief” by asking for details of what happened.
  • Do not speculate or offer possibly inaccurate information. If you cannot answer a survivor’s question, do your best to learn the facts.

 

Working With Children and Adolescents:

  • For young children, sit or crouch at the child’s eye level. Help school-age children verbalise their feelings, concerns and questions; provide simple labels for common emotional reactions (for example, mad, sad, scared, worried). Do not use extreme words like “terrified” or “horrified” because this may increase their distress.
  • Listen carefully and check in with the child to make sure you understand him/her.
  • Be aware that children may show developmental regression in their behaviour and use of language.
  • Match your language to the child’s developmental level. Younger children typically have less understanding of abstract concepts like “death.” Use direct and simple language as much as possible.
  • Talk to adolescents “adult-to-adult,” so you give the message that you respect their feelings, concerns, and questions.
  • Reinforce these techniques with the child’s parents/caregivers to help them provide appropriate emotional support to their child.

 

Working with Older Adults:

  • Older adults have strengths as well as vulnerabilities. Many older adults have acquired effective coping skills over a lifetime of dealing with adversities.
  • For those who may have a hearing difficulty, speak clearly and in a low pitch.
  • Don’t make assumptions based only on physical appearance or age, for example, that a confused elder has irreversible problems with memory, reasoning, or judgment. Reasons for apparent confusion may include disaster-related disorientation due to change in surroundings; poor vision or hearing; poor nutrition or dehydration; sleep deprivation; a medical condition or problems with medications; social isolation; and feeling helpless or vulnerable.
  • An older adult with a mental health disability may be more upset or confused in unfamiliar surroundings. If you identify such an individual, help to make arrangements for a mental health consultation or referral.