Psychological first aid

2. Psychological first aid May 2018

3. Goals 1. Present useful recommendations to say or do, in order to support all those who find themselves experiencing a situation with a high emotional load Focusing on: • Listen out • Empathetic contact • Safety of the involved 2. To initiate processes that promote the individual and community recovery in front of the event.

4. Themes

5. Introduction “Being a lonely ship in the dark, even when nothing physical could hold him, nothing was more comforting tan seeing the lights of other ships sailling the same sea.” - Alexander Lowen

6. General framework It supports population reestablish their daily life after the impact of a disturbing phenomenon. Staff trained in psychological care

7. The individual involvement by the impact of a disturbing phenomenon will depend on different factors. Mainly:

8. Injured survivors, family members. B. Survivors with high exposure to trauma or evacuees. C. Extended family members and Friends, lifeguards. D. People who lost home, work and possessions; People with trauma and pre-existing dysfunction; Groups at risk; Others that respond to the disaster. E. People in the extended community who were affected.(Wolf 2002)

9. After a catastrophic event, most people can recover without support over time. Only some will need immediate psychological support after the event. However, the effectiveness of the first psychological aid is unquestionable. Decreased symptoms • Red line: People without treatment. • Greenand blue: People with two psychological treatments.

10. Durring the next 24 hours after the event, 86% of the individuals will have some kind of reaction in one or more of the BASIC spheres. BASIC This is completely normal given the abnormal living situation.

11. BASIC normal responses

12. Temporary development of the event The individuals emotional response is also influence by the community coping framework, which depends on the temporal context of the event.

14. Picture courtesy of theSubstance abuse and mental healthservicesadministrator The duration of each phase will depend on the type of disaster, its intensity, socioeconomic development, level of preparedness, availability of resources and stress tolerance of those affected

15. Psychological first aid Psychological first contact is an approach focused on the empathic contact and safety of those affected. It assumes the existence of a natural resilience in people and communities, which acts as a motor of recovery in all areas. It describes a human response of support to another human being who is in pain and may need help

16. Principal Goal • Work with the normalization of common reactions to the event. • Establish support networks that allow the detection of cases requiring specialized intervention.

18. For whom is it? Psychological first contact is directed to any person who needs it and desires it after being affected by a serious critical event. It is important to identify and channel those who need immediate professional help: • People who can not take care of themselves or their families. • People susceptible of endangering themselves. • People who can hurt others.

19. Where can it be given? There is no established place to give psychological first aid. It seeks to maintain some privacy for confidentiality issues, especially with victims of rape.

20. Responsable support It is vital to care for the safety, dignity and rights of people who will be given psychological first aid regardless of age, gender, sex, culture, religion or ethnic origin.

21. SAFETY Avoid actions that may cause more damage. Make sure that the person is protected from physical and psychological danger. DIGNITY Provide respect based on cultural and social norms. RIGHTS Ensure that people receive care without injustice or discrimination. Help people to assert their rights and get help.

22. Ethics

24. Adaptation to Culture It is possible that without a bad intention social rules or practices can be violated Each context is different. It is important to be familiar with the culture of the person being helpped.

25. Basic recomendations for communication from World Health Organization Makethemknowyou are listening Ofrecer información concreta y simple Minimizeexternaldistractions Respectprivacy Be patience and calm Leavespacesforsilence Keepconfidenciality Place near the person keeping appropriate distance Makethemknowthey are notalone Recognizetheirstrength

26. What not to do according to wolrd helath organization Use technical expressions Judge Think you have to solve all the problems of the person Push people Tell the story of other person Interrupt Talk about your problems Take away their strength Touch the person if you are not sure that it is appropiate Make up things Make false promises Speak of others in a negative way

27. Psychological first contact - In action - PFC do not require that the respondent has to be a mental health professional. However, it is necessary to have the needed tools that allow helping the community and their own health.

28. Gathering of information In order to generate a situational perspective and establish a work plan, it is necessary to gather general information on these topics: • Crisis situation • Available support services • Safety matters

29. The work plan should be flexible and subject to any necessary adjustments. It should provide: Safety Calm Collective and individual self-efficiency Bonding Hope

30. Common transversal elements to interventions

32. Psychological first aid principles

34. CHILDREN AND TEENAGERS:Take care of them against abuse or exploitation. PEOPLE WITH HEALTH PROBLEMS, PHYSICAL OR MENTAL DISABILITY: Help to avoid abuse, violence or discrimination.

35. HELP THE AFFECTED TO CALM DOWN

36. Succesfull intervention

37. Sense of security Providing the sense of security allows : • Negative responses caused by the event, tend to disappear over time. • Reduce the likelihood of acquiring psychological disorders from the event. Itmust be priority: • Helpthe affected know the state of their loved ones. • Takecare of expossure to social media.

38. Sense of calm The neglect in activation levels product of the event, directly affects the interpersonal sphere of the individual or facilitates the development of psychological pathologies. It must be priority: • Use emotional management techniques. • Normalization of responses.

39. Sense of individual and collective identity The feeling of being able to cope with trauma-related events is vital to recover, whether in an individual self-efficacy or in a collective effectiveness. The affected person needs: • The belief of being able to overcome adversity. • Count with networks or resources that allow the access to the necessary inputs to achieve their goals.

40. Promotion of bonding Quickly recovery contact between the victim and family helps diminish the probability of presenting mental disorders in the future. Social connectivity promotes: • Acquisition of practical knowledge to face the event • Understanding and emotional ventilation. • Acceptance • Normalizaton of responses

41. Promotion of hope Keep encouragment strengthens the capacity to future planning. Social assistance must: • Help recover daily life • Maintain confidence in the victim • Diminish catastrophic perspectives

42. Emotional cointainment techniques Identify and channel with a professional those who present suicidal thoughts

43. Interventors responses In the face of the emotional burden of the respondent who provides psychological first contact, it is necessary to establish strategies to reduce their stress levels.

44. Stress, frustration and human suffering generates different reactions in the intervener :

45. Interventores characteristics Greaterinternalmotivation. Orientation in front of challenges Workdedicationbasedon a lifeperspectiveneedforstimulation and excitement Initiative to takerisks in order to rescue and helppeople Failure to acceptchanges Priority in wantingquickresults

46. Power of thoughts Passivity Respondentes fantasies Believe that by assuming or saying what may not happen, things can happen Feels pressure to do something when they only needs to listen.

47. Measures to mitigate stress in respondents What has worked in the past to address these stress levels adequately? Restproperly Avoid overloading hours of intervention Look for support inside the group to release pressure

48. Self-help techniques • Talk about what happened to a person of trust (respecting the confidentiality of those involved) • Look for healthy hobbies • Taking care of themselves. • Express feelings. • Eating properly. • Limit the ingestion of alcoholic beverages and tobacco. • The phenomenon of hypersexualization will be present, so it is recommended to measure sexual activity. • Avoid self-medication

49. Considerations for intervention AS YOU PREPARE TO HELP ¿Am I ready to help? What personal concerns might be important? What information do I have on the crisis situation? Will I go alone or together with my colleagues? Why or why not? AS YOU MOVE AROUND THE CITY Is it safe enough to be at the site of the crisis? What services and support are available? Are there people with obvious basic needs? Are there people with obvious emotional reactions? Who could need special help? Where can I provide care? WHEN YOU APPROACH PEOPLE What basic needs could the people affected have? How will I identify and introduce myself to offer support? What does it mean in this situation to help keep affected people from harm? How will I ask people about their needs and concerns? How can I better support and comfort those affected?

50. Case: Natural Disaster Example of a conversation with a concerned adult In this conversation, you have approached a woman standing outside the debris of a collapsed building. She is crying and trembling, although she does not seem to have any physical injuries