Psychological First Aid

1. Psychological First Aid Presented by Jim Messina, Ph.D.,

2. Objectives for Program • Identify reason why individuals might need Psychological First Aid • Identify components of Psychological First Aid • Identify competencies, skills and strategies needed to provide Psychological First Aid • Identify Triage for people needing PFA

3. Why would Individuals need Psychological First Aid? • They may have experienced a crisis or trauma in their lives or the lives of others • They may be very confused and caught off guard by the crisis or trauma which is happening in their lives • They may feel overwhelmed by the need to problem solve the issues they have to deal with due to the crisis or trauma • They need help to cope with their fears and worries stemming from their crisis or trauma

4. Challenges Survivors of Crises Face • Being part of the collective crisis facing the community in which they live • Repeated exposure to “surreal” life experiences of their community members • Having to maintain “one’s cool” in face of emotionally difficult and exhausting circumstances • Lacking sleep and feeling fatigued • Feeling like “no matter what gets done is never enough”

5. Other Obstacles Faced by People in Crisis • Facing moral and ethical dilemmas in dealing with each other whose issues are not easily resolved by simple responses or answers • Being exposed to anger and lack of gratitude of people in their community who feel “the system” has caused their problems • Feeling frustrated by policies and decisions by the organization set up to deal with the crisis or trauma which they are facing

6. The signs coming from survivors of their needing PFA • Wounded ideals and/or cynicism • Feeling unappreciated or betrayed by organization • Mistrusting everyone around them • Loss of enthusiasm and/or inefficiency • Grandiose beliefs about self-importance • Heroic but reckless and/or antisocial behavior • Neglecting personal safety and physical needs • Excessive tiredness and/or sleep difficulties • Inability to concentrate • Symptoms of illness or disease • Excessive use of alcohol, tobacco or drugs

7. What is Psychological First Aid? • The practice of providing a compassionate presence to people in crisis or trauma who need help because they are feeling stress, resulting from the traumatic situations within which they find themselves.

8. Skills and Attitudes to be Effective Providers of Psychological 1st Aid • Good Listening skills • Patient • Caring attitude • Trustworthy • Approachable • Culturally competent • Empathetic • Non-judgmental approach • Kind • Committed • Flexible • Able to tolerate chaos

9. Why you should know how to provide Psychological First Aid • To create a compassionate environment for survivors to help them build their resilience • To assess what a survivor might need at a particular time • To provide immediate support to survivors in stressful situations • To create a helping environment which helps survivors cope in the face of stressful events

10. Psychological First Aid Actions to use with Mental Survivors: • Making a connection with these survivors • Helping them maintain healthy boundaries with one another • Being kind, calm, and compassionate • Meeting survivors’ basic needs • Listening to them • Giving realistic assurance to them • Encouraging them to use good coping • Helping them to connect with one another for emotional support

11. Creating a Psychologically Supportive Recovery Environment • Providing sound guidance and support in their problem solving personal solutions • Creating an open and sharing communications line with them • Demonstrating and encouraging respect for confidentiality • Creation of peer support system for mutual support, problem solving, advocacy, fun, rest, and recreation

12. What lesson can be taught through Psychological First Aid? • What are the normal reactions to stressful events experienced by survivors • How to be aware of one’s tension and consciously try to relax • Encouragement of the use of a buddy system between survivors • Encouraging survivors to talk with someone they trust and with whom they feel at ease • Encourage listening to what survivors say and think about the daily stresses

13. Self-Help Psychological First Aid Strategies: • Use one of the following strategies to express your feelings on a daily basis: • Keep a daily journal about your feelings about what you experience as you pull out of the crisis • Daily use painting or drawing art projects which help you get out the stress and anxiety faced in your recovery process • Daily use playing or listening to music to get out the stress and anxiety you face • Conduct a weekly or daily “debriefing” session with fellow survivors to “tell your stories” about the stressors experienced your process

14. Triage to determine if Psychological First Aid is not enough! • If a survivor begins to show signs of physical and mental and mental fatigue where compassionate presence is not enough! • If a survivor shows signs of excessively self-medicating • If a survivor has excessively witnessed death of relatives, fellow community members or friends. • If survivors have excessively witnessed serious injury to others

15. Immediately refer Survivors for Outside Professional Help • If in triage you recognize that PFA is not enough refer out especially if you witness the survivor: • Threatens to harm or kill self or others • Cannot be calmed after PFA attempts to comfort and respond to requests and/or needs • Behaves erratically and exhibits questionable judgment, because of possible influence of alcohol or drugs • Acts confused and disoriented, saying or doing things that do not make sense in the context of the situation and that may result in harm to self or others

16. Can You Help Survivors of Crises? Through the use of Psychological First Aid: • You create an environment of compassion • You show respect for the survivors • You build up survivor’s capacity to cope with the daily stressors faced • You encourage survivors to be resilient in the face of trauma, disaster, death, and destruction