psychological first aid

1. Psychological
First Aid
Dr. Ajaz Ahmad Suhaff
Department of Psychiatry
SKIMS Medical College Bemina.

2. • The term Psychological First Aid was first coined by Drayer,
Cameron, Woodward, and Glass in a manuscript they wrote for the
American Psychiatric Association on request of the U.S. Federal Civil
Defense Administration. (1954)
• By the 1970s the principles and foundations of crisis (psychological)
intervention were being utilized in disaster work with adults and in
1988, similar interventions were being implemented with children
• By 1990 emergency organizations such as the Red Cross were
applying the principles as a preferred model for early intervention
following exposure to a traumatic event.
• In the post-9/11 era, psychological first aid has emerged as a
mainstay for early psychological intervention with survivors of
disasters and extreme events.
• (Raphael, 1977; Farberow, 1978)
• (Knudsen, Hogsted, & Berliner, 1997)
• (Pynoos and Nader, 1988)..

3. Psychological First Aid
The humane, supportive and practical help
given to the person or communities who
recently suffered exposure to serious
stressors is Psychological first aid.

4. Why do we need Psychological First Aid?
• Disasters, both natural and man-made, can
strike at any time; sometimes we get a
warning, and sometimes we do not.
• Many kinds of critical events occur in disasters
like war, violence, accidents, fires.
• People may lose their loved ones, property,
such as homes, work place , relationships,
jobs.
• All are affected BUT some more than others.

5. Why do we need Psychological First Aid? (contd)
 To promote safety
 To promote serenity
 To promote connectedness
 To promote self-efficacy
 To promote hope

6. Reactions to Stress
• Physical
• Behavioral
• Emotional
• Cognitive
• Spiritual

7. LOOK
LISTEN
LINK
PRINCIPLE ACTIONS OF PFA

8. PRINCIPLES OF PFA
LOOK • Observe forsafety
• Observe for people with obviousurgent basic
needs
• Observe for people with seriousdistress reactions
LISTEN • Make contact with people whomay need support
• Ask about people’s needs andconcerns
• Listen to people and help them to feel calm
LINK • Help people address basic needsand access
services
• Help people to cope withproblems
• Give information
• Connect people with loved ones and social
support
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9. Core Actions of PFA
1. Contact and Engagement
2. Safety and Comfort
3. Stabilization
4. Information Gathering
5. PracticalAssistance
6. Connection with SocialSupport
7. Information on Coping
8. Link with Collaborative services
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10. •To respond to contacts initiated by survivors or establish
a connection with the victims in a non-intrusive,
compassionate and respectful manner
Contact and Engagement

11. Attend to physical comfort
Promote social engagement
- place children near adults/peers
who are calm
Attend to children who are separated from
parents/caregivers
Protect from additional traumatic experiences
and trauma reminders
Safety and Comfort

12. T
o calmand orientemotionally-overwhelmed or disorientedsurvivors.
1. Give the person a few minutes / moments (of privacy), Say “you are
available if they need you…
2. Remain calm and quiet. Just remain
available
3. Offer support and help him/her
- focus on specific manageable goals
4. Enlist support from family and friends
5. Teach the person breathing techniques
6. Get the person orientated to the surroundings by providing
him/her information (GROUNDING)
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Stabilization

13. 13
Identifying immediate needs and
concerns
 Nature and severity ofexperiences
 Death of a lovedone
 Concerns about post-disaster
 Concerns about safety of lovedones
 Loss ofproperty
 Physical illness, mental health condition andneed
for medication
GATHERING INFORMATION

14. Offer help to victims/survivors in
addressing immediate needs and concerns.
 Identify the most immediate need(s)
 Discuss an action response
 Act to address theneed
 Know what services areavailable
 Inform those affected about what they can
realistically expect in terms of potential resources
and support
 Help victims to set achievable goals
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PRACTICAL ASSISTANCE

15. •Social Support is related to emotional well
being and recovery following a disaster.
•Important to establish on-going contacts with primary
support persons or other support sources, including
family members, friends and otherresources
•Facilitate pathway towards individuals/support system
(family members, friends)
Social Support

16. 16
Provide information on stress reactions and how to cope
Teach simple relaxation techniques
- breathing exercises
 Anger management
 Handling negative emotions : anxiety, anger
 Handling sleep disturbances
 Handling drug abuse
 Discuss coping with families
INFORMATION ON COPING

17. Promote Resilience
• Everyone who experiences a disaster is
touched by it
• We have the ability to bounce back after a
disaster to a new normal
• Resilience can be fostered
• One goal of PFA: support resilience in
ourselves and others

18. LINKAGE WITH COLLABORATIVE SERVICES
• Suggest an evaluation rather than treatment
• Normalize the idea of treatment
• Involve the person’s spouse or partner in the
discussion
• Mental Health Services
• Medical services
• Spiritual Services
• Welfare services
• Relevant Support Groups

19. People who Likely Need Special Attention
• Children
– Especially those separated from caregivers
• People with health conditions and disabilities
– People who are non-mobile, or who have chronic illness,
hearing/visual impairments (deaf or blind), or severe mental disorders.
• Frail elderly people
• Pregnant or nursing women
• People at risk of discrimination or violence
– Women, people of certain ethnic or religious groups, people with
mental disabilities.

20. In a nutshell, it involves:
•Providing practical care and support
•Helping people address basic needs
•Helping people connect to information
•Comforting people and helping them to feel
calm
•Protecting people from further harm.

21. What Psychological First Aid is NOT
• It is not counselling.
• It is not “psychological debriefing” in that it
does not involve a detailed discussion of the
events that are causing the distress.
• It is not asking a person to analyse their
situation or pressurising a person to talk about
their feelings.
• It is not something that only professionals can
do

22. Helping Responsibly: Ethical Guidelines
Do’s
• Be honest and trustworthy.
• Respect a person’s right to make
their own decisions.
• Be aware of and set aside your
own biases and prejudices.
• Make it clear to people that even
if they refuse help now, they can
still access help in the future.
• Respect privacy and keep the
person’s story confidential, as
appropriate.
• Behave appropriately according
to the person’s culture, age and
gender.
Don’ts
• Don’t exploit your relationship as a
helper.
• Don’t ask the person for any money
or favor for helping them.
• Don’t make false promises or give
false information.
• Don’t exaggerate your skills.
• Don’t force help on people, and
don’t be intrusive or pushy.
• Don’t pressure people to tell you
their story.
• Don’t share the person’s story with
others.
• Don’t judge the person for their
actions or feelings.

23. Thank you