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A-Z of Psychological First Aid

Have you ever come across any road accident? You would know what you are supposed to do as a bystander, right? You will give a call to the police and/or an ambulance to facilitate and support the victim. And probably by that time you would also attempt to provide physical first aid to that person.

But what about the time when you will probably meet someone who has just come out of a crisis or has an emotional turmoil going on? How would you support the person in such a situation? Clueless?

Let us today try to understand more about what you can do in such a situation. In this blog, we will discuss a concept known as “Psychological First Aid” or “PFA”, and would have a look at it scientifically!

Those of us who have observed someone in distress have usually been motivated to offer some form of support in an attempt to ease the suffering witnessed. Sometimes our efforts were effective, and sometimes they were not.

World Health Organisation recommends “Psychological First Aid (PFA)” as a useful technique that can help many people in times of crisis. A recommendation in the American Journal of Psychiatry states that “shortly after a traumatic event, it is important that those affected be provided, in an empathetic manner, practical, pragmatic psychological support” (Bisson, Brayne, Ochberg, & Everly, 2007, p.1017).

WHAT IS PFA?

Psychological first aid is defined as a “humane, supportive response to a fellow human being who is suffering and who may need support” (WHO, War Trauma Foundation & World Vision International, 2011).

The basic goals of PFA are to promote an environment of safety, calmness, connectivity, self-reliance, and hope. It is a simple, cost-effective step that can make a big difference in challenging times.

This method of care is valuable and timely during an emergency (such as the current COVID-19 pandemic) and isn’t intended as a long-term solution.

Psychological First Aid (PFA): A 4-Module Course | coronaplaza.life

WHAT PFA IS NOT?

  • It is NOT professional counseling and has been devised as  a tool that may be provided by all
  • It is NOT a psychiatric/clinical intervention
  • It is NOT a psychological debriefing

KEY FEATURES OF PFA

  • Being supportive but non-intrusive, recognising that people have the right to accept or decline assistance,
  • Active listening but without applying pressure to speak if the person doesn’t feel comfortable doing so,
  • Offers comfort and supports calmness during times of crisis,
  • Addressing current distress as well as facilitating access to continued professional care (if required),
  • Eases suffering of disaster survivors, emotional as well as physical
  • Promotes emotional recovery after a disaster event.

Step-By-Step Guide for providing support and help in form of PFA

  • Establish the basic needs, such as access to food and water
  • Essential to learn if the individual has specific new or pre-existing healthcare needs and link them to appropriate help available
  • Ensure that those who may be particularly vulnerable aren’t overlooked, such as the elderly, young, and those with mobility/communication issues who do not self-present
  • Prioritize most urgent needs
  • Reinforce positive coping mechanisms and discourage negative coping strategies
  • Link individuals with loved ones/social circle because access to social support networks augments coping.
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HELPING RESPONSIBLY- ETHICAL GUIDELINES

DO’sDONT’s
– Be honest & trustworthy
– Respect person’s right to make their own decisions
– Be aware of and set aside your prejudices and biases
– Make it clear to people that even if they refuse help now, they can still access help in future
– Respect privacy and keep the person’s story confidential, as appropriate
– Behave appropriately, according to the person’s culture, age, & gender
– Don’t exploit your relation as a helper
– Don’t ask the person for any money or favour for helping them
– Don’t make false promises or give false information
– Don’t exaggerate your skills
– Don’t force help on people
– 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 feelings or actions

RAPID PFA Model by JOHN HOPKINS

R: Rapport & reflective listening

A: Assessment (Screening- Is there any evidence of the need for PFA? Appraisal- What is the severity or gravity of need?) DISCLAIMER: This information is generated through the process of listening to the person’s story of distress and not via psychological tests or assessments

P: Prioritization (having heard the story, determine how urgent the need is for intervention)

I: Intervention (efforts towards stabilization and mitigation of adverse reactions)

D: Disposition (determining what to do next- ask yourself and the person you’ve assisted) Most outcomes are recovery or referral to professional care.

Seek Immediate Professional Help if:

  • Person states a desire to harm themselves or others
  • Person shows signs of shock- rapid breathing & pulse, severe confusion, distress that cannot be calmed, impaired thinking, no social support or lack of resilience, nausea/vomiting, dizziness, or extreme agitation.
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What about the burnout of the caretaker/helper?

If you are the caretaker/person providing PFA then the following questions might prove to be effective to reflect upon at every stage of support:

  • Before: Are you ready to help? Are you connected with a group for safety and communication?
  • During: How can you stay physically and emotionally healthy? How can you know your limits? How can you and your group support each other?
  • After: How can you take time to rest, recover, and reflect?

In addition to these questions, it is extremely important to be aware of your limits as a non-professional and immediately seek the help of one as and when necessary. Moreover, self-care is an important practice to be followed after providing PFA. This ensures that you do not suffer burnout.

After all, to help others you must maintain your physical, mental, and emotional health!

This small and concise blog would equip you with all the necessary information required for providing PFA efficiently and also taking care of yourself!

If you find this useful then do share it with others and help educate people about the concept of ‘Psychological First Aid’.

Thank You!

BLOG BY: Sakshi Kaushik (Mental Health Advocate with Fortis National Mental Health Advocacy Programme Batch of 2021, Pursuing B.Sc. Applied Psychology-3rd Year, Founder of the mental health initiative- Mind Review)

REFERENCES

Everly, G.S., Jeffrey, JR. & Lating, J.M. (2017). The John Hopkins Guide to Psychological First Aid. John Hopkins University Press. John Hopkins University- Baltimore. 3-23. Retrieved via: https://books.google.co.in/books?id=fdwsDgAAQBAJ&lpg=PP1&lr&pg=PR6#v=onepage&q&f=false

Minihan, E., Gravin, B., Kelly, B.D., & McNicholas, F. (2020). Covid-19, Mental Health and Psychological First Aid. Irish Journal of Psychological Medicine. 1-12. Doi: 10.1017/ipm.2020.41

World Health Organisation