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Key points
- Psychological first aid is a short term intervention following a crisis.
- Anyone can learn how to provide psychological first aid, a brief training is enough for you to learn how to help others.
- The appropriate response in times of critical incident can be a make or break for people in and post-crisis.
In response to the situation in Ukraine and its ongoing impact, this post presents the necessary aspects of psychological first aid in response to the current wave of violence and critical incidents in Ukraine and its borders.
A "critical incident," is an event (or events) that has a stressful impact, is significant enough to overwhelm our immediate coping skills. These can be one-time events or prolonged ones such as accidents, crime, violence, death, illness, injury, natural disaster, war, domestic violence, placement in foster care, displacement, emergency medical needs, and more.
Psychological First Aid (PFA) is a short-term intervention strategy to provide immediate support and care to individuals and communities affected by critical incidents.
Anyone trained in PFA can provide information essential to understanding the psychological dynamics of stress and trauma and connect people to needed resources.
There are different PFA frameworks. Over years of living and working in critical trauma response, I have pulled on pieces of several field-tested modalities and gathered it as the Expressive Trauma Integration( ETI).
1) First engagement. Focus on respect and compassion, especially in the first interaction.
2) Provide psychoeducation. Provide survivors with accurate information about how stress and trauma affect people.
In addition: Review coping mechanisms known to help address emotional, physical, cognitive, spiritual, and social aspects of crises.
This knowledge is essential for normalizing their symptoms and managing what they are experiencing (Read more on trauma and the brain psychoeducational).
3) Establishing a sense of safety. Even when survivors are safe and provided with the basics of shelter, food, clothing, and medications, they often don't feel safe due to the nature of stress responses to trauma.
Special measures should address this with grounding activities (read more on self-regulation).
4) Identify vulnerabilities. A variety of vulnerabilities and risks emerge after trauma. Survivors need assistance in identifying immediate vulnerabilities and how to address them. PFA intervention focuses on:
- Assist in creating possible responses
- Connect survivors to other professionals
- If needed, help devise safety plans
5) Reconnect to resources. In times of crisis, we are not aware of our resources. Everyone has resources.
The idea is to help survivors identify and recognize their own internal, personal, family, communal inner, and tangible resources.
6) Assist in sustainability. Help survivors develop short-term strategies and routines by designing a weekly framework to help facilitate a sense of stability and containment when no trained assistance is available (read more on sustainability).
When is the time to engage in trauma therapy?
Often survivors and therapists are unaware that trauma therapy should not be the first response following critical incidents.
Trauma therapy requires that the client will have a stable environment. Often survivors are living in situations where stability is not yet possible. Certain circumstances such as displacements and immigration and ongoing exposure to violence (domestic, communal, war) consume most of the survivors' resources to cope with fear, change, and instability.
Therefore, it is vital to use the PFA framework and not follow the intervention timeline accordingly (see image).
For more information on ETI intervention timeline read here.
More resources on PFA and psychosocial support interventions. Here's a link for an example of what to say and do with people in crisis.
