What are Psychological First Aid?
When emergency psychologists perform an intervention , whether in massive emergencies or in everyday emergencies, we must take into account the wide variety of reactions and feelings that we can find in each patient.
This will depend, on the one hand, on the nature and gravity of the facts, and on the other on the personal characteristics of the affected person, such as previous experiences, the social support he or she receives, his or her history of physical and mental health, his or her culture and age. In Psychological First Aid all these elements are taken into account .
The psychological intervention in emergencies
In these first moments of tension that we find when arriving at the place the facts, as it is logical, we are not going to put to make a multi-method evaluation as we would in consultation. Our source of evaluation will therefore be the observation we make of the global set of the situation and the verbalizations of both the patient himself and witnesses or another member of the security forces.
The same thing happens to the intervention as to the evaluation. In most cases we will spend hours with them, but we will not see them again, and normally the protocol of choice in emergencies will be Psychological First Aid (PAP).
First Psychological Aid
Let's focus on Psychological First Aid (PAP). Are Evidence-based techniques designed to help all types of population affected by a critical incident , applied in the first hours after the impact. After the first 72 hours they are no longer the technique of choice.
With its application we seek to reduce the level of stress and encourage adaptation and coping in the short, medium and long term.
Before applying Psychological First Aid, a knowledge of the environment in which we are going to work is made, to know what has happened and what is going to happen. We will also establish communication with the rest of the emergency personnel to coordinate in a better way.
Upon arrival at the place, whoever needs assistance is identified. Whenever possible, attempts are made to regroup the families to work with them; It is very common for spontaneous groups to emerge among those affected, and also work with them in a group manner.
Finally, once again highlight that we will have to adapt to the diversity of the population with which we are going to work. Normally they will be from very different cultures and therefore we will have to adapt our intervention to it.
The phases of Psychological First Aid
The application of PAPs is divided into eight phases. Next we will see what to do and what not to do in each of them.
1. Contact and presentation
The presentation to the affected person must be done in a non-intrusive way, explaining who we are and what we do. We must not overwhelm the affected, we keep close but without being intrusive. At this time the other person is on alert, so do not leave room for uncertainty, as this can be a source of fear.
A good approach is the key for the correct and effective application of the PAP, since it establishes the tone that the whole relationship that will follow this phase will have.
2. Relief and protection
Those affected should know that we are there to cover their basic needs, that we are there to Do not worry about more things ; from promoting water and food to a mobile phone charger or a telephone with which to help family reunification. In this way they can relax little by little and stop fearing the uncertainty of the present.
3. Emotional restraint
On many occasions those affected by an emergency they are in a state of shock, disoriented and disoriented . Our job as emergency psychologists will be to guide them in space and time in a non-aggressive way, adapting to the patient's reality.
4. Information collection
The way in which we interact with the affected is very important, we must do it in a way that does not feel uncomfortable, so we can access as much information as possible to provide the most effective help.
For this we must talk slowly, exploring all the needs and clarifying the information, we must also order the priorities of attention and address them according to the available resources . We should not give trivial advice as well as trivialize the needs according to our opinions.
5. Practical assistance
First of all, we will have to anticipate useful practical information that perhaps the victims are not aware of yet, such as where the toilets are, the regrouping points, the victualling ... etc.
In response to the questions of those affected with this information, we will be able to reduce their anxiety and we fulfill the objective of satisfying your basic needs . Thus, anxiety stops accumulating, given that we offer attention in the most fundamental way.
6. Connection with the social support network
It is very important to help those affected connect again with your support network . Either by providing them with a telephone to contact or, in case they do not have one, by contacting the security forces to request their help in this task.
Until there is no one accompanying that person, preferably from your support network, we will not leave.
7. Coping guidelines
The most important work will be to normalize symptoms, many affected believe that in addition to what has happened to them are becoming "crazy", we must distance that idea by reporting the basic stress reactions expected in the next few hours and days.
They are trained in basic relaxation techniques, diaphragmatic breathing being the technique of choice, so we will achieve reduce your level of physiological activity and we will give them a tool to cope with possible future symptoms.
On the contrary, we should not say that now he has to be strong or brave; the only thing we do with that affirmation is not to let the affected one experience their own coping resources ..
8. Connection with external services
At the time of closing the intervention, as we did at the beginning, we will have to explain that we are leaving and what will be the procedure from that moment.
We will not leave those affected alone, we will leave when the victim's social support network arrives or, failing that, our relief. We must also give guidelines to the affected about when and whom to ask for help, connecting it with the public health network.
Concluding
In conclusion I would like to highlight the usefulness in the day to day of the PAP and the need for their training throughout the population, after all do we not know all first aid techniques such as CPR or the Heimlich maneuver?
Let's take care not only of the physical, also of the mental .
