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FIRST AID

THELMA SINGSON – BARRERA, RN National Center for Mental Health. PSYCHOLOGICAL. FIRST AID. Definition.

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FIRST AID

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  1. THELMA SINGSON – BARRERA, RN National Center for Mental Health PSYCHOLOGICAL FIRST AID

  2. Definition Psychological First Aid – is simply a “first-aid” response aimed to *stabilize, *reduce symptoms and *return the survivor to functional capacity in the aftermath of a critical incident. It refers to any effort that reduces the victims’ feeling of helplessness and promotes their sense of control THELMA SINGSON – BARRERA, RN National Center for Mental Health

  3. PSYCHOLOGICAL FIRST AID THELMA SINGSON – BARRERA, RN National Center for Mental Health Practical assistance for basic human comfort and compassion

  4. What is Emotional First Aid™(EFA)? "Emotional First Aid™ is the initial response given to a person experiencing emotional distress before specific professional help is sought and obtained." (Nice-to-know-term) THELMA SINGSON – BARRERA, RN National Center for Mental Health

  5. Some examples of critical incidents : Mass disasters : natural & human-induced Multiple injuries/fatalities · Death or injury to a child · Serious injury or line of duty death · Excessive media attention · Outsiders or family members interfering with operations · Any incident grotesque by sight, smell or other circumstance likely to produce an emotional (memory) input THELMA SINGSON – BARRERA, RN National Center for Mental Health

  6. WHO is PFA for? PFA is intended for PEOPLE EXPOSED TO DISASTER (children, adults, first responders, disaster relief workers) THELMA SINGSON – BARRERA, RN National Center for Mental Health

  7. WHO delivers PFA? Mental Health Workers Other disaster response workers THELMA SINGSON – BARRERA, RN National Center for Mental Health

  8. WHEN should PFA be used? IMMEDIATE aftermath of the disaster/ critical event THELMA SINGSON – BARRERA, RN National Center for Mental Health

  9. WHERE should PFA be used? Shelters, hospitals, medical triage areas, acute care facilities, feeding locations, family reception & assistance centers, home, business & community settings, crisis hotlines THELMA SINGSON – BARRERA, RN National Center for Mental Health

  10. PFA aims to help persons to mobilize their own abilities and resources to RECOVER & REBUILD by responding to basic needs, showing concern & care, and respecting the wishes & capabilities of the person. • PFA aims to offer both safe & effective help for persons after a critical event.

  11. 3 Goals of Providing PFA Relieve both emotional & physical suffering Improve people’s short term functioning Accelerate the individual’s course of recovery THELMA SINGSON – BARRERA, RN National Center for Mental Health

  12. ELEMENTS OF PFA THELMA SINGSON – BARRERA, RN National Center for Mental Health Feeling safe, calm & hopeful and connected to others Having access to social, physical & emotional support Being ABLE TO HELP THEMSELVES as individuals & communities

  13. HOW PFA IS OFFERED? THELMA SINGSON – BARRERA, RN National Center for Mental Health By your presence Your willingness to listen Providing practical things & information the person may need right in that moment Connecting them with services & people that can assist them as they recover in the long term

  14. How to Approach PFA responsibly? THELMA SINGSON – BARRERA, RN National Center for Mental Health • YOU CAN BEST HELP IF YOU ARE: • CALM • FOCUSED • PREPARED DO NO HARM; - respect the person - Protect the person from harm - Act only in the BEST INTEREST of the person

  15. Considerations in PROVIDING PFA THELMA SINGSON – BARRERA, RN National Center for Mental Health • Do no HARM • SAFETY of yourself & others • ETHICAL principles

  16. ATTRIBUTES OF A GOOD HELPER THELMA SINGSON – BARRERA, RN National Center for Mental Health Personal readiness to help in crisis Ability to stay CALM & FOCUSED Ability to learn the basic principles & DO’S & DON’Ts Warmth & empathy with others

  17. Examples of Psychological First Aid Family Support Services involve assisting the affected family with their particular and specific needs during and shortly following a crisis. (helping them with their activities of daily living, making arrangements for them (including phone calls). - provision of warm blanket, clothing, tents, etc. - food assistance – provision of a cup of noodles, - warm broth, etc. THELMA SINGSON – BARRERA, RN National Center for Mental Health

  18. Examples of Psychological First Aid Information Support Services – provision of appropriate information Tracing Services – helps locate missing relatives THELMA SINGSON – BARRERA, RN National Center for Mental Health

  19. Examples of PFA ●Reassurance –statement that help is forthcoming (if indeed coming), provide sense of security Presence of crisis workers – human service providers especially if they are in uniform with clear identification i.e. NCMH-DOH THELMA SINGSON – BARRERA, RN National Center for Mental Health

  20. Examples of PFA Rituals i.e. allowing victims to go through grieving rituals Other support structures - this usually involves provision of a support structure to help the victims/survivors go through the different phases of a critical incident. E.g. Cebu Pacific plane crash, MV Princess of the Stars Sea tragedy THELMA SINGSON – BARRERA, RN National Center for Mental Health

  21. Examples of PFA Defusing - an early-intervention strategy that is activated while the traumatic memories are more successfully dealt with, before they are 'cemented in' and perhaps distorted THELMA SINGSON – BARRERA, RN National Center for Mental Health

  22. Defusing is a shortened version of a debriefing (PSP), lasting 20-45 minutes, and must be held within 8 hours of the incident (1-2 hours is preferable). The groups usually have 6-8 participants, and the defusing works with only three stages (introduction, exploration and information). THELMA SINGSON – BARRERA, RN National Center for Mental Health

  23. Defusing provides a structure whereby the members may support and encourage each other exchange information, and enjoy a sense of group caring. The group also provides a forum whereby the myth of uniqueness is dispelled, as many of the members will express similar feelings THELMA SINGSON – BARRERA, RN National Center for Mental Health

  24. Crisis Management Briefings large-scale crisis interventions. They are usually held for large groups (up to 300 members at a time) It lasts about 45-75 minutes, and provides information and rumor control about the crisis. THELMA SINGSON – BARRERA, RN National Center for Mental Health

  25. Crisis Management Briefings Reduce the sense of chaos, provide information about resources, assess the group for additional needs, help to restore the group to adaptive functioning, and facilitate follow up care. A community leader or allied representative associated with the crisis may be on hand with the CIS Team member to facilitate information dissemination. THELMA SINGSON – BARRERA, RN National Center for Mental Health

  26. WHEN IS PFA EFFECTIVE? THELMA SINGSON – BARRERA, RN National Center for Mental Health It is COMFORTING to someone in distress It is PRACTICAL SUPPORT – helping people w/ basic needs It is TAILORED to the NEEDS & CONCERNS of the affected persons & the situation

  27. WHEN IS PFA EFFECTIVE? THELMA SINGSON – BARRERA, RN National Center for Mental Health It is IMMEDIATE & Intended to help those who recently experienced a very distressing event It is CONNECTED to other supports (services & people) who can help in the long term

  28. WHAT PFA IS NOT? THELMA SINGSON – BARRERA, RN National Center for Mental Health It is not something that only professionals can do It is not counselling or debriefing It is not asking people to analyze what happened to them, or to put time & events in order

  29. WHAT PFA IS NOT? THELMA SINGSON – BARRERA, RN National Center for Mental Health • Although PFA involves being available to listen to people’s stories, PFA IS NOT ABOUT PRESSING people to tell you all their feelings & reactions to an event • It is not something that every person who experience a crisis will need.

  30. PFA Core Actions Contact & Engagement – initiate non-intrusive, compassionate & helpful manner Safety & Comfort – enhance ongoing safety, provide physical & emotional comfort Stabilization – calm & orient emotionally overwhelmed / disoriented survivors Information Gathering – identify immediate needs & concerns – tailor PFA interventions THELMA SINGSON – BARRERA, RN National Center for Mental Health

  31. 5. Practical Assistance -identify/ clarify the need, discuss action plan, act to address the need 6. Connection w/ social supports – enhance access, encourage use, discuss support-seeking & giving, modeling support 7. Information of Coping – give basic info about stress rxns, teach relaxation techniques, address (-) emotions 8. Linkage w/ collaborative Services – provide link to add’l. services, promote continuity of care PFA Core Actions THELMA SINGSON – BARRERA, RN National Center for Mental Health

  32. Delivering PFA Professional Behavior: Operate only within the framework of an authorized disaster response system. Model healthy responses: calm, courteous, organized, helpful Be visible & available Maintain confidentiality Remain within the scope of your expertise & designated role Do’s THELMA SINGSON – BARRERA, RN National Center for Mental Health

  33. Delivering PFA Professional Behavior: Make appropriate REFERRALS Be knowledgeable & sensitive (Culture & diversity) Pay attention to your own emotional & physical reactions. Practice SELF-CARE Do’s THELMA SINGSON – BARRERA, RN National Center for Mental Health

  34. Do not make assumptions (about what the survivors are experiencing or what they have gone through) Do not assume that everyone exposed to a disaster will be traumatized. Do not pathologize (do not label “reactions” as “symptoms” Do not talk down to or patronize the survivor, or focus on his helplessness/weaknesses, mistakes, disability. FOCUS on what he has done EFFECTIVELY to help others Delivering PFA Dont’s THELMA SINGSON – BARRERA, RN National Center for Mental Health

  35. Delivering PFA Do not assume that all survivors want to talk or need to talk to you.(Being physically present in a supportive, calm way helps survivors feel safer & more able to cope) Do not “debrief” by asking details of what happened. Do not speculate or offer possibly inaccurate information. Know the facts before answering their questions. Dont’s THELMA SINGSON – BARRERA, RN National Center for Mental Health

  36. Guidelines for Delivering PFA Politely observe first, don’t intrude. (ask simple respectful ?s to know how you may help) Provide practical assistance to make contact (food, water, blankets) Initiate contact only after you have observed the situation, the person, the family Be prepared that survivors will either AVOID you or FLOOD YOU w/ contact THELMA SINGSON – BARRERA, RN National Center for Mental Health

  37. Guidelines for Delivering PFA Speak calmly. Be patient,responsive & sensitive. Speak slowly, in simple concrete terms. Don’t use acronyms. Be prepared to listen. (Focus on hearing what they want to tell you, and how you can be of help) Acknowledge the positive features of what the survivor has done to keep safe. THELMA SINGSON – BARRERA, RN National Center for Mental Health

  38. Guidelines for Delivering PFA Give information that addresses directly the survivor’s immediate goals & clarify answers Give accurate & age- appropriate information When communicating w/ a translator, look & talk to the client, not the translator. Remember the GOAL of PFA( to reduce stress, assist w/ current needs, promote adaptive functioning, not to elicit details of traumatic experiences & losses) THELMA SINGSON – BARRERA, RN National Center for Mental Health

  39. When you are approaching a CRISIS SITUATION to assist others, think of these BASIC ACTION PRINCIPLES A = ASSESS B = BE C = COMFORT/COPING D = DO E = END/ EXIT STRATEGY

  40. When To Refer? THELMA SINGSON – BARRERA, RN National Center for Mental Health

  41. WHEN TO REFER? THELMA SINGSON – BARRERA, RN National Center for Mental Health • REFERRAL - the act of recommending that a person speak to a professional who is more competent to handle the difficulties and complexities of his/her needs. • Referral may be necessary when the stress reactions of individuals affected by disasters are causing impairments (inability to take care of self or inability to work)

  42. WHEN TO REFER? THELMA SINGSON – BARRERA, RN National Center for Mental Health When a person hints or talks openly of suicide If there is a possibility of child abuse or any criminal activity The problem is beyond your training The problem is beyond your capability. The problem does not fit the purpose of the community responder program

  43. WHEN TO REFER? THELMA SINGSON – BARRERA, RN National Center for Mental Health The person seems to be socially isolated., You have difficulty maintaining real contact with the person You become aware of dependency on alcohol and drugs When the person is engaging in risky or threatening behavior.

  44. WHEN TO REFER? THELMA SINGSON – BARRERA, RN National Center for Mental Health • When you yourself become: • Restless • Confused • Have negative recurring thoughts • Dream about the case • Feel you are the only one who can help

  45. Assessment if PSS is needed By SERVICE PROVIDERS: MSW, BHW, Midwife, PHN, MD Client PSP needed MHPSS REFERRAL FLOW CHART HOME NO YES MHPSS/ Psychosocial Intervention by MHPSS Service Providers NO MH Specialist (Psychiatrist) Improved YES HOME THELMA SINGSON – BARRERA, RN National Center for Mental Health

  46. When, Where & How to REFER THELMA SINGSON – BARRERA, RN National Center for Mental Health

  47. INTERVENTION/ REFERRAL FLOWCHART • CHILD • Talk • Play • - Support • - Educate • FAMILY • Talk • a. Support • b. educate • -Child rearing Practices • - communication styles • COMMUNITY • Talk • Suggest Activities • a. Day care • b. sportfest • c. disaster preparedness • SCHOOL • Talk • Suggest Activities • a. Sportfest • b. Disaster preparedness • c. Family day • d. Art contest FOLLOW-UP IMPROVED REFER Select Activity For Help NOT IMPROVED COUNSELING SERVICE SOCIAL SERVICE MEDICAL SERVICE • Contact people • Agency and Address (DSWD, WCPU) THELMA SINGSON – BARRERA, RN National Center for Mental Health

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