Psychological First Aid Red Cross Preparedness Academy 2014

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1 Caring for Survivors of Trauma and Disaster: An Introduction to Psychological First Aid Biographical Information Rev. William F. Engfehr III LutheranChurch MissouriSynod DisasterResponseChaplain Senior Pastor Emeritus, HolyCross LutheranChurch,Collinsville Chaplain, Illinois State Police Certified by the International Critical Incident Stress Foundation in Critical Incident Debriefing Greater St. Louis Critical Incident Stress Management Team, member Board of Directors and debriefing team leader Southern Illinois Critical Incident Stress Management Team, member and debriefing team leader Instructor, Crisis Intervention, Concordia Seminary, St. Louis Instructor, Disaster Preparedness, American Red Cross Outline Psychological First Aid Defined Definition of Psychological First Aid (PFA) Understanding Stress and Stress Reactions Psychological First Aid Basics Dealing with Stress (Self-Care) The practice of recognizing and responding to people who need help because they are experiencing stress reactions, resulting from disaster situations. Understanding Stress Stress is a state of physical, cognitive, and emotional arousal. Having stress is not bad, in itself. What is bad is experiencing excessive or prolonged stress Chaplain William F. Engfehr III 1

2 Critical Incident An event that has the power to overwhelm the coping abilities of an individual or group. Critical Incident Stress Also known as Traumatic Stress Starts with exposure to traumatic event Normal response of normal people to abnormal event Painful Most people recover Critical Incident Any event which is powerful enough to overwhelm normal coping mechanisms Vehicle Accident? Incidents Involving Children? 2014 Chaplain William F. Engfehr III 2

3 Injuries? Hazardous Exposure? Violence? Operations involving extensive MEDIA coverage. Child Neglect or Abuse? Additional Critical Incidents Patients / Victims Known to Workers? 2014 Chaplain William F. Engfehr III 3

4 Additional Critical Incidents Line of Duty Death or Major Injury of an Emergency Services Worker or Health Professional on the Job. Disasters Critical Incident Stress Physical Signs and Symptoms of Critical Incident Stress Physical Signs and Symptoms Emotional Signs and Symptoms Cognitive Signs and Symptoms Spiritual Signs and Symptoms Thirst Fatigue Headaches Racing heart Shock Gastro-intestinal distress Sweating Muscle tremors Chills Emotional Signs and Symptoms of Critical Incident Stress Cognitive Signs and Symptoms of Critical Incident Stress Emotional shock Sadness / Depression Frustration Anger / Rage Irritability Feeling overwhelmed Anxiety Fear / Panic Phobic reactions Withdrawal Mental confusion Inability to concentrate Poor attention span Difficulties in problem solving Memory disruptions Inability to calculate Impaired decision making Time distortions 2014 Chaplain William F. Engfehr III 4

5 Spiritual Signs and Symptoms of Critical Incident Stress Anger at God Withdrawal from Faith-based Community Cessation of faith-related practices Stress Reactions in Children Can vary by child and age. Children are particularly sensitive to: Separation from familiar surroundings, people, and possessions Disruption of routines Contributing Factors to Stress Reactions Disaster Characteristics Disaster characteristics Disaster response characteristics Individual characteristics Factors that affect you as a disaster responder Type of disaster When it occurs Who is affected What is affected Where it happens Disaster Response Characteristics Level of preparedness Post-disaster living situation (e.g., Individuals may need to evacuate their homes and stay in shelters, with friends or family, or in a hotel.) Limited availability of food and water Delays in receiving relief services or medical care Age Gender Family composition Cultural, ethnic, racial background Level of exposure to the disaster Loss of or injury to family member, other loved ones, pets Loss of possessions Pre-disaster stress Connectedness with others Individual Characteristics 2014 Chaplain William F. Engfehr III 5

6 Factors that Affect You as a Disaster Responder Leaving family members and loved ones to go on assignment Working in unfamiliar and challenging settings Staying in a staff shelter with little privacy Encountering unfamiliar cultural or ethnic populations whose primary language may not be English Listening to survivors stories Seeing disturbing sights Working with difficult supervisors and coworkers Returning home Psychological First Aid Basics Psychological First Aid Actions Make a Connection Making a connection Helping people be safe Being kind, calm, and compassionate Meeting people s basic needs Listening Giving realistic assurance Encouraging good coping Helping people connect Giving accurate and timely information Making a referral to a Mental Health Professionals Ending the conversation Taking care of yourself Presence Don t Wait to be Approached Introduce yourself. Help People Be Safe Be Kind, Calm, and Compassionate Safety First! Be aware of your surroundings. Enter a scene only when you are sure it is safe. Help people to reach a safe place. Call for medical assistance, if needed (Call 9-1-1). Help people to follow emergency instructions. Express patience and compassion, even if people are being difficult. Speak in a calm voice. Remain courteous and respectful of people. Pay attention to cultural appropriateness of physical proximity, eye contact, and gestures Chaplain William F. Engfehr III 6

7 Meet People s Basic Needs Listen Offer or direct them to food and water. Provide or direct them to a safe place or shelter. Check to see if they are with family or friends. Encourage them to sleep and get rest. (e.g., Take a break, take a walk. ) Be attentive. Listen carefully. Be available. Give Realistic Reassurance Encourage Good Coping Help people to feel less anxious or worried by letting them know that what they are feeling or thinking is understandable. Help People Connect Get them access to a phone to contact their loved ones. Suggest other methods of communication such as . Facilitate access to the Red Cross Safe and Well website so they can reconnect with their loved ones (www.redcross.org/safeandwell). Give Accurate and Timely Information Guide people to the appropriate sources or resources for information in your setting Chaplain William F. Engfehr III 7

8 Make a Referral to a Mental Health Professional Know when and how to make a referral. Get Help Immediately If Danger to Self or Others If someone is incapable of caring for him/herself adequately due to severe emotional distress, confusion, disorientation, irrational thinking, inability to be calmed or severe drug/alcohol intoxication End the Conversation Ask if there is anything else you can do to assist him or her. Provide them with available phones numbers or other contact information. Take Care of Yourself Dealing With Stress Model the behaviors you teach to others! Talk about what happened and impact on you Physical exercise alternating with relaxation Remind yourself it is OK that you are experiencing normal reactions to an abnormal situation Don t fight flashbacks they are normal Keep your life as routine as possible Dealing With Stress Dealing With Stress Don t make significant life changes Avoid alcohol and drug use Help co-workers by sharing your feelings and asking how they are doing Give yourself permission to react Eat regularly (and healthy) Make decisions that restore control You don t have to do it alone Seeking help is not a sign of weakness, it is a sign of wisdom 2014 Chaplain William F. Engfehr III 8

9 You will naturally extend yourself to the limits of capabilities. Do not push yourself beyond those limits, lest you become as ill as those who need your help. First Aid for Psychological Reactions in Disasters APA, 1954 Additional Resources Psychological First Aid Course, American Red Cross (Red Cross Ready Rating Program) (PFA app, 6-hour course) (International Critical Incident Stress Foundation) 2014 Chaplain William F. Engfehr III 9

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