Psychological First Aid: Responding to Trauma
Psychological First Aid: Responding to Trauma
Al Waller: Experiencing a natural disaster or other emergency events can be incredibly stressful. Even after the immediate danger has passed, the impact can still be felt by those who had to endure the event. Why is this relevant now? Well, the frequency and intensity of these events are increasing each year. For instance, according to the National Centers for Environmental Information from 2017-2021, there were 17.8 weather/climate disaster events that exceeded $1 billion per year compared to 12.8 per year in 2010-2019. Additionally, there have been at least 15 events with each loss exceeding $1 billion to affect the United States in 2022.
As these events become more common, it’s important to remember that after the cameras and crews leave the scenes, the aftereffects of these severe events do not end for those affected.
Welcome to ClearPath - Your Roadmap to Health & Wealth SM
. I’m your host, Al Waller. Today, Mihaela Vincze, public health expert for nonprofit Transamerica Institute®, is joining me to discuss the importance of caring for others after a disaster by diving into psychological first aid.
But before we get started, I’d like to remind you that if you have any topic ideas for podcast episodes that you’d like to hear about, please reach out to us at [email protected]. We’d love to hear from you!
Mihaela, it’s good to have you here.
Mihaela Vincze: It’s great to be back.
Al Waller: It's getting to the point where I feel like a week doesn't go by where I don't hear about some significant natural disaster occurring somewhere in the USA, or at least some place in the world. So, Mihaela, how do people generally feel in the aftermath of disaster or other emergencies?
Mihaela Vincze: That’s a good question since many of us do not think about the long-term effects trauma may have. According to the American Psychological Association, trauma is the ongoing emotional response that results from living through a distressing event—such as an accident or disaster. Traumatic events are not easy for people to deal with or accept—they often actually change our view of the world. The emotional responses to trauma could include flashbacks, uneasiness, jumpiness, and even physical symptoms.
When it comes to disaster, some people may feel sorrow or anger over the damage or loss, worry or despair when thinking about rebuilding their lives, or they may simply feel devastated and not know where to begin. Taking those first steps towards recovery can be easier with a little support.
Al Waller: That’s true, it’s important to support others as they heal. To be clear, what is psychological first aid?
Mihaela Vincze: Good question. You may be familiar with first aid, which is medical assistance given to a sick or injured person to prevent an injury from worsening or to simply sustain life until full medical treatment is available. Psychological first aid (PFA) is similar in that it helps survivors in the immediate aftermath of disasters, terrorism, and other emergencies by offering support to help improve health outcomes for the survivors by helping them become more optimistic, forge positive self-beliefs, and have access to the resources they need in the long run. PFA does NOT work under the assumption that all survivors will develop severe mental health problems or long-term difficulties in recovery. Instead, it focuses on supporting survivors to find adaptive and healthy coping mechanisms in the stressful aftermath of a disaster.
Al Waller: That is fascinating. So, similar to getting trained in CPR to help in an unforeseen medical emergency, we can be trained in PFA to help support survivors in the aftermath of other sorts of emergencies. That said, when disaster strikes, many people are affected. Who is PFA for?
Mihaela Vincze: PFA is for anyone impacted by disaster who has:
- Acute stress/ grief reactions
- Concerns about safety and danger
- Impairments in functioning
- Practical needs
Al Waller: That is great to know so we can be properly prepared if or when something happens. What are the reactions people can anticipate following a disaster?
Mihaela Vincze: According to the American Psychiatric Association, some common reactions of psychological trauma after a disaster include:
- Trouble staying asleep or falling asleep
- Sadness, irritability, depression, or anger
- Feeling numb or confused, having trouble concentrating
- Fatigue or feeling exhausted all the time
- Lack of appetite or, the opposite, eating more than usual
- Social isolation, reduced interest in activities
- Headaches, stomachaches, or other pains
- Misusing substances to cope
Al Waller: That can be a lot of emotions to process, especially if you are caring for others, such as children who also experienced distress. Are children affected differently by disaster?
Mihaela Vincze: Very young children may become clingy, fearful, have tantrums, or experience behaviors such as bedwetting or thumb-sucking. School-aged children may socially isolate, may find themselves having a hard time getting along with others – getting into fights, or have trouble with schoolwork. Parents, teachers, and caring adults can help children by listening and responding in an honest, consistent, and supportive manner.
Al Waller: Interesting and good counsel regarding support, Mihaela, and good behavior to consistently model with children regardless of the circumstances. That is important to know that children may respond differently than us adults. So, now that we know how people may respond, can you tell us more about PFA and what it means to deliver it?
Mihaela Vincze: Psychological First Aid’s core actions are based on five principles for the best outcomes following a disaster. The first principle is safety. Survivors may be concerned about their physical or psychological safety or the safety of those they care about. Ensure the removal of threats (perceived or actual) to reduce responses such as fear or anxiety. This can be done by reconnecting families together and providing clear and accurate information.
Al Waller: That’s fascinating! It is sensible but also nuanced to fit each situation a little bit differently. What is the next principle in Psychological First Aid?
Mihaela Vincze: The second principle is calm. Disasters are often chaotic and cause fear, distress, and anxiety among survivors. These reactions can impact our health, including our ability to sleep, think clearly, make decisions, and cope effectively. Disasters can also cause old trauma to resurface and perhaps remind people of past losses and painful events. For this principle, you can help survivors identify coping strategies they have used in the past and introduce new ones they may need to address their current distress and worries. An example of this principle in practice is teaching someone a calming technique following a car crash, to mitigate the anxiety of riding in a car following the accident.
Al Waller: That is a great point, and an important reality to keep in mind. How else can we show up for others after a disaster?
Mihaela Vincze: The third principle is connectedness. Disasters disrupt communities, so it is important to help people connect with one another again or help them create new connections with those around them who are in a similar situation. For instance, let's say that two people arrive at a safety shelter – connecting them together can help them feel less alone and they can support each other as they figure out next steps.
Al Waller: The importance of connectedness can be easy to overlook at times, but as you mentioned, it is incredibly important. How might individuals benefit from prioritizing community in terms of PFA?
Mihaela Vincze: That’s a good question as the fourth principle of PFA is self and community efficacy. Disaster research has shown that the loss of resources—personal, social, and economic, is associated with a diminished sense of self-efficacy, or the capacity to recover, and less confidence in the community’s ability to promote recovery. So, connecting survivors to resources, including them in decision-making about recovery efforts, and promoting prosocial activities or engagement in community efforts is very important. E.g. if a person, Jake, is injured, and wonders how he will be able to take care of his family, perhaps, highlight the resources in his community to help Jake feel like his family will persevere.
Al Waller: That is a wonderful example, I know sometimes when I am hurt or sick, I sometimes worry more about how it will impact my family than how it will impact me. This brings us to the final principle of PFA, can you tell us about it?
Mihaela Vincze: The fifth principle is hope. Survivors are more likely to have better outcomes after a disaster if they maintain optimism, positive expectance, and a feeling of confidence that things are predictable. Help survivors to focus on aspects that they can control, by praising them for their courage, and helping them with expectations that they can get through the difficult hours and days ahead.
Al Waller: Well said because hope can be difficult to grasp when experiencing distress, so aiding others and encouraging optimism in those stressful times can make a significant difference. Now that we know more about PFA, can you tell us who can provide PFA and how someone can receive the training?
Mihaela Vincze: PFA was designed as a collaborative effort between the Veterans Affairs’ National Center for Posttraumatic Stress Disorder and National Child Traumatic Stress Network (NCTSN). The NCTSN provides an interactive course and certification is accessible to anyone. Don’t wait until a disaster, we encourage listeners to take the free training now.
Al Waller: Thank you, Mihaela, for sharing the groundwork of Psychological First Aid, showing us the important principles of safety, calm, connectedness, self and community efficacy, and hope in the immediate aftermath following disaster.
If you’d like to check out any of the source materials mentioned today, visit transamericainstitute.org/podcast to review the episode’s transcript.
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Until the next time, I’m your host Al Waller. Stay safe, be well and thanks for listening.
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