1 psychological first aid pakistan icitap. learning objectives recognize the impact and importance...
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Psychological First Aid
Pakistan
ICITAP
Learning Objectives
Recognize the impact and importance of Psychological First Aid
Offer practical assistance to help deal with the emotional impact of a traumatic event
Recognize common stress responses in children/adults
Recognize the signs and symptoms of personal stress and learn strategies to decrease it in yourself and others
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What is Stress?
Stress: A very general term referring to the effect of anything in life to which people must adjust
For instance, anything we consider challenging causes stress, even if it is something we willingly choose to do
The key is that stress requires us to change our attention and behavior and makes demands upon our energy
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Psychological First Aid
Staying Healthy Before, During and After The Traumatic Event:
Cover Seek shelter and find a secure location. Look out for your friends and colleagues. Stay and feel safe.
Calm Relax. Take time to rest and get plenty of sleep. Eat, shower and maintain cleanliness. Exercise. Do daily activities and routines.
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Staying Healthy Before, During and After The Traumatic Event: (continued)
Connect Talk with others! Speak about what happened and share your experiences. Meet with friends and socialize.
Capacity Cope in good and positive ways
Confidence Be optimistic, positive and hopeful!
Expect to be okay. Feel assured and certain of oneself.
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Psychological First Aid
Uses skills that you already possess…
Reduces fear-driven behavior
Reduce exposure, illness, injury
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Individual Level:What are we trying to do?
Get people to do what is in their best interest
AND
Stop people from doing what is not in their best interest
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What are we trying to do?
Provide care for disaster survivors
Maintain care for current patients
Safeguard colleagues
Support other first responders
Lead effectively in crisis
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Psychological First Aid Basics
Encourage patient survival
Measure patient’s awareness and competence
Recognize patient’s strengths
Promote mental recovery
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Psychosocial Consequences of Disasters
Fear and Distress Response
Impact of Disaster Event
BehaviorChangePsychiatric
Illness
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An Event is More Stressful or Traumatic When…… Event is unexpected
Many people die, especially children
Event lasts a long time
The cause is unknown
The event is poignant or meaningful
Event impacts a large area 11
What assists our Emotional Adjustment?
Acceptance of the disaster and losses
Identification, labeling, and expression of emotions
Regaining a sense of mastery and control
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Common Physical Reactions in Adults
Sleep difficulties/headaches
Gastrointestinal problems (Diarrhea, cramps)
Stomach upset, nausea Elevated heart rate Elevated blood pressure Elevated blood sugar With extended stress, a
weakened immune system13
Common Physical Reactions in Children and Youths
HeadachesStomachachesNauseaEating problemsSpeech
difficultiesSkin eruptions
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Common Emotional Reactions in Adults
Fear and Anxiety Sadness and Depression Anger and Irritability Numb, withdrawn, or disconnected Feeling a lack of involvement
or enjoyment in favorite activities Feeling a sense of emptiness or
hopelessness about the future
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Common Emotional Reactions in Children/Youths
Anxiety & Vulnerability Fear of reoccurrence Fear of being left alone
Particularly if separated from family
Loss of “Sense of Safety” Depression Anger Guilt
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Common Behavioral Reactions in Adults
Family difficulties (physical, emotional abuse) Substance abuse Being overprotective of
family Keeping excessively busy Isolating oneself from others Being very alert at times,
startling easily Avoiding places, activities, or
people that bring back memories
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Common Behavioral Reactions in Children/Youths
“Childish” or regressive behaviorMay not be deliberate
acting out Bedtime problems
Sleep onset insomniaMid-night awakeningFear of darkFear of event reoccurrence
during night18
Common Psychological Reactions in Adults
Difficulty concentrating Difficulty with memory Intrusive Memories Recurring dreams or nightmares Flashbacks Difficulty communicating Difficulty following complicated
instructions
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Common Psychological Reactions in Children/Youths
Confusion, memory loss, and disorientation
Difficulty in concentratingMay appear as behavioral
problems in classroom School may be where child
functions bestContinuing Structure,
sense of controlSocial group
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Common Faith & Spirituality Reactions in Adults & Children
Reliance upon faith Questioning values and
beliefs Loss of meaning Directing anger toward a
higher being Cynicism
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Common Sensory Reactionsin Adults/Children in Trauma
SightSoundSmellTasteTouch
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SAFETYSAFETY FUNCTIONFUNCTION ACTIONACTION
Goals
RestoringRestoringphysical safetyphysical safetyand diminishingand diminishingthe physiologicalthe physiological
stressstressresponse.response.
FacilitatingFacilitatingpsychologicalpsychological
functionfunctionand perceivedand perceivedsense of safetysense of safety
and control.and control.
InitiatingInitiatingaction towardaction toward
disasterdisasterrecoveryrecovery
and return toand return tonormal activity.normal activity.
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SAFEGUARDSAFEGUARD
SAFETYSAFETY FUNCTIONFUNCTION ACTIONACTION
Strategies
SUSTAINSUSTAIN
COMFORTCOMFORT
CONNECTCONNECT
EDUCATEEDUCATE
EMPOWEREMPOWER
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Remove from harm’s way.Remove from the scene.Provide safety and security.Provide shelter.Reduce stressors.
SafetySecurityShelter
What Survivors Need:What Survivors Need:
What To Do:What To Do:
Safety
SAFEGUARDSAFEGUARD
SAFETYSAFETY
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Psychological Exposure Risk Zones
ON SITE (eye witness)
DIRECT EXPOSURE (eye witness)
OUT OF VICINITY
IN NEIGHBORHOOD
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Provide food, water, ice.Provide food, water, ice.Provide medical care, alleviate pain.Provide medical care, alleviate pain.Provide clothing.Provide clothing.Provide power, light, heat, air conditioning.Provide power, light, heat, air conditioning.Provide sanitation.Provide sanitation.
Basic survival needsBasic survival needs
What Survivors Need:What Survivors Need:
What To Do:What To Do:
SAFETYSAFETY
Safety
SUSTAINSUSTAIN
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Sarin Attack on Tokyo Subways
Examined & discharged
4023
Killed 12
Severely injured 62
Hospitalized 984
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For every person who is physically injured or directly impacted by a disaster, there are 4 - 10 secondary victims who experience a significant impact on their behavioral health
Remember……………..
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Establish compassionate “presence.”Establish compassionate “presence.”Listen actively.Listen actively.Comfort, console, soothe, and reassure.Comfort, console, soothe, and reassure.Apply stress management techniques.Apply stress management techniques.Reassure survivors that their reactions areReassure survivors that their reactions are““normal” and expectablenormal” and expectable
Soothing human contactSoothing human contactValidation that reactions are “normal”.Validation that reactions are “normal”.
What Survivors Need:What Survivors Need:
What To Do:What To Do:
Function
FUNCTIONFUNCTION
COMFORTCOMFORT
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Trust Determination Factors In High Concern Situations
Listening/Caring/Empathy
50%
Listening/Caring/Empathy
50%
Competence/Expertise 15-
20%
Competence/Expertise 15-
20% Honesty/
Openness 15-20%
Honesty/ Openness 15-20%
Dedication/Commitment
15-20%
Dedication/Commitment
15-20%
Assessed First 30 Seconds
Listening/Caring/Empathy
50%
Dedication/Commitment15-20%
Competence/Expertise 15-20%
Honesty/ Openness 15-20%
Assessed First 30 Seconds
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Active Listening
Make it clear that you are listening
Body Language Eye contact Distance Body orientation Facial Expression Physical Tension
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Ways of Responding
Ask mostly open-ended questions
- Closed: “Are you feeling better?”
- Open-ended: “How are you feeling?” Paraphrase & Reflect Feelings
- Assist with formal problem solving
- “Lets look at all your options” Remember your role as supportive
helper
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Information on Coping
Provide the individual with information that may help them cope with the event and its aftermath, including information about:
Common psychological reactions to traumatic experiences and losses
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Agitation Sometimes, despite our best
attempts at active listening, people still become agitated
Refusal to follow directions Loss of control, becoming verbally
agitated Becoming threatening It is usually not personal This is their reaction to an
UNCOMMON situation, and
it has nothing to do with you
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Alarm Bells/When to Refer
Harm to self Saying they want to: “End it all” “Go to sleep and never wake up again”
Excessive use of substances Driving under influence In some cases working under influence
Harm to others Child abuse Spouse abuse
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Alarm Bells/When to Refer
Loss of control Significant withdrawal (as
change in behavior) Behavior is unusually (for that
individual) confused or bizarre Unable to care for self (cannot
eat, bathe etc. - Vulnerable)
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Practical Assistance
Offer practical assistance and information to address patient’s immediate needs and concerns
Identify the most immediate needs Clarify the needs Discuss an action response Act to address the needs
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It is Not OK to suggest that…
You should work toward getting over this Let’s talk about something else You are strong enough to deal with this I know how you feel You’ll feel better soon You did everything you could You need to relax It’s good that you are alive
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Promote Resilience
Everyone who experiences a disaster is touched by it
We have the ability to “bounce back” after a disaster to a “New Normal”
Resilience can be fostered
One goal of Psychological First Aid: support resilience in ourselves and others 42
Compassion Fatigue
There is a cost to caring. We professionals who are paid to listen to the stories of fear, pain, and suffering of others may feel, ourselves, similar fear, pain and suffering because we care.
Compassion fatigue is the emotional residue of exposure to working with the suffering, particularly those suffering from the consequences of traumatic events.
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Developing Disaster ResiliencePersonal & Family Preparation
Recognize pre-existing stress Develop healthy coping skills Participate in preparedness
exercises & drills Educate yourself on your
school, city, and county response plans and your response role in a crisis situation
Make pre-emergency individual and family response plans 44
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Questions?