first aid
Post on 14-Jan-2016
26 Views
Preview:
DESCRIPTION
TRANSCRIPT
FIRST AID
PSYCHOLOGICAL
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
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
PSYCHOLOGICAL FIRST AID
Practical assistance for basic human comfort and compassion
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
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."
THELMA SINGSON – BARRERA, RN
National Center for Mental Health(Nice-to-know-term)
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
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
WHO delivers PFA?
•Mental Health Workers
•Other disaster response workers
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHEN should PFA be used?
IMMEDIATE aftermath of the disaster/ critical
event
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
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
• 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.
3 Goals of Providing PFA
1. Relieve both emotional & physical suffering
2. Improve people’s short term functioning
3. Accelerate the individual’s course of recovery
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
ELEMENTS OF PFA
• Feeling safe, calm & hopeful and connected to others
• Having access to social, physical & emotional support
• Being ABLE TO HELP THEMSELVES as individuals & communities
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
HOW PFA IS OFFERED?
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
How to Approach PFA responsibly?
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
Considerations in PROVIDING PFA
• Do no HARM
• SAFETY of yourself & others
• ETHICAL principles
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
ATTRIBUTES OF A GOOD HELPER
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
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
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
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
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
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
• 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
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
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
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
WHEN IS PFA EFFECTIVE?
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHEN IS PFA EFFECTIVE?
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHAT PFA IS NOT?
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHAT PFA IS NOT?
• 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.
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
PFA Core Actions
1. Contact & Engagement – initiate non-intrusive, compassionate & helpful manner
2. Safety & Comfort – enhance ongoing safety, provide physical & emotional comfort
3. Stabilization – calm & orient emotionally overwhelmed / disoriented survivors
4. Information Gathering – identify immediate needs & concerns – tailor PFA interventions
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
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
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
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
• 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 PFADont’s
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
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
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
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
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
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
Basic Action Principles
Explanation
A = Assess Know the situation so you will know what to do!Assess for: Safety, obvious urgent physical needs, persons w/ serious reactions, Ask for: Person’s NEEDS & CONCERNS
B = Be Know yourself well, so you can…BE attentive, BE respectful, BE aware
C = Comfort/ Coping
Give COMFORT & help people begin using their own COPING resourcesCOMFORT thru your presence, thru good COMMUNICATION & helping people to COPE
D = Do Act to help persons with their basic practical needs.Do address practical needs, Do help problem solve, Do link people w/ loved ones & other supports
E = End/ Exit Strategy
Leave persons w/ connections to supports, & take time for your own self-careEnd your assistance – refer to other supportsEnd for yourself – take time for self-care.
When To Refer?
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHEN TO REFER?
• 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)
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHEN TO REFER?
• 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
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHEN TO REFER?
• 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.
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
WHEN TO REFER?
• When you yourself become:
– Restless– Confused– Have negative recurring thoughts– Dream about the case– Feel you are the only one who can help
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
Client
• Assessment if PSS is needed
• By SERVICE PROVIDERS: MSW, BHW, Midwife,
• PHN, MD
PSP needed
HOME
MHPSS/ Psychosocial
Intervention by MHPSS
Service Providers
MH Specialist(Psychiatrist)
HOME
Improved
MHPSS REFERRAL FLOW CHART
YES
NO
NOYES
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
When, Where & How to REFER
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
INTERVENTION/ REFERRAL FLOWCHART
Select Activity
For Help
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
IMPROVED FOLLOW-UP
NOTIMPROVED
REFER
COUNSELINGSERVICE
SOCIALSERVICE
MEDICALSERVICE
• Contact people • Agency and Address (DSWD, WCPU)
THELMA SINGSON – BARRERA, RN
National Center for Mental Health
top related