Psychological First Aid

Today I'm excited because my friend Amanda Symmes agreed to run with the baton and start writing for Free Spirit's Counselor Corner column when I stepped down; her incredible must-read first post is going viral! 

Click the image to learn more about 

{I am so super proud of her!}

I'm also happy because yesterday I went to a workshop
to learn more about Psychological First Aid
Here are some highlights from my notes:

Psychological First Aid is about understanding
normal reactions to abnormal events. 
It's about looking at the here and now,
the current symptoms as a reaction to what happened
rather than the emotional history of the victim. 
No psych meds are called for after a trauma
unless the person was on them prior to the incident.

Schools are the HUB of the community;
people will gravitate there.
Meet basic needs first; shelter is a primary concern,
followed by food and water.
Dehydration can be a huge problem in trauma respond.
Once a child's physical needs are met,
emotional needs can be addressed. 
Expect 4-6 weeks for normalcy to start to be restored.

Normalcy feels amazing; traumatized people benefit from 
feeling comfortable and familiar.
Allow 24-48 hours before
helping them resume their normal routines.
Every disaster is different ...  and the same;
what we can control is stability and routine.
Today's kids are overexposed and 
images can trigger delayed responses.

During monitoring and surveillance,
be approachable.
Be present with the victims.
Come from a place of love and concern.
Help get them relief from what they are experiencing now.
Trauma victims need a compassionate presence.
Emotions are raw; in loss, the primary emotion is grief, which might present as anger, sadness, agitation, fear. In trauma, thinking is not clear.

Information decreases anxiety;
honestly answer any questions they might have.
Draw a social map; encourage them to 
honor their feelings, their bodies, their experience.

Cognitive Behavioral Therapy is the #1 treatment for trauma,
but nothing is as effective as social supports.
Put social supports in place so that
trauma victims know they are not alone.
Survivors need empathy from someone who can sit with them,
to understand and accept how they feel.

There is no such thing as closure.
People remember and want to talk about their trauma.
Research is contrary to the "turn them away" mindset.
We must be willing to listen when they're ready to talk.
Use a directive approach:
"We are here to help; is that okay with you?
Where can we start?"
Let them know that they are not alone.
Ask, "Whom can I call for you? Can I stay with you?"

We are NOT diagnosing our 
traumatized kids, just supporting them.
Normalize their feelings: "YOU are not crazy."
The jobs of children are to play and learn;
get them focused on what they need to do.
Help the survivors adapt; break the cultural divide.
Ask: "What's the culture of this system. What are the norms?"

Self-care for the caregiver is essential;.
some shared trauma experiences to beware of include
secondary trauma (picking up your client's trauma),
projective identification (absorbing what's going on with your client),
and compassion fatigue (indifference to the suffering).
The typical responder reply, "I'm fine." 
can be a cover for "I'm not doing this."
So be in touch with what's going on with you
and employ your therapeutic resources as needed.

To make her point stick, our Traumatic Stress Specialist, April Naturale, told us this incredible story of the rescue dogs at Ground Zero. She reported that the dogs were getting depressed because they weren't finding any live bodies, so their handlers laid down so that the dogs could find them, whereby giving them success, purpose. 

April did an amazing job and I feel blessed that she traveled to Houston to share her expertise with us. I'm so grateful to her and to the National Child Traumatic Stress Network for normalizing the work we did after hurricane Harvey. I was actually working in a school where the administration was reticent to openly talk through things, cautious because of fear, I suppose, of the myth that talking about it might make it worse. It felt validating to know that talking about it is, in fact, important to healing and hope in trauma recovery. 

I also feel more competent to render Psychological First Aid 
the next time I'm called to be a first responder.

1 comment

  1. Thanks for this sweet shout out! Also, your info here is invaluable. You rock :)


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