When emergency psychologists carry out an interventionWhether in massive emergencies or in everyday emergencies, we must take into account the wide variety of reactions and feelings that we can find in each patient.
This will depend on the one hand on the nature and severity of the events, and on the other hand on personal characteristics of the affected person such as their previous experiences, the social support they perceive, their history of physical and mental health, their culture and their age. In Psychological First Aid all these elements are taken into account..
In these first moments of tension that we find ourselves upon arriving at the scene, as is logical, we are not going to carry out a multi-method evaluation as we would do in consultation. Our source of evaluation will therefore be the observation we make of the overall situation. and the verbalizations of both the patient himself and witnesses or another member of the security forces.
The same thing happens to the intervention as to the evaluation. In most cases we will spend hours with them, but we will not see them again, and normally the protocol of choice in emergencies will be Psychological First Aid (PAP).
Psychological First Aid
Let’s focus on Psychological First Aid (PAP). Are evidence-based techniques aimed at helping all types of populations affected by a critical incidentapplied in the first hours after the impact. After the first 72 hours they are no longer the technique of choice.
With its application we seek to reduce the level of stress and promote adaptation and coping in the short, medium and long term.
Before applying Psychological First Aid, we understand the environment in which we are going to work, knowing what has happened and what is going to happen. We will also establish communication with the rest of the emergency personnel. to coordinate ourselves in a better way.
Upon arrival at the location, whoever needs assistance is identified. Whenever possible, we try to regroup families to work with them; It is very common for spontaneous groups to emerge among those affected; we also work with them in groups.
Finally, once again emphasize that we will have to adapt to the diversity of the population with which we are going to work. Normally they will be from very different cultures and therefore we will have to adapt our intervention to this.
The phases of Psychological First Aid
The application of the PAP is divided into eight phases. Below we will see what to do and what not to do in each of them.
1. Contact and presentation
The presentation to the affected person must be done in a non-intrusive way, explaining who we are and what we do. We should not overwhelm the affected person, we stay close but without being intrusive. At this moment the other person is in a state of alert, so do not leave room for uncertainty, as this can be a source of fear.
A good approach is the key for the correct and effective application of the PAP, since it establishes the tone that the entire relationship that will follow this phase will have.
2. Relief and protection
Those affected must know that we are there to cover their basic needs, that we are there to don’t worry about more things; from promoting water and food to a mobile charger or a telephone with which to help family reunification. That way they can relax little by little and stop fearing the uncertainty of the present.
In many cases, those affected by an emergency They are in a state of shock, disoriented and disoriented.. Our job as emergency psychologists will be to guide them in space and time in a non-aggressive way, adapting to the patient’s reality.
4. Information collection
The way we interact with the affected person is very important, we must do it in a way that does not make them feel uncomfortable, so we can access as much information as possible to provide the most effective help.
To do this we must speak slowly, exploring all the needs and clarifying the information, we must also organize care priorities and address them based on available resources. We should not give trivial advice just as we will not trivialize needs based on our opinions.
5. Practical assistance
First of all, we must provide useful practical information that perhaps the victims are not yet aware of, such as where the toilets are, the regrouping points, the supplies, etc.
When asked by those affected with this information, we will be able to reduce their anxiety and We fulfill the objective of satisfying your basic needs. Thus, anxiety stops accumulating, since we offer attention to what is most fundamental.
6. Connection with the social support network
It is of utmost importance to help those affected reconnect with your support network. Either by providing them with a telephone number to contact or, if they do not have one, by contacting the security forces to request their help in this task.
Until there is someone accompanying that person, preferably from their support network, we will not leave.
7. Coping guidelines
The most important task will be to normalize symptoms, many affected people believe that in addition to what has happened to them they are going “crazy”, we must dispel this idea by informing them of the basic stress reactions to be expected in the coming hours and days.
They are trained in basic relaxation techniques, with diaphragmatic breathing being the technique of choice, thus we will achieve reduce your level of physiological activity and we will give them a coping tool for possible future symptoms.
On the contrary, we should not say that now he has to be strong or brave; The only thing we do with that statement is not let the affected person experience their own coping resources.
8. Connection with external services
At the closing time of the intervention, as we did at the beginning, We will have to explain that we are leaving and what the procedure will be. from that moment on.
We will not leave those affected alone, we will leave when the victim’s social support network or, failing that, our replacement arrives. We must also give guidelines to the affected person about when and who to ask for help, connecting them with the public health network.
Concluding
In conclusion, I would like to highlight the daily usefulness of PAPs and the need for their training in the entire population. After all, don’t we all know first aid techniques such as CPR or the Heimlich maneuver?
Let’s take care not only of the physical, but also of the mental.
