When emergency psychologists have performed an interventionWhether in mass emergencies or in everyday emergencies, we have to take into account the wide variety of reactions and feelings that we can find in each patient.
This will depend in part on the nature and severity of the events, and on the other hand on the personal characteristics of the affected person such as past experiences, perceived social support, physical and mental health history, culture. and his age. All these elements are taken into account in psychological first aid.
Psychological intervention in emergency situations
In these first moments of tension that we find when arriving on the scene, of course, we are not going to start a multi-method evaluation as we would do in consultation. Our source of assessment will therefore be our observation of the overall situation. and verbalizations from the patient himself and witnesses or another member of the security forces.
The same thing happens with intervention as with evaluation. In most cases, we’ll be with them for hours, but we won’t see them again, and usually the protocol of choice in an emergency will be psychological first aid (PAP).
Psychological first aid
Focus on psychological first aid (PAP). they are evidence-based techniques designed to help all types of people affected by a critical incident, Apply in the first hours after 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 encourage adaptation and adaptation in the short, medium and long term.
Before applying psychological first aid, knowledge is made of the environment in which we are going to work, what has happened and what is to happen. We will also establish communication with other emergency personnel. to better coordinate us.
Upon arrival at the site, he is identified who needs assistance. Whenever possible, we try to bring families together to work with them; It is very common for spontaneous groups to arise among those affected, we also work with them in groups.
Finally, let us emphasize once again that we will have to adapt to the diversity of the population we will be working with. They will generally be from very different cultures and we will therefore have to adapt our intervention to that.
Phases of psychological first aid
The application of PAPs 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 person concerned should be done in a non-intrusive manner, explaining who we are and what we do. We have not overwhelmed those affected, we remain close but without being intrusive. At this point, the other person is on alert, so there is no need to allow room for uncertainty as it can be a source of fear.
A good approach is the key for the correct and effective application of the PAPs, since it sets the tone that will have all the relation that will follow in this phase.
2. Relief and protection
Affected people need to know that we are there to meet their basic needs, which we are there for that they don’t worry about more things; from promoting water and food to a cell phone charger or phone to help with the family reunion. In this way, they can gradually relax and stop fearing the uncertainty of the present.
3. Emotional stress
In many cases, people affected by an emergency they are in shock, disoriented and out of place. Our task 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 gathering
How we interact with those affected is very important, we need to do it in a way that we are comfortable with, so that we can access as much information as possible to provide the most effective help.
In order to do this, we must speak slowly, explore all the needs and clarify the information, in addition we must prioritize and respond to care priorities 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, you have to anticipate useful practical information that the victims may not yet be aware of, such as the location of the toilets, assembly points, refreshments … etc.
Considering the questions of those affected by this information, we will be able to reduce their anxiety and we meet the goal of meeting your basic needs. Thus, anxiety stops accumulating, since we are paying attention to the most basic.
6. Connection to the social assistance network
It is very important to help those affected reconnect to your support network. Either provide them with a telephone number to contact, or, in the event that they do not have one, contact the security forces to ask for their assistance in this task.
As long as no one accompanies that person, preferably their support network, we will not leave.
7. Adaptation guidelines
The most important task will be to normalize the symptoms, many affected feel that in addition to what happened to them going “crazy” one should move away from this idea by reporting the basic stress reactions expected within hours. and the days to come.
They are trained in basic relaxation techniques, diaphragmatic breathing being the technique of choice, so we will be successful. reduce their level of physiological activity and we will give them a tool to adapt to possible future symptoms.
On the contrary, it should not be said that he must now be strong or courageous; the only thing we do with this statement is not to let the affected person experience their own coping resources.
8. Connection with external services
At the end of the intervention, as we did at the beginning, we will have to explain that we are gone and what will be the procedure from that moment on.
We will not leave those affected alone, we will leave when the victim’s social support network arrives or, if it does not, our rescue. We also need to give direction to those affected when and where to ask for help, linking it to the public health network.
In conclusion, I would like to underline the daily utility of PAPs and the need for their training across the population, after all don’t we know all the first aid techniques such as CPR or the Heimlich maneuver?
We take care not only of the physical, but also of the mind.