The world is changing. Everything’s uncertain. Although we always hear the quote, “The only permanent thing is change”, we cannot help but still feel anxious especially during a time like this – where everything’s unclear and uncertain because of the pandemic.
Due to the current events, most of us have directly observed another person in psychological distress. It may be a person we know – a friend, a family member, a churchmate, an officemate, – or a complete stranger. It may also be ourselves.
Because of this, we’ve been encouraged to help those in need, to offer support and a hand to those people who are suffering at this time, especially to those people who we have witnessed to be suffering and to those people who need help but are afraid to ask.
However, though most of us want to offer help and support to those in need, there’s also a lot that doesn’t know how and where to start leading to toxic positivity, wrong intervention and slowing of the healing process.
This is where we understand the importance of Psychological First Aid. But first, how do we define psychological first aid?
Psychological First Aid (PFA) is a supportive and compassionate presence or support that aims to stabilize (prevent the stress from worsening), mitigate (de-escalate and dampen) acute distress, and facilitate access to continued supportive care, if necessary.
Take note that it doesn’t entail diagnosis or treatment for Psychological First Aid is not therapy. Think of it as a band-aid, it is like applying a psychological bandage to the wound for the wound to heal. Like the physical first aid, it requires basic training to be effective and reduce the risk of inadvertently making things worse.
The purpose of PFA is to provide acute, compassionate, and supportive care in the wake of adversity. It does not assume that stress reactions are pathological. Instead, it involves looking for signs that someone needs additional mental health help and connecting them to that help.
Studies show that experiences in the United States and other countries have shown repeatedly that following disasters, particularly those occasioned by violence, there is a surge of demand for health services, including mental health. And now that we are in the time of a pandemic, there is also a surge of demand for mental health services because many people are experiencing depression and anxiety due to the current events, death of a loved one due to COVID-19 or other critical illness such as respiratory diseases and heart disease, uncertainty, loss of income, stress, and burnout, etc. In response to this, disaster psychologists point to Psychological First Aid to rapidly and effectively help people in distress.
Due to the surge of demand for mental health services, the John Hopkins Center for Public Health and Preparedness developed a simple, yet an evidence-based model of psychological first aid, and it is called the RAPID PFA.
The RAPID PFA is a set of skills and processes on how to properly conduct a psychological first. Although the steps may be simple, but it still needs proper training in PFA. It is an acronym for Rapport and Reflective Listening, Assessment, Prioritization, Intervention, and Disposition and follow-up.
- Rapport and Reflective Listening is the foundation of intervention. This is where one builds a relationship and actively listen to the person in distress. It is about active listening and avoiding opinions and advice. Active listening or reflective listening is the most important part of the intervention process because this is where you will know how and what you’re going to do in the intervention session. Because many instances that people will tell you what they need and how you can help them. But first, you must be willing to listen.
- Assessment is the ability to tell if a person is experiencing acute distress or not. This is not a diagnosis but rather, looking at who is in acute distress and needs assistance than those who don’t.
- Prioritization is related to the assessment process. It is assessing who needs urgent assistance from all those people who are in acute distress. It answers the question, “to whom should I respond first?”. It is about the level of care the person needs.
- Intervention is the strategy, the certain things that can help the person heal. These are the things that offer some sense of stabilization and mitigation of acute distress.
- Disposition and follow-up is about the feedback of the intervention process. It is about how effective the intervention is and it requires follow-up to the person who received the psychological first aid.
Helping the Front Line
Aside from the purpose stated above, another purpose of psychological first aid is to provide self-care especially to those who provide it – our front liners. This is because helping others might take a toll on our mental and physical health. That’s why another goal of PFA is to provide self-care not only to those who receive it but more importantly to those who provide it.
At this time where most of the people are dealing with isolation, food uncertainty, and the fear of illness itself, our front liners are battling the COVID-19 virus and are risking their lives for everybody’s sake. While we only see their battle with the virus, we don’t think much of how they’re currently handling their psychological health.
This is where the John Hopkins Center for Public Health and Preparedness develop another program called RISE (Resilience in Stressful Events). The program aims to teach hospital teams how to respond and support their workers, especially during this time of the pandemic. The goal initially was to prevent typical burnout and vicarious trauma in medical professionals, but the same principles and structures will apply during the COVID-19 crisis.
Social support is what’s best to have during these uncertain times. Though physical distancing separated us physically, that doesn’t mean that social support should also be separated. During this time, many hospitals and mental health clinics put up a remote mental health checkup to address the need for mental health services. It is during this time that we should be sensitive, open, and actually listen to those people we need. Knowing the important skills and goals of psychological first aid may help us to properly help a person in need.