Psychological First Aid – Flashcards
Unlock all answers in this set
Unlock answersquestion
NATURAL DISASTERS
answer
- Hurricanes - Earthquakes - Floods - Tsunamis - Tornadoes - Health/ epidemics - Fire - Avalanches
question
MAN MADE DISASTERS
answer
- Terrorist incidents - Engineering failures - Environmental disasters - Explosions - Industrial accidents - Fire
question
SOCIAL/PSYCHOLOGICAL CONSEQUENCES CAUSED
answer
Loss of: - loved ones - possessions - income - social cohesion - safety/dignity - self-image - trust/future - control
question
COGNITIVE
answer
- poor concentration - confusion - indecisiveness - memory loss - preoccupation - short attention span
question
PHYSICAL
answer
- poor sleep - nausea - gastro-intenstianl problems - hyper-arousal - rapid heart rate - dizziness - fatigue
question
EMOTIONAL
answer
- shock - depression - anxiety - feeling nothing - volatile emotions - fear - overwhelmed
question
BEHAVIORAL
answer
- suspicion - irritability - argument with loved ones - sexual desire/functioning - increased drinking/eating - withdrawal
question
DISASTER AXIOMS
answer
- No One Who Witnesses a Disaster is untouched by the Experience. - Disaster Reactions are Normal Reactions for Abnormal Circumstances - In Disasters, Mental Health Assistance is often more "Practical" than "Psychological" - Most People Do Not Seek Mental Health Service After a Disaster
question
PSYCHOLOGICAL FIRST AID
answer
- Evidence-informed approach to help children, adolescents, adults, families in the aftermath of disaster and terrorism to reduce stress and foster adaptive functioning and coping. - The practice of recognizing and responding to people who need help because they are feeling stress, resulting from the disaster situations within which they find themselves. - A supportive and compassionate presence designed to reduce acute psychological distress and/or facilitate continued support if necessary
question
PRIMARY GOAL OF PFA
answer
- re-estabish immediate coping
question
WHY IS PFA IMPORTANT
answer
- Create a compassionate environment for disaster survivors and workers. - Assess what a person might need at a particular time. - Provide immediate support to those in stressful situations. - Help others cope in the face of stressful events.
question
BASIC SKILLS
answer
1. PROTECT (The individual from or perception of further harm) 2. DIRECT (the individual to a quiet safe area and provide a compassionate presence) 3. CONNECT (The individual with further support, and/or services)
question
BASIC PRINCIPLES & OBJECTIVES
answer
- Establish a human connection in a compassionate manner - Promote Safety - Care for basic needs - Create Calm - Let them tell their story - Validate feelings - Support adaptive coping - Goal oriented behavior - Provide information to help with psychological impact - Re-establish routine - Utilize existing support networks - Be clear about availability - Instill Hope
question
PFA VS. TRADITIONAL PRACTICE
answer
PFA: - Home /comm. Based - Asses strengths, adaptation, coping skills - Restore to previous level of functioning - Accepts content at face value - Reactions as normal - Psychoeducational TRADITIONAL: - Office based - Diagnosis and treat mental illness - Impacts baseline of MH functioning - Examines content - Insight into experiences - Psychotherapeutic focus
question
WHERE CAN PFA BE USED?
answer
- Shelters - Schools - Hospitals - Staging Areas - Feeding Locations - Family Assistance Centers - Community Settings - Field Decontamination/Mass Prophylaxis - Emergency Operations Centers
question
COMMON SERVICES
answer
- Individual crisis counseling: understand reactions, support, link with services, ACTIVE LISTENER, emotional support - Group : meeting with citizens, classrooms, administrators. - Educational services: brochures, talks. Psychoeducational info to facilitate sharing of experiences - Screenings/ Referrals
question
WHO SHOULD PROVIDE PFA?
answer
* Best providers: those immediately available and who know community * - behavioral health specialists - public health workers - faith based - school personnel - first responders - human services providers - volunteers - primary and emergency health care
question
DISASTERS MENTAL HEALTH INTERVENTIONS
answer
- Advocacy - Crisis Intervention - Casualty and Grief Support - Family Support - Referrals - Public Health Messaging and Consultation
question
CHARACTERISTICS OF GOOD HELPERS
answer
- good listening - patient - caring - trusting - approachable - empathetic - tolerant of chaos - culturally competent - non-judgemental - committed - flexible
question
EARLY INTERVENTION PROVIDERS
answer
- connect w/ indv. - tolerance for strong behavior - rapid assessment of survivors - provide care quickly - recognition and response - self capacities/car - provide clear, concrete info - shift from traditional
question
THINGS TO NOT DO
answer
- Assume that everyone will be traumatized - Pathologize /patronize - Force/push people to share their stories with you - Debrief (DO NOT ask for details about what happened) - Make promises that may not be kept - Give simplistic reassurances Know your own limitations in terms of providing accurate information
question
DON'T SAY
answer
"It's best if you just stay busy." "I know just how you feel." "You need to get on with your life" "EVERYTHING WILL BE O.K." "AT LEAST YOU SURVIVED" "YOU CAN ALWAYS GET ANOTHER DOG" "AREN`T YOU GLAD YOU WEREN`T IN NEW ORLEANS FOR HURRICANE KATRINA."
question
DO SAY
answer
- These are normal reactions to a disaster. - It is understandable that you feel this way. - You are not going crazy. - You did the best you could. - Things may never be the same, but they will get better, will feel better.
question
STEP ONE: MAKE CONTACT
answer
Establish a human connection: - introduce self and describe role - ask permission to talk - explain objective - immediate needs - calm, patent, responsive, sensitive
question
HELPER BEHAVIOR
answer
- let them talk - care for physical needs - information gathering - supportive communication skills
question
VALUES FOR COMMUNICATION
answer
- positive regard - empathy - respect - non judgemental - culturally competent - empowering - practical - confidential - ethical
question
INITIATING SUPPORTIVE COMMUNICATION
answer
- circulate, observe - dont intrude - introduce self - basic needs
question
VERBAL COMMUNICATION SKILLS
answer
- calm voice - simple questions - positive language - patience and compassion
question
NON VERBAL COMMUNICATION SKILLS
answer
- calm and compassionate - face person - maintain open gesture - respectful distance - soft eye contact - culturally sensitive
question
COMMENTS/QUESTIONS
answer
- supportive - reflective - empowering - open ended/closed - paraphrasing - door openers
question
ACTIVE LISTENING
answer
- verbal and non-verbal - validate - summarize and paraphrase - respect silence
question
STEP 2: STABILIZATION
answer
- address basic needs - reduce high level of stress - return to normal functioning
question
HELPER BEHAVIOR 2
answer
- promote social engagement - reunification with missing - attend to needs of acutely bereaved indv. - accurate and critical information: --> facts/reactions/methods of coping/services
question
DE-ESCALATION
answer
- intense emotions can escalate to aggression - de-escalate with verbal & non-verbal
question
VERBAL DE-ESCALATION SKILLS
answer
- speak calmly and slowly - maintain empathy and respect - keep it simple - avoid absolutes - open ended questions and statements - reframe if messages sent is not the message received
question
WHAT DO WE STABILIZE
answer
- physical discomfort (cold, wet, thirsty, hungry, injured, etc.) - psychological discomfort (understanding what has happened, safety) - emotional discomfort (fear, grief, hopelessness, anger, etc) - spiritual discomfort (shattered assumptions)
question
STEP 3: GATHER INFORMATION
answer
Objectives: assess (stabilized) person for potential future risks - prioritize immediate and long term needs
question
DISASTER MENTAL HEALTH (DMH) COUNSELOR BEHAVIOR
answer
- motor environment - inquire about: immediate past, present, immediate future - ask clarifying question - information leads to connection and referral
question
CONNECT PERSON WITH PSYCHOSOCIAL SUPPORT SYSTEMS
answer
- family, friends and co-workers - community mental health centers - employee assistance programs - faith based resources
question
STRESS
answer
a central theme in any critical incident and is a state of both physical and psychological arousal
question
DAZED OR SHOCKED
answer
- immediately after a disaster - usually subsides quickly - professional help is recommended if not subsided
question
OVERWHELMED
answer
- glassy, vacant eyes - disoriented, unable to find direction - unresponsive to questions or commands - strong emotions: crying, rocking, hyperventilating, regressive behavior, shaking, frantic search behavior! - risky activity
question
IMMEDIATE REFERRAL (RED FLAGS)
answer
- disorientation - auditory/visual hallucinations - inability to care for self - suicidal/homicidal thoughts, plans or actions - problematic use of alcohol or drugs - inappropriate anger - excessively flat emotions - frequent flashbacks, nightmares - regression to earlier stages of development - inappropriate reaction to triggering events
question
CHALLENGES UNIQUE TO DMH
answer
- Informed Consent: obtained by informing the client that you're DMH - Multiple role: multi-function team - Confidentiality: personal issues out in open - HIPPA: health info shared on a "need to know" basis - Ethics: no self-referreaks - Mandatory Reporting: state laws
question
STEP 4: DEVELOP AND IMPLEMENT A PLAN
answer
- help indv. see that there are solutions to meeting immediate needs - identify solutions - implement solutions to meet immediate needs
question
HELPER BEHAVIOR 3
answer
- explore past strategies - explore person's assets and resources - "recalibrate" expectations - possible solutions - develop workable plan - problem solving skills
question
DEVELOP A PLAN
answer
- write down problem with specific plan to address problem - prioritize problems - contact referrals
question
PROBLEM SOLVING
answer
- big/small problems - brainstorming
question
STRESS MANAGEMENT PLAN
answer
- physical safety - information - physical comfort - social engagement - predictability/control - safety and comfort
question
PEOPLE COPE WITH STRESS
answer
- Seek help from others - Use natural supports - Religious or cultural traditions - Defense mechanisms - Vigilance - Work to repair the damage
question
HEALTHY COPING
answer
- talking with another person - adequate rest, diet, exercise - positive distracting activities
question
UNHEALTHY COPING
answer
- drugs/alcohol - withdraw from fam/friends or activities - overeating - risky/dangerous - not taking care of self
question
CALMING INTERVENTIONS
answer
- therapeutic grousing - deep breathing - muscle relaxation - normalization - cognitive reframing
question
RESILIENCE
answer
- adapting well in the face of adversity, trauma, tragedy, threats or sources of stress - Bouncing back from difficult experiences
question
FACTORS IN RESILIENCE
answer
- caring/supportive relationships - accept change - realistic plans - positive view/confidence - communication and problem solving - hopeful outlook
question
RESILIENCE BUILDING
answer
- Accept: circumstances that can't be changed - Look: for opportunities to learn something about oneself - Focus: on what you want rather than what you fear - Pay attention: one's own needs & feelings - Maintain: flexibility & balance
question
PRACTICAL STEPS FOR PFA
answer
1. Setting up 2. Providing basics (food) 3. Providing supplies
question
GROUPS AT RISK
answer
- children - older persons - people with past trauma experience - bereaved spouses and partners - single parents - disaster workers - caregivers and volunteers
question
GROUPS WITH UNIQUE NEEDS
answer
- homeless or homebound - limited mobility, no transportation - people with service animals - medically dependent - deaf or hard of hearing - blind or visually impaired - language barriers - socio-economically disadvantaged - cognitive impairments, mentally ill - isolated (culturally, geographically, linguistically) - immigrants, refugees
question
COMMON REACTIONS FOR CHILDREN
answer
- anxiety and fear - nervous about future - regression to past behaviors - clinging - reluctance to go to school - sadness and crying - headaches/stomachaches - withdrawal/isolation - increased shyness/aggressiveness - difficulty sleepping
question
DIFFERENCES B/W CHILD AND ADULT REACTIONS
answer
- blame themselves for the event - may not understand event or cause and effect - may react based on developmental level - may reenact the trauma in play activites
question
CHILDREN'S FEAR POST EVENT
answer
- injury or death to loved ones - disaster recurrence - being left alone - separation from family
question
HELPING CHILDREN
answer
- Get on their level - Talk about what happened (as appropriate) - Use simple terms ( mad, sad, scared, worried) - Keep familiar routines (school and play) - Provide activities that help them express feelings - Protect them from reminders (T.V.) - Pamper and Care - Find opportunities for them to participate in decision-making - ID good things such as heroic actions / assistance
question
CHILDREN AGES 1-5
answer
BEHAVIORAL SYMPTOMS: - Bed-wetting, thumb-sucking, clinging - Fear of the dark - Avoidance of sleeping alone - Increased crying PHYSICAL SYMPTOMS: - Loss of appetite - Stomach aches - Nausea - Sleep problems, nightmares - Speech Difficulties - Tics EMOTIONAL SYMPTOMS: - Anxiety & Fear - Irritability/angry outbursts - Sadness - Withdrawal
question
INTERVENTION CHILD 1-5
answer
- verbal assurance - physical comfort - comforting bedtime routines - no unnecessary separation - child can sleep in parents' room temporarily - encourage expression regarding losses (deaths, pets, toys)/play activities - no media exposure to disaster trauma
question
CHILDREN AGES 6-11
answer
- Set gentle but firm limits on acting out behavior - Encourage verbal and play expression of thoughts and feelings - Provide structured but undemanding home chores and rehabilitative activities - Listen to the child's repeated retelling of a disaster event - Engage children in the preparation of home emergency kits and rehearse safety measures for future disasters
question
HELPING ADOLESCENTS
answer
- Give additional attention and consideration - Relax Expectations of Performance at home or school temporarily - Encourage discussion of disaster with peers, significant adults - Avoid insistence on discussion of feelings with parents - Encourage physical activity - Encourage resumption of social activities, clubs, athletics, etc.
question
HELPING ADULTS
answer
- Provide supportive listening and opportunity to talk in detail about disaster experience - Assist with prioritizing and problem solving - Offer assistance for family members to communicate - Assess and refer when indicated - Provide info. on disaster stress and coping
question
OLDER PERON: RESPONSE/CONCERN
answer
- increased focus on past/negative view of future - Fears - loss of control/independence, mortality - Less likely to seek/accept assistance - Feeling of multiple losses - overwhelmed - Disoriented as routines interrupted - Concentration & communication difficulties - may be due to hearing or vision problems - Chronic illness, dietary conditions
question
HELPING OLDER PERSONS
answer
- verbal reassurance regarding safety - Address prescription medication needs - Reunite with familiar acquaintances - Give factual information - Reassure about normal reactions - Talk about the event - Establish routines - Provide orientation information - Encourage discussion of losses and expression of emotion - Create opportunities to feel useful and valued
question
PERSON WITH DISABILITIES
answer
- same reactions - illness or disability may pose challenge in change adaption - unique access, environment and service issues
question
HELPING PEOPLE WITH DISABILITIES
answer
- establish safety (quiet) - ask how you can help - address special needs - service animal protocols - treat same as others
question
PEOPLE W/ SERVICE ANIMALS
answer
- not a pet - don't touch/treat - on duty w/ harness - animal and owner stay together - not muzzled - harness/leash
question
CULTURAL COMPETENCE
answer
- recognize culture - respect diversity - recruit indigenous workers - accessible services - customs, traditions - services culturally linguistically appropriate
question
USING COMMUNITY
answer
- identify and use leaders - use natural networks - outreach - nutrition choices (non traumatizing, culturally appropriate)
question
SOURCES OF HELPER STRESS
answer
- unprepared for own reactions - repeated exposure to grim experience - lack of sleep - inability to "do enough" - guilt - moral/ethical dilemmas - angry and seemingly ungrateful victims - frustrated - detached
question
DEPLOYMENT STRESS
answer
- leaving family - unfamiliar/challenging settings - staff shelter - unfamiliar culture - not english - survivor storis - disturbing sighs - diff. supervision - returning home
question
BURNOUT
answer
- wounded ideals - cynicism - antisocial behavior - fatigue - lack of concentration - somatic illness - sleep disruption - inefficiency - alcohol/tobacco/drugs - mistrust - self neglect - unappreciated
question
CARING FOR HELPERS
answer
- debrief - flexibility - break area - own structure - limit shift - rotations - peer support - acknowledge limits - phone contact with family - attentive to stress - self-help
question
POST DEPLOYMENT
answer
- name and role? - what worked? - function as a team? - want to talk about? - affect of experience? - self care?
