2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
Anything can happen to each of us. At any time, we can meet people who have suffered from natural disasters and accidents, who have lost their loved ones or their home, who are forced to watch how their whole usual life is crumbling before our eyes. How to help? Not to cure, not to diagnose, but to provide emergency psychological assistance? It turns out that this can and should be learned.
Immediately we will emphasize that this is not psychotherapy or psychodiagnostics, but a guide to action for everyone who sees a person on the verge of despair after a tragedy. Psychological first aid is reduced to a supportive presence, which helps to reduce the severity of the experience.
Specialists from the Institute of Public Health and Health at Johns Hopkins University in the United States have developed a model of psychological first aid that can be used by anyone, even without training in psychology and medicine.
FIVE QUICK STEPS
The model of work includes five consecutive points, the names of which in English form an abbreviation RAPID ("quick"):
- rapport - trusted contact,
- assessment - assessment of the state,
- prioritization - priority of those in need of emergency assistance,
- intervention - direct assistance,
- disposition - further action plan.
STEP 1: CONFIDENTIAL CONTACT AND WILLING TO LISTEN
The first and most important stage of psychological first aid is to establish trusting contact, even if the victim is unfamiliar to you. From the very first words, it is important to show the person that you are ready to listen and you are there. This can be achieved with reflective listening techniques.
It is necessary to establish contact as soon as possible, because an acute mental state can lead to inappropriate decisions. When starting a conversation with a victim, start with yourself: introduce yourself, explain why you are here and why you are talking to him. Then ask the first question. Asking the right questions is the key to a trusting relationship. With their help, you communicate: “You are important to me, I am here to help, but I need your participation in order to help more effectively. So I need to know a little more about you and what happened to you."
All questions can be divided into three categories:
- Closed (yes / no) - help you quickly get factual information;
- Open (what, why, how) - provide more details and suggest what kind of help you may need;
- Reflexive, paraphrasing ("Do I understand correctly that …", "That is, in other words …", "I hear that you now …") are not always questions in the literal sense, but they are necessary in order to show person that you listen to him carefully and try to understand.
Your task is to become a person-mirror: to read the state of the victim by his phrases, gestures, facial expressions and respond. In order for the person to trust you, it is important to give them the opportunity to express their grief, rage, or despair. It is necessary for catharsis to occur and the accumulated emotional stress to subside.
Do not rush to solve all his problems at once, do not simplify the situation with phrases like "Everything is not so scary" or "This is sheer trifles, the main thing is that you are alive." Thus, you only devalue what is happening and show your lack of understanding of how bad the person is. And most importantly, don't argue.
STEP 2: ASSESSMENT OF THE CONDITION AND NECESSARY ASSISTANCE
The second stage is getting information. The story that the victim tells you will include context (what exactly happened) and his reaction to what happened. By listening, you have to separate the normal responses from the extreme ones. This is not about clinical assessment and diagnosis, only common sense works. And remember: no matter what you see and no matter what you are told, do not judge the victim and do not give judgments.
At this stage, a clear sequence of actions is important:
1. Assess the physical and mental state of the person. Remember, first of all, you need to understand its medical status and, if necessary, take it to a doctor. All the rest - later.
2. Find out the details of what happened to understand the scale of the disaster.
3. Ask clarifying questions if some aspects of a person's condition and his story about events seem contradictory to you.
After such inquiries, it will become clear to you who you are dealing with and how urgently you need help. There will always be people who can cope with the difficulties themselves. They are able to maintain an optimistic attitude and are ready to move on. With such people, everything is simple: be there in case you can be of any help at least in some way.
The most difficult thing is to understand which of the victims is sane, although they are acutely worried, and who is at risk of not coping with the shock on their own. Let the "red light" light up in your mind if you see: confused thinking, suicidal intentions, aggressive behavior, hallucinations, panic attacks, impulsive and risky actions, alcohol and drug abuse. On the contrary, an alarming signal can be the lack of expression of feelings, complete inaction, avoidance of contact with anyone.
Critical indicators are changes in the functioning of the heart and digestion, traces of internal bleeding, fainting, chest pain, dizziness, numbness or paralysis (especially of the limbs or face), inability to speak or recognize speech. In this case, the help of a doctor is needed as early as possible.
STEP 3: GETTING PRIORITIES: WHO NEEDS THE MOST HELP
If you imagine a situation in which there are several victims, it is important to understand which of them needs support in the first place. Based on the information obtained at the assessment stage, you can identify people in the most serious condition: those who are unable to reason logically and serve themselves, who are going to harm themselves or others, who are not ready to solve organizational issues to overcome the crisis.
In addition, you can evaluate factors that increase the chances that a person will become worse after some time: death (whether he saw dead people and how close he was to death), loss (whether he is separated from his family and friends, is there where to stay), damage (personal injury and traumatic psychological experience). In all these cases, it is important to provide timely support.
STEP 4: ACTION CALLED TO HELP
Let's remind: the first psychological aid is not psychotherapy and not a surgical operation. Do not seek to solve the victim's problems if it is not within your purview. Sometimes it's much more important to just be there and listen without judging. Research confirms that communication and social support is the most important factor in recovering from an accident.
But what is the help itself? First, you need to understand if your interlocutor has food, clothes, documents, acquaintances who can shelter. Secondly, it is important to reduce psychological stress.
If a person seems to you mentally unstable, you need to balance his condition: give him a simple technical assignment, distract him from the painful sight, let him let off steam and speak out, make him postpone the adoption of hasty decisions.
If the victim is more or less stable, help is to support his viability. Provide him with information on how to behave and what may happen to him next, explain that the feelings that he experiences are normal in such a situation. Try to give him hope that he can handle it. If you know any stress management techniques, please share your skills. And if it seems appropriate, look with him for some other way of looking at what happened.
STEP 5: FURTHER ACTION PLAN
Even if the victim's mood has improved and you are convinced that the crisis has been overcome, do not leave him to the mercy of fate. What will happen to him after all this? Is a person able to rebuild his life piece by piece? Is there anything else you can do to help him?
If you take the liberty of helping a person who has gone through a serious life shock, you need to visit him at least once after some time. Leave him your contacts so that he feels your support - so he will know that he is not alone. Ask him if he would mind if you see him again in a week or a month.
The main thing to figure out is whether it is necessary to send the victim to someone for help. This can be a doctor, psychologist, psychiatrist, social worker, family or friends, employees of job centers and financial institutions. It is important not only to give the victim the desired phone number, but also to explain to him the significance of this step, to contact the specialists and the authorities with him, and, most importantly, to continue to support him. Gradually, thanks to you, a person will believe that all is not lost and will be reborn to life.
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Emergency Psychological Assistance
Abstracts from the synopsis. Emergency psychological assistance (hereinafter EPP) is provided to people who are experiencing an acute stressful condition. This condition is accompanied by emotional and verbal disorganization. The main principles of EPC for people who have suffered psychological trauma:
