Community-Based Psychological First Aid

A Practical Guide to Helping Individuals and Communities during Difficult Times

Gerard A Jacobs

• Publisher: Butterworth-Heinemann
• Year: 2016
• ISBN:
  9780128043585
• Topic: Social Sciences
• Subtopic: Global Development Studies
• Index: Social Sciences

Community-Based Psychological First Aid: A Practical Guide to Helping Individuals and Communities during Difficult Times presents a practical method for helping those in need in difficult times. No advanced training in psychology is needed to use it.

Injuries from disasters, terrorist events, and civil unrest are not just physical. These events also cause psychological trauma that can do lasting damage. Psychological First Aid (PFA) draws on human resilience and aims to reduce stress systems and help those affected recover. It is not professional psychotherapy, and those providing this kind of aid do not need a degree to help. Gerard Jacobs has developed this community-based method of delivering PFA over 20 years and has taught it in over 30 countries.

Along with the easy-to-follow method, Jacobs includes examples of how this works in action in different situations, and presents scenarios to practice. Unique in its approach of community engagement to train community members to help each other, this guide is an excellent resource for local emergency managers to engage in whole community emergency management.

• Presents a proven method for helping to alleviate the mental health effects of disasters, terrorist attacks, civil unrest, and other community stressors
• Offers a community-based model developed and taught by an international expert for over 20 years, requiring no advanced training or education in psychology to use
• Provides techniques that are adaptable to individual communities or cultures
• Outlines practices for self-care while helping others to prevent burnout
• Includes case studies, scenarios, and key terms to help facilitate community training

1

What is community-based psychological first aid?

Abstract

The experience of stress is an inescapable part of the human condition. Daily life is filled with decisions, choices, problems, and a variety of other challenges with varying degrees of difficulty. Generally, we deal with these challenges without even considering the stress involved. We do what we need to do to make it through the day. The great majority of these events probably do not even register in our awareness as stressful. We either fit these events into our personal view of the world (assimilation) or alter our view of the world to fit the events (accommodation). From time to time, however, everyone experiences events that require more than the average psychological energy. This book will provide simple but effective ways to help friends, family, and neighbors cope with those events, and help you to cope with them as well.

Keywords

community-based psychological first aid

CBPFA

psychological first aid

PFA

Chapter Outline

Introduction 

It Is Not Always Obvious 

Some Cautionary Notes 

PFA in a Community Context 

Introduction

The experience of stress is an inescapable part of the human condition. Daily life is filled with decisions, choices, problems, and a variety of other challenges with varying degrees of difficulty. Generally, we deal with these challenges without even considering the stress involved. We do what we need to do to make it through the day. The great majority of these events probably do not even register in our awareness as stressful. We either fit these events into our personal view of the world (assimilation) or alter our view of the world to fit the events (accommodation).

From time to time, however, everyone experiences events that require more than the average psychological energy. For example, if you are a parent, perhaps your child will misbehave or act out from time-to-time more than usual. In those moments, you need to refocus your energy, helping the child to both stop the inappropriate behavior and learn more appropriate ways to get what he or she wants. People occasionally are involved in an automobile accident. Even if no one is hurt in the accident, there will be a certain amount of extra psychological energy needed to deal with the hassles of paperwork, having the damage to the car repaired, dealing with an insurance claim, or perhaps finding alternate transportation for a while. If someone is hurt in the accident, the event requires even more mental energy. The energy required to cope with the event escalates further if someone files a lawsuit (that is true even for the person filing the lawsuit).

Sometimes the world has unpleasant surprises in the form of disasters, whether natural (eg, floods, storms, earthquakes), technological (eg, hazardous materials spills, aviation disasters), or intentional (eg, terrorist attacks or criminal acts such as assault or robbery). How many of us who are old enough remember where we were when we learned of the attacks of September 11, 2001? Do you remember the images, the emotions, the confusion? Unless you are too young, you probably remember the impact that those attacks had on many Americans. In addition, however, in the months that followed, wherever I traveled in Europe and Asia, citizens of many nations wanted to express to me their sorrow about the attacks, and spoke of the tremendous emotional and psychological impact the attacks had on them, even though they were not Americans. The world expended a great amount of psychological energy that day and in the days that followed.

Think about how you, as an individual, respond to any of these more stressful events. As events increase in stress, most people are likely to turn to family members and friends to talk about the experiences, may be even discuss ways to cope with the events. Some events may be sufficiently stressful that the usual support of family and friends proves to be insufficient, and individuals may turn to physicians or spiritual leaders for additional guidance and/or support. Usually, only when the events are particularly stressful do people turn to mental health professionals to get some professional support in working through more difficult life events and decisions. (Do note, however, that mental health professionals can also be useful in less stressful moments in life.)

Throughout much of the world, when people experience physical injuries they typically try first to manage the injury themselves. They may use techniques learned through traditions in their cultures, or those that were taught to them by their parents, or those that they learned in school. If the injury is bad enough, they may seek help from others. These others may include individuals with some formal training in first aid, or, in more serious events and in countries where such expertise is available, emergency medical technicians, paramedics, or medical professionals at a clinic or hospital. In some countries, getting and staying trained in first aid is considered a civic obligation. Some countries even require adults to have a first aid certificate in order to get or renew a driver’s license.

Every culture and community also has its own ways of coping with stressful events and managing psychological reactions to difficult moments in life. In the past decade, there has been a growing movement in the world to develop a set of skills for coping with stressful events that would work similarly to the way that first aid is used to cope with physical injury. This strategy has been known by a number of names, but is most commonly referred to as psychological first aid (PFA). Community-based PFA (CBPFA), the specific model of PFA that I will describe in this book, began with programs in Scandinavia, particularly in Denmark, and has been significantly adapted based on my more than 30 years as a clinical/community/disaster psychologist working in more than 30 countries around the world.

Essentially, CBPFA provides individuals with skills they can use in coping with the stress in their own lives, as well as stress in the lives of their family, friends, neighbors, classmates, or coworkers. At the core, these skills include a knowledge of stress and extreme or overwhelming (traumatic) stress, effective “active listening” skills, and knowledge about how to help someone get other forms of psychological support if CBPFA proves inadequate. The CBPFA model of PFA builds on the strengths of the community in which the individual lives and provides a more systematic understanding of how to cope with difficult moments and periods in life.

Providing CBPFA begins with caring about the welfare of the person experiencing stress. Knowledge of stress and traumatic stress helps you to know whether the person is experiencing an ordinary reaction to an extraordinary event in life, or if the person may be experiencing a more severe (pathological) reaction (this is fairly rare). If the person is having an ordinary stress reaction, PFA will help you know how to provide effective psychological support through truly effective listening, and possibly through the provision of practical assistance such as problem-solving or helping the person to meet practical needs such as food or shelter (sometimes referred to as “instrumental assistance”). If the person is having a response that is beyond the scope of PFA, this book will also help you understand how to help the individual get the psychological support that he/she needs to return the psychologically healthiest life possible.

Try this

To begin, it may be useful to think about the past year. What difficult times occurred in your own life, in the lives of your family, friends, colleagues? Can you identify times when you wish you could have done more to support those you care about? This book will provide you with the tools to provide the best support you can in the future.

It Is Not Always Obvious

While I was writing this book, a friend approached me and asked me to specifically mention in this book that it is not always obvious when someone is experiencing a nearly overwhelming stress. They had recently received word of a cancer diagnosis, a significant stressor that many of us will need to cope with at some point in life. Trying to go about their normal activities in their job, they talked about a sense of disconnect, with people talking about issues in the workplace that suddenly seemed unimportant to the newly diagnosed person. While others talked about this report or that event, my friend said, they were thinking about how to ensure that their children would be cared for, the financial implications, and the imminent possibility of death. This lead them to think about how many people must be struggling with personal crises that no one around them knows about. How nice it would be, they said, if we all knew that there were people around us who were ready to reach out and listen and support us through such difficult times.

Some Cautionary Notes

CBPFA does not involve psychotherapy. Learning CBPFA does not mean that you are becoming a mental health professional. That would require an undergraduate university degree, followed by years of graduate study in one of the mental health fields. Rather, CBPFA will improve your skills in taking care of yourself and in providing basic psychological support for family, friends, neighbors, and colleagues, especially at difficult moments in life.

It is important to understand the limitations of CBPFA. It can be a very useful technique for people working through and recovering from difficult episodes in their lives or simply dealing with the daily hassles of life. But it is not intended to cure psychological disorders. Please be sure to read each of these chapters so that you will be clear on what CBPFA can and cannot do, and how to help those who need something more than CBPFA.

It is also important to recognize that a book such as this can only provide enough information to get you started. As you develop your skills, it may be useful for you to seek out additional training or educational materials to enhance your knowledge and skills.

PFA in a Community Context

This book describes a model of PFA that may be useful as a starting point. It certainly will not teach you everything you could learn about this topic. But it is intended to cover the basic information needed to begin providing CBPFA.

Within the United States there are many thousands of different communities, with different religious, ethnic, socioeconomic, and cultural differences that make each one of them unique. Many of these communities also have unique ways of coping with stress. This book’s PFA model, CBPFA will be most effective if you adapt it to your own life and the life of your community. But just as there are some universal procedures in physical first aid, there are also some clear facts about how people respond to stress, and what techniques are likely to be useful in responding to those events.

Again, I encourage you to read this entire book before beginning to provide CBPFA. A number of these chapters present information that may affect the way you provide CBPFA. Among other topics, these chapters include some critical issues such as the limitations of CBPFA, how to avoid harming those whom you want to help, when to refer someone to a mental health professional, and guidelines to follow in order to be an ethical helper. Considerations in providing CBPFA to older adults, to those with disabilities, to those living in marginalized cultures, and to those in rural communities will also be discussed.

2

On being a helper and providing CBPFA

Abstract

In many cultures around the world, members of communities presume that if something difficult happens to them or to their families, their neighbors and other members of their community will come to their assistance. In the United States, this is seen in events such as barn-raisings within Amish and Mennonite communities, fund-raisers to help cover medical expenses of seriously ill or injured children and adults, church groups preparing meals for families who have experienced a death, farmers coming together to help an ailing neighbor harvest crops, or hundreds and even thousands of volunteers from outside the area helping build sandbag dikes to prevent flooding due to rising rivers. This chapter provides suggestions for how to be one of those helpers.

Keywords

effective helpers

rudeness

rejection

intrusion

skills

Chapter Outline

The Art of Helping

Characteristics of Effective Helpers

Accepting Yourself in the Role of a Helper

Rudeness and Rejection

Concern That Your Own Skills as a Helper May Not Be Adequate

Fear of Being Intrusive

Fear of Learning Embarrassing Details

Fear of Personal Danger

How to Begin

Reference

In many cultures around the world, members of communities presume that if something difficult hap...