Individuals who experience traumatic events need help facing multiple issues. Some individuals may cope better than others, while others require emotional stabilization. The purpose of first responders and volunteers helping the scene though require abilities to meet the needs of individuals. Sometimes, individuals may need only mere direction or information or basic supplies, while other times, individuals may need crisis intervention care to help stabilize themselves emotionally.
In many past blogs, we have discussed the importance of Crisis Intervention in helping individuals during a traumatic event. Traumatic events such as natural disasters, terrorism, shootings, criminal assaults, suicide, or war zones all present deep rooted trauma to individuals who endure them. Some may be better able to cope but when traumatic events occur they still present an abnormal level of surprise, pain, and loss. Hence, someone on scene will have some type of need, whether physical, mental, emotional, social or all points. First responders, volunteers, chaplains and other healthcare professionals are able to help everyone in the moment of a traumatic event by meeting whichever needs are present according to the person through basic psychological first aid.
Psychological First Aid is not long term therapy or looks to resolve the devastation that may take months and years to fix, but it does look to stop the emotional bleeding on the spot and meet the basic physical human needs of anyone in crisis, grief, trauma or loss. Whether elderly, children, adults, or others of any cultural identity, bad things happen and when they do, people need trained professionals on site to help meet immediate needs.
PFA looks to ensure grant the person a feeling of safety in the chaos, help calm and stabilize those emotionally disturbed, find necessary persons of connection for the person, connect individuals with the necessary long term aid, and grant the person a sense of hope in the despair around them. Chaplains, first responders, disaster volunteers, healthcare professionals, as well as social workers and counselors on scene are all trained in basic PFA and some at higher levels due to their training and licensures to help individuals at the level of help they need. Whether it is simply offering water or giving shelter for a night, or helping someone find a loved one, or consoling a child, or directing a family to proper resources and federal assistance to rebuild a home, or referring something emotionally distraught to a mental health professional, or finally even helping ground a person in extreme disorientation and disequilibrium, the goals and duties of those in PFA are about helping the particular need in the moment.
Like any crisis or situation, those trained in PFA are expected to initiate contact with individuals on the scene. Some may appear fine, others may appear disorientated. Those in trained should focus on the most emotionally disturbed individuals that are displaying dis-equilibrium and immobility or those who seem out of place, especially elderly or children who are alone. Crisis professionals should introduce themselves by name and the agency they work with and ask the name of the person. Asking what them what the issue is or what is wrong is a good way to help. Forcing oneself on the person, or asking detailed accounts of the event are not the best way to introduce and form a bond. Introduction and making contact and forming a bond is a key in Crisis Intervention but also critical on scene when dealing with any victims or individuals faced with trauma.
Obviously helping the person feel secure is key. Some may already feel safe, but others may feel the threat of danger still overbearing upon them. PFA workers should help reassure a person that they are safe and address all fears without dismissing them. Instead, they should help the person feel a sense of security through their presence. Obviously someone who has been raped, assaulted, or a person who has just had their home flooded or destroyed by a tornado will require long term care, but the purpose of PFA is to help the person feel secure in the moment so that the individual can logically think without the presence of fear motivating them.
In certain cases, individuals suffering from trauma need help finding calmness. They need help becoming stabilized emotionally. They are unable to cope since their coping mechanisms have become overrun and their emotional equilibrium has become imbalanced. Hence logical choices are removed and instead a state of affective, cognitive and behavioral dysfunction manifests. The PFA worker depending on their level of training and experience can help these individuals find balance and coping. Some times helping ground the person through breathing and focus techniques can bring a person back to the current event, while other times, discussing the issue and alternatives to the narrow options one faces when in crisis. In many cases, individuals will suffer from mental issues such as disorientation, lack of concentration, memory loss, or poor cognitive reasoning, while in other cases, individuals may suffer affectively through various emotions. Some emotions may be displayed such as anger or intense grief, or even guilt or shame about the event, while others may retreat from contact and suffer from disassociation, or become stuck in their own thoughts and look to flee human contact. Others may display dangerous behavioral actions and will need controlled or helped to find calm to avoid danger to themselves, others and various workers at the scene.
After a person is calm, safe and stable, one can begin to access the person’s mental, physical and social needs. Sometimes, the needs are affective, or physical, or cognitive or social, but it depends on identifying the clues and also talking to the person. Some needs may be as simple as a blanket or a glass of water, while others may be concerns over a missing child or relative or friend. Some may have minor injuries or headaches that need addressed due to the situation. Others may have concerns where one will sleep for the night if a storm damaged the home. Others may even have concerns beyond the immediate which can be addressed such as an event a person may have had the following day that will now have to be canceled. In the mist of this, the PFA worker needs to offer assistance whether at the cognitive level or physical level. This assistance may be in the form of advice, meeting physical needs, or helping the person organize what needs organized. It can involve helping the person better understand the situation and supplying the person with the necessary information they need to deal with the issue at hand.
PFA workers can also help and offer assistance through connecting individuals to other people, friends and family. Sometimes helping a person contact his friend or family helps the person find a place to stay or provides transportation. Many individuals in crisis have support systems but they are unable at the moment to contact those persons and they need assistance in making those contacts. In addition to immediate connections, later, PFA workers can help individuals find longer term help through social services, federal assistance and on a more individual note, references for mental health or healthcare services. During this process, it is important for PFA workers to not promise things but to be as honest as possible about what can be done or not done. Lying or making false promises to help alleviate a person’s mental state will not help the situation.
Throughout the process, the PFA worker also needs to address proper coping in the moment versus maladaptive coping. Like a coach, a PFA worker can help the person face the immediate issue through productive coping strategies that involve reframing of the situation and putting energy into what can be done in a given moment. This involves a variety of stress management and anger management concepts and helps the person focus on what can be done instead of utilizing maladaptive strategies that avoid or ignore the situation. Obviously, longer term care reviews the necessity of healthy coping with any traumatic event. It is unlikely that those who face traumatic events will have the same life. Recovery from injuries or therapy still leaves scars and individuals need to have the tools to face those past traumas. In addition, repairs and construction and family functions may be altered. Things will change and the ability to be resilient and cope depends on multiple subjective and objective realities. A person’s support system is key and this is why referrals and connections are so key in finding the person the help they need to create hope. With hope a person can find resiliency and the ability to adapt and rebuild in the future with healthy coping strategies.
Conclusion
Psychological First Aid is a key component of crisis intervention and for those who work in it from a mental health, healthcare, law enforcement, first responder or chaplaincy component. Knowing how to help a person in the moment and stabilize them and help meet the person’s physical, affective, cognitive and social needs are important to the recovery and adjustment of the person to the traumatic event. These events can range from disasters to assault or war zones and suicide. In all cases, crisis intervention looks to help the person find equilibrium and mobility to handle the situation, PFA helps individuals with the core basics to help those with little needs to those with the greatest needs.
Please also review AIHCP’s Crisis Intervention Specialist Certification and see if it meets your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification in Crisis Intervention.
Additional Resources
“Psychological First Aid”. National Child Traumatic Stress Network. Access here
“Psychological First Aid (PFA).What is Psychological First Aid?”. Minnesota Department of Health. Access here
“What is psychological first aid?” (2024). Doctors Without Borders. Access here
Griffin, M. “Psychological First Aid: Addressing Mental: Health Distress During Disasters”(2022). SAMHSA. Access here