Welcome Psychological First Aid: Helping Others and Yourself in Times of Stress November 2015
Instructor Introduction Doug Dicharry, MD Psychiatrist: Child & Adolescent Adult PHRC CERT Ham Radio Operator (K7CNS): WWMST 2
Essentials 3
Course Purpose … To enable you to provide basic care , comfort , and support to people who are experiencing disaster-related stress… 4
Course Objectives Recognize signs of stress in clients, co-workers, yourself. 5
Course Objectives Respond and provide support by implementing PFA principles. 6
Course Objectives Refer for additional mental health support for yourself, co-workers, and clients, when needed. 7
What is Psychological First Aid? The practice of recognizing and responding to people who need help because they are feeling stress , resulting from experiencing a disaster situation. 8
Hurricane Katrina 9
Superstorm Sandy 10
Sandy Hook 11
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Boston Marathon 13
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South Carolina 15
Umpqua 16
Why is PFA Important? PFA can help you to: Create a compassionate environment for disaster survivors and workers (including yourself) 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. 17
Good News 80% of disaster victims are resilient 18
Recognizing Disaster-related Stress 19
Purpose Focus: symptoms (and signs ) in the various categories that indicate disaster-related stress in adults and children: Feelings, emotional states Thinking, expression of thoughts Physical effects Behaviors Spiritual 20
Stress Reactions of Adults Stress reactions vary from person to person and: Can disappear . Remain the same . Get somewhat better . Grow considerably worse . The severity and duration of stress depends on how well people manage and cope with their situations. 21
Exercise 1 Stress Reactions of Adults From your own experiences with adults in disaster relief operations, describe how people react when they are in these stressful situations. Feelings Thoughts Physical Effects Behaviors Spiritual 22
Stress Reactions In Adults: Feelings Anxiety, fear 23
Stress Reactions In Adults: Feelings Resentment 24
Stress Reactions In Adults: Feelings Rage, anger, irritability 25
Stress Reactions In Adults: Feelings Terror 26
Stress Reactions In Adults: Feelings Despair, hopelessness 27
Stress Reactions In Adults: Feelings Emotional numbness 28
Stress Reactions In Adults: Feelings Guilt 29
Stress Reactions In Adults: Feelings Apathy 30
Stress Reactions In Adults: Feelings Feeling overwhelmed 31
Stress Reactions In Adults: Thoughts 32
Stress Reactions In Adults: Thoughts Difficulty concentrating, thinking, making decisions 33
Stress Reactions In Adults: Thoughts Forgetfulness, confusion 34
Stress Reactions In Adults: Thoughts Lowered self-esteem, self-blame 35
Stress Reactions In Adults: Thoughts Intrusive thoughts, memories, flashbacks; sense of unreality 36
Stress Reactions In Adults: Thoughts Thoughts of self-harm 37
Stress Reactions In Adults: Physical Effects 38
Stress Reactions In Adults: Physical Effects Fatigue, difficulty sleeping 39
Stress Reactions In Adults: Physical Effects Agitation 40
Stress Reactions In Adults: Physical Effects Physical complaints (headaches, stomach problems, etc.) 41
Stress Reactions In Adults: Physical Effects Decreased “appetites” Food Sex 42
Stress Reactions In Adults: Physical Effects Lightheadedness, weakness 43
Stress Reactions In Adults: Physical Effects Easily startled 44
Stress Reactions In Adults: Physical Effects Increased cravings caffeine nicotine sweets alcohol illicit substances 45
Stress Reactions In Adults: Behaviors 46
Stress Reactions In Adults: Behaviors Crying spells Angry outbursts Argumentativeness 47
Stress Reactions In Adults: Behaviors Avoiding people, places, and situations 48
Stress Reactions In Adults: Behaviors School and work problems Inattention to appearance, personal hygiene, self-care 49
Stress Reactions In Adults: Spiritual Change in relationship with or belief about God/Higher Power Abandonment of prayer, ritual, scripture, devotions, sacraments Questioning beliefs Loss of faith Rejection of spiritual care providers 50
Stress Reactions of Children Stress reactions in children can vary by child and age . Children are particularly sensitive to: Separation from familiar surroundings, people, and possessions Disruption of routines 51
The best way to help children… …is to help their caregivers 52
Exercise 2 Stress Reactions of Children From your own experiences with children in disaster relief operations, describe how children react when they are in these stressful situations. Feelings Thinking Physical Effects Behaviors 53
Stress Reactions In Children: Feelings Fearful Rage, anger, irritability helpless Anxious Loss of interest Sad Changing mood Guilty 54
Stress Reactions In Children: Thinking Difficulty concentrating Self-blame and thinking Intrusive thoughts, Difficulty making memories, flashbacks decisions Worry Forgetful A sense of being cut off Confused from reality Distortion of sense of Self-harm time Lowered self-esteem 55
Stress Reactions In Children: Physical Fatigue, difficulty Decreased or increased sleeping appetite Agitation Easily startled Increased activity Bed wetting level/hyperactive Physical complaints (e.g., headaches, stomach aches) 56
Stress Reactions In Children: Behaviors Crying, whining, screaming Refusal to attend school or day care Trembling Difficulty getting along with Clinging to parents and siblings and parents caregivers Using drugs and alcohol Aggressive or disruptive behavior, temper tantrums Re-living events through play (young children) Withdrawal Asking a lot of questions or Avoiding people, places, telling stories related to event situations Argumentative, defiant Regressive behaviors (thumb sucking, bedwetting, not wanting to sleep alone) 57
Contributing Factors to the Stress Response Disaster characteristics Disaster response characteristics Individual characteristics Factors that affect you as a disaster responder 58
Disaster Characteristics Type of disaster (Need vs. resources) When it occurs Who is affected What is affected Where it happens 59
Disaster Response Characteristics Level of preparedness Post-disaster living situation (e.g., Individuals may need to evacuate their homes and stay in shelters, with friends or family, or in a hotel.) Limited availability of food and water Delays in receiving relief services or medical care 60
Individual Characteristics Age Gender Family composition Cultural, ethnic, racial background Level of exposure to the disaster Loss of or injury to family, loved ones, pets Loss of possessions Pre-disaster stress (Tip: Describe the person and Connectedness with others their situation) 61
Factors that Affect You You as a Disaster Responder Leaving family members and loved ones Working in unfamiliar and challenging settings Staying in a staff shelter with little privacy Unfamiliar cultural or ethnic populations Hearing survivors’ stories Seeing disturbing sights Working with difficult supervisors and co-workers Returning home 62
Principles of PFA Understand the implications and scope of each categorical principle, including the: Awareness you can develop. (Recognize) Attitudes you can adopt. (Respond) Actions you can take. (Respond / Refer) 63
Psychological First Aid Psychological Firs t Aid Actions Actions Making a connection Encouraging good coping Helping people be safe Helping people connect Being kind, calm, and Giving accurate and compassionate timely information Meeting people’s basic Making a referral to a needs Disaster Mental Health worker Listening Ending the conversation Giving realistic assurance Taking care of yourself 64
Make a Connection Introduce yourself. Be fully present . 65
Help People Be Safe Be aware of your surroundings. Enter a scene only when you are sure it is safe. Help people to reach a safe place. Call for medical assistance, if needed (Call 9-1-1). Help people to follow emergency instructions. 66
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