The approach to first aid in the health field has a long history and has evolved in recent times. Not so with psychological first aid, a more recent term that is being used more and more as the importance that a situation with a certain emotional impact can have for the person is recognised.
Anyone can be affected (as a victim or witness) by a natural disaster, accident or terrorist act of some magnitude. That is why it is essential to have at least some minimum guidelines for action, ideally including these contents in the educational context or, failing that, to carry out specific training in order to have effective tools for intervention.
Phases of a traumatic event
There are several phases of a traumatic crisis: impact, reaction and post event . However, we will focus on the first phase in this article, perhaps the most relevant within psychological first aid as it is the first phase. It has the following characteristics:
- This is the phase that occurs immediately after the traumatic experience and can last several minutes, hours or even a few days.
- The person is often emotionally disturbed, with a limitation in thinking or acting . There is also a loss of sense of time and reality (feeling that it is not happening) and reactions ranging from hyperactivity (walking in a certain direction without stopping) to immobility or paralysis.
Intervention with the affected person
- First of all, the person acting as an intervenor must identify himself , ask the victim for his name and let him know that he is there to help.
- It is of crucial importance to remove the victim from danger if that is the case.
- The participant must remain calm and also transmit this, as it will serve as a model in front of the victim (or victims). In addition, he will try to rationalize the action and in the case that the situation surpasses him, ask for the relief if it is feasible.
- As for verbal communication, it is advisable to speak in a calm tone, giving clear and concise information, avoiding comments inappropriate for the situation and with an attitude of active listening.
- On the non-verbal side, you have to keep in touch and adopt a comfortable but attentive posture.
- Equally important is providing basic needs: water, food, blankets, etc. Also allow the victim’s emotion to flow by combining this action with others such as distraction to avoid continued attention to what has happened.
- A separate issue, and in many cases equally important, is to avoid the curious. Sometimes it is useful to give tasks to these people to help in the process and facilitate greater intimacy for the victims.
Communicating bad news
This is an important task within psychological first aid and although the information will harm the person receiving it, the good or bad performance of the participant in this communication may minimize or maximize the psychological impact of the person receiving it.
It is important to know that there are factors that will determine the degree of impact of the bad news, such as the personality of the recipient, the existence of previous losses, the relationship with the victim or the predictability or unpredictability of the bad news.
On the other hand, it is relevant to distinguish in the action protocol three phases within this communication:
1. Before starting the conversation
- If possible, it should be established which person is most qualified to deliver the bad news.
- The issuer or intervenor must have all the necessary information about what has happened, at what time and place, person or persons affected, etc.
- It is vitally important to have the identity of the victim or deceased confirmed.
- Adequate physical spaces must be provided with the necessary instruments and elements (water, handkerchiefs, etc.).
2. During information
- Whenever possible, the information should be given only once to the family, to avoid giving it several times, which increases the impact.
- The intervening person introduces himself or herself and asks the family member if he or she knows the reason for the call.
- The message should be short, avoiding excessive length, understandable and gentle, explaining what has happened, the people affected and their condition. False hopes or incorrect information should always be avoided.
- From this moment on, different reactions will appear: crying, disbelief, silences, shouting…) which must be allowed.
- If no information is requested and there is more than one family member, the person giving the news withdraws and allows the family expression, remaining in the background but attentive.
3. After communicating the bad news
- Family members should not be left alone, if they withdraw.
- Showing empathy for reactions and meeting basic needs.
- Offer other sources of support.
- Finally, analyse how the situation has affected the intervening person.
As we can see, it is fundamental to have protocols for acting in the face of normally unforeseen events that, due to their consequences , lead to emotional pain in victims and families.
As we mentioned at the beginning of the article, given the importance of both professionals and people not linked to the health field (any of us can attend an event of this type) having tools for action in this area, training in this area is necessary.
If you wish to go deeper, do not hesitate to consult the distance learning course on psychological first aid that Formación Psicológica organizes from its website.