Summary

George S. Everly, Jr, PhD, ABPP

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Psychological First Aid

■  This program is intended to introduce participants to the fundamentals of “psychological

first aid”

■  Psychological first aid (PFA) may be defined as a compassionate and supportive

presence designed to mitigate acute distress and assess the need for continued mental
health care (Everly and Flynn, 2005)

■  This program is designed specifically for:

■  Public health personnel
■  Public health educators
■  Emergency responders
■  Disaster workers with little or no formal mental health training

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Rationale: Surge

■  It is estimated that there will be an increased demand for mental health services that
could range from 15–25% of the population directly affected

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Recent Evidence Suggests

1.  Psychological crisis intervention can increase the perceptions of personal resilience and
preparedness, as well as enhance community resilience
■  OL McCabe; N Semon; JM Lating; GS Everly, Jr; et al. (In press). Developing an
academic-government-faith partnership to build disaster mental health preparedness
and community resilience: program description and lessons learned. Public Health
Reports.
■  GS Everly, Jr; OL McCabe, N Semon, CB Thompson, J Links. (2014). The
development of a model of psychological first aid (PFA) for non-mental health trained
public health personnel: the Johns Hopkins RAPID-PFA. Journal of Public Health
Management and Practice (online).

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Recent Evidence Suggests

2.  Psychological crisis intervention is superior to multisession psychotherapy post disaster,

for reducing acute distress

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Thus, Crisis-Oriented Interventions such as PFA May Be Indicated in the
Wake of Disaster

■  Furthermore, building indigenous and regional surveillance as well as acute intervention

resources seems a useful alternative to the widespread importation of such services due
to the former’s response efficiency, sensitivity to local culture, and familiarity with local
roads, neighborhoods, and geography

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The Johns Hopkins RAPID PFA Model: Five Core Elements

1.  Rapport and reflective listening (RL)

2.  Assessment

3.  Prioritization

4.  Intervention

5.  Disposition and follow-up

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PFA

■  PFA begins with listening!

■  Listening is an active, not passive process

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Assessment: Categorizing Impact

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Prioritizing: Two Approaches to Triage

1.  Evidence-based

2.  Risk-based

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Triage

=
Recognizing and
prioritizing dysfunctional
inclinations/behaviors

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Two Types of Intervention

■  Everyone can benefit from information ■  Next: mitigate acute distress

■  Otherwise … ■  Educate: explanatory guidance
■  Normalize
■  First: attempt to stabilize acute arousal ■  Reassure: instill hope
■  Remove provocative cues ■  Educate: anticipatory guidance
■  Task focus ■  Delay impulsive actions
■  Catharsis ■  Stress-management techniques,
■  Delay impulsive actions problem solving, as indicated
■  Distraction ■  Correct misunderstandings or false
information
■  Reframe, if possible

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Disposition

■  After your intervention, if the person seems more capable of taking care of him- or herself
and/or capable of discharging his or her responsibilities, then your intervention has ended

■  It is then recommended that you follow up with the person at some point deemed most
appropriate

■  Sometimes a second follow up may be useful

■  However, if a third follow up seems indicated, it’s probably time to facilitate access to
another level of care

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Taking Care of Yourself: Remember!

■  Primary civilian victims experience adverse reactions to disaster, but …

■  First responders and others in the helping professions may also be vulnerable to similar
adverse reactions!

■  THAT MEANS YOU!

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Thank You

This slide is a video.

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Lecture Evaluation

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