Psychological First Aid

Psychological first aid is a treatment aimed at reducing the mental and emotional suffering of people who have experienced trauma. Based on treatment methods used on combat veterans, psychological first aid developed in the second half of the twentieth century. In modern times, psychological first aid helps victims of natural disasters, wars, accidents, violence, and other traumatic events. Many large aid organizations endorse this form of treatment, which is intentionally simple enough to be used by people with little training. It is notable for its ease of customization to suit different people and situations. The goals of psychological first aid are to promote feelings of calmness and security in trauma victims and ensure they know that help and support are available.

Brief History

Prior to the twentieth century, scientists and medical experts had little understanding of the effects of stress and crisis on human psychology. People who experienced trauma generally received little or no psychological help. Most available methods of help were generally ineffective or even detrimental to mental and emotional well-being.

Advances in medicine and science in the twentieth century led to a greater emphasis on psychological help. During World War I (1914–1918), millions of soldiers experienced the horrors of modern mechanized warfare, and many thousands showed signs of significant psychological trauma as a result of war. Military researchers began searching for ways to keep combat veterans mentally healthy, primarily so they could continue to serve in combat.

In 1922, the US Department of War, also called the US War Office, developed a program called BICEPS to promote mental health in combat veterans. BICEPS was an acronym for brevity, immediacy, centrality, expectancy, proximity, and simplicity. This program contained some of the main points of modern psychological first aid and provided a blueprint for the development of later therapeutic systems. However, BICEPS generally was not effective in providing lasting relief to trauma victims.

Military psychologists helped to develop another technique for mental health intervention known as debriefing. The earliest forms of debriefing involved single sessions in which soldiers leaving combat talked about their experiences. The open discussion of traumatic events, which included the veterans' emotional reactions and plans for coping and moving on, often did not have the intended effect of boosting morale. This debriefing assumed all people dealt with trauma in the same ways and benefitted from a single standardized "one-off" therapy session.

Worse, the recollection of the fresh trauma central to debriefings often caused additional suffering. People who participated in debriefings but continued to suffer the psychological effects of the trauma often feared that they were mentally ill. In reality, their unusual reactions were natural, as all people react differently to stress. Regardless of the shortcomings of debriefings, they became a standard practice for the military and many humanitarian groups helping victims of other forms of trauma.

Overview

In the latter half of the twentieth century, experts gained more insight into the effects of trauma on psychology. Increasingly, these experts suggested that debriefings and other forms of intervention were not helpful and a new technique was needed. In 1954, experts representing the American Psychiatric Association and the US Federal Civil Defense Administration devised a new form of intervention called psychological first aid.

Psychological first aid originated in the civilian sphere, where it was applied to victims of disasters and other noncombat emergencies. Its precepts began catching on slowly and replacing debriefings. In the following decades, mental health workers employed psychological first aid to adult and child victims of disasters. Military personnel adopted psychological first aid practices in aiding combat veterans.

The practice of psychological first aid increased in popularity and spread to other countries. Many experts believed that it was effective in reducing the arrival and severity of the trauma-based psychological affliction post-traumatic stress disorder (PTSD). Many major organizations dealing with crisis aid and psychological trauma, including the Red Cross, World Health Organization, and Department of Veterans Affairs, endorsed the practice.

Psychological first aid differs from prior intervention techniques. It is less structured and easily customizable. This provides greater sensitivity to individual, cultural, and situational variations and acknowledgement that all people cope differently. The flexibility of the system allows it to be applied to almost anyone affected by natural disasters, wars, accidents, violence, or other types of trauma.

This form of treatment is not mandatory, although it is highly encouraged. It may be approached from different angles depending on the seriousness of the situation and other factors. For example, in psychological first aid, the person being treated does not have to recall and discuss the trauma. Rather, they are given the option of talking about the ordeal. People only choose to discuss the trauma if it is a natural step in their unique coping mechanisms.

Although psychological first aid is a comprehensive system, it was designed with simplicity in mind. First responders and members of aid organizations most often employ it. However, regular people with minimal training may easily use basic forms of the technique. The simple nature of psychological first aid allows people to apply methods effectively in the immediate aftermath of a traumatic event.

The general facets of psychological first aid include protecting trauma victims, listening to and comforting them, and helping them find additional assistance as needed. Rather than pressuring people to perform specific tasks or provide accurate recollections of events, psychological first aid focuses on making support and service available to those in need and helping people begin the healing process in the way that best suits the individual.

Bibliography

Everly, George S. Jr, and Jeffrey M. Lating. The Johns Hopkins Guide to Psychological First Aid. Johns Hopkins University Press, 2017.

Jacobs, Gerard A. Community-Based Psychological First Aid: A Practical Guide to Helping Individuals and Communities during Difficult Times. Elsevier, 2016.

"Psychological First Aid." National Child Traumatic Stress Network, www.nctsn.org/content/psychological-first-aid. Accessed 8 May 2017.

"Psychological First Aid: Field Operations Guide." U.S. Department of Veterans Affairs National Center for PTSD, www.ptsd.va.gov/professional/manuals/psych-first-aid.asp. Accessed 8 May 2017.

"Psychological First Aid Tutorial." University of Minnesota, www.sph.umn.edu/pfatutorial. Accessed 8 May 2017.

"12 Steps for Psychological First Aid." American Red Cross, www.redcross.org/m/saf/12-steps-for-psychological-first-aid#arcmobile. Accessed 8 May 2017.

"What is Psychological First Aid?" Australian Institute of Professional Counsellors, 13 Sept. 2013, www.aipc.net.au/articles/what-is-psychological-first-aid. Accessed 8 May 2017.

World Health Organization, et al. Psychological First Aid: Guide for Field Workers. World Health Organization, 2011.