Introducing Psychological First Aid Techniques to First Responders
Introducing Psychological First Aid Techniques to First Responders
One of my favorite assignments in this class has been the film review project. For this assignment we were tasked with picking a documentary to watch and analyzing the goal of the documentary. I chose to watch and review the documentary Counselors Responding to Mass Violence Following a University Shooting: A Live Demonstration of Crisis Counseling was created by the American Counseling Association and published by Alexander Street. In this film we saw a presentation about a fictional school shooting at a college and techniques mental health professionals use in the immediate aftermath and a follow up session a month later with one of the survivors. The techniques demonstrated were Psychological First Aid (PFA) and Cognitive Behavioral Therapy (CBT). Psychological First Aid is the technique used in the immediate aftermath of the incident and stood out to me as a powerful tool. While there were a lot of documentaries to choose from, I hope at some point everyone in the class can dedicate some time to watching this.
In this fictional scenario, the presentation shows the use of Psychological First Aid with two different survivors of a mass shooting on a college campus. One of the survivors is a bit more visibly shaken, as she heard the gunshots and saw bodies on the ground. The presenters of this scenario then begin to use Psychological First Aid techniques with the survivor. They first begin with helping the survivor return their breathing to normal by introducing the box breathing exercise to them. This breathing method works by having the person breath in through their nose for four seconds, holding that air in their lungs for four seconds and then releasing that air for four seconds. Repeating this method multiple times helps activate the bodies parasympathetic nervous system after a stressful situation.
The next method of Psychological First Aid the presenters use is asking the survivor to describe five non-distressing objects in the room they are in. In doing this, the survivor became more grounded back to reality and into the present situation she was in. To continue grounding the person back to reality, the presenters then had her describe the things she can feel. The survivor went on to express that she could feel the chair she was sitting in, her jeans on her legs and her feet tapping the ground. One last technique they used was having the survivor describe all the feelings she was currently experiencing.
In both scenarios with survivors, the mental health specialists never directly asked the person to describe what they just witnessed and experienced. Doing so could have a negative impact on the long-term effects of surviving this. They let the survivor decide what and how much information they wanted to discuss. All these methods used in Psychological First Aid are extremely useful and easy to implement while working with a survivor or witness to such a traumatic event.
While in this fictitious scenario the mental health professionals were on scene not too long after the event occurred, I wonder how realistic that is in everyday situations. The fictitious scenario of a mass shooting on a college campus is certainly something we can expect a massive response from all sorts of agencies- including mental health professionals. I sadly doubt that there are similar resources readily presented to those who witness something equally traumatic like a stabbing, fatal car accident or fatal fire. I am aware that in the city of Boston the Boston Police have a partnership with the Boston Medical Center’s Boston Emergency Services Team (BEST). These co-response clinicians ride along with officers and respond to calls that deal more with individuals who are in some sort of mental health crisis in hope to avoid the need to arrest the person. There are also currently only 12 of these co-response clinicians on staff, meaning that there may not always be access to someone with this specialty.
As mentioned, the techniques and methods of Psychological First Aid are easy to implement in real-life situations in the moments after the incident occurs. More likely than not, first responders to scenes will be without a mental health professional. Having all first responders familiar with Psychological First Aid methods would be extremely beneficial. Especially giving them an understanding that sometimes-asking direct questions about what someone just survived or witnessed right in the first moments after it happened may have a long-term negative impact on the trauma they endure from the incident.
Counselors Responding to Mass Violence Following a University Shooting: A Live Demonstration of Crisis Counseling. . (2014).[Video/DVD] American Counseling Association. Retrieved from https://video.alexanderstreet.com/watch/counselors-responding-to-mass-violence-following-a-university-shooting-a-live-demonstration-of-crisis-counseling