This post was intended for next week, but due to the terrible disaster that yesterday devastated so many communities in Nepal and surrounding countries, I am posting it now.
Almost every day we hear about critical incidents caused by natural disasters and conflict all over the world. Meeting basic survival needs is of course the first priority in responding. Ensuring safety and providing water, food, healthcare, and a place to stay take precedence over everything else for some days. However, during this time, structures of psychological first aid ought to be put in place. Attention to several key concerns can make a huge difference in enhancing the resiliency of individuals and communities to cope with life in the new realities that follow trauma.
In my work with critical incident responses in numerous settings in Africa and Asia over the last several years I observe an almost universal pattern: little to no preparation of staff and teams for responding to natural disasters and conflicts, even in settings known for the prevalence of these. Given resource shortages, this is understandable, but it need not be the case. In areas where history and data show high odds of future incidents, it is a near-certainty that resources will be required again in the future, so a portion ought to be spent in advance, to prepare reponses of communities and aid responders.
Ideally this would be done methodically, everywhere, before calamity is at hand, especially in areas that are prone to disaster and conflict. But even if disaster has already struck, preparation and training of psychological first aid responders can and should take place immediately. Their support will be required for months, even years.
The days and weeks just after disaster, when survival needs take priority and possibilities for delivery of psychological support are limited, provide a critical window of opportunity for preparation of psychological first aid responders. Investment now in a modest program to orient and coordinate psychological first aid responses around a common framework will pay off, in spades, in maximizing the impact of efforts that will follow.
Psychological first aid can be conducted by anyone but requires training so responders do not cause more harm and are able to care for themselves while they are caring for others.
There are different approaches to psychosocial support and psychological first aid. Unfortunately most have not been empirically documented or evaluated. I’ve spent the last several years researching the few studies available and developing training modules to work with individuals and communities affected by trauma.
I observe widespread awareness in recent years regarding the need for psychosocial support, but a great deal of uncertainty and confusion among professionals regarding what it means, what activities are involved, how it relates to psychological first aid and where it differs, who is equipped to deal such interventions, etc.
In this link you can download a PDF with more information and guidelines about Expressive Psychosocial Support, Psychological First Aid (PFA), Do No Harm and more...