As humans we have developed various technologies to be able to predict events happening on our earth. However, we are still unable to predict natural disasters, or create effective pre-warning systems that provide adequate time for people to successfully evacuate, resulting in many natural disasters having catastrophic effects. When these extraordinary events happen people from all over the world flock to the affected area, in the hope that they can help make the situation marginally better.
Since 9/11 the concept of Psychological First Aid (Psychological First Aid Field Operations Guide) has become widely accepted as an adjunct to the usual aid and rescue efforts. Its purpose is to assist individuals and communities cope with the massive psychological trauma that is usually associated with large scale disasters.
Psychological First Aid is firstly a response to the immediate needs of the survivors of a disaster before any counselling or mental help is given. These initial needs are usually for safety and protection and for reconnecting with family, before seeking professional help. The main purpose of Psychological First Aid is to set up a social support and resource system in the wake of a natural disaster, instead of merely providing one on one counselling. The need for counselling is usually not a priority shortly after the initial impact, and becomes relevant only later on when the more primary needs have been met, and it becomes evident that mental health issues are at stake.
Prior to the development of Psychological First Aid, various techniques had been used as part of this immediate psychological response, the most popular being Critical Incident Stress Debriefing (CISD) which falls under the umbrella term of Critical Incident Stress Management (CISM). Although their efficacy is widely questioned, these techniques are still in common use today, when natural disasters strike, mainly because it is an easy recipe to follow in response to trauma. It has been particularly popular with volunteer counsellors.
CISD is a seven step debriefing method, where the facilitator goes through each phase sequentially with the client, which can also be conducted in a group setting (http://www.info-trauma.org/flash/media-e/mitchellCriticalIncidentStressDebriefing.pdf ). The phases of CISD are as follows; the facilitator begins with an assessment of the survivor’s situation, then any immediate safety concerns are removed, the facilitator then gathers the facts from the client, and then explores the feelings and symptoms that the client is experiencing, after which the facilitator begins to teach healthy coping strategies and then re-enters the client back into their environment. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VH7-3XG84F4-&_user=10&_coverDate=01%2F02%2F2000&_rdoc=1&_fmt=high&_orig=browse&_origin=browse&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=76e308ea061eab5502ff10e5a60e0f78
This technique (CISD) was designed to help reduce the long term effects of trauma and ultimately decrease the development of PTSD. However, the effectiveness of this method has been questioned by various authors with some arguing that the impact of CISD can increase the possibility of developing PTSD, as they can be re-traumatised as a result of too much processing of the event too soon after the incident has occurred. http://goliath.ecnext.com/coms2/gi_0199-10209751/Psychological-debriefing-may-not-be.html
Research shows that when a person experiences a traumatic event it is stored as a visual memory, which takes time to be encoded into words. Using this research of McNally, Bryant & Ehlers (2003) argue that people who talk about the incident immediately after a traumatic experience, may not yet have finished encoding the event into words. In many cases this results in some individuals compounding their traumatic memories. The normal processing of the event has been rushed, causing them to have a higher chance of developing PTSD (nspb.net/index.php/nspb/article/view/34/31).
As this debate presently stands people are moving away from using CISD to using Psychological First Aid. However, mental health aid workers are still confused about what is the most effective method to use in this field. This confusion is only compounded in the wake of the Japanese Tsunami. When and how do you think mental health workers should respond specifically to the Japanese Tsunami, and generally to future natural disasters? http://healthland.time.com/2011/03/14/tending-to-japans-psychological-scars-what-hurts-what-helps/
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For more information visit Trauma Training Online at http://www.traumatrainingonline.com/
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