Helping the Survivors

Involves :• Offering support & reassurance• Ensuring safety & comfort• Communicating with the survivor• Providing a safe environment• Meeting physical needs immediately• Providing information necessary for appropriate

actions• Helping the survivor share their experiences• Helping the survivor regain their sense of control

over their life• Linking families & facilitating reunion with loved

ones • Identify other needs

PSYCHOSOCIALFIRST AID

Principles of Psychosocial First Aid

• Intervene immedialtely• Be effective by being direct, authoritative

& active • Help the survivors focus & accept what

has happened• Provide accurate information about the

situation• Be truthful, do not give false assurances

• Recognize the importance of action for the survivors

• Provide the survivors with emotional support

• Focus on personal coping abilities & encourage resillience

Principles of Psychosocial First Aid

Steps of ProvidingPsychosocial First Aid

1. Meet immediate needs

2. Listen to the survivor

3. Accept feelings

4. Next steps

5. Refer and follow up

Meet Immediate Needs

• Provide a safe evacuation.

• Provide physical first aid if needed.

• Help survivors collect their belongings.

• Meet the basic requirements on shelter, clothing, food.

• Ask the survivors whether they need anything else.

Listen!

• Take time to listen to the survivors. This will reduce their anxiety.

• Actively concentrate on what survivors says.

• Don’t interrupt or try to assure them that everything will be all right.

• Look at the survivors as he or she talks.

• Give required non-verbal cues to show your support and empathy.

Accept Feelings

It is normal to feel nervous, anger, guilt, grief, ashamed or even happy after surviving a disaster. Volunteers should let survivors know that it is OK to feel that way.

Next Steps

1. Assess needs for medical aid, basic relief needs, livelihood, housing and emotional support.

2. Based on these needs, discuss plan of action to fulfill those needs.

3. Provide necessary aid or information for meeting those needs.

4. Establish network with other agencies that might be able to help.

5. Ask the survivor to restart daily living task.

6. Help them to understand that keeping occupied enhances the recovery process.

7. Facilitate getting back to routine, back to work, socializing, reading, etc.

8. Encourage adoption of a healthy lifestyle : nutritious food, regular exercise, adequate sleep, etc.

Refer & Follow up

• Identify survivors who need further counselling or intervention.

• Evaluate and observe their progress.

When to refer ?

• If you are overwhelmed with the problem at hand, exceeds the training you received and surpasses the objectives of the psychosocial support program. • If someone shows signs or talks about committing suicide. • If someone is isolated from social interaction / unusually introvert.• If someone has imaginary ideas. • If someone becomes an alchohol or drug addict. • If someone shows a dangerous behavior (for example acts reckless and disregards the safety of themselves and others)• If someone has committed an act of harassment or a crime. • If someone is very exhausted, is bewildered and has recurrent nightmares or frightening flashbacks of a terrible event.

How to make referral ?

• Inform the survivor about your intentions•Let him know that you care for him and explain your reasons for the referal.• If you have the options, you should present different possibilities of referral.• Discuss matters such as fee, location, accessibility, etc. • Assure the survivor that you will continue your support until the referral process is completed. • You can offer to accompany him to the first visit with the professional.

How to Help Children and Adolescents ?

1. Establish a close and open relationship with children / adolescents.

2. Identify, clarify and focus on their needs/ problems.

3. Understand their emotions/ feelings. 4. Pay attention to them.5. Communicate clearly.

STRESS REACTION Pre-School

PSYCHOSOCIAL FIRST AID

1) Inactive. Not able to follow daily routine. 1) Provide support, rest, comfort, food, opportunity to play and draw.

2) Fear. Scared of the dark, fear of being alone.

2) Provide sense of security (acceptance, be available, hold close, comfort, if cling don’t force them away, show your affection).

3) Not able to speak. 3) Help to share feelings through talking, listening, drawing.

4) Disturbed sleep (nightmares, fear of going to sleep, fear of being alone at night)

4) Encourage talking about the dreams with teachers, parents, or someone the child trust (could be grandmother, etc.)

5) Clinging, not wanting to be away from parents or teacher

5) Provide sense of security by away being around and letting the child play.

6) Anxiety about the dead person that he will return.

6) Explain the physical reality about death.

STRESS REACTION School Children

PSYCHOSOCIAL FIRST AID

1) Issues of responsibility and guilt 1) Help to express their feelings.

2) Fears triggered by the event 2) Help to identify feelings about the event.

3) Retelling and replaying of the event 3) Permit them to talk : addres feelings and assure that they are normal reactions to an abnormal situation.

4) Feeling disturbed, confused and frightened by their responses

4) Encourage expression of feelings. Help to retain positive memories.

5) Difficulty in concentration and learning

5) Encourage them to talk to their teachers about the thoughts that are interfering with learning.

6) Disturbed sleep (bad dreams, fear of sleeping alone)

6) Support them in talking about the dreams, provide information about why we have bad dreams.

7) Change in behavior (expressive anger or aggressive behavior)

7) Help to cope with the change in their behaviour by accepting it and talking about it. (for example, it must be difficult to feel so angry”)

STRESS REACTION Adolescents

PSYCHOSOCIAL FIRST AID

1) Shamed and guilt 1) Encourage discussion of the event, feeling about it and expectations of what could have been done.

2) Sense of vulnerability about their feelings, fear of being labelled abnormal

2) Help them understand that their feelings are normal in the situation. Encourage understanding among each other and people of the same age group.

3) Drug use, anti-social behaviour 3) Help to understand the their behaviours are an effort to forget about the feelings. Help to ventilate anger, frustration over the event.

4) Accident prone behaviour,recklessness

4) Address the impulse toward reckless behaviour can lead to violence, which can have fatal consequences.

5) Changes in relationships with parents, friends and others.

5) Discuss the changes in relationship why they might be happening.

6) Feeling that one has grown up too soon ( for example, leaving school, having big responsibilities at home)

6) Encourage focus on one’s life ahead, allow them to be involved in other activities of interest.

7) Thoughts of revenge. 7) Discuss about the actual thoughts of revenge, the possible consequences of the act and encourage constructive alternative that will have long-term benefits.

What more to do for adolescents: Encourage participation in community rehabilitation. Encourage them to help children and the elderly. Encourage of social (discussion, theatre, clubs, etc.) and recreational (games,

sports, etc.) activities.

How to Help Adults ? (1)

• Make sure the survivor spends time with others [survivors should have social support].

• Encourage survivors to share. • If possible help them return to their normal daily

routine. • Give them time to grief and cry if necessary.• Ask for help and additional support from family,

friends and relatives.

How to Help Adults ? (2)

• Determine a small goal to achieve when trying to solve a problem.

• Make them realize the importance of a proper and nutritious diet. Spend time to walk, excercise and relax with the survivor, even if it is for a short time.

• Make sure they get enough sleep and rest. People under pressure need more sleep.

How to Help Adults ? (3)

• Do something that will make survivors feel happy and comfortable, for example: pray, listen to religious sermons, praise God, read a holy book, etc.

• Find a positive activity that the survivor can take part in, for example: join humanitarian / social volunteer work.

• If necessary, separate the survivors from sources that might induce more stress / pressure.

How to Help the Elderly ?

SPECIAL SITUATION RECOMMENDED ACTIONS

They might be living alone and in need of help from various sources.

Ensure them that they are entitled to access all the assistance and support available to others in society.

When families and the community is under stress, attending to the elderly is the least prioritized.

Encourage them to participate in rehabilitation efforts.

They feel as if they have lost everything in life (lost children, house, memories) and considering their age, they realize they can never regain all they have lost.

Encourage them to help children, their own grandchildren, etc.

5. Acceptance

2. Denial

3Anger

4.Depressed

1. Shock

RECOVERY PROCESS

Recovery Process

• A complex and winding process.• It is unique between individuals• “Analogy: The Snake &Ladder game”

Ladder

• Assistance received by an individual; various individual responses accelerates and helps the recovery process.

Example:

1. A safe and comfortable situation

2. Social support is available

3. Feelings of camaraderie

4. Recovery assistance is available, etc.

Snake

• Anything that can hinder or regress the recovery process.

Example:

1. Rejection from the community

2. Negative emotions, such as: guilt, anger, helplessness

3. Social support is unavailable

4. Drug or alcohol abuse, etc.

Recovery Process

• Total Recovery very difficult. The choices made for self recovery highly depend on the quality of each individual.

• Whatever small progress is made towards recovery, it is still a positive step.