Robby B. Echavez, MAEd, RPm, RPsy, MAGC (cand.)
A Webshare with Learners of the Mandaue City Science High School on Psychological First Aid last August 14, 2020
Using what we know better and are more familiar with, Shea brought the attention of the group back to first aid, a specific way of providing immediate help to individuals during or after an emergency. Is psychological first aid or PFA also like that? Being an even more specific type of first aid, does the nature of basic first aid apply to PFA? Also called stress first aid (SFA), PFA is also a frontline response, one that is meant to be responsive and easy to provide, both for the helper and the helpee.
Marielle provided the distinction between PFA and basic first aid, the former involving a focus on the mental health needs of helpees. She went so far as to indicate that PFA may look into the first effects of posttraumatic stress disorder. While true that the principles of PFA have potential utility even when addressing diagnosable trauma and stressor-related disorders, its validity and usefulness have been proven by research to be more effective when dealing with immediate cognitive, emotional, and behavioral stress responses to crisis situations.
This is done through the three action principles of PFA– looking, listening, and linking. In inculcating and programming these actions among PFAiders, with the global demand for the skill set expanding due to the pandemic, the International Federation of the Red Cross and Red Crescent (IFRC, 2020) have emphasized assessing the current situation, the helpee’s profile, risks, needs, and expected emotional reactions; active listening and calming techniques; and assisting the helpee in accessing information, connecting with loved ones, tackling practical problems, and obtaining other services and further support.
This helping algorithm has come to be challenged by the specific needs for remote PFA in an era of physical distancing, virtual connectivity, and faceless communication. For example, in Malaysia, as in many parts of the world I would venture to guess, PFA had to be remotely administered to health care workers, many of whom were dealing with enormous stressors in the frontlines (Francis, Rizal, Sabki, & Sulaiman, 2020). This situation guided the provision of rPFA as depending on the severity of the stress response.
Such challenges, not all clear and a lot of which are still emerging, requires a revisioning of PFA so that it is not just immediate, but also compact and connective (Dastur, 2020) enough to contain, encourage, reassure, and promote belongingness (Nicholson, 2020).
One possible reinvention is by pairing the action principles with their objects or targets, to streamline and focus the help that is provided to a wide array of helpees: students, educators, those in the marginalized sectors, and the multiply disadvantaged. This pairing answers the questions, in PFA what do we look at? What do we listen to? And we link with what?
I propose that we look at location– the internal and external spaces of the helper and helpee, partial of course to the helpee’s spaces. External space refers to the physical and temporal dimensions occupied by the person needing PFA. This can refer to where the helpee is in at the moment. External spaces can include day, time, logistics, and the immediate environment. After this, internal spaces can become the focus of the looking. This will train the sight of the PFAider onto the emotional world of the helpee and the universe or mess of ideas that populate what is in between his or her ears.
And then we listen to loss. First aid, as a response, is predicated by loss. Losing one’s house in a fire or a raging typhoon, the sense of safety during a break-in, or a loved one due to COVID-19 are all loss experiences some form or other of which happens to an individual who requires PFA.
Matthew provided an example he sees as a common loss experience among learners worldwide due to the school closures and the multi-systemic impact of COVID-19– the loss of educational opportunities. Skipping school is easier this year. Missing on enrolment and failing to meet admission standards or criteria is a global phenomenon rooted in food and home insecurity, another even more basic forms of loss during these trying times.
Listening to what individuals have lost allows us a greater possibility of connectiveness and compactness. It simplifies the communication process that happens in PFA because it limits to the human particular and the existential given of loss. Being a universal experience, it allows the helper a common ground with which to better contain, encourage, and reassure the grieving and distressed helpee.
In doing this, we then link with love. This requires empathy and compassion, the very heart of PFA and any reach-out, whether psychotherapy, counseling, crisis communiction, or group therapy. An unloving PFAider is unthinkable. One must be ready for the culmination of PFA in this expansive and healing action principle. Without the ability to link with compassion with a learner who has skipped several online sessions because of their home Wi-Fi bills not getting paid, there can be no consummation of PFA. Without the ability to link with empathy with a learner’s family who run the risk of being evicted from their rented apartment due to lockdown stress and economic losses, PFA will be impossible, face-to-face or remote.
Martin paints one such picture. “What if the person needing help does not accept help through the PFA that you offer?” The outcomes of help of course is something that is heavily dependent on the receptivity of the helpee. If he or she closes the door, where will our help go? Perhaps this door will remain closed only for a day, or several hours, or maybe even for just a few minutes. If one chooses to close the door on help, we must remember to link with love. We need not take it personally as if the helpee chose to close the door because of us. Empathy and compassion will tell us that seeking help is not easy as it is often times a fall from grace or an unwilling journey into the valley of vulnerability. Allow your door to be open through which the helpee can enter at a time of her or his choosing. Remember too that there are other doors through which the helpee can enter to find the support that speaks most meaningfully to her. When we do this, there is no empathic failure but a successful locating of the loss and a linking with the other with love.
Dastur, M. K. (2020, July 17). Schooling during COVID-19. https://www.ipa.world/en/en/IPA1/Webinars/schoolinglockdown.aspx
Nicholson, N. (2020, July 17). Schooling during Covid lockdown and beyond [Webinar]. https://www.ipa.world/en/en/IPA1/Webinars/schoolinglockdown.aspx
Francis, B., Rizal, A. J., Sabki, Z. A., & Sulaiman, A. H. (2020). Remote psychological first aid (rPFA) in the time of Covid-19: A preliminary report of the Malaysian experience. Asian Journal of Psychiatry, 54, 102240.
International Federation of Red Cross and Red Crescent Societies [IFRC]. (2020). Remote Psychological First Aid during COVID-19. Copenhagen: IFRC Reference Centre for Psychosocial Support.