Psychological First Aid: The Johns Hopkins RAPID PFA

George S. Everly, Jr, PhD, ABPP

The Johns Hopkins Public Health Preparedness Programs The Johns Hopkins Bloomberg School of Public Health

This program is intended to introduce participants to the fundamentals of psychological first aid

Psychological first aid (PFA) may be defined as a compassionate and supportive presence designed to mitigate acute distress and assess the need for continued mental health care (Everly and Flynn, 2005)

This program is designed specifically for: Public health personnel Public health educators Emergency responders Disaster workers with little or no formal mental health training

Psychological First Aid

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Participants will increase their abilities to: Discuss key concepts related to PFA Listen reflectively Differentiate benign, non-incapacitating psychological/ behavioral crisis reactions from

more severe, potentially incapacitating, crisis reactions Prioritize (triage) psychological/ behavioral crisis reactions Mitigate acute distress and dysfunction, as appropriate Recognize when to facilitate access to further mental health support Practice self-care

PFA Objectives

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The material in this video is subject to the copyright of the owners of the material and is being provided for educational purposes under rules of fair use for registered students in this course only. No additional copies of the copyrighted work may be made or distributed.

The material in this video is subject to the copyright of the owners of the material and is being provided for educational purposes under rules of fair use for registered students in this course only. No additional copies of the copyrighted work may be made or distributed.

George S. Everly, Jr, PhD, ABPP

Terms and Concepts

The need

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According to the United Nations International Strategy for Disaster Reduction, the frequency of disasters caused by natural hazards has been increasing

Current global destabilization and armed conflicts will likely cause the number of disasters to dramatically increase in the second decade of the millennium

Disasters on the Rise

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When considering the mental health aspects of public health emergencies and disasters, we are most concerned with the phenomenon of surge

Experiences in the United States and other countries has shown repeatedly that following disasters, particularly those occasioned by violence, there is a surge of demand for health services, including mental health

Surge of Demand: Mental Health Services after Disasters

Sources: Galea et al. (2005). The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev, 27:7891; Hamblin, J. (2004). What are the traumatic stress effects of terrorism? www.ncptsd.org/facts/disasters/fs_terrorism.html; Lating, J. (2005). Psychological contagion effect. In G. Everly, Jr & C. Parker, eds, Mental Health Aspects of Disasters, 5158. 7

In an analysis of over 160 empirical studies conducted by Norris and her colleagues (2006), 41% of studies revealed evidence of severe to very severe impairment (interference with functioning) among a significant number of disaster survivors

More Specifically

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Translating those statistics to actual demand, the increased demand for mental health services may range from 1525% of the population directly affected

Surge of Demand: Mental Health Services after Disasters

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in hours after a disaster, at least 25% of the population maybe stunned and dazed, apathetic and wanderingsuffering from the disaster syndromeespecially if impact has been sudden and totally devastating At this point, psychological first aid and triage are necessary.

Beverley Raphael (1986) When Disaster Strikes

Raphael, 1986

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The need to enhance surge capacity is self-evident; the only question is: how?

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1. Psychological crisis intervention can increase the perceptions of personal resilience and preparedness, as well as enhance community resilience OL McCabe; N Semon; JM Lating; GS Everly, Jr; et al. (In press). Developing an

academic-government-faith partnership to build disaster mental health preparedness and community resilience: program description and lessons learned. Public Health Reports.

GS Everly, Jr; OL McCabe, N Semon, CB Thompson, J Links. (2014). The development of a model of psychological first aid (PFA) for non-mental health trained public health personnel: the Johns Hopkins RAPID-PFA. Journal of Public Health Management and Practice (online).

Recent Evidence Suggests:

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2. Psychological crisis intervention is superior to multisession psychotherapy post disaster, for reducing acute distress

4. Psychotherapy post disaster may delay or complicate recovery Boscarino, Adams, and Figley, 2011, J Nerv Ment Dis

Recent Evidence Suggests:

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If correct, collectively these data suggest that traditional mental health interventions may be problematic when applied in disaster settings

Furthermore, there may be value in implementing more crisis oriented interventions

But this is not a new idea

Data May Suggest

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