Transcript Psychological First Aid Applications in Low and Middle

Psychological First Aid:
Adaptation, training & outcomes
IASC RG Meeting
Paris, November 2011
• Megan McGrath, WVI
• Leslie Snider, WTF
• Mark van Ommeren, WHO
PFA Guide for
Field Workers
• WHO publication
www.who.int
• Collaborative effort:
– World Health Organization
– War Trauma Foundation
– World Vision International
• Endorsed by 24 UN/NGO
international agencies
• In process of translation and
adaptation to varied contexts
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Process of Developing Guide
“a journey of a thousand miles begins with a single step”
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2008 scan for existing resources & needs
2009 WHO commissioned PFA systematic review
2009 Anthology of resources
2009-10 First draft designed
2010 Haiti pilot (WVI - Alison Schafer)
2010 Extensive international peer review (60+)
2011 Second select peer review from LMC
colleagues, child protection, IASC Ref Group and
plain English
• 2011 August release on World Humanitarian Day
The PFA Field Guide - Endorsements
Psychological First Aid (PFA) is:
A description of a humane, supportive response to a fellow
human being who is suffering and who may need support.
PFA involves the following themes:
– Providing practical care and support that does not
intrude
– Assessing needs and concerns
– Helping people to access basic needs (e.g. food and
water, information)
– Comforting people and helping them to feel calm
– Helping people connect to information, services and
social supports
– Protecting people from further harm
Based on Sphere (2011) & IASC MHPSS Guidelines (2007)
PFA is not....
• It is NOT something only professionals can do
• It is NOT professional counseling
• It is NOT a clinical or psychiatric intervention (although it
can be part of good clinical care)
• It is NOT psychological debriefing
• It is NOT asking someone to analyze what happened to
them or to put time and events in order
• It is NOT pressing people to tell you their story
• It is NOT asking people details about how they
feel or what happened
Why PFA?
• People do better over
the long-term if they…
– Feel safe, connected to
others, calm and
hopeful
– Have access to social,
physical and emotional
support
– Feel able to help
themselves, as
individuals and
communities
How do we know?
• “Evidence informed” - factors associated with
PTSD (ES>0.2):
– Adults: peri-traumatic dissociation, lack of social
support post-trauma, trauma severity, life stress
post-trauma, perceived life threat, peri-traumatic
emotional response
– Children: pre-trauma psychopathology, threat to
life and pre-trauma parental distress
• Supported by Hobfoll principles & evidence
that lack of social support is associated with a
poorer outcome
• Consistent with recent guidelines (NATO/
TENTS, etc.)
Recommendations
(Bisson & Lewis, 2009)
• Caution against step-by-step
manualised intervention
• Doesn’t require advance knowledge
• Can be easily taught to workers without
mental health training
PFA Action Principles
Prepare
------------------Look
Listen
Link
PFA Training
WHO/WTF/WVI have conducted training in
Suriname, Somaliland, Iraq, West Bank/
Gaza, Sri Lanka and Europe (IOM, Dutch
security network)
WVA/WTF/GPG Sri Lanka project 2011-13
WVI rolling out training within organization
Planned for Sudan, aid workers in Darfur
Many other groups planning or doing training
(TPO Nepal, Belize, IOM, IMC…)
PFA Adaptation & Training Group
established on MHPSS network
Translations of the Guide
• WHO MH Dept coordinating all official UN
translations (Chinese, Spanish, Russian,
Arabic, French)
• For non-official languages, send requests to
[email protected]
• Current translations requested:
Urdu, Tamil, Sinhala, French, Spanish, Arabic,
Japanese, Chinese, Romanian, Hebrew,
Korean…
Confirmed: French, Urdu, Japanese, Chinese
Ordering Books (WHO Bookstore)
• WHO MH Dept is sending all endorsing
agencies 50 copies of the guide (they are in
the mail)
• WHO MH Dept will send 1-2 copies upon
request, but not handling large requests
• Standard cost $12/book, but it is possible to
negotiate reduced rates (possibly about
$6/book)
• Possible for any agency/group of agencies to
access designer files for a special print run
Intriguing Questions
Do we have a shared understanding of what
PFA is - and is not? (beware CISD trap!)
How to adapt the guidance for different…?
Socio-economic contexts
Crisis events
Cultures, customs and languages
How best to capture global lessons in
adapting & applying PFA?
How to measure process & outcomes (!!) of
PFA training and application in the field?
Pre-post training knowledge, skills, practice?
Personal effects of training on trainer well-being?
Beneficiaries?…the Hobfoll principles?
References
1. Bisson, J.K. & Lewis, C. (2009) Systematic
Review of Psychological First Aid,
Commissioned by World Health
Organization.
2. PFA Anthology: www.wartrauma.nl and
www.psychosocialnetwork.net
3. Schafer, Snider and van Ommeren.
Psychological first aid pilot: Haiti
emergency response. Intervention
Journal, Vol. 8(3): 245-254, Nov 2010.
http://whqlibdoc.who.int/publications/2011/9789241548205_eng.pdf
Acknowledgements
• Writing & Editorial Team:
– L. Snider (WTF), A. Schafer (WVI), M. van Ommeren
(WHO)
• Steering Committee:
– Stefan Germann (WVI), Erin Jones (WVI), Relinde Reiffers
(WTF), Shekhar Saxena (WHO), Marieke Schouten
(WTF), Leslie Snider (WTF), Mark van Ommeren (WHO)
• Illustrations: Julie Smith (PD Consulting)
• Photos: Red Cross/Red Crescent photos courtesy of Melissa
Ekin Kizildemir & Suat Ozcagdas
• Funding: World Vision International
• Reviewers:
– We thank the many reviewers and endorsing agencies