Well, you're right at the finish line. No new material will be introduced here. But, let me try to summarize some of the more important factors, and elements, and points I've tried to make. The program was intended to introduce you to the fundamentals of something called psychological first aid. Psychological first aid, or PFA, may be defined as a compassionate and supportive presence designed to mitigate acute distress, and assess the need for continued mental health care. This program was designed specifically for public health personnel, educators, emergency responders, as well as other disaster workers with little or no formal mental health training. So, if you are a psychologist, psychiatrist, therapist of any kind, you probably said, well, I knew most of that. Well, maybe you did, and maybe you didn't. Just keep in mind, it's not therapy. It's not diagnosis. Why do we even have this field that was largely born in 1990s? It's estimated there will be an increased demand for mental health services that could range from 15-25% of the population directly effected. And interestingly enough, they will burden the entire public health system. Recent evidence suggests that psychological crisis intervention, such as psychological first aid, can increase the perception of personal resilience and preparedness, as well as enhanced community resilience. Thus, alleviating some of the strain on the public health system. Psychological crisis intervention has been shown to be superior to multisession psychotherapy post disaster, for reducing acute distress. So, this is not something that we simply do because we don't have enough shrinks to go around. Quite the contrary, crisis oriented intervention such as PFA may be indicated in the wake of disasters. Building indigenous regional surveillance as well as acute intervention resources seems a useful alternative to the widespread importation of diagnostic and therapy services. Due to the former's response efficiency, sensitivity to local culture and familiarity with local roads, neighborhoods, and geography. So then, the only question is, How do we do psychological first aid? And, the Johns Hopkins RAPID, R-A-P-I-D, is one model of PFA. It begins with listening. Listening is an active process, not a passive one. It begins with gaining rapport through listening. It's being cognizant that there are usually three groups of survivors. Those that are doing fine and don't need us. Those who look bad but probably will be resilient. And lastly, the dysfunction group who look bad and really are. They need help doing the things they need to do. After assessment, we must prioritize. We reviewed evidence-based versus risk-based models. You don't use one to the exclusion of the other. Evidence-based models say I will attend to those people who need the greatest attention first. And there is evidence of that. And the evidence is manifest by their inability to attend to the activities of daily living. The things they need to do to care for the people who need, need to be cared for. The risk based triage approach says, I'm concerned not just about the moment, but perhaps down the road a little bit. And, looking at people who have seen death and destruction, who have been physically injured, who have been separated from home and loved ones. Those people we know are at higher risk, but that's all it is, is risk. In the final analysis, psychological triage, the key resides in recognizing and prioritizing dysfunctional inclinations and behaviors. So, we've got the r, the a, and the p, what's the i all about? How do we intervene? Intervention is stabilization and mitigation. Stabilize, how can I stop things from getting worse? I can remove provocative queues. I can foster a task orientation. I could let people tell their story. I could delay impulsive actions. I can use distraction. How do I mitigate acute distress? Said another way, how do I make thing's a little better? I can educate. I can normalize. I can offer reassurance. I can foster hope. I can delay impulsive actions. I can correct misunderstandings. And, I can plant the seed of post-traumatic growth. So, my interventions consisted of stabilization and mitigation. But, there's a third prong to this approach, and it is disposition. Facilitating access to the next level of care as indicated. Whether that's medical, psychological, financial, spiritual, or logistical care. And lastly, let's not become a victim. First responders, and others in the helping profession, may also be vulnerable, and that means you. Psychological first aid ends by taking care of ourselves. So how are you feeling about psychological first aid? Well, the good news is this was a beginning. And I think it was a good beginning. And the better news is there are better opportunities out there. And a whole world is waiting for you to learn, to help others. So start here and the sky’s the limit.
