After the Wolf Has Visited the Village –

Healing after unthinkable tragedies

The Numbers

One out of every 4 children attending school has been

exposed to a traumatic event that can affect learning

and/or behavior.

Crisis Response in a Nutshell

Principle of Opposites:

Intervening in Crisis requires one to stay calm and be focused on basic needs:

If cold, add warm.If wet, add dry.

If hard, add soft.If dark, add light.

If hungry, add food.If thirsty, add water.

If homeless, add shelter.If naked, add clothes.

If lost, add orientation.If hopeless, add hope.If crowded, add space.If isolated, add people.

Walk into the middle of a crisis, stay calm, and apply the principals of opposites

Excerpt from Beginnings, Middles, and Ends – Sideways Stories on the Art and Soul of Social Work by Ogden W. Rogers

Psychological First Aid – Resources

National Child Traumatic Stress Network• Psychological First Aid for Schools Field Manual• Free 6 hour interactive course• PFA Mobile App for iPhone, iPad, (Android 2013)• http://www.nctsn.org/ • http://www.nctsn.org/resources/audiences/school-

personnel

World Health Organization• Psychological First Aid: Guide for field workers• http://whqlibdoc.who.int/publications/2011/9789241548

205_eng.pdf

Psychological First Aid or PFA

For use in any number of emergencies large and small:› Acts of violence› Natural Disasters› Terrorist Attacks› Medical emergencies› Transportation accidents› Sports Injuries› Peer Victimization› Sudden death of a member of the school

community

Psychological First Aid - PFA

Schools are first to resume operations

after disaster/emergencie

s

Preparing for emergencies is critical for ALL

school staff

Emergencies affect students’ academic

and social achievement

Trauma-related distress can have a long term impact if

left untreated

Brief interventions can produce positive

results that last

Psychological First Aid - PFA

Evidenced informed intervention model used by a range of organizations

Used in the immediate aftermath of an emergency

Goal of reducing initial distress and facilitate adaptive functioning/coping

Psychological First Aid - PFA

For use immediately following an incident (one hour to a couple of weeks)

Time limited, goal directed, strength-based

Can be delivered by any staff member – because it is NOT psychotherapy

PFA Crisis intervention is not designed

to eliminate/alleviate pain Crisis intervention is designed to

reduce the likelihood of lasting trauma/suffering

PFA - basics

Goals:› Establish positive

connections› Enhance

immediate safety› Calm and orientate› Offer practical

assistance› Connect to support

networks› Empower

Avoid:› Assumptions about

experiences/trauma

› Pathologizing› Patronizing› Talking when not

necessary› Asking for details

of the event› Speculation

PFA – Preparation

Knowledge is Power – Gathering Information› Learn about the school› Identify the Features of the Event

Location, time, number of people involved, cause, unique features, rumors

› Be aware of at-risk populations› Be aware of diversity issues

PFA Core Actions

Contact and Engagement

Safety and Comfort

Stabilization

Information Gathering:

Current Needs and Concerns

Practical Assistance

Connection with Social Supports

Information on Coping

Linkage with Collaborative

Services

Core Actions – Contact and Engagement

To initiate contacts or respond to contacts by students and staff in a non-intrusive, compassionate, and helpful manner› Before you approach – observe› Offer practical assistance (food, water)› Ask simple questions › Exude calm, be direct, no acronyms› Expect some resilience – not everyone will

need help!

Core Actions – Contact and Engagement

Core Actions - Safety and Comfort

Enhance immediate and ongoing safety, and provide physical and emotional comfort › Physical safety, physical comfort› Provide a sense of predictability› Provide information

Core Actions - Safety and Comfort

Do provide information that is accurate, direct, and clear

Do address immediate needs and concerns

Do discourage the excessive viewing of media coverage

Do not guess or speculate regarding the situation

Do not reassure through the promise of services or events unless you know they will be available

Do not probe for details or for emotional reflection

Core Actions – Safety and Comfort

Provide tasks to students, staff, and families

Active

Practical

Familiar

Soothing

Core Actions - Stabilization

To calm and orient emotionally overwhelmed or disorientated students and school staff› For individuals who appear disorientated or

extremely agitated› Most individuals will not require

stabilization› Utilize a grounding activity (5 senses)

Core Actions – StabilizationAdults, adolescents, or school-aged children who need

stabilization may be: Disoriented: engaging in aimless disorganized behavior Disconnected: numb; startlingly unaffected by the event Confused: not able to understand what is happening around

them; not making sense Panicked: extremely anxious; unable to settle; their eyes wide

and darting Hysterical: sobbing uncontrollably; hyperventilating; rocking Excessively preoccupied: unable to think about anything else In denial: refusing to accept that the event took place In physical shock: not being able to move; frozen Glassy-eyed and staring vacantly; unable to find direction Unresponsive to verbal questions or commands Exhibiting frantic searching behavior Feeling incapacitated by worry Engaging in risky activities

Core Actions - StabilizationYoung children who need stabilization may be: Staring blankly Unresponsive Displaying behaviors they had outgrown (e.g.,

urinating in inappropriate places, sucking a thumb) Screaming Crying or sobbing uncontrollably Hyperventilating Moving in an agitated way (thrashing, pushing

away) Hiding (in a corner or under a table) Clinging excessively

Core Actions - StabilizationWhat do you see?

What do you smell?

What do you feel/touch?

GROUNDING

Core Actions - Stabilization

Never underestimate the power of

Core Actions: Information Gathering

To identify immediate needs and concerns, gather additional information and tailor interventions to meet needs

Core Actions: Information Gathering

How are you doing right now? What do you need right now?

What happened to you during the event? How were you affected?

How has the event impacted you/family/friends?

Do you have concerns/worries about the future?

Core Actions: Information Gathering

Core Actions: Practical Assistance

To offer practical help to students and staff to address their immediate needs and concerns› Identify the most immediate needs› Clarify the Need› Discuss an Action Plan› Act to Address the Need

Core Actions: Practical Assistance

Those who have experienced emergencies have more favorable outcomes if:

They are optimistic They have confidence that life is predictable They have a belief that they can achieve the goals

they set They have a belief that the community is willing to

help They engage in positive self-talk They have the knowledge that they will have the

resources they need (such as support from others, money for essentials items)

Core Actions: Connection with Social Supports

To help establish brief or ongoing contacts with primary support persons or other sources of support, including family, friends, teachers, and school and/or community resources

Core Actions: Connection with Social Supports

Core Actions: Information on Coping

To provide information about stress reactions and coping to reduce distress and promote adaptive functioning › Provide basic information about stress

reactions› Adaptive versus maladaptive coping› Helping with difficulties with concentrating

and learning› Monitoring Warning Signs

Core Actions: Information on Coping

Linkage with Collaborative Services

To link students and staff with available services they need now or will need in the future.