Psychological First Aid for Caregivers of Wounded Veterans

Presented by Jim Messina, Ph.D.,

Objectives for Program

•Identify reason why caregivers of wounded Vets might need Psychological First Aid

•Identify components of Psychological First Aid

•Identify competencies, skills and strategies needed to provide Psychological First Aid

•Identify Triage for people needing PFA

Why would caregivers need Psychological First Aid?•They have experienced a crisis due to the

trauma experienced by their love ones •They are very confused and caught off

guard by this crisis •They feel overwhelmed by needing to

problem solve all the issues they have to deal with

•They need help to cope with their fears and worries stemming from their crisis

Challenges Caregivers Face•Trying to maintain normalcy despite the

crisis they are dealing with•Repeated exposure to “surreal” life

experiences of their wounded loved ones•Having to maintain “one’s cool” in face of

emotionally difficult and exhausting circumstances

•Lacking sleep and feeling fatigued•Feeling like “no matter what gets done is

never enough for my wounded love one”

Other Obstacles Faced by Caregivers•Facing dilemmas in dealing with issues in

care of their loved ones which are not easily resolved by simple responses or answers

•Being exposed to the raw emotions of their wounded loved ones on a daily basis

•Feeling frustrated by policies and decisions by the organizations which are dealing with their wounded Vets

The signs coming from caregivers of their needing PFA Wounded ideals and/or cynicismFeeling unappreciated by wounded loved oneBetrayed by “helping” organizationsMistrusting everyone around themLoss of enthusiasm and dimming hope Neglecting personal safety and physical needsExcessive sleep difficultiesInability to concentrateSymptoms of illness or diseaseExcessive use of alcohol, tobacco or drugs

What is Psychological First Aid?

•The practice of providing a compassionate presence to people in crisis who need help because they are feeling stress, resulting from the traumatic situations within which they find themselves

Skills and Attitudes to be Effective Providers of Psychological 1st AidGood Listening skillsPatientCaring attitudeTrustworthyApproachableCulturally competentEmpatheticNon-judgmental approachKindCommittedFlexibleAble to tolerate chaos

Why you should know how to provide Psychological First Aid•To create a compassionate environment

for caregivers to help them build their resilience

•To assess what caregivers might need at a particular time

•To provide immediate support to caregivers in stressful situations

•To create a helping environment which helps caregivers cope in the face of stressful events

Psychological First Aid Actions to use with caregivers:Making a connection with themHelping them maintain healthy

boundaries with one anotherBeing kind, calm, and compassionateMeeting their basic needsListening to themGiving realistic assurance to themEncouraging them to use good copingHelping them to connect with one another

for emotional support

Creating a Psychologically Supportive Recovery Environment•Providing sound guidance and support in

their problem solving personal solutions•Creating an open and sharing

communications lines with them•Demonstrating and encouraging respect

for confidentiality•Creation of peer support system for

mutual support, problem solving, advocacy, fun, rest, and recreation

What lessons can be taught through Psychological First Aid?•What are the normal reactions to stressful

events experienced by caregivers•How to be aware of one’s tension and

consciously try to relax •Encouragement of the use of a buddy

system between caregivers•Encouraging caregivers to talk with

someone they trust and with whom they feel at ease

•Encourage listening to what caregivers say and think about their daily stressors

Self-Help Psychological First Aid Strategies:Use one of the following strategies to express

your feelings on a daily basis:1.Keep a journal about your feelings about what

you experience as you handle this process2.Use painting or drawing art projects which

help you get out the stress and anxiety faced in your care giving process

3.Playing or listen to music to get out the stress and anxiety you face

4.Conduct a weekly or daily “debriefing” session with fellow caregivers to “tell your stories” about the stressors experienced in your process of supporting your loved ones

Triage to determine if Psychological First Aid is not enough!•If a caregiver begins to show signs of

physical and mental fatigue where compassionate presence is not enough!

•If a caregiver shows signs of excessive self-medicating

•If a caregiver has frequently witnessed death of the loved ones of fellow caregivers

Immediately refer Caregivers for Outside Professional Help• If in triage you recognize that PFA is not

enough refer out especially if you witness the caregiver:1. Threatens to harm or kill self or others2. Cannot be calmed after PFA attempts to comfort and

respond to requests and/or needs3. Behaves erratically and exhibits questionable

judgment, because of possible influence of alcohol or drugs

4. Acts confused and disoriented, saying or doing things that do not make sense in the context of the situation and that may result in harm to self or others

Can You Help Caregivers of Wounded Vets?Through the use of Psychological First Aid:•You create an environment of compassion•You show respect for the caregivers•You build up caregiver’s capacity to cope

with the daily stressors faced •You encourage caregivers to be resilient

in the face of the trauma, pain, and suffering their loved ones are going through in their recovery process