Chicago Department of Public Health Rahm Emanuel Mayor Bechara Choucair, MD Commissioner PSYCHOLOGICAL FIRST AID FOR COMMUNITIES (PFAC): A TOOL FOR PROVIDING IMMEDIATE HELP IN TIMES OF DISTRESS Marlita White OFFICE OF VIOLENCE PREVENTION June 27, 2012 Psychological First Aid for Communities (Adapted from Pynoos RS, National Child Traumatic Stress Network)

Guide: Where, when, and with who? Establish: PFAC core actions Process: Participate in a brief activity Practice: Review and questions Today’s Format and Goals Goals

What is PFAC?

An Introduction Psychological First Aid is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping.* *National Child Traumatic Stress Network. (2006).Psychological First Aid, Field Operations Guide 2 nd Edition

What is Trauma? An experience, that completely overwhelms the ability to cope or integrate ideas and emotions; a sense of being overwhelmed lasting for a prolonged period as the person struggles to cope with the immediate circumstances; can lead to serious long- term negative consequences by directly changing the biological functions of the brain* *Moroz, K.J. (2005) The Effects of Psychological Trauma on Children and Adolescents. Vermont Agency of Human Services Department of Health Division of Mental Health

Pioneers-(1988) Robert Pynoos and Kathleen Nader (the National Child Traumatic Stress Network- developed the Second Edition of Psychological First Aid Field Operations Guide ) International Federation of Red Cross & Danish Red Cross- 1990; Red Crescent Societies- Listen. Protect and Connect Numerous adaptations – 3, 6, 12, 18 hour training sessions, from state to state and beyond (Montana, Manitoba, UN, Chicago Dept of Public Health) Historical Background (PFA) What is PFAC?

PFAC vs. PFA PFA: Originally designed with children, adolescents, parents/caretakers, families, and adults exposed to macro-level disaster or terrorism in mind- it can also be used by and for first responders and disaster relief workers. PFAC: The Chicago Department of Public Health applied the principles outlined in PFA to experiences that occur on a more frequent basis within communities. This puts the “C” in PFAC. What is PFAC?

Potentially Traumatic Experiences

Potentially traumatic experiences: In the HOME: Substance Abuse Domestic Violence Fire Home Invasion/Theft What else?

Potentially traumatic experiences: In the COMMUNITY: Serious injury Shootings/stabbings Fights Robbery Car Accidents What else?

General Guidelines of PFAC

General guidelines of PFAC : Everyone can give PFAC

Cultural Humility There are something that you will miss or not understand when you are bridging a cultural gap to provide PFAC Make sure to tread lightly Be open to being corrected Always ask if unsure General guidelines of PFAC :

It’s the person’s/child’s experience Not every person/child will be traumatized Avoid ‘talking down’ Focus on what the child/person has done that is effective No Assumptions General guidelines of PFAC :

Working with Children

Working with children: How do young children experience trauma differently than the rest of the population?

Children at special risk Separated from parents/caregivers Adolescents who may be risk-takers Youth exposed to grotesque scenes or extreme life threatening situations CEV= children exposed to violence Working with children

Build on Protective Factors Attachment & Bonding Healthy friendships A caring, positive adult relationship Strong self-esteem Working with children

When offering PFA: Accept the person’s readiness to share Not the time to press for details Only offer accurate information Keep safety as a theme and focus Working with children

Behavior that may help Speak at child’s/person’s eye level Help child/person verbalize feelings Provide simple labels Avoid extreme words Reassure by voice, body language Working with children

PFAC Core Actions

PFAC Core Actions Core Actions Overview 1. Contact and Engagement 2. Safety and Comfort 3. Stabilization 4. Information Gathering 5. Practical Assistance 6. Social Supports 7. Coping 8. Linkage to Services

PFAC Core Actions Contact and Engagement Look, speak, acknowledge

PFA Core Actions Safety and Comfort Protect, reassure, encourage

PFAC Core Actions Stabilization Consistency, familiarity, dependability

PFAC Core Actions Information Gathering Asking, listening, organizing

PFAC Core Actions Practical Assistance Responsive, constructive, optimistic

PFAC Core Actions Social Supports Connecting, sharing, encouraging

PFAC Core Actions Coping Informing, educating, framing

PFAC Core Actions Linkage to Services Discuss, assess, link

When child is exhibiting What s/he needs: How to respond: Helplessness Passivity Provide support, rest, play; have they eaten? Establish child friendly space Generalized Fear Calm adult presence; support for each child Reassuring familiar activities- PFAC Interventions

When child is exhibiting What s/he needs:How to respond: ClinginessConsistency, honesty- doing what you say you will do, being where you say you’ll be Encourage families to spend more time together; to practice and celebrate consistency Regressive Behaviors Tolerate for limited time- e.g. 2 weeks Avoid criticizing or name-calling PFAC Interventions

Contact & E_______________ Safety and C______________ Stabi____________________ Information G______________ Practical A_________________ Social S___________________ Supports with C_____________ Linkage to S______________ PFA Core Actions Review

Wrap Up Review Define: Immediate help after a potentially traumatic event Guide: Events that happen in the community to families effect children Establish: PFAC core actions

Local Resources CDPH, Office of Violence Prevention: Emergency: 911 Information: 311 Chicago Domestic Violence Helpline: Metropolitan Family Services: Family Focus, Englewood: Heartland Human Care Services: Casa Central: Safe From the Start programs: (IL) LaRabida Child Trauma Center:

??? Wrap Up Questions