Table of Contents
Preface | How Did We Get Here? xiii
Acknowledgments xxiii
Part I Psychological First Aid First, Study the Science
1 Psychological First Aid | Definition, History, and Foundational Research 3
Defining Psychological First Aid (PFA) 4
Development of the PFA Concept 6
Rapprochement 14
Key Point Summary 16
References 18
2 Structure and Mechanisms of Psychological First Aid 22
PFA 23
Core Concepts and Mechanisms of Action 27
Validation of the Johns Hopkins RAPID PFA Model 33
COVID-19 Implications for the Implementation of the RAPID PFA Model 34
Key Point Summary 35
References 36
3 Psychological Consequences of Trauma | What You Will Encounter in the Field 40
Posttraumatic Stress Disorder 42
Depression 44
Generalized Anxiety 47
Panic Disorder 48
Substance Use Disorders 49
Unique Impact of the COVID-19 Pandemic 51
Psychophysiological Stress Reaction 52
Key Point Summary 55
References 57
4 In the Wake of Disaster | The Large-Scale Context for PFA 63
Types of Disasters 63
Natural Disasters 65
Technological Disasters 70
Human-Made Disasters 75
War-Related Syndromes: A Special Case of Human-Made Disaster 82
Factors That Increase Severity 84
Key Point Summary 87
References 88
Part II Psychological First Aid Practicing the Art
5 R-Rapport and Reflective Listening | Establishing a Relationship 105
First Things First: The Practice of Presence 105
Empathy and Rapport 107
The Empathic Cascade: The Bridge from Rapport to Adherence 107
Historical Development 109
Mechanisms of Action 110
Demonstration of the R in RAPID Model 111
Key Point Summary 124
References 124
6 A-Assessment | Listening to the Story 126
Screening 127
Appraisal 128
Cognitive Indicia 129
Emotional Indicia 129
Behavioral Indicia 130
Spiritual indicia 131
Physiological Indicia 131
Demonstration of the A in RAPID Model 131
Key Point Summary 138
References 139
7 P-Psychological Triage | Prioritization 141
Urgency 142
Psychological or Behavioral Instability: The Crisis Triad 143
Putting It All Together: The A-B-C Model of Psychological Triage 144
Demonstration of the P in RAPID Model 145
Key Point Summary 149
References 151
8 I-Intervention | Tactics to Stabilize and Mitigate Acute Distress 152
Explanatory Guidance 153
Anticipatory Guidance 155
Cognitive Reframing 156
Stress Management 158
Instillation of a Future Orientation-Hope 161
Enlisting the Support of Family and Friends 162
Delay Making Any Life-Altering Decisions/Changes 162
Faith-Based Interventions 162
When in Doubt 164
Caution 164
Demonstration of the | in RAPID Model 165
Key Point Summary 174
References 175
9 D-Disposition | Facilitating Access to Continued Care 178
Where Do We Co from Here? 178
Encouragement 180
Resources 180
Demonstration of the D in RAPID Model 181
Follow-up and Disposition 183
Key Point Summary 197
References 197
Part III Psychological First Aid Further Considerations
10 RAPID PFA Considerations with Children 201
Background Information 201
Rapport and Reflective Listening 203
Assessment 204
Psychological Triage/Prioritization 206
Intervention 207
Disposition 209
Key Point Summary 210
References 211
11 Cultural Awareness and Psychological First Aid 215
Defining Relevant Terms and Concepts 216
Initial PFA Considerations 217
Family Support and Trust 220
Spirituality and Religion 223
Distress Reactions 224
Key Point Summary 226
References 228
12 Expanding Surge Capacity | Strengthening the Fabric of Community Mental Health Services 234
The Need to Expand Mental Health Capacity Using Nontraditional Models 235
Using PFA to Expand Psychological Support Capacity 238
Key Point Summary 241
References 242
13 Self-Care | Taking Care of Others Begins (and Ends) with Taking Care of Yourself 247
The Need for Self-Care 247
Terminology 248
Risk Factors 251
Self-Care 252
Developing a Plan 257
Key Point Summary 259
References 259
Appendix | A Breathing Technique 263
Index 267
