Psychological First Aid for Caregivers of Wounded Veterans

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Psychological First Aid for Caregivers of
Wounded Veterans

• Presented by Jim Messina, Ph.D.,

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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

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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

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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 ones 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

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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

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The signs coming from caregivers of their needing
PFA

• Wounded ideals and/or cynicism
• Feeling unappreciated by wounded loved one
• Betrayed by helping organizations
• Mistrusting everyone around them
• Loss of enthusiasm and dimming hope
• Neglecting personal safety and physical needs
• Excessive sleep difficulties
• Inability to concentrate
• Symptoms of illness or disease
• Excessive use of alcohol, tobacco or drugs

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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

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Skills and Attitudes to be Effective Providers of
Psychological 1st Aid

• Good Listening skills
• Patient
• Caring attitude
• Trustworthy
• Approachable
• Culturally competent
• Empathetic
• Non-judgmental approach
• Kind
• Committed
• Flexible
• Able to tolerate chaos

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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

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Psychological First Aid Actions to use with
caregivers

• Making a connection with them
• Helping them maintain healthy boundaries with one
  another
• Being kind, calm, and compassionate
• Meeting their basic needs
• Listening to them
• Giving realistic assurance to them
• Encouraging them to use good coping
• Helping them to connect with one another for
  emotional support

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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

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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 ones 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

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Self-Help Psychological First Aid Strategies

• Use one of the following strategies to express
  your feelings on a daily basis
• Keep a journal about your feelings about what you
  experience as you handle this process
• Use painting or drawing art projects which help
  you get out the stress and anxiety faced in your
  care giving process
• Playing or listen to music to get out the stress
  and anxiety you face
• 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

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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

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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
• Threatens to harm or kill self or others
• Cannot be calmed after PFA attempts to comfort
  and respond to requests and/or needs
• Behaves erratically and exhibits questionable
  judgment, because of possible influence of
  alcohol or drugs
• 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

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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 caregivers 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