For the second part of our series on responding to the terror threat, Anne Payne, co-founder of Validium, discusses how timely psychological first aid can prevent long-term issues.

When it comes to preparing for a terror attack, revising security measures and ensuring people are trained in first aid techniques is important. But just as important is considering how best to respond to those who might not have physical injuries, but have still been caught up in the horror of witnessing people being run over, stabbed, blown up or otherwise injured.

Faced with shocked, distressed and potentially injured employees, the general focus is usually on treating physical wounds. Psychological injuries are much less often a priority – and less likely to be attended to in the right ways. The consequence of such a ‘treatment-focused’ approach is that standard occupational health practices can inadvertently cause individuals to maintain a state of helplessness, by being too paternalistic. When research shows that empowering staff to take a more proactive and positive approach to their own recovery is an essential part of limiting psychological damage. 

The ABC of psychological first aid
Fortunately, just as there’s an ABC of physical first aid: Airways, Breathing, Circulation, there’s also an ABC for psychological first aid: Attend to Basic needs with Compassion. In practice, this requires gently redirecting people to a position of stability, safety and calm. Whilst you might think it would be helpful to fuss over them and do whatever you can for them, in the way that you might if they had been physically injured, this can actually be detrimental when it comes to psychological injuries. It’s very important for their long-term recovery that they start thinking about what they need for themselves and become empowered to start doing small things for themselves, to bring their mental functioning back online as soon as possible.

So what should you say to someone who has just been traumatised? Ask them what they most need to feel safe and secure again and support them to meet this need for themselves: i.e. Attend to Basic needs with Compassion. For example, if they want to contact a family member, or want someone they trust to come and collect them, encourage them to make the call themselves, instead of doing this for them. It’s important to show compassion and understanding, but in a way that gets them to start functioning for themselves again.

Delivered effectively, psychological first aid is a systematic set of flexible, conversational, enabling actions that can be used to provide immediate support to trauma victims. The overall objective is to minimise distress in a practical, efficient and non-intrusive way, to foster short- and long-term adaptive functions. The more you can encourage employees to take positive small steps towards retaking control, the more you can facilitate their recovery. At the most basic level, this means encouraging staff to link up with family, friends, colleagues and their managers. It also involves educating people to understand that they are likely to experience some of the symptoms of trauma, ranging from hyper-vigilance and avoidance to poor concentration and insomnia.

Educate managers and first-aiders
By educating managers and first-aiders to deliver the appropriate psychological first aid response, as part of your trauma recovery plan [LINK TO FIRST ARTICLE] you can increase the ability of people to stay calm and start functioning normally again. As well as reducing the risk of them experiencing long-term damage, such as Post Traumatic Stress Disorder (PTSD), which can result in the individual constantly reliving the trauma in some way, either through flashbacks and nightmares, or by becoming upset when confronted with reminders of the trauma when doing or thinking about something else.

Most people are resilient and will recover with the support of their personal networks. That is why, as well as encouraging empowerment and education, psychological first aid also encourages people to connect with others for support. The more engaged and interconnected people are during the day, the more likely they are to reach out and support each other in the aftermath of a crisis. In some cases, an employee who wasn’t directly involved in events, but who has suffered a past trauma, might become affected by events. Its therefore important to be mindful of anyone struggling to attend work of exhibiting signs of anxiety, depression, aggression or distress in the months following the event.

Employees should be reminded of any support services in place, such as HR, OH, their GP, relevant charity helplines or the Employee Assistance Helpline (EAP), which should be able to offer immediate access to specialist trauma counselling, instead of distressed employees having to wait months for this on the NHS. With the right psychological strategy in place, you can significantly reduce the likelihood of anyone to suffer irreparable long-term damage that inhibits their ability to function on a daily basis. Although, it’s also important to note that those most affected may struggle to return to being the person they were before and may need help and support to find a new ‘normal’.