Within this section, the facilitator will summarise best practice from the research in relation to supporting people immediately following incidents. Hobfoll et al. (2007) identified five intervention principles that have empirical support to guide intervention practices and programmes. These principles are seen as core elements of intervention and will help in the process of setting policy and designing an intervention strategy. Access the full paper here. 

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Promote a sense of safety

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The facilitators will summarise the impact of traumatic events upon the biological responses of individuals. This will be expanded upon during a later part of the training in the section ‘Recovery and Adjustment.’ Schools need to ensure that key factual information is presented, even if the full picture is not yet known. When presented in the context of strong leadership, this can limit the impact of rumours e.g. on social media and promote a sense of safety. Key safety messages reduce the cycle of rumination.

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Safety messages aim to re–link images, people, and events with safety, for example: -

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It was a highly unusual set of circumstances that led to the event.

 

All agencies are working together to look after the community.

 

It is normal to try to guess what might have happened in these circumstances – we are communicating with the police and will keep you updated with the facts when we have more information.

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Promote a sense of calm

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Following incidents, strong and diverse emotions are experienced. Most people return to manageable levels of emotion within days or weeks. Approaches found to be calming include yoga, breathing exercise, muscle relaxation, mindfulness, listening to or playing music. The facilitators will reference the earlier content on psychoeducation here and the importance of ‘normalisation’ of strong physical, emotional and cognitive reactions. It is also important that individuals are aware of the potential positive impact of noticing and fostering positive emotions following incidents e.g. giving oneself ‘permission’ to watch a film that makes you feel happy or laugh, continuing to engage in enjoyable hobbies or activities, continuing to celebrate success etc. Sleep hygiene is an essential element here. When people are well rested, this can promote a sense of calm and sense of control.

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Promote self-efficacy and community efficacy

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Self-efficacy is an individual’s belief that their actions are likely to lead to positive outcomes. Community efficacy is the belief that one belongs to a group that is likely to experience positive outcomes. When trauma is experienced, there is a risk that individuals or groups lose their sense of competency to manage events. This sense of diminished capability can be generalised to other events. Identifying and utilising existing personal and group resources to facilitate positive change beyond the self, can mitigate this risk.

 

Examples may be to: -  

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• involve those affected in decision–making and planning.

• support engagement in age–appropriate, adult–guided memorial activities.

• continue to provide meaningful learning opportunities.

• remind individuals of their efficacy and existing coping strategies.

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Promote a sense of connectedness

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The facilitator will refer to the large body of research on the central importance of social support and sustained attachments to loved ones and social groups in combating stress and trauma. It has the benefit of increasing knowledge regarding wider community support following the incident and promotes a sense of community cohesion. Other benefits include social support, social activities, practical problem solving, emotional understanding and acceptance, sharing of experiences and coping strategies and normalisation of reactions. Following the attack of September 11th in New York and following terrorist attacks in Israel, one of the most common responses was to identify and to link with loved ones. Delay in making connections to loved ones was a major risk factor following the London bombings of 2005.

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Examples may be to: -

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• identify those who lack strong social support and keep them connected.

• provide formalised support where informal social support may be lacking.

• encourage social connections and a return to previous activities e.g. continue with sports / recreational activities.

• encourage communication/listen, but do not question or ask for details about the event.

• promote the understanding that each individual responds differently.

 

Instilling hope

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The final component of support is the critical element of instilling hope in those affected. According to Antonovsky, hope is defined as ‘a feeling of confidence that one’s internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected.’ Trauma often engenders a ‘shattered worldview’ (Janoff-Bulman, 1992); the vision of a shortened future (American Psychiatric Association, 1994) and catastrophising. First prioritise support for practical considerations for those affected – housing, meals, clothing, travel etc.

 

It should be pointed out that there is a danger of hinging hope on an internal sense of agency alone. In fact, there is a place for external resources (people, books, art, poetry) to inspire hope and expectancy.

 

The Positive Psychology Model (Seligman, Steen, Park & Peterson, 2005) identifies the goals of identifying, amplifying and concentrating on building personal strengths and by implication community strengths.

 

Interventions / approaches informed by the principles of Psychological First Aid can facilitate fact-based thinking and stimulate a vision for a future beyond the current circumstance. Encourage normalisation of responses and the sharing of recovery successes.