Seven Tips For Offering Psychological First Aid In Schools

Psychological first aid is defined as offering immediate, compassionate support after a traumatic event which helps children and adolescents identify coping strategies or healthy, adaptive coping methods for dealing with the crisis. Psychological first aid for children and adolescents refers to the specific steps that adults can take to help children deal with their own flight, fight or freeze response to a crisis or traumatic event.

Strategies associated with psychological first aid can be used by teachers to effectively reach and respond to students who have recently experienced or are currently experiencing a crisis or traumatic event. Further, early intervention may also prevent children from experiencing complex, long terms symptoms as a result of the trauma.

In many communities, schools are viewed as hubs of social interaction, information and at times, support. Schools can be ideal locations for children and adolescence to receive psychological first aid after experiencing a crisis or traumatic event. Students bring their social and emotional needs to school and it is often the classroom teacher who must intervene and provide support, particularly if a teacher has been charged with a teacher-counselor role within the school.
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In this article,i outline steps teachers may engage in psychological first aid practices to assist their students who have recently experienced traumatic events.

Making contact refers to building a trusting relationship with a child and establishing contact so that the child feels that someone is available and that the adult will listen, validate, support and care for them. For teachers who have established strong relationships with their students, making contact may also mean noticing subtle or pronounced behavioral changes in a student and making time for one on one contact with the child to listen. It is important that teachers establish contact but do not force a child or adolescent to tell the teacher "what happened" or "what is wrong". Children and adolescents may be asked if they would like to talk about the event or crisis, but should not feel forced to tell "the story" if they are unable or unready to do so. Some children may simply want to discuss how they feel, how their body feels or what they are worried about rather than telling intimate details of a traumatic event. Teachers should allow students to determine the course of the conversation.

Providing safety is the second step. It involves specific verbalizations or behaviors by the teacher that encourage a child to feel safe at school. This may include specific statements, such as, "You are safe here with me" or "I will do my best to keep you safe here at school". Specific safety behaviors may include allowing a student to hold a special stuffed animal, sit in the teacher's chair or near the teacher, sit near a friend in the classroom or sit in special place in the room with comfortable pillows and blankets. Adolescents may feel a greater sense of safety by talking with the teacher in private, sitting with a group of friends or near a best friend. Expressive arts can also be used to help develop a sense of safety. For example, children and adolescents may draw or paint pictures of a "safe space" or write a poem about a safe place or safe person. Children who do not feel safe at school will not be able to sustain their attention, function optimally or retain academic content or information.

The third component of Psychological First Aid, stabilizing affect, refers to helping to stabilize a student who is expressing strong emotions related to the traumatic event. Anger, sadness, fear and confusion are common affective states that may occur after a child has witnessed a traumatic event. Despite the structure of the school environment and the school day, students may experience extreme emotional states at school and may need assistance with returning to a more homeostatic emotional state. Assisting a child in this manner often involves finding a private space to sit with the child or adolescent, calmly accepting the emotion being displayed, and if the child is listening, reflecting back to the child what is happening in the moment. For example, a teacher may state, "I can see that you are very angry and frustrated right now and you are not sure what to do" or "You are so sad right now and crying very hard". Simple reflections such as these help children feel validated and help them make sense of their extreme emotions. Additional strategies for stabilizing affect may include naming the behavior that the child is displaying as a result of the emotion ("You are pounding your fists on the table because you are mad") and reminding the child that they are not alone while facing the problem ("I am here with you and I care about you. I am going to listen to you".)

Addressing needs or concerns refers to asking questions about what the child needs in the immediate moment or what concerns the child has as that time. Students who have just experienced a strong emotional outpouring may ask to use the bathroom, for a drink of water or to have a few minutes in private before going back to class. Some students may want to go home and be with family members to feel connected to and sheltered by their families. Traumatic events frequently invoke a yearning for attachment and closeness with caregivers. Other students may pose existential questions to the teacher in attempt to understand death, grieving or the "why" of man-made crises or natural disasters. Teachers should calmly respond to student needs and concerns to the best of their ability and admit when they do not know how to respond. Children and adolescents will still benefit by being able to state their needs and concerns and have a compassionate adult listen to them.

Facilitating coping is an important step in psychological first aid because it reminds students of how they are coping with the traumatic or stressful event as well as gives them time and space with an adult to identify other strategies that they can engage in to cope with their thoughts and feelings. To begin, the teacher may want to praise the very basic steps the student has taken up until that time. For example, teachers may state that a student is brave and strong for attending school despite the crisis or teachers may praise a student's wisdom for asking for support or letting an adult help him or her. Additionally, if the student is calmer at this point, the teacher can ask what the student would like to do to begin to feel better. Students may name coping skills that have worked for them in the past when they are upset and teachers should validate these instincts. A teacher may say, "You just told me that during the last time that you were really scared, you talked to your mom and dad and cried. But afterward, you felt better". Students may decide that they want to talk to trusted adults in their family or community about how they are feeling and what they worry about. Students may also reveal that they would like to draw a picture, read a book, and play with or sit with their friends. All are examples of children or teens "reminding themselves" of their innate coping skills and the different actions that they can take to cope. Students who are psychologically stuck or unable to name coping skills may benefit by having the teacher gently brain storm with the child or suggest specific coping strategies.

Finally, the last two steps in Psychological First Aid involve Linking with collaborative services and Referral to other professionals for follow up. Because of the nature of these steps parents of the student should be contacted if the teacher has not already done so. Linking with collaborative services and referrals simply means providing parents or caregivers with information about community resources which may help the student and/or family deal with the crisis or traumatic event. For example, information about services or agencies which provide food, clothing, shelter, water or which address basic needs should be shared with the parents. If those basic needs are not an issue, the teacher may then want to help the parents consider how to ensure a sense of safety, comfort and support at home. Again this may include linking families with outside services (e.g. a church leader, counselor, etc.) to provide additional intervention. This may be particularly true when the parents are too impacted by the traumatic event to be the sole source of support for the child.