Psychological first aid for workers exposed to traumatic events

Due to the nature of their occupation, workers in the field of health and public security are repeatedly exposed to potentially traumatic events. For instance, paramedics are routinely exposed to grievously wounded people while on duty. This repeated exposure makes these workers more at risk than the general population of developing mental health problems such as post-traumatic stress disorder, depression, anxiety disorders and drugs and alcohol consumption problems.

The Trauma Studies Center is currently conducting a study on psychological first aid (PFA) delivered by peer helpers in the workplace. In this study, paramedic and medical dispatcher organisations, police forces, and Centres Intégrés de Santé et de Services sociaux workers took part in the project in order to offer this new approach to psychological care to workers affected by a traumatic event (TE).

What is PFA?

Initially developed to help survivors adapt following a mass trauma event (i.e., a natural disaster, or an act of terrorism), PFA are now used with a diverse clientele and is the approach favoured by the WHO in order to prevent the psychological distress that can occur after a TE. The intervention is intended to be flexible and centred around the needs and preoccupations of the exposed individual. It can begin in the first hours following the event (the immediate phase). At this stage, it is important to provide the required physical and psychological care needed in order to foster a sense of security and a return to calmness. In contrast with psychological debriefing, PFA forbids forcing the person to talk about details of the event, to minimise emotions and to suggest to them how they should feel. Rather, the person administering PFA will show empathy and adopt validating and accepting attitudes regarding the whole gamut of emotions expressed by the person. They will also explore together the available sources of social support that can meet current needs.

Once the sense of security re-established, intervention will take the form of watchful waiting (post-immediate phase). In this manner, in the weeks following the TE, a continuous evaluation of needs as well as a screening for stress reactions and risk factors in order to ensure, when necessary, a link to appropriate help resources. The caretaker will be available to offer support and give out information on post-traumatic stress responses that can occur as well as strategies to better manage them.

Ultimately, the recovery of those exposed will result from the application of the five fundamental intervention principles of PFA:

• fostering a sense of security;
• fostering a return to calmness;
• fostering a feeling of being connected to others;
• fostering a sense of efficacy;
• fostering a feeling of hope.

Although this promising approach is evidence based, its efficacy in the workplace has not been demonstrated yet. In order to fill this gap, the Trauma Studies Center is conducting this study with the objective of determining how to implement PFA in the workplace and to evaluate its efficacy in this setting. If you have questions about this project, please join Marie-Pierre Leduc, project coordinator, at (514) 251-4000, extension 3123 or by email at: marie-pierre.leduc.cemtl@ssss.gouv.qc.ca.