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Psychological First Aid - Understanding RAPID Model

Ever been in a situation where  a friend or a close family member of yours opened up to you about how they have been feeling low for the past couple of months or something related to mental distress and you didn’t know the right words to say or make them feel better? 


People usually in such situations make statements like “Don’t worry, it gets better with time” or “It’s nothing, it’s just in your mind.” While one might assume there is no harm in saying these statements, they don’t understand how difficult it must have been for their friend to open up about the issues they have been dealing with. 

The recent advancements in the field of mental health have shed light on the importance of a concept known as ‘Psychological First-Aid’ (PFA). Although it's gaining more popularity in the modern days, it was first coined in the 1940s. PFA may be defined as a compassionate and supportive presence designed to mitigate acute distress and assess the need for continued mental health care (Everly and Flynn, 2005) 

More often PFA is used in areas of natural or man-made calamities but in recent times, just knowing how to deal with such a delicate situation can be very useful. The good news is one does not require extensive training programs or degrees  to practice Psychological First-Aid. Hence, a person who is interested in PFA requires taking a short course on the same and the willingness to help others in need.  This blog  is based on a widely practiced The John Hopkins RAPID PFA Model that consists of five core elements: 




    1. Rapport and reflective listening (RL) 

Rapport building and effective listening are also known to be the basic skills in counselling and they do half the work for you. Some people share their difficulties only because they want someone to hear them out. Sit down and listen to what they have to say. Reflective listening is also called active listening which means being there in the moment with them.

 

Rapport isn’t just about introducing oneself, it’s also about building trust and making sure that the other person feels safe and respected. Another important thing to remember during the whole process of providing PFA is being genuine and empathetic towards the person, since they already have been through a lot and it helps them to open up and talk about how they are feeling.


       2. Assessments

In academic terms, assessment refers to using tools and measures to evaluate the needs of the person. However, since PFA is about providing immediate assistance there isn’t much time to sit down and conduct tests. Here it is necessary to put one’s observation skills in use. Observe what the person is talking about, listen carefully to their words, the tone they use, observe if their words match their actions, look for non verbal cues. It may seem a lot of information to take in while actively listening to the person but one learns with practice. While assessing, it is important to keep aside one's biased beliefs and be neutral. 


        3. Prioritization

Let’s assume one is in a situation where the opposite person is  about to either harm themselves or others around him. Now a situation like this requires one’s immediate attention. One needs to be very careful of the words they use, very observant of the way they act and needs to think quickly. It’s advisable to talk through the opposite person rather than applying force on them. Prioritization in this scenario would mean to prioritize what needs to be done first. 


        4. Intervention

Before continuing with Intervention one must keep in mind that this is for providing first aid and not clinically diagnosing the person and beginning a therapeutic process.  A number of interventions listed in the John Hopkins model which are categorised in two sections;

1. To stabilize acute arousal 

2. Mitigating (making it less severe) acute distress. 


The first one includes giving them work to do, allowing catharsis, at times distraction would also be a useful technique to stabilize them.  The latter is used when one wants to prevent further damage to the person’s emotional and mental being. PFA service providers would try to put off impulsive actions that could harm the person or other around them. They could also educate, reassure, normalize and also correct any misunderstandings that could possibly cause anxiety within the person.


        5. Disposition

The final step to this model is disposition, if the person needs immediate professional help the one should be able to arrange as soon as they can. Apart from that, if the individual seems capable of functioning on their own, then all one needs to do is a regular check up on them.



        Having the basic skills such as empathy, active listening, unconditional positive regard may help in the long run but it’s also important to take care of oneself first. Understanding your triggers and dealing with them beforehand could save one a lot of trouble for themselves and others too.



Written by - Kawaljeet Kaur Bains

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