What kind of support is helpful immediately after a traumatic event?
Reliable emotional and practical support is important after a traumatic event. The most suitable type of help will depend on the needs of the people who have been traumatized.
Traumatic events might include rape, natural disasters, major accidents or life-threatening diseases. For the people who are affected – which could also include family members or witnesses – the following types of support are important shortly after the traumatic event:
- Offering kindness and compassion
- Providing information about what happened and the consequences
- Organizing practical assistance
Some people need to have psychological counseling after a traumatic event. But nobody should be forced to. Because different people cope with distressing events in very different ways, the support should always be based on the individual needs of the affected person. It’s important to give them the time to process what they’ve experienced and avoid forcing them to accept "help" that causes them even more stress.
Psychological first aid following a traumatic event
The following approach is recommended when helping people who have just had a traumatic experience. These recommendations for “psychological first aid” are intended for professional helpers, but may also be useful for people who are at the scene and would like to help. Depending on the situation, it’s a good idea to
- get an overview of the situation,
- help those affected to leave the distressing situation (to protect them from danger or onlookers, for instance),
- ensure a safe environment,
- check who needs help,
- gently offer support,
- be calm and patient,
- stay close by, and
- be available for the next few hours and days.
When dealing directly with those affected:
- Show sympathy, offer consolation and try to calm them down.
- Touching and hugging may be important – but it can also be inappropriate sometimes. If you’re not sure: Avoid physical contact or ask the person whether it's okay first.
- Speak clearly, using simple words – don’t offer too much information all at once.
- Take a back seat and be an active listener when they talk; allow for silence.
- Accept the feelings and impressions of those who have experienced the traumatic event, and look for signals from them; but don’t reinforce negative feelings.
- Ask what they need.
- Involve them in helping other affected people or in arranging food and drinks if appropriate – this can help them be more active and give them some control over the situation.
- Don’t make any unrealistic promises or pass on incorrect information.
- Don’t pressure anyone.
Practical support and information:
- Arrange medical assistance or give first aid.
- Provide information about what happened.
- Provide food, drinks and a pleasant atmosphere, if possible.
- Contact their friends and family, and involve people they know.
- If needed, organize further support (such as finding accommodation).
- Offer information about places to go for additional help (like a trauma clinic).
What else is important?
A traumatic situation can be very distressing for helpers as well. The following is important too:
- Don’t be intimidated by strong emotional responses, such as fits of anger.
- Know your own limits in your role as a helper and seek support yourself if needed.
- Pay attention to any cultural and social factors – they could affect how traumatic events are dealt with.
- Pay attention to the effect you have on others: Which words should I use? What kind of body language am I using? What is my facial expression like? How do I approach someone who has been traumatized?
- Follow any instructions given by professional helpers (such as police or rescue workers) and don’t interfere with their work.
How do people react to traumatic events?
Depending on the situation, different people can react very differently to horrifying events.
- Some people freeze, go quiet and feel numb.
- Others are confused and disoriented.
- Still others may cry and feel sad and down.
- Some are calm and collected, and hardly show any sort of stress reaction.
- But others may have intense emotional reactions, and may feel desperate or furious, or scream.
Certain people need more help than others, for instance children, older people, people with a disability, or those who are on their own or who need protection from abuse and violence. Extra support and special help may be needed then.
What psychological first aid is NOT
Please note: Psychological first aid is not a form of psychological treatment. It’s also not the same as psychological debriefing, where the people affected by the traumatic event or the helpers talk about what they have experienced a short while after. Debriefing is led by a trained professional. Psychological first aid aims to help people right after a traumatic event and give them the support they need to deal with what they experienced over the short and long term. Debriefing has become less popular among many experts because it doesn’t prevent the development of post-traumatic stress disorder.
It usually takes a few days, weeks or months to see whether someone needs psychological treatment. Only then is it apparent whether the stress reaction will go away on its own or whether lasting problems will develop. It can also take time until it’s even possible for someone to be ready for trauma-focused therapy.
Psychological counseling may be helpful until then, especially for people who have been severely traumatized. Support from others should be ensured, as well as an environment in which they can feel protected and safe, and have the opportunity to seek professional support at any time.
Frommberger U, Nyberg E, Angenendt J, Lieb K, Berger M. Posttraumatische Belastungsstörungen. In: Berger M (Ed). Psychische Erkrankungen - Klinik und Therapie. München: Urban und Fischer; 2015.
Österreichisches Rotes Kreuz (ÖRK). Psychische Erste Hilfe: Handbuch. 2015.
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