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Listen Protect Connect Model and Teach

Reference: Marleen Wong, Ph.D.


Associate Dean and Clinical Professor
University of Southern California
Why victims need Psychological First Aid
 “The wind was so fierce, it was howling and the roof of
our house was blown away. My brothers and sisters
were so afraid and I was afraid too.”
 “I heard a roaring sound like ten dam trucks blowing
their horns together, then, suddenly our house was
rocked up and down and sideways and our things and
appliances cluttered and scattered.”
 “The water came through our house and I was
drowning, I didn’t see my parents nowhere.”
 “There was a man who brought a gun and came to our
school. He shoot our teacher. We had to put the school
on lockdown.”
Possible Trauma Reactions among
Children
 Worries and fears – about safety, security, re-occurrence
of the event and the on-going situation
 Changes in behavior – changes in school performance,
decreased concentration and attention; changes in sleep,
appetite, mood (swings), activities; increased irritability,
temper tantrums
 Physiological responses – increased sensitivity to sound,
startle responses, somatic complaints
 Focus on event – repeated questions / discussions about
the event, increased interest in media coverage
 Spiritual changes – questioning of beliefs, struggle with
sense of fairness and with understanding
How do children usually deal with trauma?

 “Sometimes, I talk to some of my teachers because I


have my favorites, they are the ones I feel comfortable
talking to and somehow they understand.”
Adult Issues That Affect Children
 Adults may not recognize distress in children

 Adults may be preoccupied with their own issues

 Adults may deny children’s reactions

 Children may be compliant in the aftermath of an


event
In order to recover
 Children need friends and caring adults to
work through trauma and grief

 Adults need other caring adults to work


through trauma and grief
Why adults need training in PFA?

 “I don’t know what to say and I’m afraid I’ll make it


worse.”
 “I too am a victim, I’m at a loss.”

 Resulting student perceptions:


 “I know a couple of teachers that did not get the point
at all.”
 “I don’t really talk to them because they don’t know
where I’m coming from and nobody understands my
pain.”
PSYCHOLOGICAL FIRST-AID
“FIRST – AID” response aimed to stabilize,
reduce symptoms and return the
victim/survivor to functional capacity in the
aftermath of a critical incident
Any effort that reduces the victim’s feeling of

helplessness and promotes their sense of


control

THELMA S. BARRERA, RN
Psychological First-Aid

 FAMILY SERVICES – effort to locate missing relatives


 RITUALS
 SUPPORT SYSTEM – provision of a support structure
to help victims go through different phases of a critical
incident
e.g. Typoon Yolanda and its Storm Surge, Cebu Pacific Plane crash
Psychological First-Aid

 MATERIAL SUPPORT - warm blanket, clothing


 FOOD ASSISTANCE
 REASSURANCE – help is coming/ sense of security
 PRESENCE OF CRISIS WORKERS – in uniform& identified
 APPROPRIATE INFORMATION
With Psychological First Aid
 Every adult
plays an important role
The responsibility of caring adults is to provide
psychological first aid after crises and disasters
 Listen

 Protect

 Connect

 Model

 Teach
Listen
 Encourage children to share experiences and express
feelings of fear or concern

 Be willing to listen and respond to verbal and non-


verbal cues

 Give children extra reassurance, support and


encouragement
Listen
 You want to convey your interest, empathy and care

 Where were you when this crisis happened?

 What was your fist thought?

 What do you remember about that day?


Protect
 Maintain structure, stability and predictability. Having
predictable routines, clear expectations, consistent
rules and immediate feedback

 Keep your ears open and eyes watchful, especially for


further victimization

 Keep environment free of anything that could re-


traumatize the child

 Validate the student’s life experience


Protect
 What’s the most difficult thing to deal with right now?

 Are you worried about how you are reacting?

 Are you worried about your safety? . . .


 Around other children? . . .
 Around some adults? . . .
Connect
 Check with children on a regular basis

 Encourage interaction, activities, with friends, with


teachers

 Refer/take students to meet new teachers or counselors

 Keep track of and comment on what’s going on in their


lives

 Share positive feedback from parents, teachers and other


important adults
Connect
 What would make things easier to cope with?

 What can I do to help you right now?

 What can your teachers do to help?

 What can your friends do to help?

 What can your family do to help?


Model
 Calm and optimistic behavior

 Maintain level emotions and reactions with children


 Stay in the middle – no highs or lows – to help them
achieve balance

 Take constructive actions to assure children’s safety

 Express positive thoughts for the future

 Help children to cope with day-to-day problems


Teach
 About normal stress symptoms and how to cope

 Acknowledge the normal changes that can occur in


people who are traumatized or grieved
 Physical changes
 Emotional changes
 Cognitive changes
 Changes in spiritual beliefs

 Help children to problem solve:


 How to go to school everyday / How to stay in school /
How to do well in school with friends and family
In a crisis and disaster,
In a trauma and stress
In a moment . . . . .

 In a heartbeat . . . .

. . . Everything changes . . .
DepED in partnership with UNESCO
 Develop a Teachers Manual for Secondary Students to
be uniformly used for psychosocial support
interventions
 Basing that the school is a place of Safety, Security and
Support (3S’s), the Teachers Manual is called SEES
Program – Support, Enabling and Empowering
Students
 Pilot Training of its utilization was last March 19-21,
2015 in Tacloban City
 Project Management Committee Meeting for feedback
and revision last March 26, 2015

 National Training of the revised and finalized manual


was last April 17-18, 2015.
Psychological First Aid (PFA) is NOT
 Counseling
 A practice that is limited to professionals
 Psychological debriefing. Individuals are not asked to
discuss details of the event that caused the distress
 A session where individuals are asked to analyze
what happened to them
 About persuading people to tell you about how they
are feeling and reacting to the event
 Critical Incident Stress Debriefing
(CISD)
It is best to remember that PFA
 Is about helping people:

 SAFE

 CALM

 CONNECTED

 SUPPORTED and

 HOPEFUL
AS a vulnerable Person: As an effective PSSP/PFA:
you need a - (Confidence) you should be a -
C – Countenance (calm expression, mental composure)
R – Riches (or Reach/es)
U - Understanding
T – Ties and Time
C – Circumstance (can easily change)
H – House and Home

CRUTCH
Reminder:
 Don’t get crushed
Otherwise you’ll get confused
And your world would crumble
And finally you’ll crash.
Healing After Traumatic Stress (HATS)
Reference: Robin H. Gurwitch, Ph.D.
Duke University Medical Center
Center for Child and Family Health
National Child Traumatic Stress Network
TEACHER:
Latest Requirements Included
 Expert in numerous subjects
 Educator
 Trauma Counselor
 Psychologist
 Emergency Medical Technician
 Cop
 Bomb Disposal Specialist
 Surrogate Parent
Common Elements of Effective
Interventions
 Directly address the incident

 Educate both child and family

 Correct inaccurate maladaptive and attributions

 Teach anxiety management

 Teach coping skills

 Provide parallel components of caregivers


HATS: Family Exercises
 Supports activity completed at school

 Promotes communication
 Between parents/caregiver and child
 Between school and home

 May help with parental healing

 Promotes family coping


What Happened
 Sets the stage for listening and respect

 Gives child the permission to talk

 Balance with positive experience exercise

 Gently correct misperceptions / misattributions

 Can be repeated throughout HATS exercises – adding


details as coping improves
Searching for Sense of Safety
 Preparedness and resilience building by identifying helpers
before an event

 Identifies people to talk to about event

 Reinforces ideas of safety that are undermined after a


disaster

 Helps children learn important information for


identification and reunification

 Family exercise helps to promote their safety planning


Getting back to Basics
 Reinforces the importance of routine

 Reinforces the importance of consistency


 School day
 Homework
 Behavior
 Home chores and responsibilities

 Note: Normalize problems with concentration and


attention – modify assignments
Naming Feelings
 Multiple emotions (often conflicting) after a disaster

 Expanding feelings vocabulary

 Normalizing emotions

 Helping to recognize “different timetables of healing”

 Note: May revisit “What Happened” exercise


Feeling, Words and Faces
 Relaxation – Fighting back against negative feelings

 Normalizing reactions

 Teaching bodily responses to stress and anxiety

 Work relaxation (color breathing, physical exercise)


into routine

 Teaching new coping strategy for disaster and “life


challenges”
Finding Hidden Treasures
 Family recognition of different positive treasures

 Make positive memories – Recognize that children


may be uncomfortable or feel guilty when having fun
or having positive emotions

 Treasure can continue to grow – Consider a class


treasure chest to add during the year
Good Dreams and Bad Dreams
 Sleep problems have negative impact on school
performance and behaviors

 Normalize sleep difficulties


 Falling asleep
 Staying asleep
 Bad dreams

 Coping strategy for sleep


 Combine with relaxation skills
 Combine with talking to others
Redirecting Thoughts
 Normalizing the thoughts

 Understanding intrusive thoughts


 Impact school, home, friends, activities

 Develop positive coping menu

 Engage in positive activity


 As class
 As family
Finding the Pearl
 Adding special things about himself/herself

 Encourage family to add one more special quality


about their child

 Recognize that each person has qualities that make


him/her special

 Recognize that remembering these special qualities


helps us heal after disaster and helps us better handle
life challenges
Looking Ahead and Setting Goals
 Important step in building resilience

 Recognize growth

 Review positive coping

 Learn to set realistic goals

 Recognize when goals met


Goal Achievement
 New coping skills learned and used

 Tree for each child with leaves for family activity


 Accomplishment
 Emotions
 Achievements

 Tree for the class – Tree of Progress and Good Things


 Each child can add to the class tree
Holidays: Happiness and Humbug
 Family education and involvement

 Activity reinforces child’s importance in other’s lives

 Reinforce importance of practicing HATS skills


 Relaxation
 Communication and Sharing
 Through stopping and Redirection
 New goals, treasures, routine
To the World,
YOU may be just One Person
But to One Person
YOU may be just the World
Thank you!