ANXIETY: Quickly calming distress and improving mental health

In response to the coronavirus pandemic, disaster psychologists point to Psychological First Aid to rapidly and effectively help people with anxiety and distress. Adapted from the APA 4.20.20 Pappas

The coronavirus pandemic has turned ordinary activities into risky endeavors, locked people away in their homes and exposed front-line health-care workers to dangerous and heart-wrenching situations.
In response, some disaster psychologists and their colleagues are reaching out with Psychological First Aid. This approach, commonly used in the aftermath of acute disasters like tornadoes or typhoons, aims to reduce immediate distress and improve adaptive functioning in the face of a traumatic event.
The difference now, says Amy Nitza, PhD, a psychologist and director of the Institute for Disaster Mental Health at the State University of New York at New Paltz, is that everyone is both feeling the impact and needing to support others around them who are also impacted.
“We talk about the responder and the survivor or the helper and the survivor, and in this case we’re all both,” Nitza says. “Everybody can benefit from having the tools to respond effectively to someone in distress because we’re all interacting with people in distress every day.”
Nitza and her colleagues are working with local governments and international organizations alike to push out Psychological First Aid trainings. Elsewhere, disaster psychologists are targeting health-care workers. And there are signs that interest in Psychological First Aid is surging organically. A free Coursera course in Psychological First Aid developed by psychologist George Everly Jr, PhD, a professor at the Center for Public Health Preparedness at Johns Hopkins University, usually sees about 300 to 400 students per week, Everly says. In the first week of April, 11,000 people took the class.
“That says something about desperation, about recognition of need,” Everly says.
Psychological First Aid is designed to mitigate distress during or right after a disaster or traumatic event. Psychological First Aid training has not been subjected to rigorous experimental testing in the field because it's not delivered in a standardized way and because of ethical issues involved in withholding care from people experiencing trauma. However, it is considered “evidence-informed,” says Karla Vermeulen, PhD, the deputy director of the Institute for Disaster Mental Health.
The basic principles of safety, calming, efficacy, connectedness and hope have empirical support, as outlined in a review led by clinical psychologist Stevan Hobfoll, PhD (Psychiatry, Vol. 70, No. 4, 2007). A pilot study led by Everly found that people who recounted a stressful life event to someone trained in Psychological First Aid showed lower anxiety immediately afterward compared to those who were simply listened to (Journal of Nervous and Mental Disease, Vol. 204, No. 3, 2016).
Psychological First Aid does not assume that stress reactions are pathological. Instead, it involves looking for signs that someone needs additional mental health help and connecting them to that help.
“The great majority of reactions are ordinary human reactions to extraordinary events, but there are things that can require a professional,” says Gerard Jacobs, PhD, an emeritus professor of clinical psychology and former director of the Disaster Mental Health Institute at the University of South Dakota.

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