Psychological First Aid for Cisco DIRT Responders

© 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-Intro-rbharani 1
Psychological First-Aid
(PFA) for Cisco DIRT
Responders
Rakesh Bharania
Tactical Operations
Note: This material is being released by Cisco to support the global humanitarian
tech community’s preparedness around mental health issues related to disaster
deployment. Organizations should feel free to adapt this material as necessary.

© 2016 Cisco Systems, Inc. All rights reserved. Cisco PublicDIRT-intro-rbharani 2
 Goals of the class
 Defining Psychological First-Aid (PFA)
 Disaster-related Stress Behaviors
 PFA Actions
 Putting it all together
Agenda

Before we go any further …
Thank you for volunteering.

 To empower Cisco Disaster Incident Response Team
(DIRT) members with mechanisms to identify
disaster/crisis- related stress in themselves and others
 To identify actions you can take to provide comfort
and support to yourself, colleagues or others who are
experiencing disaster-related stress.
 To know what resources are available for additional
help.
Even though we are technology responders, remember
that disasters are fundamentally human events, not
technological ones!
Goals

Introducing
Psychological First-Aid

PFA is the practice of recognizing and responding to people
(yourself and others) who need help because they are feeling
stress, resulting from the crisis situation in which they find
themselves.
Knowing PFA will allow you to:
 Create a compassionate environment for yourself,
fellow responders, and disaster survivors.
 Assess what a person might need & give immediate
support.
 Help develop good coping mechanisms.
What is Psychological First-Aid?

Disasters and other humanitarian crises are stressful for both
survivors, and the workers who help them:
 Small disasters (house fire): affects a family and
a neighborhood.
 Large disasters (9/11, Hurricane Katrina, Ebola, Syrian
refugee crisis) have a global “stress footprint”
affecting populations near and far.
Stress is a common reaction among disaster workers – 1/3
report depression/negative emotions after the emergency even
if their personal experience was positive.
You’re at risk: deployed, or working support on the back-end.
Categories of stress: Feelings, Thoughts, Physical Effects,
Behavioral, Spiritual.
Disasters and Stress

 Rage/Anger/Irritability
 Resentment
 Anxiety, Fear
 Despair, Hopelessness
 Numb
 Terrified
 Guilty
 Sad
 Helpless
 Loss of control
 Uninterested
 Overwhelmed
Feelings

 Difficulty concentrating
 Difficulty making decisions
 Forgetful
 Confused
 Distortion of time
 Lowered self-esteem
 Survivor guilt
 Self-blame
 Intrusive thoughts / flashbacks
 Worry
 A sense of being cut off from
reality
 Self-harm
Thoughts

 Fatigue
 Difficulty sleeping (insomnia) /
difficulty getting to sleep or
staying asleep the whole night
 Agitation
 Physical ailments (headaches,
stomach problems, etc.)
 Decreased/increased appetite
 Decreased/increased sex drive
 Easily startled
 Increased cravings: caffeine,
nicotine, sweets, alcohol, illicit
substances
 Lightheadedness
 Weakness
Physical Effects

 Crying spells
 Angry outbursts
 Avoiding people / places /
situations
 Argumentative
 Not wanting to leave scene
until work is finished
 Work problems
 Denying the need to “turn off”
and rest
 Risky behaviors (erratic
driving, unsafe sex or multiple
partners, etc.)
 Inattention to appearance and
self-care
Behaviors

 Change in belief/relationship
with God/Higher Power
 Abandonment of prayer, ritual
 Questioning beliefs of their
faith
 Rejection of spiritual care
providers
 Struggle with questions about
meaning of life, justice,
fairness, afterlife
 Loss of familiar spiritual
supports
 Loss of faith
Spiritual

Contributing Factors to Stress Response
 Cause of disaster (human/natural)
 When it occurs (time of day/year)
 Who was affected
 What is affected (schools,
healthcare, famous structures)
 Where it happens (geographic
boundaries)

 Leaving family and loved ones to go on deployment
 Working in unfamiliar and challenging environment
 Little privacy
 Encountering unfamiliar cultural or ethnic populations
 Listening to survivors’ stories
 Seeing disturbing sights
 Working with difficult supervisors and co-workers
 Returning home and re-integrating
Supporting the deployment remotely also has its own
challenges… like being at home yet feeling you’re at a disaster.
Factors that affect you as a responder

PFA Actions

We will now introduce the principles of Psychological First-Aid
(PFA)
Consider these principles as the awareness you can develop,
attitudes you can adopt, and actions you can take to provide
comfort and support to yourselves and your teammates.
Most disaster stress is temporary and will abate over time with
good support mechanisms in place.
Adopting PFA actions

 Make a connection
 Helping people be safe
 Being kind, calm,
compassionate
 Meeting people’s basic needs
 Active listening
 Helping people connect
 Giving timely and accurate
information
 Encouraging good coping
 Taking care of yourself
PFA Actions

 Make a connection
> Don’t have to wait for someone to approach you.
> Focus your attention on the other person
 Help people be safe
> Be aware of your surroundings
> Enter a scene only when you’re sure it’s safe
 Be kind, calm, compassionate
> Could be as easy as handing someone a bottle of water.
> Express patience and compassion, even when people are being difficult
> Speak in a calm voice
> Remain courteous and respectful of people
> Disaster work can be chaotic and intense – it’s easy to be impolite
without meaning to. Apologize.
PFA Actions in detail

 Meet people’s basic needs
> Disaster workers often ignore their own needs of eating and drinking,
getting rest, and staying engaged with a supportive community.
> Offer or direct people to food and water
> Encourage your teammates to sleep and get rest (rotate duties, “take a
walk”, etc.)
 Listen
> When some people are stressed, they want to talk about it.
> Be attentive, listen carefully, be available
> You can’t make someone talk who doesn’t want to.
 Give realistic reassurance
> Remember that what people are feeling and thinking is understandable
> Don’t minimize their reactions.
PFA Actions in detail (cont’d.)

 Encourage good coping
 Help people connect
> It is important to connect people to their usual support systems.
> Family, friends, etc.
> Use a phone / email / IM / WebEx etc. to stay in touch.
 Give accurate & timely information
> Avoid amplification of rumors and misinformation.
> Expect “fog of war”
 Take care of yourself – adopt the PFA actions personally.
PFA Actions in detail (cont’d.)

Putting it together

 Be tolerant
> treat all with respect and dignity.
 Keep boundaries:
> Don’t tell people what to do/what not to do
 Respect people’s privacy:
> Even if a person is a danger to themselves, there are ways of
engaging help that maintain trust.
Rules of the Road

 Limit on-duty work time to no more than 12 hours per day.
 Rotate work assignments between high stress and lower stress
functions.
 Drink plenty of water and eat healthy snacks and energy foods.
 Take frequent, brief breaks from the scene when you are able.
 Keep an object of comfort with you such as a family photo,
favorite music, or religious material.
 Stay in touch with family and friends.
 Pair up with another responder so that you can monitor one
another’s stress.
 Your reactions are normal – give yourself permission.
Taking care of yourself – here or there.

 If a person appears to be in immediate danger to themselves or
others, then seek immediate help! Call 9-1-1
 If a person appears to be inconsolable and is no longer able to
function in a normal capacity even after you have used PFA and
attempted to take care of immediate needs.
 If the person behaves erratically, or exhibits questionable
judgment in a way that does not make sense in the context of the
situation.
 Resources for escalation…
> 9-1-1 or other emergent care
> Your TacOps coordinator
> Referrals to Cisco Employee Assistance Program (EAP)
When should you escalate?

Connect with us…
 Primary Resource: www.cisco.com/go/tacops
Site contains links to all of our other resources…

Thanks for watching!

Psychological First Aid for Cisco DIRT Responders

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