19. Psychosocial support

Last update: 2022-09-14

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Normal reactions to abnormal events
Emotional. Anxiety, grief, guilt, anger, irritability, frustration, sadness, shame, numbness, loss of hope, loss of meaning, feeling of emptiness. Mental. Loss of concentration, memory loss, confusion, intrusive thoughts, difficulties in decision making, disorganized thought. Physical. Increased heartrate, sleeping problems, aches (stomach, head), back and neck pain, muscle tremors and tension, loss of energy, inability to rest and relax. Social. Risk taking, over- or under-eating, increased intake of alcohol or cigarettes, aggression, withdrawal, isolation.

Normal reactions to abnormal events

Emotional. Anxiety, grief, guilt, anger, irritability, frustration, sadness, shame, numbness, loss of hope, loss of meaning, feeling of emptiness.
Mental. Loss of concentration, memory loss, confusion, intrusive thoughts, difficulties in decision making, disorganized thought.
Physical. Increased heartrate, sleeping problems, aches (stomach, head), back and neck pain, muscle tremors and tension, loss of energy, inability to rest and relax.
Social. Risk taking, over- or under-eating, increased intake of alcohol or cigarettes, aggression, withdrawal, isolation.

Psychosocial support

The term “psychosocial” refers to the dynamic relationship between the psychological and social dimensions of a person, where the dimensions influence each other. The psychological dimension includes emotional and thought processes, feelings and reactions. The social dimension includes relationships, family and community networks, social values and cultural practices.
“Psychosocial support” refers to actions that meet the psychological and social needs of individuals, families and communities.
We provide psychosocial support to help people who have been affected by a crisis to recover. Early and adequate psychosocial support can prevent distress and suffering from turning into more severe mental health problems.

Hobfoll et al (2007) proposed that five principles should drive psychosocial support during emergencies. Interventions should ensure safety and promote:
Calm Connectedness Personal and collective efficacy Hope

Psychosocial support activities include:

Psycho-education and awareness raising on psychosocial issues.
Life skills and vocational skills.
Recreational and creative activities.
Sports and physical activities.
Restoring family links.
Child friendly spaces.
Community committees.
Supporting memorials and traditional burials.
Psychological first aid.
Lay counselling.
Support and self-help groups.

Psychological first aid (PFA)

PFA is...
Comforting someone who is in distress and helping them feel safe and calm. Assessing needs and concerns. Protecting people from further harm. Providing emotional support. Helping to provide immediate basic needs, such as food and water, a blanket or a temporary place to stay. Listening to people but not pressuring them to talk. Helping people obtain information, services and social support.

PFA is not...
Something only professionals do. Professional counselling or therapy. Encouraging a detailed discussion of the event that has caused the distress. Asking someone to analyse what has happened to them. Pressing someone for details on what happened. Pressuring people to share their feelings and reactions to an event.

PFA is about comforting someone who is in distress and helping them feel safe and calm. It provides emotional support and helps people to address immediate basic needs and find information, services and social support. The three action principles of Look, Listen and Link indicate that PFA is a way to approach someone in distress, assess what help he or she needs, and help him or her to obtain that help.

LOOK (Pay attention to a situation)

Establish what has or is happening.
Establish who needs help.
Identify safety and security risks.
Identify physical injuries.
Identify immediate basic and practical needs.
Observe emotional reactions.

LISTEN (Pay attention to the person)

Introduce yourself.
Pay attention and listen actively.
Accept others’ feelings.
Calm the person in distress.
Ask about needs and concerns.
Help the person(s) in distress to find solutions to their needs and problems.

LINK (Take action to help)

Find information.
Connect with the person’s loved ones and social support.
Tackle practical problems.
Obtain services and other help.

Active listening is a key component of PFA

Actively concentrate on what the affected person says.
Do no interrupt or try to assure them that everything will be all right.
Make frequent eye contact and ensure that your body language signals that you are listening.
Gently touch the hand or shoulder of the affected person, if appropriate.
Take time to listen when people describe what happened. Telling their story will help people understand and eventually accept the event.