South African Institue For Traumatic Stress
Room 122 Emthonjeni Centre, University of the Witwatersrand
Cr Jorrisen & Station Streets (Entrance from Station Street)
Braamfontein Johannesburg, 2001
Tel: (+27 11) 717 8677, Mobile: 084 2988 135, Fax: 086-6568-216
Leoni.Futter@wits.ac.za

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Psychological first aid after a traumatic event
The psychological first aid for people who have survived a traumatic event, for example, armed robbery, rape, and motor vehicle accidents is:

to get them to a place of physical and psychological safety as soon as possible, give them emotional support from trauma trained counsellors, who can refer them to a trauma trained professional if required. NOTE!!
While good trauma counseling helps enormously, unskilled trauma counsellors can do a lot of damage. Unless you have a prior psychiatric illness or are pregnant, it is best not to take a tranquilizer after a traumatic event.

NOT EVERYONE NEEDS TRAUMA COUNSELLING! Not do not push people into counselling when they look fine, and say that they are alright.

What can I do to help a victim immediately after the incident?

• 1. Ensure that the person is physically safe and that any medical problems are attended to.
• 2. Get a blanket or a jacket to put around the victim's shoulders. This is to keep him/her warm and protect his/her dignity if clothing is torn or soiled.
• 3. Move the person away from the scene of the crime or turn them so that they are not looking at the scene. Try to find a quieter place away from the noise and confusion of police investigations, ambulances, and so forth.
• 4. Encourage the victim to breathe slowly and deeply.
• 5. Stay with the person and reassure him/her by giving information that is true and contributes to a sense of safety. For example, "the robbers have gone now and the police are here", or "your brother is on his way and should be here soon". Do not lie to the person or use meaningless platitudes. Speak in a clear, calm voice and repeat yourself as necessary.
• 6. Get the victim a warm drink and something to eat. Explain that although they may not feel like eating it is likely that their blood sugar level is very low and that something small to eat helps.
• 7. If the victim is comfortable (and wishes it) hold his/her hand but do not hug or intrude on his/her personal space.
• 8. If the victim is still feeling out of control (ongoing panic, crying uncontrollably, or seems to be in a dreamlike state) after two hours, seek help from professional medical and psychological personnel.
• 9. Protect the victim from possible secondary victimization resulting from insensitive questioning, being blamed for the incident and so forth.
• 10. It is very important that you do not push the victim to talk about what happened, especially where talking about the event is increasing their distress or anxiety.

How do I recover from trauma?
Immediately following a trauma, almost everyone will find themselves unable to stop thinking about what happened.
Many will also exhibit high levels of arousal. For most, fear, anxiety, remembering, efforts to avoid reminders, and arousal symptoms, if present, will gradually decrease over time.
Use your personal support systems, family and friends, when you are ready to talk.
Recovery is an ongoing gradual process.
It doesn't happen through suddenly being "cured" and it doesn't mean that you will forget what happened.
But, most people will recover from trauma naturally over time.
If your emotional reactions are getting in the way of your relationships, work, or other important activities you may want to talk to a counsellor. (Fact Sheet National Centre for PTSD).

Why is it important that mental health professionals get specialist training in traumatic stress response?
Despite the high levels of traumatic exposure among the South African population, many mental health professions in our country qualify without ever developing a deep understanding of traumatic stress response.
This is partly due to the fact that the field of traumatic stress is a relatively young field and one that has been advancing at a tremendous rate over the past two decades.
Traumatic stress response requires very specific skills and techniques which are not the standard tools of supportive counselling or brief psychotherapy.
When counsellors and therapists rely on inadequate or inappropriate tools they prevent the client from receiving the necessary care, and may in fact do significant and lasting damage to the clients' psychological health.
In the absence of a deep understanding of traumatic stress, many South African mental health professionals incorrectly view trauma response as technically simple. If people are not sufficiently skilled, they feel helpless in the face of complex trauma cases. This is a serious threat to the counsellors' mental health and personal happiness.
The most common survival response for people who are poorly skilled to deal with traumatised people is to be emotionally cut off from the people they are dealing with, which is part of what is called negative resilience. People who are emotionally cut off from others are also compromised in their ability to do their jobs.