Johns Hopkins RAPID model Flashcards
(25 cards)
What is Psychological First Aid?
PFA can be defined as a compassionate and supporting presence designed to mitigate stress and assess the need for continued mental health care.
It is not about diagnosis or treatment.
What is the goal of PFA/ psychological crisis intervention?
The goal of PFA is to stabilise and mitigation.
What does RAPID PFA model stand for?
Rapport and Reflective listening
Assessment of needs
Prioritization
Intervention
Disposition and Follow up = Observe
How to convey Rapport and Reflective listening
Make contact
Provide an introduction
Establish rapport
Use specific active reflective listening techniques such as paraphrasing to establish some degree of empathy.
What is the best way to reflective questions?
Open ended questions - no leading replies.
Summary paraphrase
- Sounds to me like
- so in other words
- what your saying is
- What I’m hearing you say is
What is the Assessment stage?
Assessment of basic physical and psychological needs.
Assessment is derived from a guided conversation.
Distress VS Dysfunction?
Post disaster
60 - 90% experience acute distress. These survivors will show resilience and while having some adjustment difficulty they will sustain or quickly regain function capacity.
5- 49% of those directly affected may experience more lasting or impairing dysfunction. You need to Identify, asses and intervene.
What are some distress cognitive reactions?
Temporary confusion
Inability to concentrate
Reduced problem solving capacity
Overwhelmed
Obsessions
Reliving the event
Nightmares
What are some distress emotional reactions?
Fear
Sadness
irritability
Anger
Frustration
Bereavement - loss
Anxiety
What are some distress behavioural reactions?
Temporary phobic avoidance
Compulsions
Hoarding - can be seen as adaptive,
Sleep disturbance
Eating disturbance
Easily Startled
What are some distress spiritual reactions?
Questioning faith
Questioning God’s actions
What are some distress physiological reactions?
Change in appetite
Change in libido
Psychogenic headaches - not associated to any physical harm.
Psychogenic muscle aches/spasms
Decreased immunity
What are some disfunction cognitive reactions?
Incapacitating confusion, diminished Cognitive capacity
Hopelessness
Suicidal thoughts
Homicidal thoughts
Hallucinations
Paranoid delusions
What are some disfunction emotional reactions?
Panic attacks - EXTREME Anxiety, causes irrational behaviour.
Immobility depression - Numb and depressed.
Affective numbing
PTSD
What are some disfunction behavioural reactions?
Persistent avoidance
Immobilising compulsions
Aggression/violence
Reclusiveness
Impulsive risk taking
Self medication
What are some disfunction spiritual reactions?
Cessation of faith related practices
Projecting faith onto others.
What are some disfunction physiological reactions?
Changes in cardiac function
Changes in gastrointestinal function
Appearance of occult blood
Chest pain
Dizziness
Numbness/paralysis - Arm/leg/face more specific.
Inability to speak/ understand speech.
Unconsciousness
What are the three Ds in the risk-based triage approach?
Death, Dislocation, and Disabling Impact.
What is the significance of asking a survivor if they saw human remains?
Seeing human remains, especially for those unaccustomed to it, can lead to lasting psychological distress, serving as a vulnerability (diathesis) that may affect them for weeks, months, or even a lifetime.
Why is it important to know if the person thought they were going to die?
The perception of impending death can increase the risk of long-term psychological distress and trauma.
What does sub-acute risk refer to in this context?
Sub-acute risk refers to psychological impacts that may emerge days, weeks, or even months after the traumatic event.
Key to prioritisation
Recognising and prioritising dysfunctional inclination/ behaviour
Intervention about stabilisation - How would you stabilise acute arousal?
- Remove provocative cues.
- Encourage a task focus - pivot their attention else where.
- Allow catharsis - allow them to vent.
- Delay impulsive actions - Right now might not be the best time.
- Use distractions.
Intervention about mitigation - How would you mitigate acute distress, foster improved ability to function?
- Educate - explanatory guidance (explain why it happened).
- Normalise - this happens to many people.
- Reassure - instil hope.
- Educate - anticipatory guidance.
- Delay impulsive actions.
- Stress management techniques, problem solving skills.
- Correct misunderstanding or false information.
- Reframe if possible - is the glass half empty or how full (dependence how you view it). Opportunities allow to faster recovery.
