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Candice Hoke, George Everly, Ph.D., Jeffrey Lating, Ph.D., Matthew Kirkhart, Ph.D.

A Validation of Group Psychological First Aid

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Natural disasters, sociopolitical conflicts, and regional crises possess the potential to create dramatic changes in a community. Research has indicated an increase in psychopathologies such as post-traumatic stress disorder, mood disorders, and substance abuse following such critical incidents. Since 1954, the American Psychiatric Association has publicly recognized the need for a form of psychological triage in the aftermath of a disaster. The approach to be evaluated in this study is group psychological first aid (gPFA). Conceptualized at the individual and group level, PFA is a structured method for a crisis interventionist to assess what level of care an individual may need in the wake of a critical incident. Recommended by organizations such as the Institute of Medicine and the American Red Cross as a method to provide brief and efficient care to survivors of critical incidents, PFA has yet to be evaluated in controlled settings. While general PFA principles are empirically-based, literature searches yield little evidence regarding the effect of specific mechanisms of PFA in a group context.

A Validation of Group Psychological First Aid is a study intended to empirically assess the potential benefit of a form of psychological triage in a group context. The proposed thesis has identified potential mechanisms that may facilitate healing in the aftermath of a critical incident. The potential mechanisms are as follows: imparting information, universality and group cohesion, cathartic disclosure, and empathy and altruism. Survivors of a crisis are also allowed an opportunity for catharsis in a structured environment, which research has indicated is important to initiate psychological and physiological healing in the aftermath of a crisis. The shared reactions of fellow survivors may elicit empathic and altruistic reactions toward others in the group. Group members are provided the opportunity to establish social support networks, with resources from the interventionist and fellow group members. The interventionist can disseminate information about an incident, maladaptive symptoms of trauma, and adaptive coping methods to group members who have experienced a critical incident such as a personal loss, a significant setback, or a change in living arrangements in the last year. Through the provision of information regarding the trauma, the cathartic discussion, and observation of the group leader(s) in a structured environment, interventionists have the opportunity to assess group members who may be in need of intensified physical and psychological care. All group members will have the opportunity to receive information regarding resources for intensified care. The proposed study is intended to contribute empirical data regarding the effect of a gPFA session on self-reported state anxiety, state distress, state optimism, and state resilience. Using this data, public health officials can build upon methods for brief interventions in future, naturalistic settings.

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