Planning Psychological First-Aid – Flip the Chart Upside-Down


Those of us who do psychological first-aid work after disasters are very familiar with this chart of the emotional phases that people go through as time progresses.  The chart is helpful because it shows that there is an emotional “high” after a disaster hits that is not intuitively obvious.  We would expect people to be traumatized and devastated but what we often see on the ground is communities coming together, the outside world rushing to their aid and a euphoric relief that they made it even though others didn’t.  However these Heroic and Honeymoon stages are short-lived.  Once the international attention has waned, and the initial rush of adrenalin is gone, a whole lot of real problems remain.  The reality of limited resources of time, money and energy set in and the Disillusionment phase continues for quite some time.


From a disaster response point-of-view it can be useful to flip this familiar chart upside-down and call it a graph of “emotional felt needs”.  Our role as psychological first-aid responders is to help mitigate the emotional difficulties that the community experiences so that they can make it through to a New Normal during reconstruction.  The danger to children, adults and vulnerable communities is that if they are not supported during the peaks of emotional distress they will develop psychological disorders, increase at-risk behaviors or even despair to the point of suicide.

A flipped chart that emphasizes felt emotional needs during disaster phases.
A flipped chart that emphasizes felt emotional needs during disaster phases.

The greatest factor that affects this graph is not the severity of the disaster, but the level of support that the community receives.  It often happens that a community that suffers massive casualties also receives a tremendous amount of support, but a location that suffered moderate damage only a few kilometers away is neglected comparatively.

If we track the level of support that a community receives after a disaster, we find that the greatest need for psychological first-aid comes not in the immediate aftermath of the disaster during the Heroic or Honeymoon phases, but towards the end of the Honeymoon phase and throughout the Disillusionment phase on past the First Anniversary into Reconstruction.

Every disaster is different, and even every community will experience the same disaster in a unique way.  But the ideal time to start training psychological first-aid is one to two months after the Impact event, during the Honeymoon Phase when there is energy and optimism to prepare for what is coming next.

During the Heroic phase most people who want to help are focused on meeting immediate physical needs and communities themselves will see little need for emotional care.  Typically, trainers will find few people who will slow down long enough to receive instruction at this point.

We have found that psychological first-aid interventions like OperationSAFE for children are best timed for very late Honeymoon stage on into Disillusionment and Recovery.  Usually this means starting between two to three months after the Impact event, even as other relief agencies are starting to pack up and go home.


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