Adherence to Psychological First Aid after Exposure to a Traumatic Event at Work among EMS Workers: A Qualitative Study

Abstract

Managing post-traumatic stress reactions in the first few days after exposure to a potentially traumatic event in the course of one’s work remains a challenge for first responder organizations such as Emergency Medical Services (EMS). Psychological First Aid (PFA) is an evidence-informed approach to reducing initial distress and promoting short- and long-term coping strategies among staff in the aftermath of exposure. PFA provided by peer helpers is considered a promising solution for first responder organizations. Unfortunately, first responders may encounter stigma and barriers to mental health care. Therefore, a deeper investigation is needed regarding adherence over time to implemented PFA intervention. The purpose of this study is to qualitatively explore factors that influence adherence to PFA intervention of recipients and peer helpers. EMS workers (n = 11), working as PFA peer helpers for one year, participated in semi-structured interviews. Data were analyzed using thematic analysis; intercoder reliability (κ = 0.91) was also used. Researchers identified four themes and 11 subthemes influencing adherence to PFA intervention: (1) individual perceptions and attitudes of peer helpers and recipients about pfa intervention; (2) perceived impacts on peer helpers and recipients; (3) organizational support to pfa intervention; and (4) congruence with the occupational culture. Study findings herein suggest that it is conceivable to act on various factors to improve adherence to PFA intervention among peer helpers and recipients within EMS organization. This could lead to enhanced understanding of the challenges involved in sustaining a peer led PFA program for first responders.

A feasibility study of psychological first aid as a supportive intervention among police officers exposed to traumatic events

“…These recommendations are congruent with the Dynamic Sustainability Framework (DSF), which was developed for the implementation of health interventions in organizations ( Chambers et al, 2013 ), as well as the current literature on PFA’s implementation in organizations. Research effectively showed that PFA training gives responders the confidence to use the intervention with prospective beneficiaries even if they were not trained in mental health ( McCabe et al, 2011 ), and that the adherence of Emergency Medical Services workers as PFA-responders was based on their confidence and ability to provide an adapted intervention as well as their feeling of being adequately equipped ( Tessier et al, 2021 ).…”

“…It is important to mention that the adaptation of PFA was based on authors’ experience with police officers seeking psychotherapy services at the Montreal Trauma Studies Center. Moreover, a similar project was conducted with paramedics (see Tessier et al, 2021 ). First, the context in which PFA could be used was broadened.…”

“…Semi-structured interview grids were co-created with the SQ to get participants’ perspectives on the demand (objective 1), practicability (objective 2), and accessibility (objective 3) of the PFA program. Based on authors’ previous involvement in studies with public safety personnel ( Tessier et al, 2021 ), the research team developed a first draft of the interview grid. The initial draft was submitted to collaborators within the SQ who are responsible for the implementation of the PFA program.…”

Evaluation of the Implementation of the NFFF Stress First Aid Intervention in Career Fire Departments: A Cluster Randomized Controlled Trial

“…Unfortunately, in many areas of occupational behavioral health practice-and in fire and EMS organizations particularly-debriefing and related interventions are still widely used. In response, efforts to provide alternatives to CISD, such as Psychological First Aid, have gained momentum [45].…”