The myth of the 1-day training: the effectiveness of psychosocial support capacity-building during the Ebola outbreak in West Africa

Abstract

Background.In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support in emergencies, focusing particularly on whether the PFA training provided during the Ebola outbreak enabled non-specialists to incorporate the key principles into their practice.Methods.Semi-structured interviews were conducted in Sierra Leone and Liberia with 24 PFA trainers; 36 individuals who participated in PFA training; and 12 key informants involved in planning and implementing the PFA roll-out.Results.Findings indicate that many PFA training-of-trainers were short and rarely included content designed to develop training skills. As a result, the PFA training delivered was of variable quality. PFA providers had a good understanding of active listening, but responses to a person in distress were less consistent with the guidance in the PFA training or with the principles of effective interventions outlined by Hobfoll et al.Conclusions.There are advantages to training non-specialists to provide psychosocial support during emergencies, and PFA has all the elements of an effective approach. However, the very short training programmes which have been used to train non-specialists in PFA might be appropriate for participants who already bring a set of relevant skills to the training, but for others it is insufficient. Government/NGO standardisation of PFA training and integration in national emergency response structures and systems could strengthen in-country capacity.

The Effect of Psychological First Aid Training on Knowledge and Understanding about Psychosocial Support Principles: A Cluster-Randomized Controlled Trial

“…It is possible that these outcomes are more strongly associated with other factors in the professional life of PHU staff members, such as the type of workplace, years of job experience, and staff support [17,18]. To the extent that training may impact these outcomes, more extensive inputs are likely required, including the provision of supportive supervision [15]. It is also clear from our earlier work [15] that providing psychosocial support in line with PFA principles requires restraint in the use of common responses such as reassurance and advice-giving, and engaging in a new style of interaction may initially promote uneasiness in helpers.…”

“…To the extent that training may impact these outcomes, more extensive inputs are likely required, including the provision of supportive supervision [15]. It is also clear from our earlier work [15] that providing psychosocial support in line with PFA principles requires restraint in the use of common responses such as reassurance and advice-giving, and engaging in a new style of interaction may initially promote uneasiness in helpers.…”

“…The study was carried out by Queen Margaret University, United Kingdom, in collaboration with the War Trauma Foundation and VU University Amsterdam, The Netherlands, University of Makeni, Sierra Leone and John Snow Research & Training Institute, Inc. (the latter not involved in analysis or interpretation of the data). This cluster-randomized controlled trial (cRCT) in Sierra Leone was part of a larger mixed-methods study on the effectiveness of the PFA training conducted in Liberia and Sierra Leone during this period [15]. Ethics approval was obtained from Queen Margaret University and the Government of Sierra Leone (03 August 2016).…”

The Role of Psychological First Aid to Support Public Mental Health in the COVID-19 Pandemic

“…Psychological first aid is undoubtedly essential in enhancing the mental and emotional recovery of patients from traumatic experiences like disasters and pandemics. Disaster management organizations like the ARC are at the forefront of adopting PFA to help disaster survivors cope with the distress originating from traumatic experiences [3]. Psychological interventions are necessary for promoting resiliency and recovery of disaster survivors by reducing mental breakdown.…”

“…During the 2014 Ebola virus disease (EVD) outbreak in Liberia and Sierra Leone, PFA was pivotal in mounting psychological responses to the epidemic. The training-of-trainer (ToT) model, as well as the PFA guide provided by World Health Organization, enabled the education of healthcare workers, community leaders, teachers, and social workers in responding to the outbreak [3]. PFA's significance in mounting psychological intervention during a crisis makes it a beneficial tool for enhancing the mental well-being of trauma-stricken populations.…”