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PSYCHOLOGICAL FIRST AID TREATMENT PLAN FOR CHILD 1 Psychological First Aid Treatment Plan: Unaccompanied Child Danielle R. Allen Liberty University Author Note I have no known conflict of interest to disclose. Correspondence concerning this article should be addressed to Danielle Rose Allen, Liberty University, 1971 University Blvd, Lynchburg, VA 24515. Email: drallen9@liberty.edu

PSYCHOLOGICAL FIRST AID TREATMENT PLAN FOR CHILD 2 Psychological First Aid Treatment Plan: Unaccompanied Child This paper is adapted from the Psychological First Aid Field Operations Guide Second Edition published by the National Child Traumatic Stress Network/National Center for PTSD in conjunction with Substance Abuse and Mental Health Administration (SAMSHA) and the Robert Wood Foundation. Nature of the Disaster Natural disasters, including earthquakes, floods, and fires, are becoming increasingly more prevalent worldwide, and their impacts, both tangible and intangible, can be devastating (Andrades et al., 2018). Earthquakes specifically possess a number of characteristics that increase the risk of more prevalent and intensified, as well as longer-lasting, negative impacts on survivors (Stebnicki, 2016). As a result, the nature trauma involved in an earthquake can potentially incorporate wide-ranging physical, mental, cognitive, social, emotional, and spiritual consequences that pose a threat to our overall well-being and quality of life (Stebnicki, 2016). Jacobs (2016) notes that community disasters can be categorized into two different types, including human- or technologically produced disasters and natural disasters. However, it is important to recognize that most do not fit seamlessly into one category or the other and typically possess intersecting elements (Jacobs, 2016). This stems from the convoluted nature of the disaster, its potential to permeate through various life domains, and the evolution of its impact over time (Jacobs, 2016). An earthquake fits the bill for a natural disaster, although curiously an argument to the contrary could be made as our society has been building awareness of the realistic role humans in manipulating climate and environmental events (Andrades et al., 2018; Stebnicki, 2016). Apart from this highly debated aspect, which is irrelevant to the current

PSYCHOLOGICAL FIRST AID TREATMENT PLAN FOR CHILD 3 discussion, even deeming an earthquake as a primarily natural disaster lends itself to further complexity when societal responses following the aftermath exacerbate the original level of impact (Stebnicki, 2016). Earthquakes are also disasters that tend to occur without warning, giving little, if any, time to prepare, and in essence last longer than the duration of the actual earthquake itself when accounting for aftershock events and prolonged states of fear (Jacobs, 2016). Both of these factors indicate the existence of a higher quantity and intensity of stress responses among survivors than that of their counterparts (Jacobs, 2016). I elected to complete a psychological first aid treatment plan for an unaccompanied child, a female adolescent assessed upon observation after an earthquake during initial psychological first aid steps as alone and frightened, factors warranting special attention. Samantha, who is about 10 years old, lives with her parents and younger brother in a small town near the center of a massive earthquake. Due to the fact that the earthquake occurred in the middle of a weekday, both parents were working and Samantha was at school. After the earthquake, when Samantha found her way back home, she was devastated to find her home in rubbles and no sign of her family. Scared, confused, and overwhelmed, she eventually was escorted to the nearest shelter. She is spotted sitting among other survivors but it is obvious she is keeping a safe and sufficient distance. There appears to be no interaction with anyone else at the shelter. Samantha had attempted to ask other survivors about her family, but was having trouble recognizing anyone due to being new to the area. Her family just moved to the town only a few months ago. Still constructing a sense of belonging and navigation of the unfamiliar area, Samantha is exhibiting a pre-event stressor that Jacobs (2016) notes, in discussing Spielberger’s model of individual reactions to stress, renders her more vulnerable to negative coping.

PSYCHOLOGICAL FIRST AID TREATMENT PLAN FOR CHILD 4 Samantha is able-bodied and in good health, with no physical disabilities, acute medical concerns, or injuries. However, physical and emotional concerns are still present. Samantha is experiencing some difficulties with sleeping and eating. In addition, despite her initial presentation as sad and weeping, she now exhibits an emotionless, flat affect, a typical observation in children Samantha's age as a response to trauma (Jacobs, 2016). She expresses openly her concern that not returning home earlier that day prevented her from protecting her home and family, whom she fears is hurt, dead, or risking their lives searching for her. According to Jacobs (2016), guilt is also a common response in school-age children and often manifests as viewing either all or part of the traumatic event as their fault. In order to efficiently address the needs of those impacted, it is critical to understand the extent of the physical and psychological trauma inflicted by a natural disaster such as this one. Children make up one group, among a number of others, that is especially vulnerable to the negative repercussions of natural disasters (Raccanello et al., 2023). Their level of cognitive and emotional development places them at a higher risk of experiencing long-term traumatic effects (Raccanello et al., 2023). Eight Core Actions of Psychological First Aid Contact and Engagement Establishing a connection with Samantha to help her feel safe and secure. Goal – To establish a relationship with Samantha that promotes trust and rapport. Interventions:  Adequately observe Samantha to establish a confident and effective approach.  Introduce myself providing only necessary and easily digestible information, paying special attention to vocal tone and body posture.

PSYCHOLOGICAL FIRST AID TREATMENT PLAN FOR CHILD 5  Use strategies to build rapport with Samantha and help orient her to the shelter.  Create a safe and comfortable environment for Samantha to talk about her feelings and experiences.  Use active listening to validate Samantha's emotions and concerns.  Encourage Samantha to express her feelings and provide her with support and empathy. Safety and Comfort Meeting Samantha's immediate needs for safety, shelter, and medical attention. Goal – To offer Samantha the necessary resources to feel safe, secure, and comfortable. Interventions:  Help ensure Samantha has access to basic needs like food, water, and housing.  Evaluate Samantha's immediate physical, emotional, and medical needs, as well as anything that may fall beyond the scope of my training.  Ensure that Samantha has access to appropriate resources and support services, such as counseling or medical care.  Clarify any immediately harmful misinformation and answer questions honestly, taking extra care not to make promises despite my empathetic state.  Provide Samantha with comforting and regulatory activities or toys.  Create a safe, calm, and quiet space to promote grounding and productive emotional and physical release.  Discuss Samantha’s current situation and needs with another team member or supervisor, providing updates as needed. Stabilization Helping Samantha manage her emotions and regain a sense of control and autonomy.

PSYCHOLOGICAL FIRST AID TREATMENT PLAN FOR CHILD 6 Goal – To help Samantha feel more in control of her emotions and safe to express them. Interventions:  Encourage use of coping skills and protective factors, such as spiritual connection, positive memories and stories, and hobbies and interests.  Teach Samantha ways to deal with her anxiety and stress, such as deep breathing and relaxation strategies.  Provide psychoeducation to Samantha about the effects of trauma and help normalize responses.  Encourage Samantha to identify her coping strategies and support systems.  Help Samantha develop a routine, or “new normal,” and structure to her day to reinstate a sense of stability and predictability. Information Gathering Providing information to Samantha about the situation and available resources. Goal – To provide Samantha with accurate and useful information about the present situation and available assistance. Interventions:  Provide Samantha with clear developmental stage- and age-appropriate information about the earthquake and its impact.  Answer Samantha's questions and address any misconceptions or concerns she may have as they arise.  Provide Samantha with information about available resources and services that can help her meet her needs.

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