After the Boston Marathon Bombings

Almost hidden among the first responders dealing with the aftermath of the appalling Boston Marathon bombings on April 15, 2013 were the mental health professionals providing psychological first aid to the survivors.    Although an estimated 50-60% of all people directly or indirectly affected by a traumatic event will recover without the need for mental health services,  professionals dealing with post-traumatic stress in survivors have long recognized that a large minority of survivors require psychological support to recover. 

Since earlier critical incident stress management approaches have often been found to do more harm than good,  the newer system of psychological first aid (PFA) is now the preferred method of dealing with trauma cases.   Developed jointly by the U.S. Department of Veteran Affairs and the National Child Traumatic Stress Network, PFA is intended to help people during the immediate aftermath of traumatic events such as terrorism or natural disaster.    Among PFA's goals are to reduce emotional distress and to foster short- and long-term adaptive functioning.     PFA is administered by trained first responders whether working for disaster relief organizations, Medical Reserve corps, or other aid agencies called into emergency situations.

Among the mental health professionals called in to help survivors of the Boston bombings was Dr. Kermit Crawford of the Boston School of Medicine.   A licensed clinical psychologist who specializes in disaster behavioural health response,  Dr. Crawford is well experienced in dealing with trauma survivors in previous disasters such as Hurricane Sandy and recognizes that the PFA counseling provided to date is only the first stage in the recovery process.   In describing his initial work with Boston marathon survivors and their families, he stated that the early goals of PFA were to establish safety and emotional stability, reduce stress, provide comfort, and provide access to whatever information they may need.  "They need to be in the place where they're certain that they are protected, that their fears and anxieties about what happened are somehow managed, that their emotions are somewhat stable," he added.    While providing victims with the answers they need about the causes of the bombing as well as new information as it becomes available,  victims need to be reassured that the immediate danger is past and that they are safe for the time being    Helping trauma sufferers recognize the symptoms linked to posttraumatic stress will follow as well as  training them to handle flashbacks and other delayed reactions to what they have gone through.  

"We'll be alright," Dr.  Crawford said in an interview with the Atlantic.  "We just have to get there."


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