A Rapid Realist Review of Group Psychological First Aid for Humanitarian Workers and Volunteers.

Julia Corey,Sarah Davidson,Brynne Gilmore,Aoife De Brún,Timothy Frawley,Frédérique Vallières

doi:10.3390/ijerph18041452

Abstract

Humanitarian workers are at an elevated risk of occupational trauma exposure and its associated psychological consequences, and experience increased levels of anxiety, depression, and post-traumatic stress disorder (PTSD) compared to the general population. Psychological first aid (PFA) aims to prevent acute distress reactions from developing into long-term distress by instilling feelings of safety, calmness, self- and community efficacy, connectedness and hope. Group PFA (GPFA) delivers PFA in a group or team setting. This research sought to understand ‘What works, for whom, in what context, and why for group psychological first aid for humanitarian workers, including volunteers?’ A rapid realist review (RRR) was conducted. Initial theories were generated to answer the question and were subsequently refined based on 15 documents identified through a systematic search of databases and grey literature, in addition to the inputs from a core reference panel and two external experts in GPFA. The findings generated seven programme theories that addressed the research question and offered consideration for the implementation of GPFA for the humanitarian workforce across contexts and age groups. GPFA enables individuals to understand their natural reactions, develop adaptive coping strategies, and build social connections that promote a sense of belonging and security. The integrated design of GPFA ensures that individuals are linked to additional supports and have their basic needs addressed. While the evidence is sparce on GPFA, its ability to provide support to humanitarian workers is promising.

Highlights

Following the completion of the rapid realist review (RRR) with the included studies for a more general understanding of “how, why and for whom Group PFA (GPFA) works for humanitarian workers and volunteers”, we further reviewed youth/adolescent-specific literature and made inferences about how the findings from the RRR might be relevant to this population (Figure 1)
The inclusion of 15 documents identified through a systematic search of databases (n = 6), websites, and grey literature (n = 9) (See Figure 2); Two reference panel virtual meetings, where theories were presented and feedback provided; Two feedback reports from the reference panel assessing how input was incorporated, and providing updated findings for their review; Review of literature specific to youth/adolescents participating in group interventions and/or youth/adolescents mental health considerations for interventions; Two virtual meetings with external experts, where the refined programme theories (PTs) and findings from the youth-related supplemental work were disseminated
There is a dearth of evidence on how, why and for whom GPFA works to address the needs of this cadre

Summary

Introduction

Increased risks of adverse mental health outcomes among humanitarian aid workers have been well documented by a range of studies spanning the last two decades. In reviewing the evidence for trauma exposure and trauma-related mental illness among humanitarian aid workers, Connorton et al [2] found that humanitarian workers experience increased levels of anxiety, depression, and post-traumatic stress disorder (PTSD) compared to the general population. An increased risk of anxiety and depression symptoms have been reported among aid workers after controlling for the presence of such disorders prior to deployment, providing evidence for the experiential nature of humanitarian missions as a mediating factor in mental health outcomes [3].

Methods

Results

Discussion

Conclusion