EMOTIONAL FIRST AID

EMOTIONAL FIRST AID

Offering
Video or Audio Consultation (25-min)

Key Features

Emotional first aid

Get support to manage personal distress

Private and safe

Talk to an expert in a safe and private space

Timely start
See your expert on-time

Make a personalised plan

Identify coping strategies
 EMOTIONAL FIRST AID
Session Structure
Starting the session:

Start the call with setting expectations- Introduce yourself

and tell the client that the next 25 minutes will be focused
on how to help the client manage current distress or stress.
If they mention 4-5 sources of stress or seem unsure about
what to focus on, try to narrow down the focus within 5-7
minutes and ask them to select one issue only for the call.
Prioritize one topic - Ask the client which issue might be
bothering them the most at the current time or which topic
might be most useful to work on for the call. Once
you identify the problem, you can spend the next 10
minutes going a bit deeper into it and look into a solution
(even if temporary).

If the client identifies long-term issues after prioritization (e.g.,

emotional abuse, history of illness) then focus on how to
manage the current impact of this. Typically, these kinds of
issues can only be addressed in therapy and you can make a
clear recommendation
for therapy.
 EMOTIONAL FIRST AID
Session Structure
Ending the session

Most clients will need a concrete “action step” as a take-

away based on the identified issue

As far as possible make a clear recommendation about

therapy - let them know how it will benefit them, or for
which particular issue they have raised during the call,
that therapy could be appropriate for.

Let the client know they can book a therapy session with
you or another therapist on the app for multiple sessions
with the same person and for continuity of care. They can
also book another emotional first aid session, and they will
be connected with whoever is first available.
 EMOTIONAL FIRST AID
Session Structure

Documentation
Document the interaction briefly in 2-3 sentences unless there
are safety concerns.
1. Presenting problem
2. What was recommended
3. Any issues/concerns/red flags

Any sessions that reveal client risk or suicidality should be

treated as a crisis call, and deviate from normal EFA
protocol and assess for risk and safety planning and
recommendation to higher level of care.
 EMOTIONAL FIRST AID
Questions to ask

Identifying and prioritizing the need of the client:

How have you been impacted by the lockdown / change of
routine?
What do you wish to address in our first aid session today?
Tell me about the distress you have been experiencing given
the current situation
Could we identify a specific aspect to work on during
today’s call?
On a scale 1-10 (10 being the most distressed, where do you
currently find yourself?
Can we identify the factors that are elevating your distress
levels currently?
Miracle question - to help narrow down the relatively
immediate stressor
 EMOTIONAL FIRST AID
Commonly useful coping strategies (as per context):

Reassurance | focusing on enhancing hope

Normalizing the panic and stress to mitigate meta
disturbance - global experience, ‘together in misery, hence
together in coping’ logic
Creating a sense of safety “fight flight” reaction is common
in times of crisis (e.g., moving
away from too much news, avoiding conflict where
possible)
Journaling | venting | talking to someone they trust
Regulating sleep and appetite - focus on physical health
Discussing possible hacks for physical safety until the
lockdown lasts (in case of abuse and lack of safety)
 EMOTIONAL FIRST AID
Commonly useful coping strategies (as per context):

Focus on temporary changes and behavioural actions

mainly
Deep breathing | muscle relaxation | drawing | doodling |
painting (activities to soothe)
Emphasising the present moment - mindfulness as a
practice
Recommend specific meditations on the app - e.g., stress
reduction, freedom from anxiety pack, walking meditation,
sleep stories, sleep music
Physical exercise - within the restrictions and boundaries a
client might exist in
Actions they can take to take control of anxiety (e.g.,
following regulations, self-care, not treating thoughts as
facts, being careful of making assumptions, only problem
solving issues within their control)
 EMOTIONAL FIRST AID
Commonly useful coping strategies (as per context):

Practicing gratitude - maintaining a gratitude journal - focus

on what they have (e.g.,
right now I am okay and healthy)
Normalizing the difficulty of adjustment and change -
focusing on how to adapt to changes rather than fight the
need for change
To suggest relevant referrals for further help
Referral to emergency in case of suicidality/acute self-harm
 EMOTIONAL FIRST AID
To avoid

Checking for long standing patterns

Asking for history or earlier, similar experiences
Elaborate sentences or explanations
Overloading with activities / strategies
Encouraging too much venting from the client - won’t leave
space for intervention
 EMOTIONAL FIRST AID
Rough timeline during the 25- minute session

Rapport building and problem identification - 5 to 7 min

Intervention - 8 - 10 min
Questions | Referrals | Takeaways - 5 min
 EMOTIONAL FIRST AID
Use Cases: Anxiety

1. Check Facts In The Moment To Help Reduce The Intensity Of

Extreme Emotions, Ask Yourself:

What Event Triggered My Emotion?

What Interpretations Or Assumptions Am I Making About The
Event?
And Does My Emotion Or It's Intensity Match The Facts Of the
Situation Or Does It Just Match My Assumption Of The
Situation?
 EMOTIONAL FIRST AID
Use Cases: Anxiety

2.When You Find Yourself Worrying, Ask Yourself:

What Are You Predicting Will Happen, And What Is The

Likelihood It Will Actually Happen?
What Are The Best Case Scenario And Most Likely Scenarios?
How Many Times Have You Made This Prediction And It Came
True?
If The Worst Case Were To Happen, What Would You Do To Cope
With It?
What Are The Costs And Benefits Of Worrying About This?
 EMOTIONAL FIRST AID
Use Cases: Anxiety

3. Postponing Your Worry: This Approach Involves Postponing Your

Worry To A Worry Period That Is The Same Time, Place, And
Duration Each Day.
4. Grounding, JPMR, Deep Breathing, Meditation, seeking social
support- speaking to someone they trust
5. Colouring/music or any other hobbies for coping
6. Journaling- To help identify triggers; Making note of thoughts
and identifying range of control
7. Constructive Worry - set aside structured worry time - write down
thoughts/worries for 10-15 minutes and then move to another
activity.
8.Sleep hygiene tips
 EMOTIONAL FIRST AID
Use Cases: Anxiety

9.Creating a routine for self care- Habit tracker (Listing three goals
in a schedule format- Marking out what they have done at the end
of everyday and place it in a place they can see it everyday which
helps create a sense of being held accountable)
10.Challenging negative automatic thoughts and identifying the
effect they have on behaviour patterns.
11.Psychoeducation on importance of therapy and continuity in care
for anxiety
 EMOTIONAL FIRST AID
Use Cases: Anxiety

12.Specific to COVID-19:

Limiting time on social media and moderate news intake

(Read news from trusted sources and seek accurate information)
Maintain social connection- Talk to friends and family (Set
boundaries and communicate about topics you would like to
avoid discussing)
Focus on things you can control (Precautionary measures)
Practice mindfulness and try to be present and accept your
emotions
Pursue hobbies and maintain a self care routine
Maintain a gratitude journal
Normalising the panic and stress
 EMOTIONAL FIRST AID
Use Cases: Job Loss

1.Normalize and validate the loss - talk about the stages of grief
briefly and check where the client is at - working towards stage of
acceptance
2. Building a new structure and routine - how will they spend their
time productively given the backdrop of a job loss
3.Ways to find meaning and purposeful activity - e.g., reaching out
to their work networks to start looking for opportunities
4.Binaural beats, 4-7-8 breathing technique and sleep stories from
the app to improve the quality of sleep.
 EMOTIONAL FIRST AID
Use Cases: Job Loss

5. Helping them reframe(instead of focusing on the job you don’t

have focus on the job you want.) This will help them look forward
and also assess career goals.
6.Self care is essential so that they can connect with themselves and
rediscover their values.
7. Behavioural Activation- Spend time doing something they like,
their hobbies. Improve their skills.
8.Meditation and mindfulness resources - being in the here and now
9.Get social support or connect with friends indirectly at the very
least(social media.)
 EMOTIONAL FIRST AID
Use Cases: Productivity

1. Focusing on temporary changes and behavioural actions.

2. Awareness - being an observer of your thoughts, emotions and
behaviour in response to the triggers and accepting them (knowing
that it’s okay to feel disturbed, being more compassionate
towards self and productivity expectations, check if expectations
are realistic).
3. Normalising - the difficult to adjust and change as per the new
situation (focusing on adapting).
4. Setting a routine
 EMOTIONAL FIRST AID
Use Cases: Productivity

5. Taking breaks as needed - e.g., work for 20 minutes take a break

for 5
6. Capitalising on times of the day when they are most likely to have
energy and feel productive - what is their peak performance time?
(e.g., morning vs. evening)
7. Looking at reducing screen time if this is something that gets in
the way of productivity
8. Setting goals - breaking down goals, batch similar tasks together,
pomodoro technique.
9. Setting hours for a task instead of being rigid about it.
10. Focus on well-being instead of treating productivity as a
challenge.
11. Emphasis on present moment - inculcating mindfulness as a
practice.
12. Tackle must-do tasks first
 EMOTIONAL FIRST AID
Use Cases: Family Conflict

1) Adapting to the change - Communicate and find out about how to

temporarily manage the new normalcy and clarify expectations to
deal with the change to avoid conflicts.

2) Notice, acknowledge and accept any unpleasant feelings with the

current adjustment, current living situation ( Normalize these
feelings ). Allow oneself to sit with the experience, use techniques
of mindfulness such as stress reduction, grounding, diaphragmatic
breathing, 5 minute guided mindfulness series etc...
 EMOTIONAL FIRST AID
Use Cases: Family Conflict

1) Adapting to the change - Communicate and find out about how to

temporarily manage the new normalcy and clarify expectations to
deal with the change to avoid conflicts.

2) Notice, acknowledge and accept any unpleasant feelings with the

current adjustment, current living situation ( Normalize these
feelings ). Allow oneself to sit with the experience, use techniques
of mindfulness such as stress reduction, grounding, diaphragmatic
breathing, 5 minute guided mindfulness series etc...
 EMOTIONAL FIRST AID
Use Cases: Family Conflict

3) Self Care - Reflect upon activities that are pleasurable for you
and take pockets of time
during the day to invest time in yourself.
List of Activities - Examples - Reading, Exercising, Listening to
music, Journaling, Dancing,
Painting, Sketching, Doodling , Taking a walk ( within the boundaries
of your house ), Skin care, etc....

4) Reflect upon activities that you would enjoy to do with family.

Set a schedule for shared living space mutually.
 EMOTIONAL FIRST AID
Use Cases: Family Conflict

5) Conflict Resolution - Focus upon one issue at a time, focus on the

current issues ( indicating "time out" when you notice the significant
other bringing up a past issue or seem to blame - coming back to the
present moment ). Focus upon communicating your feelings, needs
and expectations assertively. Consciously establish an open and
respectful space for
communication.

6) Boundary setting - To maintain self preservation during these

times, communicate your feelings and intentions behind taking out
time for yourself clearly. Practice persistently to make it a
comfortable process.

Assertive communication - using "I" statements ( I feel, I need, I

would like...), broken record technique, can practice assertive
communication (to improve self efficacy) by using the technique of
scripting ( Identifying a triggering event, describing about your
feeling in the moment clearly, focus of stating your needs,
describing the positive consequences for the
action)
 EMOTIONAL FIRST AID
Use Cases: Family Conflict

7) Identify a spot in your home ( your room, your balcony , terrace

etc ...) that would make you feel calm and safe ( as an anchor )
where you would prefer to go to take time out for yourself.

8) If you are stuck between a conflict or experiencing

overwhelming sensations/ feelings with a conversation that's
uncomfortable
a) communicate about the discomfort in the moment. Ask for more
time.
b) move yourself to the spot you identified as a safe space and
spend time with yourself ( use deep breathing and grounding to
manage any unpleasant emotions ).

9) Connect with friends, extended family members, with the people

you love to keep away from being in each other's space too much.

10) Refer appropriately to therapy in case of any observation of

deeper issues.
 EMOTIONAL FIRST AID
Use Cases: Internet Addiction/Spending too much
time on the TV or internet

1.Explain concepts of physiological and psychological aspects of

addiction if needed.
2.Turn off notification alerts so that the need or habit of checking
has one less cue for the
behaviour taking place every time it beeps(news app and social
media apps)
3. Using screen exposure time as an indicator of the app/ phone
usage
 EMOTIONAL FIRST AID
Use Cases: Internet Addiction/Spending too much
time on the TV or internet

4.Set a log-in and log-out time for reading (news/ covid-19 stats/
prevention measures etc.) Keep it realistic to begin with and cut it
down steadily each day to the ideal desired one.
5.Avoid googling health symptoms. In case of indications or health
related discomfort, contact your doctor.
6.Actively avoid the topic during telephonic conversations with
friends and family. Initiate or lead the conversation with topics that
are less stressful and more meaningful during this time of crisis
 EMOTIONAL FIRST AID
Use Cases: Internet Addiction/Spending too much
time on the TV or internet

7.Unnecessary discussion of statistics, geographical state wise

comparisons of data, its related political issues, increase frustration.
Feeling of lack of control becomes more evident which worsens
anxiety or stress.
8.Boredom is an unfortunate byproduct of the time. Hence
embrace it or expect the same to be present, instead of seeing it as
a handicapping or restrictive factor. Remember the time
is to adapt and not fight. So no “why questions” rather “how
questions” would help.
 EMOTIONAL FIRST AID
Use Cases: Internet Addiction/Spending too much
time on the TV or internet

9.The Internet becomes an automatic way out of boredom but we

cannot rely on it as a cure. This is because the internet also does not
give a structure or goal out of boredom but is a tool for distraction.
10.Substitution with hobbies, engaging activities as we have already
discussed in management techniques can be suggested here as well.
11.Engaging in Meditative practice or Relaxation would help if
anxiety is present in the off-screen time.
 EMOTIONAL FIRST AID
Use Cases: Domestic Violence

1.Always first check on whether it is safe for the client to talk (are
they in a private space and is the risk of being found out low)
2.If not safe to talk, offer chat (through booking a therapy session)
3.Clarify support systems (e.g., a neighbour they can talk to if they
need to, any kind of safety planning they can engage in with you)
4.Listen non-judgmentally and hear them out - ask how they are
taking care of themselves during this time
5.Validate the impact of what they may be going through
6.Advocacy - referral to an NGO if they are receptive to it and/or in
physical danger - e.g., Pembala in bangalore, Vanitha Sahaya Vani
(run by Blr Police)
7.Taking things one day at a time and focusing on survivorship for
the day
8.Referral for Therapy (long-term)