A new kind of help for victims of terror

It is a Sunday morning in Hendon, north-west London, and I’m with a group of 50 people at the first-ever training session for volunteers of the Community Security Trust’s new pyschological response team. 

In the scenario we have been given, a bomb has exploded in Barnet in the middle of the working day. Half of us are people who have been affected by the blast, but thankfully have no life-threatening injuries. The other half are acting out the role of psychological first responders (PFRs). 

“Mike” stays with me, asking if I want anything to eat or drink. When I ask what’s happened, he tells me he only knows there has been an incident, “but as soon as I get updates from anyone who’s in charge, I’ll get them to you as soon as I can”. 

I actually find it quite disturbing to pretend that I’ve been through an incident like this — as I’m sure most people would. But it was interesting to see how others in the group responded. We had been asked earlier in the session to recall some high-pressure events we had experienced in our lives. One woman had mentioned a car crash — but the scenario training reminded her that in 1994 she had been working nearby Balfour House in Finchley (which housed the UJIA at the time) when it was bombed by Palestinians. Until the role play, incredible as it seems, she had completely forgotten.

There is a real cross-section of the community present. Some women are wearing sheitels or tichels (head scarves) with long skirts; others have dyed pink hair and jeans. Men with kippot sit next to men without. 

There is a brief discussion about what a first responder should do if the person they’re treating is of the opposite sex and Charedi. To agreement from the group, an Orthodox female therapist suggests that the first responders should ask before offering any direct contact. 

“When I did the CST physical training, the majority of my group were men,” one woman tells me. “This is the opposite”, she says, gesturing to the room, which is at least eighty per cent female. 

While a few of the people there identify themselves as previous CST volunteers, discussions I have with a number of attendees suggest that many present are occupational therapists, counsellors or psychologists, who want to help. But they may actually find this sort of treatment the hardest to master, because it runs counter to what they are used to doing. 

Dr Nikki Scheiner, the psychologist running the session, makes it quite clear what the PFRs are meant to provide — “listening, emotional support and practical support”, and what they are under no circumstances meant to provide — “counselling, psychotherapy, medication”. 

She quotes Professor Jonathan Bisson, clinical reader in psychiatry at Cardiff University, who says that after an incident of this kind “for most people… simple, pragmatic, practical support, provided in a sympathetic manner by non-mental health professionals, seems most likely to help”. 

Dr Scheiner also points out that there are some natural responses a person might usually make to try to calm someone down which cannot be used in such instances. 
“Never give people false hope or false promises,” she says. An example of that might include saying “I’m sure everyone’s all right”. The emphasis, she says, is on acknowledging the distress of the person you’re talking to, and helping them to ground themselves in the here and now.  

Partly for that reason, she tells the PFRs they should not be attempting to help someone they know, because it might affect what they say. Instead, they should let another first responder provide assistance in such a case. 

Dr Amanda Lurie is another expert involved in the creation of the programme. She has been the clinical lead for the Clinical Health Psychology Department at Salford Royal for over 20 years, specialising in intensive care.

“It’s absolutely crucial [to have this service available]”, she says. 

“Sometimes people cope with the immediate crisis and then something small happens within that scenario that actually triggers the difficulty of coping afterwards. People miss the whole concept of the support, just somebody saying ‘are you ok, how are you, could I go and get somebody to feed your pet’, something like that.

“Evidence says that if you support people well at this stage, then you can do some relapse prevention, some work that helps people all the way through the journey after an incident such as this”.