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Outdoor First Aid

You Know First Aid. But What About Psychological First Aid?

Knowing how to help a scared hiking partner is as important as knowing how to tape an ankle.

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A few years ago, I joined a couple of buddies on a mountain biking trip way above my skill level. Braving a skinny ridge above a canyon floor with my healthy fear of heights left me stressed out and anxious about getting on the bike the next day. A minor trauma to be sure—but similar to so many moments we can process as either potential triumphs or long-lasting anxieties. I rode away with a little bit of both, and I’m not quite sure my companions had the tools to help me do any better.

Scary things happen sometimes, thanks to real or even perceived danger. Every backpacker needs the skills to process potentially harrowing experiences, from exploring a cave despite claustrophobia, sustaining a backcountry injury, or witnessing a partner deal with a trauma. And as potential first responders, we ought to have a systematic approach for aiding stressed individuals compassionately and effectively. 

One strategy, psychological first aid, uses an evidence-informed approach to reduce the impact of traumatic stress. Better yet, it’s not just for rescuers or therapists. It’s for everyone. Creating a psychological first aid kit became an essential skill early in the pandemic, and as we now start to rekindle adventure plans—and take bigger risks—those tools will prove just as critical in the outdoors. 

“A smart first step: creating a sense of safety or comfort. Just saying the phrase “now that that’s over” can signal to someone that their fight-or-flight response can be dialed down.”

Some basic principles empower us to offer real-time support to people experiencing psychological trauma—whether that means aiding avalanche survivors or simply being with freaked-out companions after something scary. A smart first step: creating a sense of safety or comfort. Just saying the phrase “now that that’s over” can signal to someone that their fight-or-flight response can be dialed down. Follow that up with some practical support—maybe a cup of coffee or a warm layer. Even in the midst of tough situations like that scary ride, paying attention to urgent needs like injuries and while emphasizing teamwork can soften the blow down the line. 

Next, think about involving the stressed person in their own care, in order to create a sense of efficacy and collaboration: You took a scary fall. But we’re safe now—the steep part of the climb is over. Can I get you some water? Once you’re ready, maybe you can help me figure out our route for the next leg of the hike. 

Practicing psychological first aid also means listening without compelling someone to talk, creating hope and positivity, and working to develop a support network. This isn’t debriefing—there’s no need to rehash the details of a traumatic event, and no requirement for those affected to share their thoughts. The goal is more immediate—offering calm, comfort, and security in the wake of a traumatic event. 

Psychological first aid has proven successful for dealing with big events, but these themes translate well to everyday life on the trail. Small doses of kindness and caring among teammates can transform moments of fear and anxiety into small victories and profound growth. Not bad for a first aid kit that doesn’t take up any space in your pack.