In the past, I have encountered various situations where psychological first aid was essential. For example, a coach suffered a heart attack during private training at the team’s facilities—fortunately, no players were present. Another instance involved a serious elbow injury to a player during a volleyball match. Or a fatal car accident involving German canoe coach Stefan Henze during the Rio de Janeiro 2016 Olympic Games. Additionally, Georgian luger Nodar Kumaritashvili tragically died during training before the 2010 Vancouver Olympics’ Opening Ceremony. We all hope to avoid such incidents and crises, but we must be prepared to provide the best possible support when they occur.

Before we start looking at what we can do in such situations, we first need to understand what a crisis is so we can make a deliberate and conscious decision about which behavior is appropriate. According to Caplan (1966), the father of modern crisis theory, a person in crisis faces time-limited threatening circumstances. These threatening circumstances present a significant problem for them. The person cannot currently escape this problem nor solve it with their usual problem-solving methods.

In the face of – in sports usually – a situational or adventitious crisis, people experience four distinct phases according to Caplan (1964). In the first phase, a person’s self-concept is threatened, and anxiety increases, prompting the use of usual problem-solving techniques. If these techniques fail (phase 2), anxiety rises further, causing extreme discomfort and leading to trial-and-error attempts to restore balance. In phase 3, continued failure results in severe anxiety or panic, prompting automatic relief behaviors. In phase 4, ineffective measures lead to overwhelming anxiety, resulting in cognitive impairment, emotional instability, and behavioral disturbances, indicating a crisis state.

The symptoms of a crisis may vary between individuals and are unique to each person. They might include the inability to meet basic needs, decreased use of social support, inadequate problem-solving, inability to attend to information, isolation, denial, exaggerated startle response, hypervigilance, panic attacks, feeling numb, confusion, and more.

Now, what can we do in such crisis situations? The first thing is to follow the three-step guiding principle (Nikendei, 2017):

First, perceive the situation and the affected individuals. Focus on the details: what do you see, what do you hear, who is involved, and what is happening around you? It’s about accepting the situation through open perception without too quickly interpreting it subjectively, reducing the complexity as much as possible, and minimizing the pressure to react directly.

Second, perceive yourself. This is key to successfully acting in a crisis. Anyone who wants to help must be capable of helping. This includes understanding your personal reaction to the situation. If the situation affects you dysfunctionally, you might not be able to help others effectively. Remember, “If I’m in, I’m out.” Only those who are aware of their needs at any moment can act freely.

Third, perceive the needs of the person in front of you. It’s essential to understand the informational and emotional needs of everyone involved. Clarify the real needs through focused questioning, reality-checking, active listening, observing, and acting empathetically.

One of the most important aspects is to create a safe environment where the individual feels physically and emotionally secure. Providing comfort and reassurance that their feelings are normal and valid is crucial. Additionally, offering a non-judgmental and empathetic ear allows the individual to express their thoughts and emotions without interruption. Using grounding techniques, we can help them stay present and manage overwhelming emotions, though we must be cautious as some techniques might be contraindicated. We can offer accurate information about stress reactions and coping strategies, and educate about the normalcy of stress responses and the importance of self-care. Moreover, we should help individuals connect with social support by encouraging them to seek assistance from friends, family, or teammates, and facilitate connections with professional support services if needed.

If you are interested in learning more about offering support in crisis situations, I highly recommend downloading the excellent free resource Crisis Intervention for Adults Using a Trauma-Informed Approach: Initial Four Weeks of Management, edited by the Registered Nurses’ Association of Ontario (RNAO). This document shares the most important evidence-based aspects of providing support in a crisis, including a solid theoretical background on crisis and crisis management, as well as clear and precise practice recommendations (including crisis plan templates and more).

In addition, a team of sport psychology professionals in Germany has created a guideline for psychological first aid in sport psychology, published by the German Olympic Sports Association (DOSB). Although the document is available only in German and I do not have the rights to share a translated version here, I am linking the original document for anyone who wants to take a closer look at it, possibly with the help of internet-based translation tools. You can access the document here. Other national olympic committees might also have such guidelines that might also fit the specific culture the athletes and coaches are working in.

I hope that the concepts of psychological first aid will help you prepare for such situations. We all hope that nothing like it occurs; however, we need to be prepared. It’s similar to what we do with athletes when we go through different “What if” scenarios to ensure they are ready for anything. Thus, we also need to be prepared for serious situations where people might need our assistance. As the famous saying goes, “If you fail to prepare, you prepare to fail.” May you never need to use your knowledge of psychological first aid, but if you do, you’ll know what to do.