Frequently Asked Questions

What is Stress First Aid (SFA)?

Stress First Aid (SFA) is a self-care and peer support framework designed to help individuals in high-stress environments manage stress reactions and promote recovery. It involves recognizing stress responses, providing immediate support, and linking individuals to further resources if necessary.

Who can benefit from SFA in harm reduction settings?

The researchers behind TxCOPE have worked closely with the creators of SFA and the harm reduction community to tailor this framework to their specific needs. SFA is designed for a wide range of harm reduction workers, including outreach workers, community health workers, peer support specialists, and other professionals or volunteers who support persons who use drugs.

What are the four sources of stress injury according to SFA for harm reduction workers?

A stress injury is a disruption in normal functioning caused by exposure to stressors that overwhelm an individual's ability to cope. SFA identifies four primary sources of stress injury that harm reduction workers may experience:

Life Threat: Harm reduction workers often encounter situations where their own lives or the lives of their clients are at risk. This could involve exposure to violent environments, overdoses, or other life-threatening scenarios, leading to intense fear or helplessness.
Loss: This includes experiencing and grieving the death of clients, losing relationships with clients or colleagues, or the loss of hope and motivation. Loss can also encompass the erosion of a sense of safety, trust, or purpose in one's work.
Inner Conflict: This type of stress injury occurs when harm reduction workers face ethical dilemmas or moral conflicts. For example, there may be a discrepancy between personal values and the actions they need to take in their professional roles, leading to feelings of guilt, shame, or moral injury.
Fatigue: The cumulative effect of dealing with chronic stressors such as high caseloads, insufficient resources, and continuous exposure to human suffering can lead to wear and tear. This results in physical, emotional, and mental exhaustion without adequate rest or recovery periods.

Understanding these sources helps in identifying the type of stress injury and applying the appropriate interventions to promote recovery and resilience among harm reduction workers.

What are the signs of stress that SFA addresses in harm reduction settings?

Signs of stress can include physical symptoms (e.g., fatigue, headaches), emotional responses (e.g., anxiety, irritability), cognitive difficulties (e.g., trouble concentrating), and behavioral changes (e.g., withdrawal, changes in sleep patterns). SFA aims to address these signs early to prevent more severe stress reactions, especially those exacerbated by exposure to traumatic stress.

What are the core actions of SFA?

SFA has seven core actions to help workers and their teams recover from stress injuries. These core actions are represented by the seven C's:

Check: Assess the situation and the individuals involved for signs of stress.
Coordinate: Ensure that the right people and resources are available to provide support.
Cover: Provide immediate safety and security.
Calm: Help individuals reduce their immediate distress.
Connect: Encourage connection with others for social support.
Competence: Restore or build the individual’s ability to handle stress.
Confidence: Support the individual’s confidence in managing stress and moving forward.

How does SFA differ from other stress management programs?

SFA is unique in its focus on peer support and immediate intervention in high-stress environments. It is designed to be practical and easily applied by non-mental health professionals, making it accessible to harm reduction workers who may not have extensive mental health training.

Can SFA be adapted for different harm reduction environments?

Yes, the SFA framework is flexible and can be adapted to suit different harm reduction environments and populations. It is designed to be customized to meet the specific needs and stressors of various settings, from street outreach to clinic-based harm reduction programs.

How is SFA currently implemented in harm reduction settings?

We will offer this 6 month research study starting in Central Texas starting in December 2025, with plans to expand across TX, LA, AR, OK, NM and tribal areas. We invite all organizations, leaders, and workers supporting harm reduction for persons who use drugs to participate in this study. If randomly assigned to the control group, your organization will be offered the opportunity to be trained in SFA/HRW at the conclusion of the study.

What does participation in the study involve?

Participation includes several components designed to support your use of Stress First Aid (SFA) in your day-to-day work:

A 2-hour Stress First Aid training to introduce key concepts and skills.
6 monthly learning collaboratives that reinforce the material, offer space for questions, and provide opportunities to learn from other harm reduction workers.
Short surveys completed at three time points: baseline, 2 months, and 6 months.
A chance to participate in a brief interview or focus group, where you can share more detailed feedback about your experience using SFA.

How are participants in the SFA study compensated?

Participants receive $25 for each completed survey and $25 for participating in an interview or focus group.

Where can I learn more about enrolling in the SFA study?

You can learn more about enrolling in the SFA study by contacting our research team at SFA@austin.utexas.edu or by filling out our Contact Us form here. We will provide you with detailed information about the study, including the enrollment process, requirements, and benefits of participation.

Do you have any resources about the SFA study that I can share with my organization?

Yes! You can download our SFA for harm reduction workers fact sheet here.