Introduction to
Psychological
First Aid (PFA)
ADDC Practitioner
Interest Forum
Sept. 2013
The Psychological First Aid
Field Guide
Acknowledgements
• Writing and Editorial Team - Leslie Snider (War Trauma Foundation, WTF),
Mark van Ommeren (World Health Organization, WHO) and Alison Schafer
(World Vision International, WVI).
• Steering Group (alphabetical) - Stefan Germann (WVI), Erin Jones (WVI),
Marieke Schouten (WTF), Shekhar Saxena (WHO), Alison Schafer (WVI), Leslie
Snider (WTF), Mark van Ommeren (WHO).
• Funding - World Vision International
• Illustrator – Julie Smith, PD Consulting
• In addition, we acknowledge the 27 anonymous respondents who participated in a
•
pre-consultation survey on the need to develop this document. Plus the many
individuals and agencies who contributed to the peer review process.
This guide will be formally endorsed by many member organisations of the IASC
Mental Health and Psychosocial Support Reference Group, including …..
The Psychological First Aid
Field Guide - Endorsements
Group Discussion
1. What comes to mind
when you think
about “First Aid”?
2. What comes to mind
when you think
about “Psychological
First Aid”?
PFA is not....
• It is NOT something only professionals can do
• It is NOT professional counseling
• It is NOT a clinical or psychiatric intervention (although it can
be part of good clinical care)
• It is NOT psychological debriefing
• It is NOT asking someone to analyze what happened to them
or to put time and events in order
• It is NOT pressing people to tell you their story
• It is NOT asking people details about how they
feel or what happened
Psychological First Aid (PFA) is:
A description of a humane, supportive response to a fellow
human being who is suffering and who may need support. PFA
involves the following themes:
– Providing practical care and support that does not intrude
– Assessing needs and concerns
– Helping people to access basic needs (e.g. food and water,
information)
– Comforting people and helping them to feel calm
– Helping people connect to information, services and social
supports
– Protecting people from further harm
Based on Sphere (2011) & IASC MHPSS Guidelines (2007)
Examples:
The place of PFA in overall mental health
Mental health care by mental
and psychosocial response
health specialists (psychiatric
nurse, psychologist, psychiatrist
etc)
Basic mental health care by
PHC doctors
Basic emotional and practical
support by community workers
(Psychological First Aid)
Specialised
services
Focused (person-toperson) non-specialised
supports
Activating social networks
Communal traditional
supports
Community
and family
supports
Strengthening
community
and
Supportive child-friendly
family supports
spaces
Advocacy for basic
services that are safe,
socially appropriate
and protect dignity
Basic services and security
Social considerations in
basic services and security
Why PFA?
• Following crises, people do better over the
long-term if they…
– Feel safe, connected to others, calm and hopeful
– Have access to social, physical and emotional
support
– Feeling able to help
themselves, as
individuals and
communities
Who is PFA for?
• PFA is for very distressed people who have been
recently exposed to an extremely distressing event.
• It can be provided to children and adults
• Not everyone who experiences a crisis event will need
or want PFA. Do not force help on people who do not
want it
• PFA is not
necessarily for
everybody
Adapting to culture
(& context)
1. What might be necessary to
consider to adapt to culture?
2. What might be
necessary to
consider to
adapt to
context?
What is covered in PFA Skills
Training?
•
•
•
•
•
•
•
•
Careful analysis of culture and context
Ethical principles of PFA, including a number of do’s and don’ts
Practicing of good and effective communication
Preparing yourselves to provide PFA – practically and
emotionally (e.g., self-care)
A detailed overview of the Action Principles of PFA
Consideration of people who may likely need more specialised
care, such as vulnerable groups, children and adolescents, etc.
How to provide PFA for children
Lots and lots of role plays, simulations and communication
exercises to develop SKILLS in PFA
The Action Principles of PFA
Principle Actions
LOOK
 Check for safety.
.
 Check for people with obvious urgent basic needs.
 Check for people with serious distress reactions.
LISTEN
 Approach people who may need support.
 Ask about people’s needs and concerns.
 Listen to people, and help them to feel calm.
LINK




Help people address basic needs and access services.
Help people cope with problems.
Give information.
Connect people with loved ones and social support.
Examples of distress responses
•Physical symptoms (e.g. Shaking, headaches, fatigue, loss of appetite, aches &
pains)
•Crying, sadness, depressed mood, grief
•Anxiety, fear
•Being “on guard” or “jumpy”
•Being afraid that something really bad is going to happen
•Insomnia, nightmares
•Irritability, anger
•Guilt, shame
•Confused, emotionally numb, or feeling unreal or in a daze
•Being immobile or withdrawn
•Not responding to others, not speaking at all
•Disorientation (not knowing one’s name, where they are from or what is
happening)
•Not being able to care for oneself or one’s children
Helping people feel calm
•Brief breathing exercise
•Brief “tapping” exercise
•Brief mindfulness exercise
using items in the room
Positive Coping Strategies
•Getting rest
•Easting as regularly as possible
•Drinking plenty of water
•Spending time with family & friends
•Discuss problems with someone you trust
•Do activities that help you relax – e.g. Walking,
singing, praying, playing with children)
•Engage in physical exercise
•Find safe ways to help others
Negative Coping Strategies
•Taking drugs, smoking or drinking alcohol
•Sleeping all day
•Working all the time without any R&R
•Isolating yourself from friends and loved ones
•Neglecting basic personal hygiene
•Violence
Principle
Actions
LOOK
.



Check for safety.
Check for people with obvious urgent basic needs.
Check for people with serious distress reactions.
LISTEN



Approach people who may need support.
Ask about people’s needs and concerns.
Listen to people, and help them to feel calm.
LINK




Help people address basic needs and access services.
Help people cope with problems.
Give information.
Connect people with loved ones and social support
Questions?