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Introduction to Psychological First Aid (PFA). ADDC Practitioner Interest Forum Sept. 2013. The Psychological First Aid Field Guide. Acknowledgements

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introduction to psychological first aid pfa
Introduction to Psychological First Aid (PFA)

ADDC Practitioner Interest ForumSept. 2013

the psychological first aid field guide
The Psychological First Aid Field Guide


  •  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 …..
group discussion
Group Discussion
  • What comes to mind when you think about “First Aid”?
  • What comes to mind when you think about “Psychological First Aid”?
pfa is not
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
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)


The place of PFA in overall mental health and psychosocial response


Mental health care by mental 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)

Focused (person-to-person) non-specialised supports

Activating social networks

Communal traditional supports

Supportive child-friendly spaces

Community and family supports

Strengthening community and family supports

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
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
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
Adapting to culture (& context)
  • What might be necessary to consider to adapt to culture?
  • What might be necessary to consider to adapt to context?
what is covered in pfa skills training
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
examples of distress responses
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
Helping people feel calm

Brief breathing exercise

Brief “tapping” exercise

Brief mindfulness exercise using items in the room

positive coping strategies
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
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