Psychological First Aid (PFA) is a crucial approach for helping people after traumatic events. It focuses on providing immediate support, ensuring safety, and promoting stabilization. PFA aims to reduce stress and assist in healthy recovery through compassionate connection and practical assistance.

Key principles of PFA include active listening, assessing needs, and teaching coping strategies. By connecting survivors with social supports and additional resources, PFA helps individuals navigate the aftermath of crises and fosters long-term recovery and resilience.

Principles of Psychological First Aid

Overview and Goals of Psychological First Aid

• Psychological First Aid (PFA) is an evidence-informed approach designed to reduce stress symptoms and assist in a healthy recovery following a traumatic event, natural disaster, public health emergency, or even a personal crisis
• PFA aims to establish a human connection in a non-intrusive, compassionate manner through practical assistance and support
• The primary goals of PFA include enhancing immediate and ongoing safety, providing physical and emotional comfort, calming and stabilizing survivors, helping survivors to tell their stories and experiences, and providing practical assistance and information to help address immediate needs and concerns

Ensuring Safety and Providing Comfort

• Safety and comfort are the immediate priorities of PFA to help stabilize the situation and reduce distress
• Ensure the physical safety of the individual by removing them from or reducing exposure to the threat or danger (hazardous environments, violent perpetrators)
• Provide physical comforts that can reduce distress such as water, food, blankets, a safe and private place to rest, and access to a phone or communication methods to contact loved ones
• Offer emotional comfort through empathetic listening, validating feelings, and reassuring the person that their reactions are normal given the circumstances
• Respect the individual's privacy while providing comfort and avoid pressuring them to talk about their experiences before they are ready

Promoting Stabilization and Providing Practical Assistance

• Stabilization is the next priority after ensuring safety and comfort to calm and orient emotionally overwhelmed or disoriented survivors
• Use grounding techniques to help the person become more aware of the present moment and their current surroundings (encourage them to take slow breaths, notice their feet on the floor, the sounds around them)
• Provide practical assistance to help address immediate needs and concerns based on the individual's unique situation
• Practical assistance may include providing accurate and up-to-date information, connecting the person with immediate resources (temporary housing, financial assistance, transportation), and helping to identify and prioritize current needs and develop an action plan

Communication Techniques

Active Listening Skills

• Active listening is a key communication skill in PFA that involves giving the person your undivided attention and conveying a genuine interest in understanding and helping them
• Face the person and maintain an open and relaxed body posture, use appropriate eye contact, and eliminate or reduce distractions when possible (silence phone, move to a quieter area)
• Listen more than you speak, be comfortable with silence and allow the person to break the silence, avoid interrupting the person or rushing to provide solutions
• Use verbal and non-verbal cues to demonstrate active listening such as nodding, brief verbal affirmations, and mirroring the person's body language
• Reflect back and summarize what the person has shared to ensure you have understood them correctly and validate their experiences and feelings

Gathering Information and Assessing Needs

• Information gathering is an essential part of PFA to assess the person's immediate needs and concerns and connect them with the appropriate resources and support
• Ask open-ended questions that invite more than a yes or no response and cannot be answered with a single word to encourage the person to share more about their experiences, needs, and concerns
• Avoid asking questions that begin with "why" as they may imply blame or judgment, instead ask questions that begin with "what" or "how" (What are you most concerned about right now? How are you coping with what happened?)
• Be patient and allow the person time to respond, avoid pressuring them to share more than they are comfortable with or ready to share
• Assess for any immediate medical needs, safety concerns, or practical needs such as food, water, shelter, clothing, or communication methods

Connecting with Social Supports

• Connecting survivors with their social support network is an important aspect of PFA as social support can enhance coping and recovery following a crisis
• Ask the person about their existing social supports such as family members, friends, co-workers, or community members they trust and feel comfortable reaching out to for support
• Offer to help the person contact their social supports if needed, provide them with a phone or communication methods if available
• Encourage the person to utilize their social support network for practical assistance (temporary housing, childcare, transportation) as well as emotional support and comfort
• Provide information on community resources and support groups that may be helpful based on the person's specific needs (bereavement support groups, domestic violence shelters, mental health services)

Coping and Recovery

Teaching Coping Strategies

• Teaching and reinforcing positive coping strategies is an essential component of PFA to help survivors manage distress and promote resilience and recovery
• Educate the person on common stress reactions they may experience following a crisis such as intrusive thoughts, sleep disturbances, irritability, or withdrawal and reassure them that these are normal reactions to an abnormal event
• Teach simple relaxation techniques such as deep breathing, progressive muscle relaxation, or grounding exercises to help reduce stress and promote a sense of calm
• Encourage the person to engage in positive self-care activities that they find comforting or enjoyable such as spending time with loved ones, exercising, journaling, or practicing their faith or spirituality
• Help the person identify and prioritize current problems and break them down into manageable steps to foster a sense of control and accomplishment

Linking with Additional Services and Resources

• Linking survivors with additional services and resources is the final stage of PFA to ensure ongoing support and promote long-term recovery
• Assess for any ongoing medical or mental health needs and provide referrals to appropriate healthcare providers or mental health professionals as needed
• Provide information on community resources that can assist with ongoing needs such as housing assistance, legal aid, employment services, or financial assistance programs
• Encourage the person to seek additional support if they continue to experience significant distress or difficulty functioning in daily life activities
• Provide written information on coping strategies, community resources, and referrals for additional services that the person can take with them and refer back to as needed