Psychological First Aid (PFA; created by the National Child Traumatic Stress Network in partnership with the National Center for PTSD) is intended for use with children, adolescents, caregivers, families, and adults and can be implemented in a variety of settings including field hospitals, shelters, EDs, family assistance centers, and even schools. PFA is based on the assumption that most people will not develop posttraumatic stress symptoms in response to a traumatic event and that by meeting people’s immediate needs through human connection, we provide a buffer against ongoing distress. This is a supportive intervention that can be delivered by mental health professionals, first responders, and other disaster response workers in the immediate aftermath of a disaster, which is defined as up to 4 weeks post-exposure.
Several guidelines have been identified for delivering PFA. The provider should observe the situation before approaching the individual. Respectful questions should be asked to determine what the individual/family needs to determine the approach taken. Be calm, patient, responsive, and speak in a developmentally and culturally appropriate way. When working with children, it is particularly important to help children verbalize their emotions, listen carefully to the child and conduct frequent check-ins to make sure that the child knows that they are heard, identify the child’s strengths, be aware that the child may show developmental regression, and that parenting guidance might be needed.
Survivors may present as disoriented, panicky, withdrawn, irritable/angry, and/or extremely worried. Focus should be placed on problem solving and offering coping strategies in response to the immediate situation.
There are eight core actions of PFA: Contact and Engagement, Safety and Comfort, Stabilization, Information Gathering, Practical Assistance, Connection with Social Supports, Information on Coping, and Linkage with Collaborative Services. It is likely that not all actions will need to be taken. The provider engages in active listening to determine which core action(s) is needed. Each core action is defined below.
- Contact and Engagement: Respond to and initiate contact with survivors
- Safety and Comfort: Enhance safety by providing physical and emotional comfort
- Stabilization: Calm and orient survivors (if needed)
- Information Gathering: Identify immediate needs/concerns
- Practical Assistance: Offer practical help in response to immediate needs/concerns
- Connection with Social Supports: Facilitate contact with established supports
- Information on Coping: Provide information on stress reactions and basic coping skills that can be used to decrease distress
- Linkage with Collaborative Services: Link survivors with community-based services