What Is Psychological First Aid?

After someone experiences a traumatic event, their early responses can lead to distress that can interfere with coping. Psychological first aid (PFA) is a disaster relief technique developed by the National Child Traumatic Stress Network and National Center for PTSD (post-traumatic stress disorder).

The goal of the intervention is to provide safety, stability, and resources to people in the immediate aftermath of a traumatic event to increase survivors’ abilities to cope. This article explains how PFA is used, who does it, and its outcomes. 

What Is Psychological First Aid?

PFA is not on-site therapy. Instead, it connects with people in the aftermath of a disaster with resources and support for their immediate needs. 

PFA includes eight core components, which include:

• Making initial contact 
• Ensuring people are safe and comfortable
• Calming and orienting people
• Identifying people's immediate needs
• Offering practical assistance
• Connecting people with resources
• Providing coping strategies
• Linking people to collaborative services

PFA is not professional mental health care. In fact, laypeople (people without professional credentials) often perform it. However, certain understandings about people's coping needs guide PFA, including:

• The need to feel safe, connected, and hopeful
• The need for access to support
• The need for self-reliance

History

As a concept, PSA was introduced in the mid-20th century. However, it gained traction as a disaster response in the post-9/11 era.

In 2001, in response to mass shootings in schools, the workplace, and terrorist attacks, the National Institute of Mental Health brought 60 mental health experts together to discuss the psychological interventions to mass violence. Since then, PFA has become an integral early intervention disaster response.

"Psychological first aid" is the most widely used term to describe immediate emotional support following a crisis. However, other terms are also used, including:

• Community-based psycho-social support
• Disaster behavioral health first aid
• Mental health first aid
• Stress first aid
  

When Is It Used?

PFA benefits anyone who has survived or witnessed a traumatic event, including people of any age and gender. The World Health Organization (WHO) identifies the following as crisis events that could benefit from PFA:

• Natural disasters
• War
• Terrorist attacks
• Disease outbreaks
• Displacement 
• Robbery
• Assault

In the aftermath of a disaster, people have common stress reactions. By reducing people’s immediate stress through PFA, people may have a better ability to cope long-term. Common stress reactions include:

• Confusion
• Fear
• Hopelessness
• Insomnia
• Pain
• Anger
• Grief
• Shock
• Guilt

Who Does It?

Anyone can be trained in psychological first aid. However, since certain people are more likely to be present following a disaster, PFA is commonly used by the following:

• First responders
• Healthcare workers
• School crisis response teams
• Disaster relief organizations

How It Works

Providing PFA may look different from crisis to crisis and even from person to person in the same predicament. That’s because each situation is unique. In addition, while there are common reactions to disasters, each person has an individual response, and their immediate needs vary. 

People trained in PFA learn how to promote the following:

• Safety: Responders help people locate food, shelter, and medical attention.
• Calm: Responders listen to people’s stories and feelings.
• Connection: Responders help people locate friends and family and keep families together.
• Hope: Responders remind people that help is coming and tell them about resources available to them.
• Self-efficacy: Responders give suggestions on how people can help themselves.

The Evidence for PFA

Despite its widespread use and promotion, there is little scientific evidence to support the effectiveness of PFA following disasters. However, the practice is still considered an evidence-informed practice (using current best practices in making decisions regarding care of an individual).

PFA is based on well-established concepts of human resilience. In addition, mental health and disaster research and response organizations developed PFA. Therefore, the practice is based on existing knowledge and research.

Summary

Psychological first aid (PFA) is a disaster relief response that supports people in the immediate aftermath of a crisis. The goal is to reduce people's primary stress by connecting them with resources, reuniting them with family and friends, and offering hope to have a better ability to cope long term.

A Word From Verywell

PFA is an essential skill that nearly anyone can learn. However, it is crucial for first responders, medical workers, and disaster relief workers. Several organizations offer PFA training. If you are interested in training, the American Psychological Association has a list of the training provided by various organizations.