Psychological First Aid (PFA) is a modular and communicative approach to provide assistance in the immediate aftermath of a disaster or traumatic event.
It involves evidence-informed techniques that aim to reduce stress and foster short and long-term adaptive functioning. After the first 72 hours they are no longer suitable and a more specialised psychological intervention is required.
In general, the aims of Psychological First Aid are:
- Providing non-invasive support and care.
- Helping people address basic needs and concerns.
- Helping people to connect to information, services and social supports.
- Protecting people from further harm.
Mental Health professionals are not the only people who are capable of performing PFA, it can ideally be implemented by anyone because a disaster is not exclusive to any one group of people. In fact, we may also be familiar with some other first aid techniques such as cardiopulmonary resuscitation (CPR) or the Heimlich manoeuvre?
How is PFA provided?
- Seek assistance from social services such as an ambulance, policemen or fire-fighters if they are not already there, in addition to reaching the victims’ relatives.
- Make first contact with the person affected. To do this:
Move the person as far away from the conflict as possible. They should be taken to a more relaxed environment. We should provide a calm atmosphere free of stress. The affected person should avoid seeing, hearing, smelling or feeling anything related to the trauma.
We should be on the same level and next to the victim. We should ask for permission to talk with the person affected as well introduce ourselves and let them know that we are there to help them. We should maintain visual and physical contact (however, we should ask first for permission since some people may be uncomfortable with it).
- Address the affected person’s basic needs: provide water, food or medical care, avoid cold and heat, offer them a place to sleep, offer child care etc. Help the individual return to an emotionally stable place.
- Show interest by asking the person what happened. Nevertheless, if they are not willing to talk, we should not pressure them. We should not force anyone to talk or pressure them to give details about their loss or trauma. They will speak on their own time.
When actively listening, it is important to listen carefully and empathically, analysing the individual emotionally, assuring them that what they are suffering is normal due to the traumatic situation. This is essential since, the affected person may often feel like they are going crazy and losing control of the situation.
We should be kind and understanding with people that behave in a demanding or irritating way.
We should avoid using answers that may give false hope such as: “Don’t’ worry”, “everything is going to be okay”… We should not play down the importance of what has happened and we should never create false expectations since, the affected person will not trust our capacity understand them and feel empathy.
We should speak calmly and slowly; we should not be over dramatic either.
- Analyse the problem by examining the individual’s past and future to know what aspects should be addressed immediately and which ones can be postponed.
In this sense, establishing a plan of action can bring security and a feeling of control to the individual. For this reason, we should first help the person to address their urgent needs and identify what they can expect in the following hours and days. As some of their problems get resolved, the affected person gains a greater sense of control and helps to strengthen their self-esteem and response to the crisis.
- Consider the different personal resources that the individual has used throughout their life during stressful situations and suggest other alternatives that they could also use. People often tend to suppress their feelings in stressful situations.
One should not try to solve the affected individual’s problems as this would invalidate them. It is important to encourage them to take control of the situation and their lives.
- Help to carry out the plan of action if it is necessary and keep contact with the affected individual after that period.
- Provide information about the available resources within the community (social services, psychological care, refuge…) as well as information about the development of the critical situation. We should always be sincere when providing a sense of security and avoid giving unnecessary details that only cause more pain.
In order to provide correct information about the event and possibly correct the individual’s false beliefs, it is important to be well-informed before giving any additional news about what happened.
- Connect the affected individual with their loved ones and the available social support, since it has been proven that people who feel more supported after a crisis react more positively than those who do not feel supported.
We should gather their relatives or people who support them. When there are children involved it is very important to keep their close relatives as near as possible. We should provide a wide variety of religious assistance according to each culture and religious community.
When finishing, we should explain that we are going to leave and how everything is going to continue from that moment on.
We should not leave the individual alone since we can only leave if the victim’s social support or another person who can provide assistance is present.