Abstraction:

What is PFA?
PFA is a humane and supportive response to an individual who is in need of support. During and after a disaster, it is
provided to respond to the psychological needs of children, adults, and families. Also, it is designed to reduce the initial
distress caused by traumatic events, which fosters immediate and long-term adaptive functioning and coping. PFA also
involves the following themes:

PFA is not:
-a psychological debriefing
-concerned with obtaining details about traumatic experiences and losses
-a form of treatment
-an act of labeling and diagnosing
-counseling
-exclusive to professionals
-needed by everyone who was affected by a disaster

Since the main goal of PFA is to allow the person to adapt and become capable of overcoming psychological
distress, here’s a diagram about helpful factors to achieve long-term recovery:
Who is PFA for?
PFA providers must not assume that all survivors of disasters will develop severe mental health problems (i.e.,
psychological disorders) or long-term difficulties. Instead, they must understand that survivors may experience broad
range of initial reactions (e.g., physical, psychological, behavioral, or spiritual), which may cause distress and
interfere in adaptive coping and recovery.

So, PFA is for distressed people who have experienced a serious crisis event. Everybody may receive PFA
regardless of demographics (i.e., age, religion, social status, etc.). However, vulnerable populations have to be
prioritized such as:
- People with serious life-threatening injury who need emergency medical care
- People who suffer from emotional distress who are incapable of caring for themselves and others
- People who may hurt themselves and others
- Children and adolescents separated from their primary caregivers
- People with health conditions, physical disabilities, and mental disorders by keeping them safe and access
to medical care
- People at risk of discrimination or violence
- People with substance use problems
- Mothers with small children or babies
- People who have lost family members and significant belongings
- People who were exposed first hand to life threating situations and those who witnessed gruesome events
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When assessing for individuals’ distressed reactions, it is important to note that they may show differing responses
such as (but not limited to):
- Physical symptoms (shaking, headaches, tired feeling)
- Sadness, depressed mood, grief
- Anxiety, fear
- Being “on guard” or “jumpy”
- Always worried
- Insomnia, nightmares
- Irritability, anger
- Guilt and shame
- Confused, emotionally numb
- Withdrawn, not having progress
- Unresponsive to others
- Disorientation
- Unable to take care of oneself and immediate family

Above all, PFA providers must ensure that severely distressed people are not left alone – away from any harm
or threat – where help from health personnel, local leaders, and other community members is present.

When and where is PFA provided?

PFA is usually given when the provider had first contact with the distressed individual. It can be administered in
various settings such as shelters, field hospitals, camps, emergency facilities, evacuation centers, communities, and
even through calls and other virtual settings. Ideally, privacy must be maintained. Also, confidentiality, ethical rules,
and respect for the person’s dignity must be properly established.

Who can provide PFA?

PFA is administered by well-trained responders such as health and allied health professionals, volunteers,
members of the clergy and faith-based organizations, and trained responders from community organizations and
local government units.
How is PFA provided?
Responders (or PFA providers) must keep in mind the following basic objectives before administering PFA:
- Establish a non-intrusive human connection with the survivor
- Provide immediate safety, comfort, and support
- Allow survivors to calm down and become oriented when he/she is overwhelmed or distraught
- Ask survivors of their immediate needs and concerns and accommodate accordingly
- Connect survivors to social support networks, including family members, relatives, friends, among others
- Support survivors towards achieving adaptive coping by acknowledging their coping efforts and strengths,
and allowing them to take an active role in their recovery
- Provide helpful information that may help survivors cope effectively with the psychological impacts of the
disaster
- Set clear information about your availability (as PFA provider) and link survivors to other members of the
response team, mental health service providers, public-sector, local government units, among others
- Help survivors understand the disaster and its context
- Allow survivors identify their own strengths and abilities to cope
- Assist in identifying survivors who need further or specialized help
- Be present as survivors go through the first period of high intensity and uncertainty
- Reduce chances of PTSD (Post Traumatic Stress Disorder) or other psychological disorders

As always, preparation is key. Before entering a crisis site, remember the following:
Crisis event – basic information about the disaster or crisis
Support services – active actors and organizations that provide services
Safety concerns – presence of imminent dangers and/or threats

To guide PFA providers, an established set of action principles is adopted and followed, which is presented in the
diagram below:

Look
This principle prioritizes the survivors’ safety, urgent basic needs, and observance of their distress reactions.
Safety – look for dangers and threats that may harm you and the survivors (e.g., active conflicts, damaged roads,
unstable buildings, etc.).
Basic needs – look for any injuries or pains on survivors that need immediate medical attention; ask survivors of
their urgent basic needs; refer those who need further or specialized help to professionals.
Serious distress reaction – observe those who are extremely upset, unresponsive, overwhelmed, and in shock;
accompany them in a safe place until help is sought.
Listen
This principle focuses on engagements with survivors who need support by asking and taking note of their urgent
concerns; providing comfort; not forcing them to talk when they don’t want to; being a role model by keeping your
composure amidst stressful situations.

Link
This principle addresses urgent needs and concerns through practical support. Since PFA is a short time and one
time intervention, providing social support through linking them to their loved ones and service providers will boost
their morale. Also, by encouraging them to engage with positive coping strategies (e.g., getting enough rest,
spending time with family, doing self-care, and even helping others), their strengths and coping capacities are
nourished, which will help them manage and regain control of the situation.

To give you an overview, here are some dos and don’ts when providing PFA: