ASSIGNMENT

PSYCHOLOGICAL FIRST AID

SUBMITTED TO:
MISS IRAM QAYYUM

SUBMITTED BY:
MR. AHMAD HASSAN NAEEM
SUBJECT:

TRAUMA PSYCHOLOGY

(PSY-613)
Psychological First Aid

Psychological First Aid (PFA) is an evidence-informed approach that is built on the concept of
human resilience. PFA aims to reduce stress symptoms and assist in a healthy recovery following
a traumatic event, natural disaster, public health emergency, or even a personal crisis.

Psychological first aid (PFA) is a technique designed to reduce the occurrence of post-traumatic
stress disorder. It was developed by the National Center for Post-Traumatic Stress Disorder (NC-
PTSD), a section of the United States Department of Veterans Affairs, in 2006. It has been
endorsed and used by the International Federation of Red Cross and Red Crescent
Societies, Community Emergency Response Team (CERT), the American Psychological
Association (APA) and many others. It was developed in a two-day intensive collaboration,
involving more than 25 disaster mental health researchers, an online survey of the first cohort that
used PFA and repeated reviews of the draft.

According to the NC-PTSD, psychological first aid is an evidence-informed modular approach for
assisting people in the immediate aftermath of disaster and terrorism to reduce initial distress and
to foster short and long-term adaptive functioning. It was used by non-mental health experts, such
as responders and volunteers. Other characteristics include non-intrusive pragmatic care and
assessing needs. PFA does not necessarily involve discussion of the traumatic event and avoids
any activity associated with "debriefing" as that technique has been associated with increased rates
of PTSD.

Components
 Protecting from further harm  Discussing coping strategies
 Opportunity to talk without pressure  Social support
 Active listening  Offer to return to talk
 Compassion  Referral
 Addressing and acknowledging concerns

Steps
 Contact and engagement  Stabilization
 Safety and comfort  Information gathering

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 Practical assistance  Coping information
 Connection with social supports  Linkage with services
Why use PFA?

Emotional distress is not always as visible as a physical injury, but is just as painful and
debilitating. After going through a life altering experience it is common to be effected emotionally.

 Everybody who experiences a disaster is touched by it

 Reactions manifest differently at different periods of time during and after the incident.

Some common stress reactions include:

 Confusion  Fear
 Feelings of hopelessness and helplessness
 Sleep problems  Aggressiveness
 physical pain  Withdrawal
 anxiety  Guilt
 Anger  Shaken religious faith
 Grief  Loss of confidence in self or others.
 Shock
While Physical First Aid is used to reduce physical discomfort due to a bodily injury,
Psychological First Aid is a strategy to reduce the painful range of emotions and responses
experienced by people exposed to high stress

Goal of Psychological First Aid

The goal of Psychological First Aid is to create and sustain an environment of:

 Safety
 Calm & Comfort
 Connectedness
 Self-Empowerment
 Hope

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1. Safety
As a PFA provider, you should firstly aim to reintroduce a sense of safety, as this has been
shown to reduce negative reactions over time. Safety here refers to both physical and
psychological safety. Psychological safety refers to protecting people from situations that
may cause them further distress, such as seeing terrible things on the news or in person,
receiving bad news in an insensitive or uncontrolled way, or even being approached by the
media. In some settings, promoting safety will involve helping people put in place their
own strategies to prevent further exposure to these stressors. As a PFA provider, you may
also support their physical safety by guiding them away from any ongoing threat and
helping them meet basic needs such as accessing water, food, and shelter, or helping them
obtain emergency medical attention.
2. Calm & comfort
Secondly, we’re aiming to promote calm, as we know it is normal for people to experience
a wide range of strong emotions after a trauma. This principle refers to helping people cope
with strong emotions, as well as creating a calm environment for the impacted person,
workplace or community. For example, you may use simple psychological strategies such
as controlled breathing to help individuals cope better with any strong emotional reactions.
Further, calming may involve creating a sense of order and organization in crisis settings,
such as creating quiet spaces for highly distressed people, or safe areas for children
separated from their loved ones.
3. Self-Empowerment
Thirdly, we seek to promote a sense of self and community efficacy. This is about helping
people to have a sense of control over positive outcomes by encouraging people to see a
link between the actions they take, either as an individual or as a community, and positive
outcomes. This principle highlights that people, teams and communities bring with them
many existing strengths and resources, and they are best placed to determine what is best
for their situation. It may be simply a matter of reminding people of their own abilities, or
you might help them to determine and access what resources they may be missing so that
they can take positive actions to support their own recovery.
4. Connectedness

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 The fourth principle is connectedness, which is critical to recovery from trauma. Social
connections help people to solve practical problems through information sharing and
helping with daily tasks, as well as to gain emotional understanding and acceptance of what
has happened. As a PFA provider, you might support connection by ensuring families are
kept together, helping people contact loved ones, or linking them with relevant services.
5. Hope
And finally, instilling hope. Most of us are unprepared for a very traumatic event and it can
lead to people no longer seeing the world as a safe or predictable place as they did before
the trauma. This can lead to a sense of hopelessness, and people can even give up trying.
As a PFA provider, we can help instill hope by helping individuals to understand that their
reactions are common, and conveying an expectation that people can recover from trauma,
and you can support people to take one step at a time and to notice small gains so that they
can begin to look forward.

Psychological first aid action principles

The World Health Organization (WHO) has developed a framework consisting of three action
principles to assist in the delivery of psychological first aid. These principles provide guidance for
how to view and safely enter an emergency situation (LOOK) in order to understand the needs of
affected people (LISTEN) and link them with the information and practical support they need
(LINK).

Principles Actions
Look  Check for safety.
 Check for people with obvious urgent basic needs.
 Check for people with serious distress reactions.

Listen  Approach people who may need support.

 Ask about people’s needs and concerns.
 Listen to people and help them to feel calm.

Link  Help people address basic needs and access services.

 Help people cope with problems.
 Give information.
 Connect people with loved ones and social support.

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Look

1. Check for safety

 What dangers can you observe, e.g. damaged road, unstable buildings, fire, flooding
etc.?
 Ask if you can be there safely without harming yourself or others.
 If you are not certain that the area is safe, then DO NOT GO!
2. Check for people with obvious urgent basic needs.
 Does anyone need emergency first aid?
 Do people need urgent protection (e.g. clothing)?
 Are there any people who might need special attention?
 Know your role and try to obtain help for people who need special assistance or who
have obvious urgent basic needs.
3. Check for people with serious distress reactions
 Are there people who are extremely upset, immobile, not responding to others,
disturbing others, or in shock?
 Where and who are the most distressed people?
 Consider who may benefit from psychological first aid and how you can best help.

Listen

1. Approach people who may need support

 Approach people respectfully and according to cultural norms.
 Introduce yourself by name and organization
 Ask if you can provide help
 If possible, find a quiet and safe place to talk
 Help the person feel comfortable
2. Ask about the people’s needs and concerns
 Address any obvious needs. For example, if a person’s clothing is torn or they need a
blanket
 Always ask for people’s needs and concerns
 Do not assume you know

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  Find out what is most important to them at this moment
 Help them work out what their priorities are.
3. Listen to people and help them to feel calm
 Stay close to the person
 Do not pressure the person to talk
 Listen in case they want to talk about what happened
 If they are very distressed help them to feel calm and try to make sure they are not
alone

Link

1. Help people address basic needs and access services

 For example, food, water, shelter, material needs
 Learn what specific needs people have and try to link them to available assistance
 Do not make promises you cannot keep
2. Help people cope with problems
 Help identify their most urgent practical needs and assist with prioritizing.
 Help the person identify support people
 Give practical suggestions for people to meet their own needs (e.g. how to register
with Centre link etc.)
3. Give information
 Find out where to get information and updates
 Try to get as much information as you can before approaching people with support
 Keep updated
 Only say what you know
4. Connect people with loved ones and social support
 Keep families together and children with their parents
 Help people to contact friends or relatives.
 If prayer or religious practice is important people may benefit from being linked with
their spiritual base.

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Preparing to Deliver Psychological First Aid

In order to be of assistance to disaster-affected communities, the Psychological First Aid provider

must be knowledgeable about the nature of the event, current circumstances, and the type and
availability of relief and support services.

Planning and preparation are important when working as a Psychological First Aid provider. Up-
to-date training in disaster mental health and knowledge of your incident command structure are
critical components in undertaking disaster relief work. You may also be working Preparing to
deliver with children, older adults and special populations, all of which require additional in-depth
knowledge. In deciding whether to participate in disaster response, you should consider your
comfort level with this type of work, your current health, your family and work circumstances,
and be prepared to engage in appropriate self-care.

Entering the Setting

Psychological First Aid begins when a disaster response worker enters an emergency management
setting in the aftermath of a disaster. Successful entry involves working within the framework of
an authorized Incident Command System (ICS) in which roles and decision-making are clearly
defined. It is essential to establish communication and coordinate all activities with authorized
personnel or organizations that are managing the setting. Effective entry also includes learning as
much as you can about the setting, for example, leadership, organization, policies and procedures,
security, and available support services. You need to have accurate information about what is
going to happen, what services are available, and where they can be found. This information needs
to be gathered as soon as possible, given that providing such information is often critical to
reducing distress and promoting adaptive coping.

Providing Services

In some settings, Psychological First Aid may be provided in designated areas. In other settings,
providers may circulate around the facility to identify those who might need assistance. Focus your
attention on how people are reacting and interacting in the setting. Individuals who may need
assistance include those showing signs of acute distress, including individuals who are:

 Disoriented  Confused

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  Frantic or agitated  Panicky
 Extremely withdrawn, apathetic, or “shut down”
 Extremely irritable or angry
 Exceedingly worried

Group Settings

While Psychological First Aid is primarily designed for working with individuals and families,
many components can be used in group settings, such as when families gather together for
information about loved ones and for security briefings. The components of providing information,
support, comfort, and safety can be applied to these spontaneous group preparing to deliver
situations. For groups of children and adolescents, offering games for distraction can reduce
anxiety and concern after hours and days in a shelter setting.

When meeting with groups, keep the following in mind:

 Tailor the discussion to the group’s shared needs and concerns.

 Focus the discussion on problem-solving and applying coping strategies to immediate
issues.
 Do not let discussion about concerns lapse into complaints.
 If an individual needs further support, offer to meet with him/her after the group discussion.

Maintain a Calm Presence

People take their cue from how others are reacting. By demonstrating calmness and clear thinking,
you can help survivors feel that they can rely on you. Others may follow your lead in remaining
focused, even if they do not feel calm, safe, effective, or hopeful. Psychological First Aid providers
often model the sense of hope that survivors cannot always feel while they are still attempting to
deal with what happened and current pressing concerns.

Be Sensitive to Culture and Diversity

Providers of Psychological First Aid must be sensitive to culture, ethnic, religious, racial, and
language diversity. Whether providing outreach or services, you should be aware of your own
values and prejudices, and how these may agree with or differ from those of the community being
served. Training in cultural competence can facilitate this awareness. Helping to maintain or

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reestablish customs, traditions, rituals, family structure, gender roles, and social bonds is important
in helping survivors cope with the impact of a disaster. Information about the community being
served, including how emotions and other psychological reactions are expressed, attitudes toward
government agencies, and receptivity to counseling, should be gathered with the assistance of
community cultural leaders who represent and best understand local cultural groups.

Be Aware of At-Risk Populations

Individuals that are at special risk after a disaster include:

 Children, especially those:

 Separated from parents/caregivers
 Whose parents/caregivers, family members, or friends have died
 Whose parents/caregivers were significantly injured or are missing
 Involved in the foster care system
 Those who have been injured
 Those who have had multiple relocations and displacements
 Medically frail children and adults
 Those with serious mental illness
 Those with physical disability, illness, or sensory deficit
 Adolescents who may be risk-takers
 Adolescents and adults with substance abuse problems
 Pregnant women
 Mothers with babies and small children
 Disaster response personnel
 Those with significant loss of possessions (for example, home, pets, family memorabilia)
 Those exposed first hand to grotesque scenes or extreme life threat

Especially in economically disadvantaged groups, a high percentage of survivors may have

experienced prior traumatic events (for example, death of a loved one, assault, disaster). As a
consequence, minority and marginalized communities may have higher rates of preexisting
trauma-related mental health problems, and are at greater risk for developing problems following
disaster. Mistrust, stigma, fear (for example, of deportation), and lack of knowledge about disaster
relief services are important barriers to seeking, providing, and receiving services for these
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populations. Those living in disaster-prone regions are more likely to have had prior disaster
experiences.

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