Psychological first aid

PFA is

• A humane, supportive response to a fellow human being who is suffering
• Simple and practical: anyone can provide it, no professional training required
• Respecting dignity: treating people with respect regardless of their background
• Immediate: provided in the first hours and days after a crisis
• Adaptable: adjusts to different people, cultures, and situations
• Evidence-based: recommended by WHO, Red Cross, and major health organisations

PFA is NOT

• Not therapy or counselling: it does not involve diagnosis or treatment
• Not psychological debriefing: do not pressure people to recount the details of what happened
• Not only for professionals: anyone can learn and apply PFA
• Not forcing people to talk: some people prefer silence. That is valid
• Not providing false reassurance: do not say "everything will be fine" when it might not be
• Not making decisions for people: help them access their own coping abilities

Safety

Help people meet their basic needs for shelter, food, and water. Remove them from immediate danger. Provide accurate information about what has happened and what is being done.

• Ensure physical safety first
• Provide a calm, quiet space if possible
• Protect from further exposure to traumatic events

Calm

Help reduce acute distress. People in crisis may feel overwhelmed, confused, or panicked. A calm presence is contagious.

• Speak in a steady, warm tone
• Offer simple, factual information
• Help with breathing exercises if welcomed

Self-efficacy

Help people feel capable of taking action. People who believe they can cope are more likely to recover well.

• Encourage small, practical decisions
• Ask "What would help you right now?"
• Support their ability to help themselves

Connectedness

Help people access social support. Connection to family, friends, and community is a powerful protective factor.

• Help reunite families when possible
• Encourage contact with loved ones
• Link to community and religious supports

Hope

Help people feel optimistic about the future. Realistic hope is based on acknowledging the difficulty while highlighting strengths and resources.

• Recognise people's strengths and coping
• Share stories of recovery (with permission)
• Remind them that reactions are normal and temporary

Look

Observe the situation before approaching. Assess safety, identify people with urgent needs, and note signs of distress.

• Check for safety: are there ongoing dangers?
• Identify urgent needs: who needs medical attention, shelter, or protection?
• Look for signs of distress: crying, trembling, blank stare, confusion, agitation
• Note who is alone: isolated individuals may need more support
• Observe without rushing: take a moment to understand the situation

Listen

Approach people who may need support. Introduce yourself. Ask about their needs. Listen actively without judgement.

• Introduce yourself: "Hello, my name is... I'm here to help"
• Ask simple questions: "How are you? What do you need right now?"
• Listen more than you speak: silence is fine
• Validate feelings: "It's understandable that you feel this way"
• Do not pressure: if someone does not want to talk, respect that

Link

Connect people with practical help and social support. Help them access the resources they need.

• Basic needs: food, water, shelter, blankets, medication
• Information: what happened, what is happening, who to contact
• Family reunion: help locate and contact family members
• Services: medical care, social services, legal aid
• Community: neighbours, religious groups, local organisations

Young children (under 6)

• Stay close: physical proximity to a trusted adult is the most important thing
• Speak simply: "Something scary happened, but you are safe now. I am here with you"
• Allow regression: thumb-sucking, bedwetting, and clinging are normal temporary responses
• Maintain routines: regular mealtimes, playtime, and bedtime provide security
• Use play: drawing, puppets, and storytelling help young children process emotions
• Avoid graphic details: shield them from disturbing images and conversations
• Physical comfort: hugs, holding hands, and being carried provide reassurance

Older children and teenagers

• Be honest: answer questions truthfully, adapted to their age
• Validate feelings: "It's OK to be scared. I was scared too"
• Give them tasks: feeling useful (packing, helping younger children, distributing water) reduces helplessness
• Encourage peer support: time with friends is therapeutic for teenagers
• Limit media exposure: repeated news images can be re-traumatising
• Watch for warning signs: isolation, aggression, risky behaviour, substance use, decline in school performance
• Involve in decisions: teenagers benefit from feeling heard and included

Specific challenges

• Mobility: difficulty evacuating, accessing shelters, or standing in queues
• Medication: disrupted access to essential daily medication
• Cognitive decline: increased confusion or disorientation during a crisis
• Sensory impairment: hearing or vision loss makes communication harder
• Social isolation: many elderly people live alone and may have no one to check on them
• Past trauma: emergencies may trigger memories of previous difficult experiences

How to help

• Speak clearly: face-to-face, slowly, in a calm voice
• Check on them regularly: visit or call elderly neighbours
• Help with practical needs: medication, mobility aids, food, water
• Provide reassurance: repeat information patiently
• Respect independence: offer help without taking over
• Contact family: help reconnect them with relatives or carers
• Watch for signs of confusion: elderly people may not recognise they need help

During the crisis

• Take breaks: step away regularly, even for 5 minutes
• Eat and drink: maintain blood sugar and hydration
• Work in pairs: never work alone for extended periods
• Set boundaries: you cannot help everyone. Focus on what is within your reach
• Accept your limits: it is normal to feel overwhelmed

After the crisis

• Talk about your experience: with a colleague, friend, or family member
• Rest: allow yourself time to recover physically and emotionally
• Maintain routines: return to normal activities as soon as possible
• Physical activity: exercise helps process stress hormones
• Seek professional help: if symptoms persist beyond 2 weeks, consider talking to a psychologist
• Recognise secondary trauma: vivid images, nightmares, and emotional numbness are signs you need support