Trauma Intervention: Psychological First Aid (Pfa)

TRAUMA
INTERVENTION
PSYCHOLOGICAL FIRST AID (PFA)
What is PFA?
• PFA is a humane, supportive response to a fellow human being who
recently Suffered exposure to serious stressors.
• It is designed to reduce the initial distress caused by traumatic events
and to foster immediate and long term adaptive functioning and
coping.
THEMES OF PFA
What PFA is NOT
• Psychological First Aid is
• NOT Psychological debriefing
• NOT obtaining details of traumatic experiences and losses
• NOT treating
• NOT labeling or diagnosing
• NOT counseling
• NOT something that only professionals can do
• NOT something that everybody who has been affected by an emergency will need.
• It is not useful, and may be harmful, to ask a disaster survivor to

systematically recount their perceptions, thoughts and emotional
reactions during a recent stressful event.
Who is PFA for?
• PFA is for distressed people who have been recently exposed to a serious
crisis event. It involves people of all ages, including children.
• Do not force help on people who do not want it, but make yourself easily
available to those who may want support.
• PFA does not assume that all survivors will develop severe mental health
problems or long‐term difficulties in recovery. Instead, it is based on an
understanding that disaster survivors will experience a broad range of early
reactions (e.g.. physical, psychological, behavioral, or spiritual) Some of these
reactions might cause enough distress to interfere with adaptive coping and
their recovery may be helped by PFA.
People who need special attention &
support (At Risk Population):
• People with serious life‐threatening injury need emergency medical care
• People who are too upset that they cannot care for themselves or their
children
• People who may hurt themselves or others
• Children & Adolescents – particularly those separated from their caregivers
– need protection from abuse and exploitation.
• People with health conditions or mental and physical disabilities – take
them to a safe place, protect them from abuse.
• Mothers with babies and small children
• Those with significant loss of possessions (home, family etc)
• N/B Incase of trauma people experience a range of distressing
symptoms.
• Most people will recover well over time, especially if they can restore
their basic needs and receive appropriate support and PFA.
• Make sure that severely distressed people are not left alone and
try to keep them safe until the reaction passes or until you can find
help from health personnel, local leaders or other community
members in the area.
When & Where is PFA provided?
• You can provide PFA when you first have contact with very distressed people. This
is usually during or immediately after an event.
• PFA is designed for delivery in diverse settings. You can provide PFA in shelters,
field hospitals, camps, acute care facilities (emergency departments), centers for
first responders or other relief workers, crisis hotlines, feeding locations, family
reception and assistance centers, homes, businesses, schools, evacuation centers
and other community settings.
• Ideally try to provide PFA where you can have some privacy to talk
with the person when appropriate.
• It doesn’t have to be a professional providing this kind of services but all people
involved in the rescue process can offer PFA
HOW IS PFA PROVIDED?
• Provision of PFA follows four basic principles: PREPARE, LOOK, LISTEN, LINK
PREPARE
• Before entering a crisis site learn about the following [CSS]:
•  Crisis event – What happened? When & where it took place? Who and how many
people are likely to be affected?
•  Support services – Who is providing the basic needs (food, water & shelter), emergency
medical care and tracing family members? Where & how can people access those
services? Who else is helping? Any community members involved?
•  Safety concerns – Is the crisis over or continuing? What dangers may be in the
environment (rebels, landmines or damaged infrastructure)? Are there areas to avoid
entering because they are not secure or because you are not allowed to be there?
• Once you are well prepared your work is half done.
LOOK
• Crisis situations can change rapidly. You may not have enough time
to prepare adequately or the scene may be different from what you
learned before you enter the site. Be calm, be safe and think before
you act. Consider following questions as you “look” around you:
1.SAFETY: What dangers can you see in the environment (active conflict, damaged
roads, unstable building etc.)? Can you be there without likely harm to yourself or
others?
a. If you are uncertain about the safety then do not go. Try to get help for people in
need. If possible, communicate with people in distress from a safe distance until
appropriate help arrives.
2.BASIC NEEDS: Look for anyone critically injured and need immediate
emergency medical help? Does anyone seem to need rescuing from
being trapped or from immediate danger?
• Who needs urgent basic needs (food, water, shelter)? Who needs
basic needs and special attention to be protected from discrimination,
abuse and violence? Who else around me need help?
a. Know your role and your limits.
b. Get help for people who need special assistance or who have
obvious urgent basic needs.
c. Refer critically injured people to medical care/physical first aid.
3.SERIOUS DISTRESS REACTION: Are there anyone who is extremely
upset, not able to move on their own, not responding to others, who
might harm themselves or others or in shock?
• Where and who are the most distressed people?
a. Prioritize accordingly and provide PFA; Do not leave them alone, try
to keep them safe until the reaction passes or until you find help from
health personnel or other community members in the area.
LISTEN
• Listening properly to people you are helping is essential to understand their situation and
needs, to help them to feel calm, and to be able to offer appropriate help. Learn to listen with
your:
Eyes ›› giving the person your undivided attention » Ears ›› truly hearing their concerns »» Heart ›› with caring and
showing respect
RAPID Model of PFA can guide here:
R- Rapport and Reflective listening
A- Assessment
P-Prioritizing
I-Intervention
D-disposition
Rapport (Approach people who may need support)
Approach people respectfully and according to their culture. Introduce yourself by
name and organization. Ask if you can provide help.
If possible, find a safe and quiet place to talk.
• Help the person feel comfortable; for example, offer water if you can.
• Try to keep the person safe- Remove the person from immediate danger, if it is safe to
do so.
• »» Try to protect the person from exposure to the media for their privacy and dignity.
• »» If the person is very distressed, try to make sure they are not alone.
Assessment and Prioritizing (As k about people’s needs and concerns)
• Although some needs may be obvious, such as a blanket or covering
for someone whose clothing is torn, always ask what people need and
what their concerns are.
• Find out what is most important to them at this moment, and help
them work out what their priorities are.
• Check for any exposure to death(human remains); dislocation (from
family or significant others) and disability (physical injury etc)
Intervention
• If psychologically unstable: Remove from provocative cues; allow catharsis;
delay impulsive actions; give tasks to do.
• Mitigate acute stress: educate them on the issues at hand; reassure; delay
impulsive actions; normalize symptoms; correct misunderstandings and false
information.
• »» 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.
• Keep your tone of voice calm and soft
LINK
• Facilitate access to higher levels of care if there is need
• Facilitate referral ( you are the one to make contact to the referral
source)
• Link to family and support groups
• Link to other helpers e.g financial needs, medical, legal, red cross
• Do follow up. Ask for their contact and permission to call after your
help.
SELF CARE

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TRAUMA

• It is not useful, and may be harmful, to ask a disaster survivor to

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