Psychological first aid

Domain V · Systemic, relational, group & community · Brymer, Jacobs, Layne · 2006

What it is

Psychological first aid (PFA) is not a psychotherapy and not a phased treatment. It is a modular, evidence-informed early-response framework for children, adolescents, adults, families and responders in the hours, days and (WHO) weeks after a disaster, terrorism, accident or other serious crisis.…

Format

• Information Gathering: Current Needs and Concerns: identify immediate needs and tailor the help (not a formal assessment).
• Information on Coping: information about stress reactions and coping, to reduce distress and promote adaptive functioning.

Who practises it, and how they are trained or regulated

• Licensing: PFA is freely distributed and not a licensed programme; neither guide requires certification to deliver it. Training is offered by the developers (e.g. NCTSN's online PFA course).

Evidence status, as the guide reports it

• Psychological first aid (PFA) is not a psychotherapy and not a phased treatment. It is a modular, evidence-informed early-response framework for children, adolescents, adults, families and responders in the hours, days and (WHO) weeks after a disaster, terrorism, accident or other serious crisis.…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• people who cannot report their own needs (cognitive impairment, sensory loss, small children).
• information overload in distressed people (repeat later, write it down); your own urge to reassure beyond the facts.
• the person takes an active role and leaves with a concrete next step; unrealistic expectations of services (correct them early).
• drift into a trauma narrative (gently refocus on present needs); people who minimise needs out of guilt that others have it worse.
• self-deploying, arriving without service information (you will be unable to link), or your own unaddressed loss making the work unsafe for you.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.