Module 2
2.1 PSYCHOLOGICAL FIRST AID
WHAT IS PSYCHOLOGICAL FIRST AID (PFA)?
Imagine a situation where a natural disaster has just occurred and people are gathered
in shock , some are crying, some are silent, and others appear confused and
overwhelmed. A helper approaches, speaks calmly, listens to their concerns, reassures
them that they are safe, and helps them find basic support or loved ones. This
immediate, compassionate response is known as Psychological First Aid (PFA).
Psychological First Aid is a supportive and practical approach aimed at reducing initial
distress and helping individuals cope in the aftermath of a crisis. It does not involve
therapy or diagnosis; instead, it focuses on providing safety, comfort, understanding,
and connection to further support when needed.
Seven Themes of Psychological First Aid
Psychological First Aid is guided by seven core themes that promote recovery and
resilience:
1. Safety – Helping people feel protected from further harm
2. Calmness – Reducing intense emotional reactions
3. Hope – Encouraging realistic optimism about recovery
4. Connectedness – Promoting connection with family, friends, and community
5. Self-efficacy – Supporting people’s belief in their ability to cope
6. Dignity and respect – Treating individuals with empathy and non-judgment
7. Practical assistance – Addressing immediate needs and concerns
These themes are drawn from WHO, IASC guidelines and the resilience framework
proposed by Hobfoll et al. (2007).
WHO NEEDS PFA/WHO IS PFA FOR?
PFA is intended for any person experiencing psychological distress due to a crisis or
adverse event.
It is useful for:
● People affected by large-scale crises such as natural disasters, pandemics, or
community violence
● Individuals facing personal crises such as accidents, medical emergencies,
bereavement, or abuse
● Students and young people dealing with:
o Bullying
o Anxiety or panic attacks
o Academic failure
o School violence
o Family conflict or loss
⚠ Not everyone exposed to a crisis needs PFA ,some people cope effectively on their
own.
It is for people who are distressed , not mentally ill.
How is PFA Provided?
PFA is provided through simple, supportive human actions rather than formal
psychological interventions. It involves:
● Being present and emotionally available
● Listening with empathy
● Identifying needs and concerns
● Offering practical help
● Connecting people with social and professional supports
● Ensuring privacy, safety, and confidentiality
PFA should be flexible, culturally sensitive, and based on the individual’s immediate
needs.
WHO CAN PROVIDE PFA?
Anyone and everyone who has basic training in PFA can provide it. It is not
something only professionals with specialised knowledge can perform. PFA skills
are not difficult to learn since it is part of our daily lives without us even realising it.
However, one should keep in mind that not everyone requires PFA. People react in
different ways at different times. An event can cause distress to anyone, but some
people can manage on their own and do not need help.
WHO DELIVERS PFA
PFA can be delivered by anyone who has received basic training, including:
● Teachers and educators
● Parents and caregivers
● Peers and classmates
● Community workers and volunteers
● Health workers and first responders
● Social workers and support staff
It does not require specialised professional qualifications, though training is
recommended.
PFA is relevant in the educational and social settings. It can be helpful for students
dealing with distressing events in school settings (such as bullying by peers, anxiety
attacks, failing a grade, school violence) and interpersonal settings (such as domestic
violence, sexual, physical, emotional abuse or neglect, crime in their surrounding
community, death in the family).
WHEN DO YOU PROVIDE PFA?
During or shortly after the occurrence of a distressing event or an emergency.
Reminders of the crisis, such as anniversaries of the day, may trigger distress.
WHERE DO YOU PROVIDE PFA?
Anywhere safe, calm and comfortable for the provider and receiver of PFA. Privacy
and confidentiality are also to be ensured.
WHY PROVIDE PFA?
There is evidence for certain resilience factors developing in people who have
experienced a crisis event if they:
● Feel safe, calm, hopeful and connected to others
● Have access to social, physical and emotional support
● Regain a sense of control by being able to help themselves
DO’s AND DON’Ts OF PFA
DO’s
● Be patient and calm. Listen actively and acknowledge their feelings.
● Stay near the person, but keep an appropriate distance depending on their
age, gender and culture.
● Respect their privacy. Maintain confidentiality about the matters they discuss,
especially when they disclose private events.
● Find a quiet, calm place to talk and minimise outside distractions as much as
possible.
● Maintain eye contact and speak to them in a simple manner so that they can
easily understand what you want to convey.
● Let them know that they are heard and validated through verbal affirmations
and body language. For example, nod your head and say “hmm…”
● Acknowledge their strengths and how they have helped themselves.
DON’Ts
● Don’t pressure someone to open up and share their story.
● Don’t give your personal opinions or judgments about the person’s situation.
● Don’t touch the person as it may be considered inappropriate by some.
● Don’t talk about your own troubles.
● Don’t use too technical terms.
● Don’t take up their problems as your own problems.
● Don’t give false promises or false reassurances.
● Don’t take away the person’s strength and sense of being able to care for
themselves.
STEPS IN PFA (Action principles)
PREPARE
The first step in PFA is to PREPARE to face the situation before you enter it. Learn
about:
● The distress event itself. Understand what exactly happened, how it
exactly happened, and who were involved in it.
● Available services and supports. What are the available sources of
support for the person needing help? How exactly can this support be made
available to them?
● Safety concerns. What are some of the safety concerns within the
student or in their environment?
1. LOOK
● Look out for who needs help. Be aware of any distressing event
immediately following which a person might require help or reaching out.
● Look out for emotional reactions. Persons experiencing
distressing situations exhibit behavioural and emotional symptoms related to
the event. These symptoms must be identified and addressed.
2. LISTEN
● Contact and engagement. Establish contact with the distressed person
and let them know you are available to listen to and support them. Building trust
is the foremost step to providing PFA. They can be asked about how they are
feeling in the aftermath of the distressing event, but DO NOT force them to talk
about it.
● Safety and comfort. Help them feel safe, calm and comfortable. Offer
them a safe, private place to share if they feel the need to.
● Stabilisation (if needed). People undergoing distress can show strong
emotional reactions as a result of it. Sometimes they require a safe place to
express themselves and how they are feeling. Assist them by finding a private
space to let them fully express themselves and calmly accepting the emotion
being displayed. This simple act can help them feel validated.
● Information gathering: needs and current concerns. This step
involves asking the person about their needs and other concerns at that time.
This can facilitate them to feel heard and share their current state of mind and
how they would like to be supported. The expressed needs can be as minimal
as asking for a sip of water, or wanting to share their deepest concerns
regarding the issue. Offer them calm, compassionate words of empathy and
understanding.
3. LINK
● Practical assistance. In response to them stating their current needs,
provide any practical ways of help to them.
● Connection with social support. Connecting a person with needed
social support involves helping them identify who might be able to best help
them in their situation. Some might feel more comfortable with family
members or with certain other important social connections.
● Information on coping. This core action is important as it helps the
person recognise their innate coping skills. Ask them about the coping
methods they utilised until that point and appreciate them for it. Facilitate them
in recognising other ways of coping that have worked for them in the past.
● Linkage with collaborative services. Linking the person with
collaborative services involves linking them with other persons and
professionals who are equipped with providing further assistance. This can
be done by contacting the parents of the person, or teachers, and letting
them know that they require assistance and support addressing their
concerns. This is done to ensure the safety of the affected person and
helping them cope with their distress in an efficient manner.
The Kerala landslides and other crisis situations showed us that while disasters destroy land
and homes, Psychological First Aid helps protect human dignity, emotional stability, and hope
, from the very first moment