PSYCHOLOGICAL FIRST AID WORKSHEET

BASIC PFA PROVISION

Read each section carefully. Then write your own words, phrases, or responses in the spaces provided. The goal is
to build calm, supportive, and practical responses for a person in distress.

1. The Entry: Presence and Demeanor. Before you speak, your body should tell the person, “I am safe, I am
steady, and I am not here to overwhelm you.” In PFA, providers are advised to observe first, approach only
when appropriate, and use calm, non-intrusive presence.
a. Anchor yourself. If they are seated, sit nearby at eye level if possible. If they are standing, stand at
a respectful distance and do not crowd them.
b. Keep your hands visible and relaxed. Avoid folded arms, finger-pointing, fidgeting, or clutching a
phone/clipboard unless you genuinely need it.
c. Use soft eye contact. Look at them enough to show attention, but do not stare or “lock on.” The goal
is presence, not pressure.
d. Move slowly. Sudden movements can feel intrusive when a person is already overwhelmed.
e. Respect personal space. The exact distance depends on the person and the setting, but the guiding
rule is: close enough to support, far enough not to feel invasive.

My own reminders for presence and demeanor:

2. Vocal Modulation. Your voice should function like a brake, not an alarm. Official PFA guidance specifically
recommends speaking calmly, slowly, and in simple concrete terms.
a. Tone: low, calm, warm, and steady. Think “compassionate authority,” not cheerfulness and not
monotone.
b. Tempo: slower than normal conversation, with pauses after short sentences. Silence is useful
because it gives the person room to process.
c. Volume: slightly softer than the distressed person, but still clearly audible.
d. Word/ Language choice: Use words that are simple, concrete, calm, and nonjudgmental. In a crisis,
people process best when your words are short, familiar, and easy to act on. Avoid jargon, labels, long
explanations, or emotionally loaded phrases that can make the person feel more confused or judged.
Use the language the person you are helping is comfortable with.

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WHAT TO USE WHAT TO AVOID

✓ Short sentences.  Technical terms like “panic attack” or “trauma response”.
✓ One idea/question at a time.  Abstract or philosophical language.
✓ Plain words.  Moralizing language.
✓ Gentle, direct statements.  Too many instructions at once.
✓ Questions that ask about immediate needs.  Too many questions at once.
 Open-ended “why” questions when the person is overwhelmed.
Examples:
→ “My name is __________. I’m here with you.”
→ “You are safe right now.”
→ “We’ll take this one step at a time.”
→ “You do NOT have to explain everything now.”

My own phrases for a calm voice:

3. Contact and Engagement. The first PFA task is not problem-solving; it is making a non-threatening
connection. PFA emphasizes positive, compassionate, non-intrusive contact and asking simple respectful
questions.

Suggested sequence:
a. Introduce yourself.
b. Ask permission to stay.
c. Offer one simple helpful presence. The idea is to give one small, steady support that feels safe and
not overwhelming. In practice, “one simple helpful presence” could mean:
→ sitting nearby quietly,
→ saying, “I’m here with you,”
→ offering water,
→ helping them move to a quieter place,
→ or just staying with them so they are not alone.
d. Let them control how much they share.
This approach matters because people in acute distress often cannot process long explanations or emotionally
loaded questions. REMEMBER: The goal is to reduce threat, not intensify it.

Example script:
→ “Hi, I’m _______. I’m here to help.”

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→ “Would it be okay if I sit with you for a moment?”

→ “You do not need to talk unless you want to.”

My own phrases for contact and engagement:

4. Safety and Comfort. Once contact is made, focus on immediate safety and comfort needs. PFA guidance
repeatedly identify safety, comfort, food, water, and a quiet space as early priorities. REMEMBER: Marlow’s
Hierarchy of Needs – deficiency/basic needs must be met first.

What to do:
→ Offer water and/or food.
→ Offer a chair or a quieter location.
→ Reduce noise, crowding, and stimulation where possible.
→ Check for injury, dizziness, trouble breathing, or other urgent physical needs.

Why this works: practical comfort helps interrupt the stress spiral and gives the person a concrete foothold
in the present. PFA frames this as part of helping the person feel safe and calm enough to manage the next
step.

My own phrases for safety and comfort:

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5. Stabilization and Grounding. If the person is panicking, very agitated, crying hard, hyperventilating, or seems
disconnected, keep the intervention extremely simple. PFA supports calming and orienting overwhelmed
people, and grounding exercises like slow breathing are specifically mentioned.

Simple grounding scripts:

→ “Look at me for a second.”
→ “You’re here with me.”
→ “Put both feet on the floor.”
→ “Take one slow breath with me.”
→ “Name three things you can see.”

5-4-3-2-1. The 5-4-3-2-1 technique is a recognized grounding method for distress and can be used in crisis
response.
“Tell me 5 things you can see.”
“Now 4 things you can feel.”
“Now 3 things you can hear.”
“Now 2 things you can smell.”
“Now 1 thing you can taste.”

IMPORTANT NOTE: Grounding scripts may not work for every person. Some may feel more irritated or
pressured when asked to do them. If the person seems annoyed or resists, do not insist. Pause the script,
reduce stimulation, and return to simple support such as calm presence, a quieter space, water, or one short
question about what they need. A very practical fallback line is: “That’s okay. We can stop. I’ll just stay with
you for a moment.” This keeps the person from feeling controlled, which is often the reason grounding fails.

My own grounding phrases:

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Research three grounding techniques and explain how to do them:

TITLE INSTRUCTIONS / EXPLANATION

6. Needs Check. After the person is more settled/calm, shift to very simple needs-based questions. PFA
guidance recommends asking about immediate needs and concerns rather than pressing for details of the
event.

Use questions like:

→ “What do you need right now?”
→ “Do you want water, a quieter space, or someone to call?”
→ “Is there one thing that would help most in the next 10 minutes?”
→ “Who do you want with you?”

Avoid “Why are you feeling this way?” because it demands more reflection than many people in acute distress can
manage. The safer move is to ask what is needed now, not why or how they arrived there. REMEMBER: Psychological
debriefing is NOT recommended. (for more information on the advice against psychological debriefing, see [Link]
health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/other-significant-emotional-and-medical-unexplained-
somatic-complaints/psychological-debriefing-in-people-exposed-to-a-recent-traumatic-event)

My own needs-check questions:

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7. Practical Assistance. PFA is strongest when it turns distress into one small doable next step. PFA explicitly
includes practical help, problem-solving for immediate concerns, and linkage to support systems.

Examples:
→ Help draft one text: “I need a break and someone to stay with me.”
→ Help make one call.
→ Help arrange transport or escort.
→ Help plan the next 30 minutes, not the whole week.

You can say:

→ “Let’s solve just this part first.”
→ “What is the next smallest step?”
→ “I can stay while you send the message.”

My own phrases for practical assistance:

8. What Not to Do. PFA is very clear that helpers should avoid debriefing, pushing for details, speculating, or
labeling the person’s reactions. It also cautions against talking down to people or assuming everyone needs
to talk.

Avoid these:
 “Tell me everything that happened.”
 “You’re having a panic attack.”
 “This is a trauma response.”
 “Calm down.”
 “Everything happens for a reason.”
 “You’re overreacting.”

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Also avoid:
 Touching without permission.
 Overexplaining.
 Correcting emotions.
 Making promises you cannot keep.

A good rule: if your sentence increases shame, confusion, or pressure, rewrite it.

My own reminders for what to avoid:

9. Closure and Handoff. Do NOT leave a stabilized person without a clear bridge to the next support. PFA
stresses linkage with social supports and collaborative services as a core objective.

Close with:
→ “We have a plan for the next step.”
→ “I’m going to stay until [name/office/caregiver] comes.”
→ “After that, you’ll be with [resource/person].”
→ “You do not have to manage this alone.”

If there is any suicide risk, psychosis, inability to care for self, violence risk, intoxication, or medical danger,
escalate immediately and bring/link to emergency services rather than relying on PFA alone.

My own closure and handoff phrases:

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SUICIDE RISK / ACTIVE SELF-HARM: FIRST RESPONSE ONLY

Important: This section is NOT suicide intervention training. It is ONLY A FIRST-RESPONSE GUIDE for what to
do UNTIL a trained crisis responder, clinician, emergency team, parent/guardian, or other responsible adult takes
over.

If the person is actively trying to hurt themselves, has a suicide plan, or seems unable to stay safe, treat it as an
emergency.

1. Stay calm. Keep your voice low, steady, and simple. Do not panic, lecture, or sound rushed. Do not overtalk.
2. Do not crowd them. Keep a respectful distance, move slowly, and avoid standing over them or surrounding
them.
3. Stay with the person. Do not leave them alone if there is any immediate risk.
4. Remove self-harm objects if you can do so safely. Take away or move sharp objects, cords, medicines,
weapons, or anything else they could use to hurt themselves.
5. Speak in short, clear sentences. Say only what is needed, for example:
→ “I’m staying with you.”
→ “I’m going to get help now.”
→ “I’m going to stay with you while we get help.”
→ “You are not alone.”
→ “I need to keep you safe.”
→ “We will take the next step together.”
→ “I’m going to stay with you while we get help.”
6. Ask only the minimum needed. Find out if they are in immediate danger, have already started hurting
themselves, or have access to what they could use.
7. Get help right away. Contact the school/workplace crisis pathway, the counselor or designated responder,
parent or guardian if needed, or emergency services if the risk is high.
8. Do not promise secrecy. Say clearly that safety comes first.
9. Do not hand off casually. Stay until a responsible adult, crisis responder, or emergency team takes over.

Additional Resources:
[Link]
[Link]
[Link]

Where to bring them

→ Bring the person to an emergency department, emergency care facility, or local mental health crisis service.

What first responders do What first responders do not do

✓ Stay with the person.  Do not try to provide counseling or full suicide assessment.
✓ Use a calm, simple, nonjudgmental  Do not debate, lecture, or minimize.
voice.  Do not promise secrecy.
✓ Reduce access to dangerous objects  Do not leave the person alone if danger is immediate.
if you can do so safely.  Do not assume “calming down” is enough if there is plan, intent, or active self-
✓ Alert the designated crisis responder, harm.
supervisor, counselor,  If you do not trust yourself to intervene, do not do anything EXCEPT to call a crisis
parent/guardian, or emergency line, a mental health professional, or emergency services. Your primary goal in a
services right away. crisis is to keep the person safe, and the best way to do that is to connect them
✓ Follow the emergency pathway of with trained professionals who can provide immediate, life-saving support.
your setting.

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Research and create your own list of local emergency contacts for suicide prevention.
• Every contact must be located within the Philippines.
• You must verify, that all hotlines and links are currently active. (Update this regularly)
• Minimum of three.

INSTITUTION / ORGANIZATION CONTACT DETAILS

(contact number if a crisis hotline; address if emergency setting such as hospitals)

REFLECTION

1. Which part of the response feels easiest for you to do? Why?

2. Which part feels hardest? Why?

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3. What phrase feels most natural for you to say in a crisis?

4. What do you want to practice more?

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