Psychological First Aid Module

1. What is the role of the PFA Providers?

Beyond the above-mentioned knowledge and skills, the orientation or attitude of the facilitator is important. The role of
the facilitator is to provide the opportunity and guide the process of self-reflection and learning. Although there is a
psycho-educational dimension to the modules, facilitators are not necessarily experts or teachers and should not position
themselves as such. Rather, they should respond to students in an empowering manner that:

 Shows unconditional positive regard and a belief in their ability to cope;

 Encourages them to help themselves and make their own decisions rather than imposing solutions;
and

 Fosters self-awareness and perseverance in honing coping skills.

DO DONT’S

Introduce yourself – your name and role Don’t assume that the student knows who
you are or what your role is

Maintain a calm and soft tone of voice Don’t shout or speak very quickly
with a moderate volume

Use supportive phrases to show empathy

(“I understand what you are saying”) and
Don’t pressure the student to speak if they
acknowledge any losses or difficult feelings
do not want to.
that the person shares (“I am so sorry to
hear that”, “That sounds like a tough
situation”).

2. What should PFA Providers look for?

Beyond the traditional classroom, PFA providers must learn how to look between the lines for signs of stress and anxiety.
The following are common reactions to stressful events (IASC, 2020):

 Emotional reactions: feeling sad, angry, scared, etc.

 Behavioral reactions: lack of motivation, avoiding doing activities, becoming violent, etc.

 Physical reactions: headaches, muscle pain, back pain, difficulty sleeping, lack of appetite, etc.

The signs of stress described above are natural and may fluctuate over time. Some people may have longer-lasting and
more intense reactions. When this happens, they might be seriously distressed. Feeling serious distress is a normal reaction
to extraordinary circumstances, but it can stop people being able to function. In a situation like this, it is likely that you will
need to refer the student to specialized support. Consider referring if he/she is:

 So upset they cannot take care of themselves or others

 Being very anxious and fearful

 Talking about wanting to hurt or kill themselves

 Does not know their name, where they are from, or what is happening

 Being very withdrawn

 Shouting

 Being angry

 Threatening to hurt others

 Feeling disoriented or “unreal”

3. How can I manage interactions effectively?

Managing interactions, whether physically or virtually, can be sometimes challenging. Here is a summary of common
situations and what facilitators can do to manage them:

SITUATION POSSIBLE STRATEGIES

Tense Atmosphere  Use icebreakers or humor to break the tension

 Remind students that there are no right or wrong answers, all answers are acceptable

Non-participation  Silence is also an effective way to get people to talk. After you ask a question, just stay silent
and someone might speak out

 Paraphrase the question you asked

 Encourage the silent participants by asking them directly what they think or if they have
something to say

Sleepy, bored, or tired  Change the activity

 Shorten/end the activity/module

Participant doing other  Set rules at the beginning of the module and remind students of the norms (e.g., Keep
things (texting, etc.) cameras on, mute microphones, etc.)

 Call the student to participate

  If behavior is repetitive, talk to the person outside of the session to see if he/she has
concerns and is really interested to be part of the group

Conflict or arguments  Don’t side with any one participant

 Acknowledge their perspectives

 Remind participants that there are no right or wrong answers, and they can agree to
disagree

A participant breaks  Allow the person to cry and comfort if appropriate

down
 If crying is prolonged, suggest a break so you can talk to the student in private. If you have a
co-facilitator, that person can be with the student in another location while you resume the
session. The person can rejoin the group when he/she is ready.

Below are the titles of the first 4 modules and the corresponding take-away messages for the students:
Title Take away Message
Module 1 Validating feelings and normalizing reactions My feelings toward this
disaster/pandemic are normal
and valid. Others may also feel
the same way. It is okay to not
feel okay.
Module 2 Calming down and Managing one’s Emotions and I can manage my own emotions
Thoughts and I am able to bring myself to
calm down
Module 3 Identifying and Addressing Needs I am capable of identifying my
own and other people’s needs. I
can link others to the proper
channels which can best
address their concerns
Module 4 Identifying Sources of Strengths I am strong because I can rely
on my inner strength and
because I have people around
me who support me
 Module I: Validating Feelings and Normalizing Reactions

Objectives
 Identify feelings/reactions related to the pandemic/any form of disaster
 Accept that all feelings and reactions are normal and valid

Materials/Handouts
 Small Whiteboard and marker/bond paper and marker
 Sample Graph of Emotions
 Common Reactions of Students to Stressful Events
 Handout: When Terrible Things Happen (attached at the end of this module)

ACTIVITY: Graphing Feelings

Instruction: I want to ask, KAMUSTA KAYO? This is a strange crisis that we are all experiencing, don’t you
agree? So how are you? Are you okay, not okay? Were you not okay three months ago but okay now? Were you
okay at the start but okay now? Can I ask you to identify about 5 feelings or emotions that you have experienced
during the past few months/weeks or days? I will give you time to think about it.
 Using the sheet of paper, can you create a graph or a pie chart of feelings/emotions that you have or may
have had during all the crises that you experienced

Sharing and Comparing Graphs

Say: If you are done, may I ask to share his graph… (During the sharing, listen for feelings that
they rate with 50 percent or higher). Acknowledge it and say if you felt the same. Call on another
student. Do this until all or most have been shared.

ANALYSIS
Say: What were the feelings that were mentioned a lot? Write these down on your whiteboard/manila
paper.
What did you notice about your reactions to the different situations? Are these normal reactions to
everything that you experienced? I would like to show you this table of common reactions of students to
stressful events. Please read those and tell me what you realize.
Say: It’s good that you realized that these are normal reactions as of this time. I want you to realize
that it is okay to not feel okay.

ABSTRACTION
Show page 1 of the handout “When Terrible Things Happen” from the National Child Traumatic Stress
Network (NCTSN). Say: Say: I want to share with you a document called: When Terrible Things
Happen. You may access it on this webpage/google folder/etc. Please read it because it can help you
better identify your reactions and it also gives you a list of behaviors that can help you cope and
behaviors that you should try to avoid.
APPLICATION

Say: Today we learned that our reactions to any stressful event/disaster are normal and valid. How
can you apply this learning to your life? (Pause and call 2 -3 students to share).
Acknowledge all answers then say: can someone come up with a short line that we can say altogether
that would sum up what you just learned?

100
My Emotions

75

50

25

0
worried scared angry numb

Common Reactions of Students to Stressful Events

 feel a strong responsibility to the family.

 feel anxious brought about by uncertainty of the future.
 feel intense or prolonged grief for not being able to wake.
 may become self-absorbed and feel self-pity.
 may experience changes in their relationships with other people.
 may also start taking risks, engage in self-destructive behavior, have avoidant
behavior, and become aggressive.
 may experience major shifts in their view of the world accompanied by a sense of
hopelessness about the present and the future.
 may become defiant of authorities and parents while they start relying on peers
for socializing through social media.
 may feel guilty and anxious having been separated from their loved ones due to
lockdown.
 Module I Handout: When Terrible Things Happen

There are a wide variety of positive and negative reactions that students can experience during and immediately
after crisis situations. These Include:

Domain Negative Responses Positve Responses

Cognitive Confusion, worry, self-blame Determination courage, optimism, faith

Emotional Shock, sorry, grief, sadness, fear, anger, Feeling involved, challenged, mobilized
numb, irritability, guilt, and shame
Social Fights with others or does not speak Seeks out others who can help them, helps others
with others in need
Physiological Tired, headache, muscle tension, Alertness, readiness to respond, increased energy
stomachache, difficulty sleeping, fast
heart beat

Module II: Calming Down and Managing One’s Emotions and Thoughts

Objectives
By the end of the session, students should be able to:

 Identify positive ways to manage one’s emotions

 Practice calming down using a relaxation exercise
 Be able to practice reframing one’s thoughts
Materials/Handouts
 Manila Papers
 Permanent Markers

INTRODUCTION

So far, we’ve talked about your reactions to the pandemic or any form of disaster. Today, we will talk about how to manage
your feelings.

ACTIVITY # 1
Yesterday I asked you to identify your different reactions and feelings towards the pandemic or any type of
stressful situation that you may have experienced recently. Can you recall what those feelings were? Today,
let’s talk about some ways to help you manage your feelings. Can you recall for me some of those feelings that
you mentioned yesterday?

The facilitator then writes those actions down right beside each feeling. The teacher then asks another student
to recite. She does this until she has 5-6 examples.
These actions help make us feel better. They help us address our stress. But can we identify if there are actions
here that would be considered unhealthy ways of dealing with stress? Which ones would be considered healthy
ways of coping? What made you say that?

Say: Please take a look at your list of emotions from yesterday and list down the ways that you deal with the
emotions. Can you identify if you were using healthy or unhealthy ways of dealing with the stress? Today, I
want to remind you of healthier ways of dealing with our feelings. I will teach you three new and easy ways:

ACTIVITY # 2

Suggestion # 1: Count backwards. If you feel that you are getting more upset or stressed or anxious or nervous.
You can ask to be excused or you can just close your eyes, or turn around and just silently, count backward
from 10 until 1. While doing so, focus on your breathing and tell yourself to calm down. Let us try it together.

Suggestion #2: 3-2-1 Senses Check. In this method, I want you to quietly name 3 things you can see around
you, 2 things you can feel and 1 thing that you can hear. While doing that, breathe in and out 5 times but every
time you do so, you add one more second to each inhale and one more second to each exhale.

Suggestion #3: Reframe. This means that a feeling usually comes from a thought and when we can change or
reframe a thought, then we can change how we feel. For example, I feel angry because my mother called me
lazy. I think my mother called me that way because she does not see me working hard or maybe because she is
just really unfair all the time. I can reframe that by saying, my mother is just very stressed and tired tonight.
She does not mean what she says. By reframing the thought, I have changed the way I feel about the situation.
Alternative Activities
Other breathing exercises, yoga poses, tai-chi with humor injected into it, engaging in sports but in a
non-competitive manner, or dance moves using both slow and fast beats.

ANALYSIS
What do you feel? What do you think was the point of this activity?

ABSTRACTION

Can you compare how you feel right now with how you felt before we started with the relaxation
activity? On a scale of 1-5, 5 being the highest, rate your level of stress before and after we started
with the exercise. Did the levels change?

APPLICATION

How can you apply your newfound knowledge to your daily life?
 Module III: Identifying and Addressing Needs

Objectives
By the end of the session, students should be able to:

 To identify one’s current needs and those of one’s family

 Become aware of the various institutions, departments, and centers present within the
school environment or the immediate community
 Take note of the important numbers and information regarding whom to approach for their
needs
Materials/Handouts
 List of Emergency Contact Numbers and Information: This should be filled out by the teacher
before the start of the session
 List of needs during a pandemic and how to access them
 Pens or Pencils
 Handout: Needs Form

Additional Information on Psychological First Aid (PFA)

Regardless of the type of disaster or pandemic, people who are affected often need help in the following:
Frequent Needs (WHO et al., 2011)
 Basic needs: food, shelter, water, clean toilets
 Health services for those who are ill and injured (and for those who seem to be suffering
from anxiety, trauma and depression)
 Simple and correct information about the event, loved ones and services available for them
 Access to cell phones, internet, email in order to contact loved ones and other sources of
social support
 Being consulted about major decisions that will directly affect their lives (e.g., being
transported to another province, moving to a bunk house, etc.)

ACTIVITY 1
Show the sheet called List of Emergency Contact Numbers and Information. Ensure that the sheet is
properly filled out by the teacher. A copy of this sheet should be shown during class time or the teacher
can provide a link where the students can get this information from.
Say: I want to show you a list of emergency contact numbers that I want you to take note of or you may
want to take a screenshot with your phone. (Give them time to copy or take a photo). Let us all discuss
first what these offices do. (Teacher explains how each office can help).
ACTIVITY 2
Show this list of common needs of survivors after a disaster and discuss with the class.
Say: Take a look at the common needs of survivors after a disaster or pandemic. Do you think it is
complete? What other needs should be on the list? Take a look at this list of needs of people during a
pandemic and how to access them. Let’s discuss these for a while.
Please get a piece of paper and make three columns (you can show an example). On the first column,
list down all the members of the family whom you live with. On the second column, identify the
immediate needs of this person that your family cannot address as of this moment. On the third
column, identify where you can refer this person to or who you can approach in order to ask for help
regarding the needs of this person. If you do not know anyone who can help that person, just leave it
blank first. (Give them time to do this)
How many of you know who to refer your loved ones to for their needs? May I know what these needs
are and who you are going to refer your loved ones to? (Please commend them for knowing whom
they could approach in times of need).
Can we talk about what you think your own needs are? Who can you approach in order to address your
own needs? Why do you think it is important for all of you to learn about whom you can go to for your
own needs and the needs of your family?
Acknowledge them for having good support systems and for knowing who to link themselves or their
family members to.
ABSTRACTION
Say: Can some of you share with us stories that show how at times, even these linkages cannot do
their responsibilities efficiently? Why do you think these groups had a hard time? Can you also tell me
some great or good stories about how other groups were able to help you very well?
APPLICATION
Say: Now that you know how to LINK, can you tell me how you will apply this new knowledge to your
life right now?
Listen to their answers and acknowledge them.
CLOSING
Ask students to come up with a chant or cheer after that activity. It should be a chant that will remind
them to find people/organizations to help them/their loved ones address their most pressing needs.

List of Emergency Contact Numbers and Information

Organization Contact # and Address Contact Person

Barangay Health Office

Barangay Disaster Team

DSWD office

Hospital

Psychologist or Social
Worker

Covid Screening Center

 Your School

Module IV: Identifying Sources of Strength

Rationale
The aim of this module is to encourage students to revisit their strengths in order to support their self-
efficacy to deal with their situation. In order to encourage a hopeful outlook, the module serves to
reinforce students’ sources of support and internal and external resources.

Objectives
 Identify personal, social, and emotional sources of strengths during and in the aftermath of the
disaster/stressful situation
 Identify their internal and external sources of strength
Materials
 Drawing of a kite (or of a vinta, windmill, a train with several carriages, a caterpillar with several
body segments, a tree, spider web, fingers, etc.)
 Blank sheets of paper
 Coloring materials
Review

Does anyone remember what the three previous sessions were about? (Give clues if they cannot)
Last meeting, we talked about our needs and how to address them. We talked about how to control our
reactions and emotions. Now let us reflect on what has helped us to move on. We can move on and not
continue to feel the way that we were feeling days or months ago because we have strengths.

Show the drawing of a kite and say: This is a drawing of a kite (saranggola). Can you tell me what
makes it go up in the air? (Wait for answers) You are right, it needs the wind, it needs to be made of
good material, it needs a line or a long string, it needs a strong brace, etc. This is our way of reminding
you that you have resources within yourselves or with others that have allowed you to begin your
process of recovery. Just like a kite, you too have what it takes to fly.

ACTIVITY

Can you draw a kite with a diamond with 4 parts? On each part of the kite’s diamond, please write
down what you think are your sources of strength. What makes you strong despite what you have
gone through? Can you also identify what or who acts like the wind for you? Who or what helps you
soar?
Give them time to draw, answer and color their drawings. After, give them time to share their drawings
online.
ANALYSIS
What have you realized about each other after that group sharing? What have you realized about
yourself? Do we have common sources of strengths??

ABSTRACTION
How are you similar to the kite? Can you think of other objects that can be a symbol for your many
sources of strength?

APPLICATION
The next time you feel weak, what can you focus on in order to remind yourself that you have a number
of sources of strength?

CLOSING
Would any of you want to volunteer to come up with a poem or a rap about what you have learned
about your sources of strength and those who help or support you? Here is an example:

Module IV Handout: Sample Kite Drawing