Introduction to Psychological First Aid (PFA)

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Introduction to Psychological First Aid (PFA)
ADDC Practitioner Interest ForumSept. 2013
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The Psychological First Aid Field Guide

• Acknowledgements
•  Writing and Editorial Team - Leslie Snider (War
  Trauma Foundation, WTF), Mark van Ommeren (World
  Health Organization, WHO) and Alison Schafer
  (World Vision International, WVI).
•  Steering Group (alphabetical) - Stefan Germann
  (WVI), Erin Jones (WVI), Marieke Schouten (WTF),
  Shekhar Saxena (WHO), Alison Schafer (WVI),
  Leslie Snider (WTF), Mark van Ommeren (WHO).
• Funding - World Vision International
• Illustrator Julie Smith, PD Consulting
•  In addition, we acknowledge the 27 anonymous
  respondents who participated in a
  pre-consultation survey on the need to develop
  this document. Plus the many individuals and
  agencies who contributed to the peer review
  process.
• This guide will be formally endorsed by many
  member organisations of the IASC Mental Health
  and Psychosocial Support Reference Group,
  including ..

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The Psychological First Aid Field Guide -
Endorsements
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Group Discussion

1. What comes to mind when you think about First
   Aid?
2. What comes to mind when you think about
   Psychological First Aid?

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PFA is not....

• It is NOT something only professionals can do
• It is NOT professional counseling
• It is NOT a clinical or psychiatric intervention
  (although it can be part of good clinical care)
• It is NOT psychological debriefing
• It is NOT asking someone to analyze what happened
  to them or to put time and events in order
• It is NOT pressing people to tell you their story
• It is NOT asking people details about how they
  feel or what happened

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Psychological First Aid (PFA) is

• A description of a humane, supportive response to
  a fellow human being who is suffering and who may
  need support. PFA involves the following themes
• Providing practical care and support that does
  not intrude
• Assessing needs and concerns
• Helping people to access basic needs (e.g. food
  and water, information)
• Comforting people and helping them to feel calm
• Helping people connect to information, services
  and social supports
• Protecting people from further harm
• Based on Sphere (2011) IASC MHPSS Guidelines
  (2007)

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The place
of PFA in overall mental health
and psychosocial response
Examples
Mental health care by mental health specialists
(psychiatric nurse, psychologist, psychiatrist
etc)
Specialised services
Basic mental health care by PHC doctors
Basic emotional and practical support by
community workers (Psychological First Aid)
Focused (person-to-person) non-specialised
supports
Activating social networks Communal
traditional supports Supportive child-friendly
spaces
Community and family supports
Strengthening community and family supports
Advocacy for basic services that are safe,
socially appropriate and protect dignity
Basic services and security
Social considerations in basic services and
security
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Why PFA?

• Following crises, people do better over the
  long-term if they
• Feel safe, connected to others, calm and hopeful
• Have access to social, physical and emotional
  support
• Feeling able to help themselves, as individuals
  and communities

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Who is PFA for?

• PFA is for very distressed people who have been
  recently exposed to an extremely distressing
  event.
• It can be provided to children and adults
• Not everyone who experiences a crisis event will
  need or want PFA. Do not force help on people
  who do not want it
• PFA is not necessarily for everybody

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Adapting to culture ( context)

1. What might be necessary to consider to adapt to
   culture?
2. What might be necessary to consider to adapt
   to context?

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What is covered in PFA Skills Training?

• Careful analysis of culture and context
• Ethical principles of PFA, including a number of
  dos and donts
• Practicing of good and effective communication
• Preparing yourselves to provide PFA practically
  and emotionally (e.g., self-care)
• A detailed overview of the Action Principles of
  PFA
• Consideration of people who may likely need more
  specialised care, such as vulnerable groups,
  children and adolescents, etc.
• How to provide PFA for children
• Lots and lots of role plays, simulations and
  communication exercises to develop SKILLS in PFA

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The Action Principles of PFA
Principle Actions
LOOK . Check for safety. Check for people with obvious urgent basic needs. Check for people with serious distress reactions.
LISTEN Approach people who may need support. Ask about peoples needs and concerns. Listen to people, and help them to feel calm.
LINK Help people address basic needs and access services. Help people cope with problems. Give information. Connect people with loved ones and social support.
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Examples of distress responses

• Physical symptoms (e.g. Shaking, headaches,
  fatigue, loss of appetite, aches pains)
• Crying, sadness, depressed mood, grief
• Anxiety, fear
• Being on guard or jumpy
• Being afraid that something really bad is going
  to happen
• Insomnia, nightmares
• Irritability, anger
• Guilt, shame
• Confused, emotionally numb, or feeling unreal or
  in a daze
• Being immobile or withdrawn
• Not responding to others, not speaking at all
• Disorientation (not knowing ones name, where
  they are from or what is happening)
• Not being able to care for oneself or ones
  children

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Helping people feel calm

• Brief breathing exercise
• Brief tapping exercise
• Brief mindfulness exercise using items in the
  room

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Positive Coping Strategies

• Getting rest
• Easting as regularly as possible
• Drinking plenty of water
• Spending time with family friends
• Discuss problems with someone you trust
• Do activities that help you relax e.g. Walking,
  singing, praying, playing with children)
• Engage in physical exercise
• Find safe ways to help others

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Negative Coping Strategies

• Taking drugs, smoking or drinking alcohol
• Sleeping all day
• Working all the time without any RR
• Isolating yourself from friends and loved ones
• Neglecting basic personal hygiene
• Violence

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Questions?
Principle Actions
LOOK . Check for safety. Check for people with obvious urgent basic needs. Check for people with serious distress reactions.
LISTEN Approach people who may need support. Ask about peoples needs and concerns. Listen to people, and help them to feel calm.
LINK Help people address basic needs and access services. Help people cope with problems. Give information. Connect people with loved ones and social support