Theresa Menders / co-author “Psychological First Aid: Pocket Field Guide”
Theresa Menders is a documentary photographer, independent humanitarian advocate, and senior director at a global pharmaceutical company. She is earning her Doctorate of Public Health (DrPH) from the University of Illinois at Chicago and is co-author of “Psychological First Aid: Pocket Field Guide.”
When disaster strikes, whether it’s a natural calamity, forced displacement, conflict, or an individual emergency like a house fire or car accident, the immediate focus is often on addressing physical injuries and securing safety. However, the psychological wounds inflicted by such events can be just as debilitating as physical trauma. Psychological First Aid (PFA) offers a structured yet flexible framework for providing emotional support that anyone can learn. This vital skill enables individuals to assist people in distress, helping them to cope and begin their journey toward recovery.
What is Psychological First Aid?
PFA, as outlined by the World Health Organization (WHO), is a humane and evidence-informed approach designed to reduce initial distress and foster longer-term resilience. Rooted in principles of care, comfort, and communication, PFA is not a one-size-fits-all solution but rather a set of adaptable actions that can be applied across diverse contexts, from large-scale disasters to personal tragedies. Importantly, it is not therapy or professional counseling, but instead a practical, supportive response that anyone can provide.
How does it work?
PFA is based on the understanding that people affected by crises will have a wide range of reactions. Some may appear calm, others deeply distressed. Importantly, PFA does not assume all individuals are traumatized or require professional mental health interventions. Instead, it emphasizes providing immediate, compassionate support that respects the individual’s dignity, autonomy, and cultural context. Through my experience as a trained PFA provider and trainer, as well as in documenting humanitarian crises globally, I’ve witnessed firsthand the transformative impact of this approach. In refugee camps, for instance, displaced families often grapple with the compounded stresses of losing loved ones, homes, and livelihoods while navigating uncertainty about the future. In these settings, offering a listening ear, ensuring basic needs are met, and connecting people to further resources can significantly reduce feelings of helplessness and despair. Similarly, PFA is valuable in more localized emergencies. Consider a house fire where a family loses all their possessions or a car accident that leaves individuals shaken and fearful. Though less far-reaching than large-scale disasters, these situations still create immense stress for those involved. By addressing emotional needs alongside physical ones, anyone trained in PFA can provide holistic care that fosters senses of safety and stability.
Preparation for delivering PFA
Before helping individuals in distress, it is essential to prepare mentally and logistically. This includes learning about the specific context of the crisis, whether it’s a natural disaster, conflict, or an individual emergency. Preparation involves knowing your role and limitations, being aware of available resources, and ensuring your own safety and well-being. For anyone providing PFA, preparation may also mean understanding the cultural background of those affected and reflecting on personal biases to provide respectful and culturally sensitive care.
The WHO’s primary action principles of PFA can be summarized as “Look, Listen, and Link”. This approach helps guide practitioners on how they should assess and then safely enter a situation, engage with affected people, understand their immediate needs, and then connect them with the appropriate resources. These principles are designed to guide anyone, not just emergency personnel, in providing effective support.
Look, Listen, and Link
LOOK
The “Look” component involves assessing the situation and identifying who may need help. This includes: ensuring physical safety by checking the immediate environment is secure; observing for people in obvious distress, such as crying, agitation, withdrawal, or confusion; and identifying basic needs like food, water, or medical attention. Even in a local emergency like a car accident, scanning the scene and prioritizing who might need immediate support is a key first step.
LISTEN
Active listening is at the heart of PFA. This means approaching individuals respectfully, asking about their needs and concerns in a non-intrusive manner, and allowing them to share their experiences without pressure. Empathy and validation are key. Listening goes beyond just hearing words. It requires observing body language and tone, recognizing unspoken fears, and validating emotions. Simply by being present and attentive, anyone can provide reassurance and reduce feelings of isolation.
LINK
The final component, “Link,” involves helping individuals access additional resources and support. This might include providing information about available services, reconnecting people with family or community members, or referring those with severe distress to professional mental health services. Linking people to resources bridges the gap between immediate support and long-term recovery.
What PFA can offer
The benefits of PFA extend beyond the immediate aftermath of a crisis. For those receiving support, PFA can help restore a sense of control and normalcy. By addressing emotional and psychological needs early on, it reduces the risk of long-term mental health issues such as post-traumatic stress disorder (PTSD). Research shows that individuals who receive compassionate, practical support are better prepared to recover psychologically and reintegrate into their communities.
For those providing PFA, the experience can be deeply rewarding. Knowing how to offer effective emotional support fosters confidence and reduces feelings of helplessness in crisis situations. Moreover, learning PFA equips individuals with skills that can be applied in everyday life, such as active listening and empathy, which strengthen personal and professional relationships.
One of the strengths of PFA is its versatility. While the principles remain consistent, the approach can be adapted to different settings and populations. In the aftermath of hurricanes, earthquakes, or floods, PFA providers may focus on creating safe spaces, reuniting families, and addressing immediate concerns such as food and shelter. In refugee camps or conflict zones, the emphasis might shift to restoring a sense of stability and providing information about available resources. Even in individual emergencies, such as car accidents or house fires, PFA can help individuals process their emotions and connect with loved ones or local support systems. For example, during a massive power outage in an urban area, individuals trained in PFA might prioritize calming people who are panicking in elevators, assisting elderly residents who are stuck in high-rise apartments, or ensuring children feel safe in darkened spaces. Each scenario requires flexibility and sensitivity to the unique needs of those affected.
Practicing self-care as a PFA provider
While offering PFA can be incredibly fulfilling, it is not without its challenges. Providers often find themselves in emotionally charged and high-stress situations, which can take a toll on their own mental health. Recognizing and addressing this impact is critical to ensuring they can continue to serve others effectively. Practicing self-care is not a luxury, it is a necessity. Self-care begins with acknowledging your limits. Even the most compassionate helper cannot solve every problem, and accepting this reality can prevent feelings of guilt or inadequacy. Taking time to rest, reflect, and recharge after offering support allows providers to process their emotions and maintain their mental well-being. Simple practices such as mindfulness, adequate sleep, and regular meals can make a significant difference in resilience.
It is also important for PFA providers to build a support network. Sharing experiences with colleagues or trusted friends can offer relief and provide perspective. Many organizations emphasize peer support systems for debriefing after challenging situations. These conversations can help normalize emotional reactions and provide strategies for coping with future stressors. While it’s natural to want to help as much as possible, overextending oneself can lead to burnout so creating boundaries is essential. Setting clear limits on the time and energy devoted to crisis response ensures that helpers remain effective and can return to their personal lives back at home in a healthy state of mind. By prioritizing self-care, PFA providers not only safeguard their own well-being but also enhance their ability to support others in times of need.
Finding PFA training
PFA is not just for emergency personnel. It’s a skill that anyone can learn and use to make a meaningful difference in the lives of others. By integrating PFA into their communities, individuals can provide compassionate and practical support during times of crisis, helping people regain strength and hope in the face of adversity.
One of the most important aspects of PFA is its accessibility. Anyone can learn the skills needed to provide psychological first aid. The WHO’s PFA Guide for Field Workers is a comprehensive resource that outlines practical steps and strategies for offering effective support. The guide emphasizes that PFA is not therapy. It does not involve diagnosing or treating mental health conditions; instead, it focuses on humane and practical actions that anyone can take to help others in distress.
There are a number of online PFA courses available through different agencies and organizations. The UK Health Security Agency (UKHSA) offers both a general PFA course as well as a course focused on providing PFA to children and young adults in a crisis. U.S.-based Johns Hopkins University also offers a PFA course. The U.S. Center for Disease Control offers a PFA course geared toward radiation disasters, however, many of the same principles can be applied to general crisis situations.
Training in PFA typically covers scenarios ranging from natural disasters to individual emergencies. Participants learn how to use the “Look, Listen, Link” framework or similarly effective approaches, understand common reactions to crisis events, and practice communication techniques that foster trust and calm. Many organizations and communities offer free or low-cost PFA training programs, making it an accessible option for those who wish to contribute during times of need.
In a world where crises are increasingly frequent and complex, learning PFA is not just valuable, it’s essential. By equipping yourself with these skills, you can be a source of stability and resilience for those around you, transforming moments of chaos into opportunities for recovery and connection.
Links:
WHO PFA Guide for Field Workers
UKHSA general PFA course
UKHSA children and young adult PFA course
Johns Hopkins PFA course
Center for Disease Control
