Psychological First Aid (PFA) is an immediate way to help people after a disaster or traumatic event. It aims to provide support to reduce initial distress and promote resilience.
By addressing basic needs such as safety, comfort, and emotional connection, PFA helps reduce the risk of long-term mental/emotional harm.
PFA is important because it teaches the skills to support individuals emotionally, including coping strategies, and strengthens community togetherness.
Additional resource: Hobfoll, S. E., Watson, P., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., … Ursano, R. J. (2007). Five Essential Elements of Immediate and Mid-Term Mass Trauma Intervention: Empirical Evidence. Psychiatry: Interpersonal and Biological Processes, 70(4), 283–315. doi.org/10.1521/psyc.2007.70.4.283
Promote safety
Ensure physical and emotional safety by removing yourself and others from harm’s way and creating a secure environment.
- Access to food, water, clothing and blankets, bathrooms, and a private space for prayer or meditation, if possible, provides physical comfort and support.
- Try to eat healthy foods and get plenty of fluids, sleep, and exercise.
- Put your oxygen mask on yourself first. You will be better able to assist others, such as family members, if you take care of your own safety before turning to them.
Additional resource: Markenson, D. (2014). Principles of Mass Casualty and Disaster Medicine. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. doi.org/10.1007/978-1-4471-6362-6_44
Provide calm
Help one another to feel calm and secure by offering reassurance, reducing agitation, and promoting a sense of stability. One way to do this is through the use of grounding techniques.
When to use grounding techniques
- In moments of heightened anxiety
- When feeling disoriented or overwhelmed
- During panic attacks
- As part of a daily routine
Why to use them
- They are calming and help with physical/emotional regulation
- They help reduce the use of risky or harmful behaviours
- They are versatile and can be used by anyone and everyone
How to do them
Mindful meditation using a body scan
A body scan helps you reconnect to your physical self and notice any sensations you’re feeling.
The 5, 4, 3, 2, 1 exercise
Mindfully take in the details of your surroundings using each of your senses:
- 5 – See: List five things you can see around you. They could be pieces of furniture or photos on the wall.
- 4 – Feel: Next, touch four things, like the soft fabric of a sweater or the cool surface of a table.
- 3 – Hear: Identify three distinct sounds — something like the distant hum of traffic or a ticking clock.
- 2 – Smell: Recognize two things you can smell, like your own perfume or fresh bread. Even unpleasant odours count.
- 1 – Taste: Notice one thing you can taste. Take a sip of water, munch on a snack, or simply remember your last meal.
Affirmations
Breathing exercises
Deep, intentional breaths can signal to your body that everything’s okay, resetting your system. You can try techniques like boxed breathing to help calm your nervous system.
The raisin technique
Practice grounding by using a raisin or small candy to centre yourself in the present.
Ice or cold water
Splashing cold water on your face or holding an ice cube in your hand provides a controlled shock to your system, helping you shift your focus from what is distressing you.
Additional resource: Wang, L., Norman, I., Edleston, V., Oyo, C., & Leamy, M. (2024). The Effectiveness and Implementation of Psychological First Aid as a Therapeutic Intervention After Trauma: An Integrative Review. Trauma, Violence, Abuse, 0(0). doi.org/10.1177/15248380231221492
Promote connectedness
Connect with others for support, whether it’s family, friends, or community resources. Social support is very important for recovery.
- Mental health and well-being: Disasters can be traumatic experiences that lead to a range of emotional responses such as fear, anxiety, grief, and even depression. Addressing emotional comfort and using peer support helps protect against this.
- Sense of safety and security: Emotional comfort helps you feel safe and secure. Knowing that there is support available, both from peers and social networks, helps you cope with the uncertainty and stress that comes after a disaster.
- Promoting community resilience: Strong social networks and supportive relationships within communities contribute to faster recovery and help you get used to changes after a disaster.
- Identifying and addressing special needs: Vulnerable populations, such as the elderly, children, or those with disabilities, often have specific needs that may not be immediately obvious. Prioritizing their emotional comfort helps ensure these needs are identified and dealt with, reducing the risk of further issues.
Additional resources:
- Pan-American Health Organization. (2019). Mass Casualty Management System Course Manual. iris.paho.org/handle/10665.2/51484
- National Association of School Psychologists. (2020). Responding to a Mass Casualty Event at a School: General Guidance for the First Stage of Recovery.
Empowerment
Make decisions and take actions that restore a sense of control in your life.
Education empowers you to take control of your safety and well-being. Knowing what to do in emergencies reduces panic and increases your confidence in handling challenging situations.
For families with children
Take actions that help your children feel a sense of control and safety.
- Provide warmth and support
- Give praise
- Spend time together and talk with one another
- Encourage good behaviour
- Address fighting and aggression
- Maintain routines
- Encourage play
- Stay connected with family and friends when possible
Additional resources:
- American Academy for Pediatrics. (2018). Family Reunification Following Disasters: A Planning Tool for Healthcare Facilities.
- Federal Emergency Management Agency (FEMA). (2013). Post-Disaster Reunification of Children: A Nationwide Approach.
- United Nations Office on Drugs and Crime. (2009). Caring For Your Child in Crisis Situations.
Hope and optimism
Use realistic optimism to help imagine a positive future:
- Realistic optimism is when you balance out negative and positive things while staying open-minded and curious.
- It requires the courage to explore (a) while believing that the future will be better than the past, and (b) without fear of failure.
- A way to do this is through a gratitude exercise, such as writing down three good things that happened to you today.
Additional resource: International Federation of Red Cross (IFRC). (2017). IFRC Emergency Response Framework.