Psychological First Aid

STUDY
PLAY
Adaptive Coping
Positive and healthy actions that help to reduce anxiety and lessen other distressing reactions, improve the situation, or help the survivor get through difficult times. Examples include maintaining health-promoting habits, humor, distraction and using and providing social support.
Avoidance
Survivors' attempts to remove themselves from, or protect themselves against distress. These reactions include trying to avoid talking, thinking, or having feelings about the traumatic event and avoiding any reminders of the event, such as people or places.
Core Actions
Eight strategies PFA providers can use to flexibly address the needs of survivors in the immediate aftermath of a disaster.
Confidentiality
Confidentiality involves keeping information about the survivor as private as possible unless the survivor grants permission.
Culture
Refers to the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. When thinking about culture, keep in mind age, ethnicity, gender, religion, sexual orientation, socioeconomic status, as well as those with disabilities, individuals with low literacy, or those with limited English proficiency.
Change reminders
Situations that remind survivors of how life has changed as a result of a disaster. They can include people, places, things, activities, or hardships. Examples are waking up in a different bed in the morning, going to a different school, or being in a different place.
Continuity of care
A method whereby survivors maintain consistent care when moving across various providers or services.
Collaborative services
Linking survivors to additional services that they may need at the moment or in the future. These may include housing; medical, mental health or social services; schools; childcare; faith-based services; and support groups for substance abuse or bereavement.
Cultural leaders
A prominent member of a cultural group who best understands the local customs, traditions, rituals and practices. This can include a tribal leader, religious/spiritual professional, traditional healers, or a spokesperson for a cultural group.
Child-friendly space
A safe space for children to promote recreational and developmentally-appropriate activities. Such a space should be set up in a corner or a separate room out of high-traffic areas and away from rescue activities. It should be staffed by caregivers who are experienced in working with children of different ages. Stock it with books, paper, crayons, toys, and games.
Disaster
Any emergency event, including natural disasters (earthquakes, tornadoes, hurricanes), accidents (train wrecks, plane crashes, fires), terrorist attacks, pandemic, or other emergencies (school shooting, arson, community violence).
Developmental issues
Children, adolescents, adults, and families go through stages of physical, emotional, cognitive, and social development. These developmental milestones can include family member birthdays; toddlers becoming toilet trained; school aged children learning to read, write, and do arithmetic; older adolescents learning to drive; adults having a child; or families buying a new home. Disasters can cause interruptions, delays, or reversals in the family's or a family member's development.
Depression
Reactions that include depressed or irritable mood, loss of appetite, sleep problems, fatigue, feelings of worthlessness or guilt, and sometimes thoughts of suicide. Depression is associated with grief reactions and related to post-disaster adversity.
Engagement
The act of making an effective connection with a survivor on a verbal and non-verbal level. It includes your physical approach, body language, sense of calmness, communication, and a sense of compassion.
Grief
Reactions that occur when survivors experiences the death of loved ones or loss of possessions. These losses may lead to feelings of sadness, anger, guilt, or regret over the death, missing or longing for the deceased or things destroyed, and dreams of seeing the deceased again.
Grounding techniques
A technique to orient a survivor to the present moment and decrease strong dissociative, emotional and/or physical reactions.
Hope
A belief that one's actions will help bring about positive change. Help survivors engage in proactive and constructive activities and promote positive expectations that there can be a next hour, day, and week.
Hardships
Stresses and adversities that follow in the wake of disasters. These can contribute to feelings of anxiety, depression, irritability, uncertainty, and exhaustion. Examples include loss of home or possessions, lack of money, having to change schools, separations from friends and family, and unemployment.
HIPAA
The Health Insurance Portability and Accountability Act is a federal law that provides federal protections for personal health information and gives people an array of rights with respect to that information
Intrusive reactions
Ways that traumatic experiences come back to mind. They include distressing thoughts or mental images of the event or dreams about what happened. These can also be upsetting emotional or physical reactions to reminders of the experience.
Loss reminders
Situations that bring to mind the absence of a loved one or possessions gone, and bring up strong feelings like sadness, longing, or nervousness. They can include sights, sounds, places, smells, specific people, the time of day, situations, and feelings. Examples include seeing a picture of a loved one who died or seeing belongings that were destroyed.
Maladaptive coping
Ineffective and often unhealthy actions that attempt to reduce anxiety and other distressing reactions. These actions include the use of drugs and alcohol, smoking, over-eating, excessive anger, and extreme avoidance.
National Emergency Child Locator Center
In some presidentially-declared disaster areas there will be a National Emergency Child Locator Center operated by the Center for Missing & Exploited Children to assist in the location and reunification of children with their families.
Psychological First Aid
PFA is an evidence-informed, flexible, modular intervention to assist survivors and responders in the immediate aftermath of a disaster. PFA is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping.
PFA provider
Any disaster response worker who provides early assistance to affected children, families, and adults as part of an organized disaster response effort. PFA providers can include first responders, medical and mental health professionals, school personnel, religious professionals, public health officials, and disaster volunteers.
Provider Care
Activities that protect the welfare of disaster responders by promoting healthy self-care practices before, during, and after disaster work. Organizations need to have and implement policies for stress prevention and management and individuals need to regularly practice these strategies.
Physical arousal
Physical changes that make the body react as if danger is still present. These reactions include constantly being "on the lookout" for danger, being easily startled or jumpy, being irritable or cranky, having outbursts of anger or tears, having difficulty sleeping, and having difficulty paying attention or concentrating.
Physical reactions
Reactions that include bodily distress, such as headaches, dizziness, stomachaches, muscle aches, rapid heartbeat, tightness in the chest, hyperventilation, and bowel problems. Survivors may experience these types of reactions even in the absence of any underlying physical injury or illness.
Relaxation techniques
Activities to help survivors reduce levels of anxiety and tension and to promote a sense of calming. One such technique is the breathing technique that is used to help stabilize survivors and provide them with an adaptive coping strategy in times of distress.
Referral
The process of linking survivors with follow-up or additional services the survivor may require.
Safety
After disasters, survivors may be concerned about their own safety, the safety of their loved ones, their community, and things they most deeply value. The first steps require the removal of actual or perceived threats to reduce the physiological responses to fear and anxiety. Accurate information can also increase a sense of safety.
Service Delivery Sites and Settings
PFA is designed for delivery in diverse settings and in any place that the need for the services exists: general population shelters, schools, special needs shelters, field hospitals and medical triage areas, acute care facilities, hotlines or in public health emergency settings, such as decontamination settings and Points of Dispensing (POD) sites.
Survivor
An individual of any age or gender, with different cultural, religious, or ethnic background who has been affected by a disaster, including disaster responders.
Shelter
Are locations used for the temporary housing of individuals who have been displaced or need refuge as a result of a disaster. These locations usually include schools, community and recreation centers, or other large facilities.
Social support
Types of comfort and assistance that people give to one another. These include emotional support, sharing in activities, obtaining or providing advice, and receiving or giving a helping hand when it's needed.
Survivor Current Needs Form
A tool for PFA providers to document survivor current needs and concerns. The form will help you gather information, plan your intervention, and can be used to communicate with referral agencies to help promote continuity of care. The form is located in Appendix D in the PFA Field Operations Guide.
Traumatic grief
Reactions that occur when survivors have suffered the traumatic death of a loved one. They may focus on the circumstances of the death, how the death could have been prevented, what the last moments may have been like, and who was at fault. These reactions can interfere with grieving and make it difficult for survivors to adjust to the death.
Trauma reminders
Situations that evoke upsetting thoughts and feelings related to the event. They can be sights, sounds, places, smells, specific people, the time of day, situations, location, or even feelings. Examples after a tornado can include the sound of wind, rain, helicopters, screaming, and individuals present with the survivor at the time of the event.