Psychological First Aid (PFA) is an evidence-informed modular approach to help children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism. Individuals affected by a disaster or traumatic incident, whether survivors, witnesses, or responders to such events, may struggle with or face new challenges following the event. PFA was developed by the National Child Traumatic Stress Network and the National Center for PTSD, with contributions from individuals involved in disaster research and response.

PFA is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping. PFA does not assume that all survivors will develop severe mental health problems or long-term difficulties in recovery. Instead, it is based on an understanding that disaster survivors and others affected by such events will experience a broad range of early reactions (e.g., physical, psychological, behavioral, spiritual). Some of these reactions will cause enough distress to interfere with adaptive coping, and recovery may be helped by support from compassionate and caring disaster responders.

PFA core actions constitute the basic objectives of providing early assistance within days or weeks following an event. Providers should be flexible, and base the amount of time they spend on each core action on the survivors’ specific needs and concerns. The core skills are designed to be helpful in addressing the survivors’ and responders’ needs and concerns. PFA is designed for delivery in diverse settings. Mental health and other disaster response workers may be called upon to provide Psychological First Aid in general population shelters, special needs shelters, field hospitals and medical triage areas, acute care facilities (e.g., Emergency Departments), staging areas or respite centers for first responders or other relief workers, emergency operations centers, crisis hotlines or phone banks, feeding locations, disaster assistance service centers, family reception and assistance centers, homes, businesses, and other community settings.

The eight PFA Core Actions include:

• Contact and Engagement: To respond to contacts initiated by survivors, or to initiate contacts in a non-intrusive, compassionate, and helpful manner.
• Safety and Comfort: To enhance immediate and ongoing safety, and provide physical and emotional comfort.
• Stabilization (if needed): To calm and orient emotionally overwhelmed or disoriented survivors.
• Information Gathering on Current Needs and Concerns: To identify immediate needs and concerns, gather additional information, and tailor Psychological First Aid interventions.
• Practical Assistance: To offer practical help to survivors in addressing immediate needs and concerns.
• Connection with Social Supports: To help establish brief or ongoing contacts with primary support persons and other sources of support, including family members, friends, and community helping resources.
• Information on Coping: To provide information about stress reactions and coping to reduce distress and promote adaptive functioning.
• Linkage with Collaborative Services: To link survivors with available services needed at the time or in the future.

In addition to translating PFA into several languages, NCTSN members and partners have worked to develop PFA adaptations for school personnel (for use in the aftermath of a school crisis, disaster, or terrorism event), as well as community religious professionals, Medical Reserve Corps members, and staff at facilities serving families and youth who are experiencing homelessness.

To access the PFA Field Operations Guide, adaptations, handouts, and other resources related to PFA, visit NCTSN Resources. To learn more, visit the PFA Online course on the NCTSN Learning Center for Child and Adolescent Trauma.