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Psychological First Aid

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Center for the Study of Traumatic Stress

CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Psychological First Aid: How You Can Support Well-Being in Disaster Victims

People often experience strong and unpleasant emotional and physical responses to disasters. Reactions may include combinations of confusion, fear, hopelessness, helplessness, sleeplessness, physical pain, anxiety, anger, grief, shock, aggressiveness, mistrustfulness, guilt, shame, shaken religious faith, and loss of confidence in self or others. A variety of helpful interventions can assist individuals and communities to recover.

Following a disaster, governments and relief organizations play an important role in reducing distress
for both victims and the broader society. Ensuring equitable distribution of resources (such as food, clothing and shelter) and prompt access to healthcare increase trust and improve outcomes. Adhering to ethical principles when providing interventions and relief efforts enhances community well- being.

When interacting with individuals affected by a disaster event, there is consensus among international disaster experts and researchers that Psychological First Aid (PFA) can help alleviate painful emotions and reduce further harm from initial reactions to disasters. Your actions and interactions with others can help provide PFA to people in distress, by creating and sustaining an environment of (1) safety, (2) calmness, (3) connectedness to others, (4) self- efficacy—or empowerment, and (5) hopefulness. Consider the following suggestions:

DO:

■■  Help people meet basic needs for food & shelter, and obtain emergency medical attention. Provide repeated, simple and accurate information on how to obtain these (safety).

■■  Listen to people who wish to share their stories and emotions; remember there is no wrong or right way to feel (calming).

■■ Be friendly and compassionate even if people are being difficult (calming).

■■ Provide accurate information about the disaster or trauma and the relief efforts. This will help people understand the situation (calming).

■■ Help people contact friends or loved ones (connectedness).

■■ Keepfamiliestogether;keepchildrenwithparentsor other close relatives whenever possible (connectedness).

■■ Give practical suggestions that encourage people towards helping themselves and meeting their own needs (self-efficacy).

■■ Direct people to locations of available government and non-government services (hopefulness).

■■ If you know that more help and services are on the way, remind people of this when they express fear or worry (hopefulness).

DON’T:

■■ Force people to share their stories with you, especially very personal details (may decrease calming).

■■ Give simple reassurances like “everything will be ok” or “at least you survived” (often diminishes calmness).

■■ Tell people what you think they should be feeling, thinking or doing now or how they should have acted earlier (decreases self-efficacy).

■■ Tell people why you think they have suffered by giving reasons about their personal behaviors or beliefs (also decreases self-efficacy).

■■ Make promises that may not be kept (decreases hope).

■■ Criticize existing services or relief activities in front of people in need of these services (diminishes hope and calming).

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