Psychological First Aid Tutorial
PFA Key Actions:
Promote Safety
Calm and Comfort
Connectedness
Self Empowerment
- Choose from the options below:
The goal of PFA is to reduce psychological distress by:
PFA is designed for use by the non-mental health professional while serving in an emergency response role:
PFA can be used where disaster services are provided such as:
The following four elements form a framework for providing Psychological First Aid. Use these actions to create an environment where individuals can begin their recovery.
More detail will be provided on these actions in later sections.
After experiencing a traumatic event, individuals exhibit stress reactions in various ways. Reactions can be physical, behavioral, emotional, cognitive, and spiritual.
Restoring a sense of safety is one of the first steps in the healing process. Help to ensure both physical and emotional safety through practical steps. For example:
In the aftermath of a traumatic event, creating an environment of calm and comfort can help to ease the survivor's distress and to promote hope and healing. For example:
Restoring the individual's connection to their own support system and introducing them to additional disaster resources will aid resiliency. For example:
PFA encourages survivors to take an active role in their own recovery. Promote self-empowerment by helping survivors to find ways to meet their own needs. For example:
How you first approach the survivor is important in establishing an effective relationship and can increase receptivity of further assistance. The following recommendations will aid in promoting a respectful and supportive interaction with survivors:
Active listening is a structured way of listening and responding by focusing on the person in crisis. Tips for active listening include:
Preschool age children (ages 1 to 5) do not have skills to verbalize their experiences and tend to act out their feelings. They often experience regressive behaviors.
School age children (ages 6 to 11) have increased ability to talk about their experience but are unable to understand how the traumatic event relates to the reactions they are experiencing. They often experience regressive behaviors.
Developmentally teenagers (ages 12-18) are trying to separate from their parents and establish their own identities so they may be resistant to taking direction from adults. They may do better with peer interactions or one-on-one with adults. They too can exhibit regressive behavior.
When compared to other age groups, senior citizens typically have enhanced coping skills due to their extensive life experiences. However, other considerations may impact an older adult's reaction to trauma such as diminished physical strength or cognitive skills, or a fear of loss of independence. There may also be a generational emphasis on self-reliance and a stigma of “public welfare”that increases reluctance to accept help.
Individuals may have physical, cognitive, emotional, mental, developmental, or sensory disabilities that result in functional needs. The responder should consider these functional needs when providing PFA. For example:
Cultural beliefs and practices will tend to govern a survivor's understanding of a disaster and his or her behavioral response to the crisis.
When working with people in crisis, it is sometimes necessary to refer them to an individual that can provide a higher level of care. Your supervisor will identify the procedures to be followed when making a referral. Understanding the limits of your knowledge and skills is critical to your ability to care for people in crisis. When in doubt consult your supervisor.
It is important to recognize the difference between behaviors considered typical for a person experiencing trauma, and behaviors that that may indicate professional mental health assistance is required.
Individuals that threaten to harm themselves or others require an immediate referral to a mental health professional. Stay with the individual until they can connect with the appropriate personnel. Red flags to watch out for include:
Responder self-care is a critical component of Psychological First Aid. Responders deploy on short notice, face terror and destruction, and work long hours. These challenges make normal mechanisms of self-care difficult to access and easy to overlook.
It is imperative for responders to tend to their physical, emotional, and spiritual wellbeing. Without adequate self-care, fatigue, adrenaline, and a desire to help can lead to ineffective, or even regrettable, decisions and practices.
Self-care includes actions taken before, during and after deployment.
Responders such as yourself may experience stress reactions similar to others who have been exposed to traumatic events. However, responders may also have reactions specific to their role as a responder. Examples include:
This is the end of the Psychological First Aid Refresher. Now use your PFA skills to respond to survivors in the Practice section.
Practice PFAUse your Psychological First Aid skills to respond to the following disasters!
You have completed the Practice PFA scenarios!
Return to MenuA tornado has devastated part of a local neighborhood. You are deployed as a responder the day following the tornado.
You are walking through the neighborhood, checking on residents and offering help. You see a man sitting alone near a moderately damaged home.
How do you approach him?
When first approaching a survivor, it is important to introduce yourself and the agency you represent as well as to ask permission to help. Focus on the survivor's needs and not on your own need to help. Avoid promising more than you will be able to provide. Offer items such as water or a blanket to help meet their immediate basic needs.
The survivor responds to your introduction. “Hi, sure we can talk. I am Charlie. Thanks for the water. It was a terrible storm but I am doing all right. My neighbors have it worse than I do. You better check on them.”
How do you reply?
Not all survivors are ready to accept help or need it. Respect their decision and leave the door open for them to access help later. Validate their resiliency and let them know about available services if they decide they need support in the future.
You are an usher at a Point of Dispensing (POD) site, also known as a Mass Dispensing Site. People are coming through the site to receive oral antibiotics following anthrax dispersal at a professional football game. Your job is to usher the public through the line to the next available person dispensing the medication.
“Is this antibiotic safe? What is it going to do to me?”
How do you reply?
Acknowledge the person's concerns in a calm manner to help ease the person's distress. Avoid either dismissing their concerns or causing additional alarm. Explain what the person can expect next and how they will receive the answers to their questions. Use simple, easy to understand instructions.
“I'm sorry. What did you say? I just can't concentrate!”
How do you reply?
Difficulty concentrating is a common stress reaction. In this situation where many people need to move quickly through the POD and your job is to facilitate rapid movement, there may not be much time to interact with the individual. Validate their experience, and then repeat the information, using short, easy to understand instructions. Avoid causing the person additional distress or alarm.
Two weeks following a terrorist attack, you are staffing a Community Assistance Center. Your job is to be the first point of contact with people as they arrive. There are many resources available including disaster assistance, behavioral health services, and other community resources.
“It's been a long time since my 4-year-old sucked her thumb, but ever since the blast she's been doing it all the time. We live two blocks from where it happened and the evacuation really scared her. Do you think I should be worried?”
How do you reply?
Pre-school age children often regress to earlier behaviors, so thumb sucking does not indicate a need for a referral to a Mental Health Professional at this time. Listen to the parent to better understand the situation. Extra parental attention can be supportive to a child as they cope with the event, and allows the parent the opportunity to watch for other behavior changes that could indicate something more serious is occurring. If available, written materials on helping children cope with disasters could be provided.
“My teenager keeps saying he doesn't see the point in living if we have to face these kinds of attacks. I'm just not sure how seriously I should take him.”
How do you reply?
The threat of suicide should always be taken seriously. The woman should first talk to a Licensed Mental Health Professional, who can assess the situation and determine the best strategy for helping the son.
“I've been barely hanging on all year, since I lost my wife, and now this happens! Will I ever get back in my house? Where will I go?”
How do you reply?
This person has too much going on to be sent away with a handout. He probably should talk to a Licensed Mental Health Professional or other provider specified in your onsite procedures. People who have experienced recent losses or other traumatic events are at a greater risk for serious psychological and emotional reactions to trauma. If possible, accompany the man to where he needs to go within the Center to prevent frustration that may cause him to change his mind about seeking help.
This Tutorial is also available as a native application for Apple iOS and Android. If you have an Android phone or an Apple device (iPhone, iPad, or iPod Touch), download the app instead of using this mobile website version. This will ensure that you receive update notifications and that you can access the Tutorial even when wifi or cell service is disrupted.
If you don't have an Android phone or Apple iOS device, see instructions below on how to store this PFA mobile website on your phone for offline use when network connectivity is unavailable.
This Tutorial is also available as a native application for Apple iOS and Android. Download the app by touching the image below. Using the app instead of this mobile website will ensure that you receive update notifications and that you can access the Tutorial even when wifi or cell service is disrupted.
In certain situations you may not have mobile network connectivity or wifi access, and you will not be able to access the web. It is possible to store this PFA mobile website on your Android or Apple iOS device for offline use when no network is available.
Note: When you use this tool without network access, you may still receive an error about your connection. Simply tap OK and wait a moment. The content saved to your device should still load.
”in the bottom toolbar.Note: When you use this tool without network access, you may still receive an error about your connection. Simply tap OK and wait a moment. The content saved to your device should still load.
This mobile app and website are intended to serve as a just-in-time refresher on Psychological First Aid (PFA). These resources assume that the learner has previously participated in a comprehensive PFA training and do not intend to provide a complete education in the topic.
After completing this tutorial, the learner will be able to:
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This training resource was developed by University of Minnesota: Simulations, Exercises, and Effective Education Preparedness and Emergency Response Learning Center (U-SEEE PERL), which is supported in part by the Grant Number 1U90TP000418 from the Centers for Disease Control and Prevention (CDC). The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. U-SEEE PERL Principal Investigator: Debra K. Olson.
U-SEEE PERL and the UMN School of Public Health gratefully acknowledges the work of those who contributed to the development of this training resource.
Thank you to many stakeholders who thoughtfully reviewed this resource and provided their feedback.
©2012 Regents of the University of Minnesota. All rights reserved.
The University of Minnesota is an equal opportunity educator and employer.
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These resources assume that the learner has previously participated in a comprehensive PFA training and do not intend to provide a complete education in the topic. For additional Psychological First Aid training, we suggest the following free online sources:
Search for face to face training at:
For links, apps, and news pertaining to mobile emergency preparedness and response visit: