Psychological First Aid (PFA)

PFA is what the term "first aid" implies. It is an immediate response to some form of injury to stabilize its impact and assess for additional level of care. This is not a new concept nor are the skills of PFA new or require any level of intense training. In fact when one reviews the core components of PFA, it seems like common sense. Nonetheless, in the face of a disaster, common sense is challenged. If you consider when PFA was formally developed, after 9/11, while at the peak of the Mitchell model controversy, PFA filled a gap that the Mitchell model did not address and other responders failed to provide, that is, a model for the rest of us who are impacted in the face of a disaster.  This part of the training however, is not designed to provide a training on PFA.  There is an online manual that I encourage you to review. The link is provided in the margin. Understanding its role though, when to apply it, and for the purposes of this training, how to integrate it into Onsite interventions is considered a core efficiency.

PFA Core Actions

1. Contact and Engagement
2. Safety and Comfort
3. Stabilization
4. Information Gathering: Current Needs and Concerns
5. Practical Assistance
6. Connection with Social Supports
7. Information on Coping
8. Linkage with Collaborative Services

Review of these core components reflect basic crisis intervention techniques that are particularly helpful at the scene of a disaster. That is the purpose of this field operations guide. Anyone, EAP or not, responding to a disaster scene to help need to understand that this is the model to use.  That being said, unless you are a first responder, it is best to stay away from a disaster scene in the making. You may however become unwillingly a part of it by the location of your services.

On 9/11 I worked in the NY financial district across from the World Trade Center.  We were an internal EAP that joined our medical department in responding near by the WTC after the first plane hit.  A triage station was set up to provide medical first aid to anyone in need. As a non medical provider, I went out in search of anyone in need and brought them to the site for attention. Most of my assistance however was to assist in a mass evacuation process that was going on. As events were unfolding the exodus was interrupted with chaos. Civilians were panicking, having asthma attacks, fainting, and severely agitated. the task however was to help people get from point A (dangerous area) to Point B (less dangerous area). PFA was used when that goal was interrupted. People needed to be contacted at the level (ground) they were at and told they would be ok and that safety was near by. Escorting, providing water and in an area where additional supports existed was the task of the moment. If they needed medical assistance it was found for them. If they needed information to get home, updated transit information was provided. After the buildings came down, people had emerged from the dust.  They were despondent, eyes glazed, covered in dust like it had snowed on them.  Their only need was to be pointed in a direction of safety and water.  This is what PFA was designed for, Psychological First Aid is designed for delivery by mental health and other disaster response workers who provide early assistance to affected children, families, and adults as part of an organized disaster response effort...it is a supportive intervention for use in the immediate aftermath of disasters and terrorism. (PSYCHOLOGICAL FIRST AID, Field Operations Guide 2nd Edition)