Psychological First Aid (PFA)

Practical Assistance

Goal

To offer practical help to survivors in addressing immediate needs and concerns.

Exposure to disaster, terrorism and post-event adversities is often accompanied by a loss of hope. Those who are likely to have more favorable outcomes are those who maintain one or more of the following characteristics:

  • Optimism (because they can have hope for their future)
  • Confidence that life is predictable
  • Belief that things will work out as well as can reasonably be expected
  • Belief that outside sources act benevolently on one’s behalf (responsive government)
  • Strong faith-based beliefs
  • Positive belief (for example, “I’m lucky, things usually work out for me”)
  • Resources, including housing, employment, financial

Providing people with needed resources can increase a sense of empowerment, hope, and restored dignity. Therefore, assisting the survivor with current or anticipated problems is a central component of Psychological First Aid. Survivors may welcome a pragmatic focus and assistance with problem-solving.

Discussion of immediate needs occurs throughout a Psychological First Aid contact. As much as possible, help the survivor address the identified needs, as problem-solving may be more difficult under conditions of stress and adversity. Teaching individuals to set achievable goals may reverse feelings of failure and inability to cope, help individuals to have repeated success experiences, and help to reestablish a sense of environmental control necessary for successful disaster recovery.

Offering Practical Assistance to Children and Adolescents

Like adults, children and adolescents benefit from clarifying their needs and concerns, developing a plan to address them, and acting on the plan. Their ability to clarify what they want, think through alternatives, select the best option, and follow through develops gradually. For example, many children can participate in problem-solving, but require the assistance of adolescents or adults to follow through with their plans. When appropriate, share the plans you have developed with parents/caregivers, or involve parents/caregivers in making the plans, so that they can help the child or adolescent to carry them through. Offering practical assistance is composed of four steps:

Step 1: Identify the Most Immediate Needs

If the survivor has identified several needs or current concerns, it will be necessary to focus on them one at a time. For some needs, there will be immediate solutions (for example, getting something to eat, phoning a family member to reassure them that the survivor is okay). Other problems (for example, locating a lost loved one, returning to previous routines, securing insurance for lost property, acquiring caregiving services for family members) will not be solved quickly, but the survivor may be able to take concrete steps to address the problem (for example, completing a missing persons report or insurance form, applying for caregiving services).

As you collaborate with the survivor, help him/her select issues requiring immediate help. For example, you might say:

Adult/Caregiver

I understand from what you’re telling me, Mrs. Williams that your main goal right now is to find your husband and make sure he’s okay. We need to focus on helping you get in contact with him. Let’s make a plan on how to go about getting this information.

Adolescent/Child

It sounds like you are really worried about several different things, like what happened to your house, when your dad is coming, and what will happen next. Those are all important things, but let’s think about what is most important right now, and then make a plan.

Step 2: Clarify the Need

Talk with the survivor to specify the problem. If the problem is understood and clarified, it will be easier to identify practical steps that can be taken to address it.

Step 3: Discuss an Action Plan

Discuss what can be done to address the survivor’s need or concern. The survivor may say what he/she would like to be done, or you can offer a suggestion. If you know what services are available ahead of time, you can help obtain food, clothing, shelter, or medical care; mental health or spiritual care services; financial assistance; help in locating missing family members or friends; and volunteer opportunities for those who want to contribute to relief efforts. Tell survivors what they can realistically expect in terms of potential resources and support, qualification criteria, and application procedures.

Step 4: Act to Address the Need

Help the survivor to take action. For example, help him/her set an appointment with a needed service or assist him/her in completing paperwork.

Last updated: December 2, 2015