1.
PsychologicalFirstAid.StrongerTogether.Aguidetohelpyouandyourcommunity
PAHO/NMH/19-015
©PanAmericanHealthOrganization2019
Allrightsreserved.PublicationsofthePanAmericanHealthOrganization(PAHO)areavailableatwww.paho.org.Requests
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(www.paho.org/permissions).
AllreasonableprecautionshavebeentakenbyAllreasonableprecautionshavebeentakenbyPAHOtoverifytheinformationcontainedinthispublication.However,the
publishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityforthe
interpretationanduseofthemateriallieswiththereader.InnoeventshallPAHObeliablefordamagesarisingfromitsuse.

2.
CreatedbytheInkLinkteam(www.theinklink.org).IllustrationandgraphicdesignbyEmmaTissier&HélènePouille.EvaluationbyLaureGarancher&OlivierColdefy.
ThePanAmericanHealthOrganizationandtheCaribbeanDevelopmentBank
developedthisbookletasatooltohelpyoutakecareofyourselfandyourcommunity
duringcrisissituations.Thisisachievedthroughpsychologicalfirstaid,alsoknown
asPFA,ahumane,supportiveandpracticalresponsetoafellowhumanbeingwho
issufferingandmayneedsupport.
InInthisbooklet,our“PFAhelper”willguideyouthroughthethreebasicprinciplesof
PFA:look,listenandlink.Thiswillhelpyoutoapproachaffectedpeople,listenand
understandtheirneeds,andlinkthemwithpracticalsupportandinformation.Itwill
alsobringtoyourattentiontheneedsofspecificgroups,includingmen,women,
childrenandadolescents,andpeoplewithdisabilities,amongothers.
OnlyanadultshouldbeaPFAhelper.
EnjoyEnjoythebooklet,readitagainfromtimetotime,shareitwithfriends,familyand
membersofyourcommunity,andspreadthemessage:
“StrongerTogether.”

3.
Thisguidewillhelpyoutoknowthemostsupportivethings
tosayanddofordistressedpeople.
Peoplewho
aresuffering
mayneed
support.

4.
L
O
O
K
LOOK

5.
L
O
O
K
becalm besafe thinkbeforeyouact
LOOK
YOURSafetyfirst!
Crisissituationschangerapidly:
•Weatherconditions
•Flooding
•Buildingsthatmaycollapse...
Taketimeto«look»aroundyou
beforeofferinghelp.
PFAshouldbeprovidedbyadults.

6.
L
O
O
K
IFYOUCANNOTACT,LOOK
FORHELPORTRAINEDPEOPLE
Shelter,
food,
water?
Protectionfrom
theweather,
clothing?Needrescuing,such
aspeopletrappedor
inimmediatedanger?
Criticallyinjuredand
inneedofemergency,
medicalhelp?
BASICNEEDS?LIfEthreatening
conditions?

7.
L
O
O
K
Emotionallynumb,
feeling“outofit”
ordisconnected
Shaking,headhaches,
feelingverytired,
lossofappetite...
Notknowingtheirownname
orwhathappened...
Anger,
anxiety
&fear
Peoplemayreactinvariouswaystoacrisis,immediatelyafterandinthefollowingdays.
Severelydistressedpeople
shouldnotbeleftalone!
Trytokeepthemsafe
untilthereactionpasses
oruntilyoucanfindhelp.
•children&adolescents
•peoplewithhealthconditions
orphysicalandmentaldisabilities

8.
L
I
S
T
E
N
LISTEN

9.
L
I
S
T
E
N
LISTEN
Donotpressure
anyonetotellyou
whattheyhave
beenthrough
Somepeoplemaynotwantto
speakaboutwhathashappened.
However,theymayvalueitif
youstaywiththemquietly,or
offerpracticalsupportlikea
mealoraglassofwater
Eyecontact
Facialexpressions
Gestures
Beawareof
wordsand
bodylanguage
Howtolistenproperly

10.
L
I
S
T
E
N
...
Helpthepersonfeelcomfortable.
Findasafeandquietplacetotalk.
Offerwaterifyoucan.
Bepatientandcalm
Stayclosebut
keepanappropriate
distance
Listeniftheywanttotalk
aboutwhathappened
LetthemknowthatLetthemknowthat
youarelistening.
Nodyourheadorsay
“hmmmm…”
Behonestaboutwhatyou
knowanddon’tknow
Acknowledge
feelings&loss
Acknowledge
strength
Allowforsilence
togivetheperson
timetoshare

11.
L
I
S
T
E
N
Youcanhelpthembyfollowingthesetips!
Somepeoplemayfeel“outofit”ordisconnected.
Forexample,theymaystayisolatedornotanswer.
Theymaylook“lost”,notknowwhathappened
orfeeltheydon’tknowwheretheyare...

12.
L
I
S
T
E
N
Don’ttell
themsomeone
else’sstory
Don’ttalk
aboutyour
owntroubles
Don’tmake
upthingsyou
don’tknow
Don’tinterruptor
rushsomeone’sstory
(don’tlookatyourwatch
orspeakrapidly...)
Theyhavetofeeltheirstrength
andcapacitytocareforthemselves

13.
link
L
I
N
K

14.
L
I
N
K
link Helppeopleaddress
basicneedsandaccess
services
Followupwithpeopleifyoupromisetodoso

15.
L
I
N
K
Apersonindistress
canfeeloverwhelmed
...Helpthemtoconsidertheirmost
urgentneeds,andhowtoprioritize
andaddressthem.
Beingabletomanageafewissueswill
givethepersonagreatersenseof
controlinthesituationandstrengthen
theirownabilitytocope!

16.
L
I
N
K
Whattodo?
Onlysaywhatyouknow
Donotmakeupinformationorgivefalsereassurances
Keepmessagessimpleandaccurate
Repeatthemessagetobesurepeoplehearandunderstandit
Rumourswillbecommon!
Findoutwheretogetcorrectinformation&when&wheretogetupdates
Makesurethatvulnerablepeoplealsoknowaboutexistingservices

17.
SPECIAL
NEEDS

18.
-Returntoearlierbehaviors
(e.g.:bed-wettingorthumb-sucking)
-Clingtocaregivers
-Reducetheirplayoruserepetitive
playrelatedtothedistressingevent
-Believetheycausedbad
thingstohappen
-Developnewfears
-Becomelessaffectionate
-Feelalone
-Becomepreoccupiedwith
protectingorrescuingpeopleprotectingorrescuingpeople
-Feel“nothing”
-Feeldifferentfromor
isolatedfromtheirfriends
-Displayriskybehavior
&negativeattitudes
-Providefactsaboutwhathappenedand
explainwhatishappeningnow
-Allowthemtobesad
-Don’texpectthemtobetough
-Listentotheirthoughts&fearswithout
beingjudgmental
-Setclearrules&expectations-Setclearrules&expectations
-Askthemaboutthedangerstheyface
&discusshowtheycanbeavoided
-Encouragethemtobehelpful
-Remindthemoftenthattheyaresafe
-Explainthattheyarenottoblamefor
badthingsthathappened
-Givesimpleanswersaboutwhathappened,
withoutscarydetails
-Allowthemtostayclosetoyouiftheyare-Allowthemtostayclosetoyouiftheyare
fearful
-Bepatientwithchildrenwhostart
demonstratingproblembehaviorsfromwhen
theywereyounger
-Provideachancetoplayandrelax
-Keepthemwarmandsafe
-Keepthemawayfromloudnoises
andchaos
-Speakinacalmandsoftvoice
-Givethemcuddlesandhugs

19.
Staywiththepersonortrytomake
suretheyhavesomeonetohelp
themifyouneedtoleave
Considerlinkingthepersonwitha
protectionagencyorotherrelevant
support,tohelptheminthelongertermsupport,tohelptheminthelongerterm

20.
Butif,
you,orpeoplearoundyou,
stillexperiencedistressful
reactions,likenightmares,
flashbacks,orintensesadness,
itistimetoseekprofessionalhelp
Talkwithahealthcareprofessionalwith
mentalhealthtraining,ifavailable
Itisnormaltofeelsad,upset
ortoexperiencestrongemotions

21.
Asahelper,youmayfeel
responsibleforpeople’s
safety&care
Helppeople
helpthemselves!
Rememberthatyouarenot
responsibleforsolving
everyone’sproblems
Thinkaboutwhathelpedyouto
copewithstressinthepast
Checkhowfellowhelpers
aredoing.Findways
tosupporteachother
Youmaywitnessorexperience
terriblethings(destruction,injury,
deathorviolence)andhearstories
ofotherpeople’spainandsuffering
Alloftheseexperiencescan
affectyou
Talkaboutyourexperienceof
helpinginthecrisissituation
withfriends,lovedonesorother
peopleyoutrustforsupport.
Acknowledgewhatyouwereable
todotohelp,eveninsmallways.
Acceptthelimitsofwhatyoucould
dointhecircumstances.
Evenduringthecrisis,taketimeforyourself.
Managestressbyhavinghealthyhabits:
-Keepreasonableworkinghourstoavoidexhaustion
-Dividetheworkloadamonghelpers,workinginshifts
duringtheinitialrecoveryphase
-Takeregularrestbreaks