Sustainability of Psychological First Aid Training for the Disaster Response Workforce

Psychological first aid (PFA) is a set of tools designed to help responders address stress-related reactions among survivors immediately after a disaster or traumatic event. Helping survivors feel safe, reducing stressrelated symptoms, and fostering positive coping strategies enable responders to better meet survivors' basic needs and ensure their linkage to critical resources and social support. These are important steps in initiating the recovery process. Addressing survivors' immediate needs is also important because prolonged stress in the aftermath of a disaster or traumatic event may lead to longer-term mental health problems such as posttraumatic stress disorder, depression, and substance use. Early intervention after a disaster may be important to prevent these longterm sequelae.Psychological first aid is evidence informed but not evidence based because of the difficulty of studying it under controlled conditions and because the elements employed may vary depending on the needs of the individuals being assisted. Rather, the concepts of PFA have been derived from an initial set of "empirically supported intervention principles"-promoting a sense of safety and calming along with a sense of self-efficacy, community efficacy, connectedness, and hope- developed by an expert panel in 2007.1 Although different PFA models have been developed over time, all share these core principles, which are encompassed in the eight PFA core actions described in the National Child Traumatic Stress Network's PFA field operations guide2 and outlined in Table 1.Psychological first aid relates to mental health care as "first aid" relates to medical care. All responders, particularly those who will be interacting with survivors, should be aware of the principles of PFA. In addition, PFA may be of benefit to the responders themselves to help them understand and cope with their own stress reactions and those of their colleagues. In this way, PFA is important in creating not only resilient communities but a resilient response workforce. Also, PFA is not an intervention that must be delivered by mental health professionals, the supply of whom would probably not be sufficient to meet the needs of all survivors in a large-scale disaster. For these reasons, PFA training should be accessible to workers in a wide range of response agencies.