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Psychological First Aid: Adaptation, training


Psychological First Aid: Adaptation, training & outcomes IASC RG Meeting Paris, November 2011 Megan McGrath, WVI Leslie Snider, WTF Mark van Ommeren, WHO – PowerPoint PPT presentation

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Title: Psychological First Aid: Adaptation, training

Psychological First AidAdaptation, training
  • IASC RG Meeting
  • Paris, November 2011
  • Megan McGrath, WVI
  • Leslie Snider, WTF
  • Mark van Ommeren, WHO

PFA Guide for Field Workers
  • WHO publication
  • Collaborative effort
  • World Health Organization
  • War Trauma Foundation
  • World Vision International
  • Endorsed by 24 UN/NGO international agencies
  • In process of translation and adaptation to
    varied contexts

Process of Developing Guidea journey of a
thousand miles begins with a single step
  • 2008 scan for existing resources needs
  • 2009 WHO commissioned PFA systematic review
  • 2009 Anthology of resources
  • 2009-10 First draft designed
  • 2010 Haiti pilot (WVI - Alison Schafer)
  • 2010 Extensive international peer review (60)
  • 2011 Second select peer review from LMC
    colleagues, child protection, IASC Ref Group and
    plain English
  • 2011 August release on World Humanitarian Day

The PFA Field Guide - Endorsements
Psychological First Aid (PFA) is
  • A description of a humane, supportive response to
    a fellow human being who is suffering and who may
    need support. PFA involves the following themes
  • Providing practical care and support that does
    not intrude
  • Assessing needs and concerns
  • Helping people to access basic needs (e.g. food
    and water, information)
  • Comforting people and helping them to feel calm
  • Helping people connect to information, services
    and social supports
  • Protecting people from further harm
  • Based on Sphere (2011) IASC MHPSS Guidelines

PFA is not....
  • It is NOT something only professionals can do
  • It is NOT professional counseling
  • It is NOT a clinical or psychiatric intervention
    (although it can be part of good clinical care)
  • It is NOT psychological debriefing
  • It is NOT asking someone to analyze what happened
    to them or to put time and events in order
  • It is NOT pressing people to tell you their story
  • It is NOT asking people details about how they
    feel or what happened

Why PFA?
  • People do better over the long-term if they
  • Feel safe, connected to others, calm and hopeful
  • Have access to social, physical and emotional
  • Feel able to help themselves, as individuals and

How do we know?
  • Evidence informed - factors associated with
    PTSD (ESgt0.2)
  • Adults peri-traumatic dissociation, lack of
    social support post-trauma, trauma severity, life
    stress post-trauma, perceived life threat,
    peri-traumatic emotional response
  • Children pre-trauma psychopathology, threat to
    life and pre-trauma parental distress
  • Supported by Hobfoll principles evidence that
    lack of social support is associated with a
    poorer outcome
  • Consistent with recent guidelines (NATO/ TENTS,

Recommendations (Bisson Lewis, 2009)
  • Caution against step-by-step manualised
  • Doesnt require advance knowledge
  • Can be easily taught to workers without mental
    health training

PFA Action Principles
  • Prepare
  • -------------------
  • Look Listen Link

PFA Training
  • WHO/WTF/WVI have conducted training in Suriname,
    Somaliland, Iraq, West Bank/ Gaza, Sri Lanka and
    Europe (IOM, Dutch security network)
  • WVA/WTF/GPG Sri Lanka project 2011-13
  • WVI rolling out training within organization
  • Planned for Sudan, aid workers in Darfur
  • Many other groups planning or doing training (TPO
    Nepal, Belize, IOM, IMC)
  • PFA Adaptation Training Group established on
    MHPSS network

Translations of the Guide
  • WHO MH Dept coordinating all official UN
    translations (Chinese, Spanish, Russian, Arabic,
  • For non-official languages, send requests to
  • Current translations requested
  • Urdu, Tamil, Sinhala, French, Spanish, Arabic,
    Japanese, Chinese, Romanian, Hebrew, Korean
  • Confirmed French, Urdu, Japanese, Chinese

Ordering Books (WHO Bookstore)
  • WHO MH Dept is sending all endorsing agencies 50
    copies of the guide (they are in the mail)
  • WHO MH Dept will send 1-2 copies upon request,
    but not handling large requests
  • Standard cost 12/book, but it is possible to
    negotiate reduced rates (possibly about 6/book)
  • Possible for any agency/group of agencies to
    access designer files for a special print run

Intriguing Questions
  • Do we have a shared understanding of what PFA is
    - and is not? (beware CISD trap!)
  • How to adapt the guidance for different?
  • Socio-economic contexts
  • Crisis events
  • Cultures, customs and languages
  • How best to capture global lessons in adapting
    applying PFA?
  • How to measure process outcomes (!!) of PFA
    training and application in the field?
  • Pre-post training knowledge, skills, practice?
  • Personal effects of training on trainer
  • Beneficiaries?the Hobfoll principles?

  1. Bisson, J.K. Lewis, C. (2009) Systematic Review
    of Psychological First Aid, Commissioned by
    World Health Organization.
  2. PFA Anthology and
  3. Schafer, Snider and van Ommeren. Psychological
    first aid pilot Haiti emergency response.
    Intervention Journal, Vol. 8(3) 245-254, Nov

  • Writing Editorial Team
  • L. Snider (WTF), A. Schafer (WVI), M. van Ommeren
  • Steering Committee
  • Stefan Germann (WVI), Erin Jones (WVI), Relinde
    Reiffers (WTF), Shekhar Saxena (WHO), Marieke
    Schouten (WTF), Leslie Snider (WTF), Mark van
    Ommeren (WHO)
  • Illustrations Julie Smith (PD Consulting)
  • Photos Red Cross/Red Crescent photos courtesy of
    Melissa Ekin Kizildemir Suat Ozcagdas
  • Funding World Vision International
  • Reviewers
  • We thank the many reviewers and endorsing agencies