Psychological first aid (PFA) is a humane, supportive response to someone who is suffering and who may need support. PFA can help reduce the initial distress of children caused by accidents, natural disasters, conflicts and other critical incidents.
PFA helps children to:
- Feel safe, connected to others, calm and hopeful
- Have access to social, physical and emotional support
- Feel able to help themselves, as individuals and as part of communities
When to carry out psychological first aid
- Psychological first aid for children can be given during an emergency situation or immediately after a critical event
In crisis events, children react and think differently to adults, and so PFA should be based on an awareness of how children react in emergencies. Common reactions of children who have been through distressing events include sleep disorders, feelings of anxiety and depression, social withdrawal from others, concentration difficulties, crying, clinging behaviour and regression. Not all children need psychological first aid. Like adults, some children cope very well with difficult experiences. However, recovery can be helped when children receive appropriate support at an early stage.
Who can give psychological first aid to children?
Staff and volunteers working directly with children, such as partner organisations, teachers, educators, health and social workers, can provide psychological first aid for children. Others who support children in distress, including anyone who arrives shortly after a crisis event, can also give psychological first aid for children. Whenever possible, helpers should find a quiet place where children, parents and caregivers can feel safe and comfortable to talk and be comforted.
What does PFA for children involve?
- Giving practical care and support that does not intrude
- Assessing needs and concerns
- Helping children to access basic needs (e.g. food and water, information)
- Comforting children and helping them to feel calm
- Helping children connect to information, services and social supports
- Protecting children from further harm
PFA is not:
- Something only professionals can give
- Professional counselling
- A clinical or psychiatric intervention, although it can be part of good clinical care
- Psychological debriefing
- Asking children to analyse what happened to them or to put time and events in order
- Pressing children to tell you their story
- Asking people details about how they feel or what happened
How to deliver psychological first aid for children:
- Check for safety – be aware of potential dangers in the environment, and ensure that your own safety is not at risk. Do what you can to find a safe environment to communicate with parents and caregivers in distress.
- Look for children with obvious basic needs – children with critical injuries, trapped or in need of rescue, with obvious basic needs such as protection from the weather or torn clothing. Be aware of people around you who can help and refer critically injured children and their parents or caregivers to medical services.
- Look for children and parents or caregivers who have serious distress reactions.
- Approach children and parents or caregivers who may need your support. Part of the initial contact with the distressed child and family is asking about their needs and concerns. However, be aware that people who are very distressed may find it difficult to explain clearly what they need.
- Always initiate the contact by introducing yourself. When you approach small children, sit down next to them, or squat, so you are at the same level. Explain who you are, what you do, whom you work for and what you are doing here. Make your explanations simple and allow for questions. Sometimes the best way to approach children and their families is to offer to link them to practical assistance, such as food, water and blankets.
- Listen to the child and parents or caregivers and help them feel calm by:
- Staying close to the child and parent or caregiver
- Listening if they want to talk about what happened
- Not pressuring anyone to talk if they don’t want to
- Help children and parents and caregivers address their basic and specific needs, such as:
- Basic needs, food, water, shelter and sanitation
- Specific needs – healthcare, clothing and cups and bottles for feeding small children
- Help people cope with problems
- Give information: One of the most frightening aspects of stressful events is the worry and concern about your own safety and well-being, and that of others you care about. Try to get as much information as you can before you approach people to offer support. Keep information to children concrete and in short sentences. If you are uncertain whether the child or their parents or care-givers have understood the information, ask them to repeat what you have told them. Encourage them to ask questions if they do not understand. Children and their parents or care-givers are likely to want information about:
- The event
- Loved ones or others who are affected
- Their safety
- Their rights
- How to access services and things they need
- Connect children with loved ones and social support – One of the biggest determinants of how a child copes with a stressful event is whether or not the child was separated from or has lost its parents or caregivers. Helping a child reunite with his or her family can be one of the most important actions in psychological first aid for children. If the child is alone, and if s/he cannot be reunited with his or her family members, follow all the necessary protocols to make sure the child is linked to an organisation or a person who will take responsibility for the child. Follow the guidance provided in the Inter-Agency Guiding Principles on Unaccompanied and Separated Children.
- Where children show signs of needing further support (e.g. those who continue to be highly distressed, who show continued dramatic changes in personality and behaviour, who cannot function daily in their life or who are a danger to themselves or others), ensure they are referred to appropriate services
Training staff and volunteers in delivering PFA
Ensuring that staff and volunteers are confident and well-equipped to provide initial support for children in an appropriate way can make a significant difference in delivering an effective emergency response.
Topics that can be covered by training:
- Introduction to psychological first aid for children
- Children’s reactions to crisis
- Identifying children who need psychological first aid, and the action principles of psychological first aid
- Initial contact with distressed children
- Communicating with children
- Parents and caregivers in distress
An example outline of a 2-day training in PFA for children is available from Save the Children: Psychological First Aid Training Manual for Child Practitioners
Additional tools and resources
Information on this page is primarily taken from:
- Save the Children, Psychological First Aid Training Manual for Child Practitioners
- WHO (2011), Psychological First Aid: Guide for Field Workers
Additional tools and resources are available here