Psychological First Aid
for First Responders:
Tips for Emergency and
Disaster Response Workers
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SAMHSA Resources At-A-Glance
Information Clearinghouses
National Mental Health Information Center (NMHIC)
P.O. Box 42557, Washington, DC 20015
(800) 789-2647 (English and Español)
(866) 889-2647 (TDD)
mentalhealth.samhsa.gov
National Clearinghouse for Alcohol and Drug Information (NCADI)
P.O. Box 2345, Rockville, MD 20847-2345
(800) 729-6686 (English and Español)
(800) 487-4889 (TDD)
ncadi.samhsa.gov
Treatment Locators
Mental Health Services Locator
(800) 789-2647 (English and Español)
(866) 889-2647 (TDD)
mentalhealth.samhsa.gov/databases
Substance Abuse Treatment Facility Locator
(800) 662-HELP (4357) (Toll-Free, 24-Hour English and Español
Treatment Referral Service)
(800) 487-4889 (TDD)
www.findtreatment.samhsa.gov
Hotlines
National Suicide Prevention Lifeline
(800) 273-TALK (8255)
(800) 799-4889 (TDD)
SAMHSA National Helpline
(800) 662-HELP (4357) (English and Español)
(800) 487-4889 (TDD)
Workplace Helpline
(800) WORKPLACE (967-5752)
www.workplace.samhsa.gov/helpline/helpline.htm
Managing Intense Emotions
When people are first faced with disaster and
you first meet them, intense emotions are often
present and appropriate. They are a result of
intense fear, uncertainty, and apprehension.
DO:
Communicate Calmly: Use SOLER
- Sit squarely or stand using the L-stance
(shoulder 90º to the other person’s shoulder).
- Open posture.
- Lean forward.
- Eye contact.
- Relax.
Communicate Warmth:
- Use a soft tone.
- Smile.
- Use open and welcoming gestures.
- Allow the person you are talking with to
dictate the distance between you.
Establish a Relationship:
- Introduce yourself if they do not know you.
- Ask the person what they would like to be
called.
- Do not shorten their name or use their fi rst
name without their permission.
- With some cultures, it is important to always
address the person as Mr. or Mrs.
Use Concrete Questions to Help the Person
Focus:
- Use closed-end questions.
- Explain why you are asking the question.
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Come to an Agreement on Something:
- Establish a point of agreement that will help
solidify your relationship and gain their trust.
- Active listening will help you fi nd a point
of agreement.
Speak to the Person with Respect:
- Use words like please and thank you.
- Do not make global statements about the
person’s character.
- Lavish praise is not believable.
- Use positive language.
If the Person Becomes Agitated, He or She
May—
Challenge or Question Authority:
- Answer the question calmly.
- Repeat your statement calmly.
Refuse to Follow Directions:
- Do not assert control. Let the person gain
control of self.
- Remain professional.
- Restructure your request in another way.
- Give the person time to think of your request.
Lose Control and Become Verbally
Agitated:
- Reply calmly.
- State that you may need assistance to help
them.
Become Threatening:
- If the person becomes threatening or
intimidating and does not respond to your
attempts to calm them, seek immediate
assistance. (2)
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(2) Adapted from “Nebraska Disaster Behavioral Health Psychological First Aid Curriculum” at mentalhealth.samhsa.gov/dtac/EducationTraining.asp.
Psychological First Aid for First Responders
When you work with people during and after a
disaster, you are working with people who may be
having reactions of confusion, fear, hopelessness,
sleeplessness, anxiety, grief, shock, guilt, shame,
and loss of confi dence in themselves and others.
Your early contacts with them can help alleviate
their painful emotions and promote hope and
healing.
Your goal in providing this psychological first
aid is to promote an environment of safety, calm,
connectedness, self-efficacy, empowerment, and
hope.
DO:
Promote Safety:
- Help people meet basic needs for food
and shelter, and obtain emergency medical
attention.
- Provide repeated, simple, and accurate
information on how to get these basic needs.
Promote Calm:
- Listen to people who wish to share their
stories and emotions, and remember that there
is no right or wrong way to feel.
- Be friendly and compassionate even if people
are being difficult.
- Offer accurate information about the disaster
or trauma, and the relief efforts underway to
help victims understand the situation.
Promote Connectedness:
- Help people contact friends and loved ones.
- Keep families together. Keep children with
parents or other close relatives whenever
possible.
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Promote Self-Efficacy:
- Give practical suggestions that steer people
toward helping themselves.
- Engage people in meeting their own needs.
Promote Help:
- Find out the types and locations of
government and nongovernment services
and direct people to those services that are
available.
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DO NOT:
- Force people to share their stories with you,
especially very personal details.
and shelter, and obtain emergency medical
attention.
- Give simple reassurances like “everything will
be OK” or “at least you survived.”
- Tell people what you think they should be
feeling, thinking, or how they should have
acted earlier.
- Tell people why you think they have suffered
by alluding to personal behaviors or beliefs of
victims.
- Make promises that may not be kept.
- Criticize existing services or relief activities in
front of people in need of these services.(1)
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(1) Adapted from “Psychological First Aid,” the Center for the Study of Traumatic Stress at www.centerforthestudyoftraumaticstress.org and used with permission.
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