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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)

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)

Treatment Locators

Mental Health Services Locator
(800) 789-2647 (English and Español)
(866) 889-2647 (TDD)

Substance Abuse Treatment Facility Locator
(800) 662-HELP (4357) (Toll-Free, 24-Hour English and Español
Treatment Referral Service)
(800) 487-4889 (TDD)


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)

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.


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
  • 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

  • Use closed-end questions.
  • Explain why you are asking the question.

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

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

  • Reply calmly.
  • State that you may need assistance to help

Become Threatening:

  • If the person becomes threatening or
    intimidating and does not respond to your
    attempts to calm them, seek immediate
    assistance. (2)

(2) Adapted from “Nebraska Disaster Behavioral Health Psychological First Aid Curriculum” at

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.


Promote Safety:

  • Help people meet basic needs for food
    and shelter, and obtain emergency medical
  • 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

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


  • Force people to share their stories with you,
    especially very personal details.
    and shelter, and obtain emergency medical
  • 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
  • Make promises that may not be kept.
  • Criticize existing services or relief activities in
    front of people in need of these services.(1)

(1) Adapted from “Psychological First Aid,” the Center for the Study of Traumatic Stress at and used with permission.

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