Psychological first aid

Psychological first aid

After a traumatic event or situation such as a natural catastrophe, a terrorist attack or a plane crash, the people affected are in a situation of great vulnerability, in addition to experiencing great suffering. In these critical moments, Emergency psychological intervention is essential to restore the emotional balance of those affected. Let's see what Psychological First Aid (PAP) consists of.


  • 1 What are Psychological First Aid?
  • 2 Basic principles
  • 3 Psychological First Aid Protocol

What are Psychological First Aid?

Brief and immediate psychological intervention at a time of crisis is known as Psychological First Aid (PAP). Its main objective is to help affected people to face the traumatic event and avoid having as many sequels as possible. However, this psychological intervention also offers protection, security and hope.

The PAPs try to restore the emotional balance of the people affected after a catastrophe. That is, reduce their emotional distress and support them so that they are reunited with their ability to face what happened. In fact, thanks to this type of resources, stress levels are reduced, those affected connect with their support network and start up various coping skills in the face of what happened.

Thus, we can say that this type of psychological intervention acts as an initial support so that the experience lived does not become devastating and end up invading and deteriorating the lives of affected people.

Basic principles

The First Psychological Aid is carried out by professionals in the field of mental health and are organized around a series of basic principles:

  • To protect.Affected people have to feel protected and safe. They have just experienced an atrocious situation that has broken all feelings of controllability, balance and security, so seeking shelter and avoiding contact with the media during the first hours is essential.
  • Lead. Those affected may be unable to direct themselves for everything they have experienced or have doubts about what to do and how to act. Mental health professionals will guide the next steps and organize all those affected.
  • Connect. This principle consists in connecting people with their personal resources, as well as with other available and useful social resources. It is about promoting the confrontation of what happened from the person and from the outside.
  • Try.Another principle that we should not forget is the psychological intervention itself with people who show signs of acute stress, anxiety and grief, as well as any other behavior deemed necessary.
  • Acute care. Assistance to a traumatic event only allows acute and short-term care. Something that the professional must take into account for the establishment of the therapeutic relationship with those affected.

In addition to knowing these basic principles to provide quality psychological care, professionals must allow the free expression of feelings by victims, as well as practice responsible listening and convey an attitude of acceptance. All from empathic and trustworthy behavior.

First Psychological Aid Protocol

The First Psychological Aid (PAP) is governed by action protocols. This is the result of the experience of professionals who have studied the effects of various methods of action in emergency situations.

The CLOSE protocol is one of the best known in this area. It consists of eight sequential stages to provide comprehensive psychosocial care. Its structure and composition is as follows:


This first phase consists of a Psychologist's contact with the crisis situation. To do this you have to inform yourself and understand the main characteristics of what happened:

  • Contextualization
  • Environment assessment
  • Patient or group selection
  • Initial Patient Evaluation


In this phase the psychologist must begin contact with the affected person, taking into account the following aspects:

  • Observe the nonverbal aspects of the victim.
  • Make contact and establish the therapeutic relationship.
  • Promote the psychological distancing of what happened by the victim.
  • Ask questions related to the events and that facilitate descriptions that lead to cognitive processing. In this way, the person is prevented from concentrating solely on the emotional aspects.


Once the contact is established, the psychologist or mental health professional has to make an evaluation of the following aspects:

  • Initial examination or examination of the mental state.
  • Identification of the problem.
  • Coping style of the affected.
  • Identification of the personal resources of the affected person and the available social support.

Emotional restoration

This phase consists of the facilitation of emotional communication in order to reach a good adaptive functioning.

The psychologist will ask the affected person questions with the aim of expressing their emotions. and how it feels To do this, you can use the ability of active listening and physiological activation and deactivation techniques.

In addition, it will be tried as far as possible to recover the social network of the affected, as well as to be accessible and available.

Crisis Understanding

The objective of this phase is for the affected person to understand the crisis. For this, you can provide general information about the problems and effects of stress and specific information about the event. Ideally, promote an adaptive narrative in the person and answer all their questions.


This phase consists in activating the affected person to action. For this, it is recommended:

  • Recover the level of cognitive processing. The goal is for the person to focus on activities and events.
  • Prepare an action plan. Together with the affected person, they will decide how to act by exploiting their resources and personal strategies.
  • Plan personal verbal contracts for the plan to be fulfilled.

Operating recovery

This phase pretends that the person regains his normal life, For this, the psychologist has to promote the following actions:

  • Plan upcoming tasks and activities and in company.
  • Promote the affected person to function independently.
  • Leave him accompanied, either by healthcare professionals or by family or friends.
  • Study the possible derivation or transfer.
  • Inform the affected person of their hospitalization, in case it occurs.
  • Plan accommodation and activities for the home.


As in any psychological intervention, psychological first aid also considers necessary carry out short and medium long term follow-up. The objective is for the affected person to feel that there is a continuity in the psychological care received.

As we can see, psychological first aid helps to ensure that a traumatic situation does not go any further and that The affected person feels attended, understood and protected at all times. A great work in which mental health professionals are the fundamental link for those affected to move forward.

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