Frequently Asked Questions: Psychological First Aid (PFA)

Learn about the benefits of using Psychological First Aid (PFA) as a Healthcare Worker and Public Safety Personnel. Uncover essential FAQs and start your journey to secure a PFA certification. 

  • PFA is an approach to assisting and managing people’s reactions during or in the immediate aftermath of an acute crisis. Emotional and practical support is provided to individuals, families, or communities who are having difficulty coping. Recipients will receive kind, supportive interactions that establish connections in a compassionate, non-judgmental manner. The goal of PFA is to help the individual determine their best path forward and engage in resilient behaviors.  
  • Resilience is an individual’s capacity to adapt, cope, and reorient themselves under conditions of adversity that promote and sustain their wellbeing. A person’s capacity for resiliency can be strengthened through skill acquisition, knowledge, and experience. Examples of resilience include accepting both the good and bad days, developing problem solving skills, recognizing negative thoughts and behaviors, and perceiving setbacks or “failures” as opportunities for learning. It is important to remember that there is no correct way to execute resiliency, and everyone must find the tools that allow them to successfully adapt and persevere.     
  • Self-care is another essential component of PFA. You may become overburdened and unfit to help others if you do not continuously attend to your own cognitions. The PFA certification course teaches you how to identify the support systems and protective factors you will use to manage stress and maintain your physical, mental, spiritual, and emotional health. Psychological First Aid – Self-Care | Canadian Red Cross Learning 

Prior to PFA, psychological debriefing was widely practiced and involved detailed discussions outlining distressing experiences. These conversations can trigger negative responses and potentially re-traumatize individuals. As a result, PFA was developed as an alternative to psychological debriefing to minimize unnecessary negative responses and re-traumatization.

  • Who: Any distressed person, including children, adults, and the elderly.
  • What: Providing emotional and practical support.
  • When: During or immediately after a crisis event.
  • Where: Anywhere it is safe and private.
  • Why: Increase the likelihood that people will choose positive coping strategies and engage with a resiliency pathway.

The short answer is “no,” PFA is not an evidence-based practice, it is an evidence-informed practice. The conclusions of evidence-based practices have been drawn from experimentation (i.e., randomized control trials) and empirical data. For example, a treatment such as Cognitive Behavioral Therapy (CBT) is an evidence-based practice. Comparatively, PFA is an evidence-informed practice. Evidence-informed practices blend research evidence, practitioner experience, and participant background. In this case, PFA is built on the principles of Cognitive Behavioral Therapy (CBT) and incorporates general emergency response literature, your unique personal and professional background, and the context and culture of the individual being assisted. 

Yes, you need training before engaging in PFA. The Canadian Red Cross offers two certification options: 12 hours in-class OR 45-90 minutes of online learning and 7 hours in-class. 

PFA is available in a variety of languages and is intentionally designed to be adaptable for any culture or context. Access the guide in English and French at:

  • PFA is designed to provide supportive and practical help to individuals who are experiencing a crisis. The principals and skills of PFA can be used by all types of Healthcare Workers and Public Safety Personnel. They can be used to help children and adults who are experiencing any psychological distress related to COVID-19. 
  • PFA skills are designed to help you navigate conversations in a supportive and helpful manner, while not causing further harm. As the COVID-19 pandemic progresses, you are never sure when a colleague, or employee will be affected by crisis. PFA allows you to assist individuals as they experience challenges on their own timeline. 
  • It is essential to remember that PFA is also about ensuring your needs are met first. You should not be providing PFA if you are experiencing psychological distress. Following PFA’s steps of Look, Listen, and Link, you can create and utilize a self-care plan that identifies the support systems and protective factors you will use to manage stress.
  • American Red Cross
  • ARQ National Psychotrauma Centre (Formerly War Trauma Foundation)
  • Canadian Red Cross
  • World Health Organization (WHO) 
  • Inter-Agency Standing Committee
  • International Committee of the Red Cross 
  • International Medical Corps
  • Mercy Corps
  • Regional Psychosocial Support Initiative – REPSSI
  • Sphere Project 
  • United Nations Department of Management
  • United Nations Department of Safety and Security
  • United Nations High Commissioner for Refugees
  • United States Marine Corps 
  • United States Navy 
  • War Child
  • It is not professional counselling or an alternative to counselling. 
  • It is not asking someone to analyze what happened to them or engage with distressing memories and experiences. Although PFA involves being available to listen to people’s stories, it is not about pressuring the recipient to tell you their feelings and reactions to an event. You must meet people where they are at in the moment.
  • It is not giving advice. A central tenet of PFA is supporting self-efficacy. Self-efficacy is an individual’s belief in their capacity to act in the ways necessary to reach specific goals or complete tasks. Offering advice or personal opinion concerning the recipient’s choices and best path forward reduces self-efficacy. Instead, focus on promoting collaborative and individual problem solving, and offer suggestions if necessary.
  • PFA provides a general skill set that will help you navigate difficult situations. PFA teaches you what to say and do, how to be supportive and helpful, and how to avoid unintentional harm.
  • PFA helps reduce stigma associated with mental health crises by promoting conversations about self-care and collective wellness.
  • PFA helps acknowledge the hidden strengths of resiliency as a means of moving forward.
  • PFA can be specialized and adapted for a specific environment. Healthcare Workers and Public Safety Personnel can adjust PFA to improve congruence between the intervention and organizational culture.
  • Look, Listen, and Link are the steps taught in the Canadian Red Cross and World Health Organization (WHO) PFA courses. However, other certification courses or manuals may categorize their steps differently.  
  • Look for people who need help. This can include watching for signs of stress in ourselves and others, keeping an eye on people who have experienced crisis or high-risk situations, and abnormal behaviors that indicate a person is psychologically struggling.
  • Listen to the person in distress. At this point the provider would directly ask, and actively listen to an individual’s needs and immediate concerns. Do not pressure the recipient to speak if they are unwilling. Your role is to provide the individual with a space to explore, identify, and choose their own action plan.  
  • Link the individual to helplines, services, and professionals for further assistance. If requested, connect the recipient with a local religious leader or their community specific body.

After completing the PFA course you will be certified for 3 years. 

PFA can be used by anybody who has the certification. This means that you do not need prior education in psychology or therapy, however, know your limits and get help if someone needs more advanced support. 

  • Before you sign up for a certification course consider what you would like to learn and make sure that you are choosing the right course for your needs.
  • Mental Health First Aid (MHFA) and Psychological First Aid (PFA) have different focuses but act as complementary processes for different situations. PFA is the first building block, followed by MHFA. 
  • PFA certification teaches participants to recognize and minimize psychological distress within themselves and other people during, or in the immediate aftermath of, a crisis. MHFA trains people to identify, understand, and help a person who may be developing a mental health issue at any point in time. 
  • PFA interventions can help unveil which psychosocial supports are needed by Healthcare Workers (HCWs) and Public Safety Personnel (PSP). As a leader or manager this will allow you to provide the most effective support to your employees and avoid providing ineffective resources that will not be utilized.
  • PFA initiates a conversation about mental health and how mental health is discussed in the workplace. It is possible that overtime this will help reduce stigma and barriers to mental healthcare for PSP and HCWs.
  • Employees who are psychologically struggling are more likely to get the attention and help they need to improve their mental health.
  • As a leader or manager you will learn how to communicate more effectively with employees. Managers may be among the first people approached when someone is experiencing psychological distress in a professional environment. Use the skills learned in PFA training to engage in active listening, providing support to normalize symptoms, and shift cognitions.
  • PFA training can help you navigate challenging situations including the boundaries of your role, appropriate professional behavior, and respecting an employee’s privacy.
  • Actively demonstrate an endorsement and commitment toward the PFA program. It helps to increase employee buy-in and reduce apprehension in participation. This will help increase the program’s success in the long run.
  • Provide annual training opportunities.
  • Ensure peer supporters have access to appropriate supervision and monitoring following their training.
  • Empower PFA peer supporters in the workplace.
  • Provide dedicated spaces or time for PFA.
  • Avoiding behaviors that will obstruct PSP or HCWs from receiving and providing PFA.

Canadian Red Cross. (n. d.). Psychological first aid: Pocket guide. CRC_Psychological_First_Aid_Guide.pdf (


IASC Mental Health and Psychosocial Support Reference Group. (2020). Basic psychosocial skills: A guide for COVID-19 responders. IASC Guidance on Basic Psychosocial Skills – A Guide for COVID-19 Responders | IASC (


IASC Reference Group on Mental Health and Psychosocial Support. (2020).  Operational considerations for multisectoral mental health and psychsocial support programmes during the COVID-19 pandemic. IASC Guidance on Operational Considerations for Multisectoral Mental Health and Psychosocial Support Programmes during the COVID-19 Pandemic | IASC (


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Sphere Association. (2018). The sphere handbook: Humanitarian charter and minimum standards in humanitarian response (4th ed.). Practical Action Publishing.


Tessier, M., Lamothe, J., & Geoffrion, S. (2021). Adherence to psychological first aid after exposure to a traumatic event at work among EMS workers: A qualitative study. International Journal of Environmental Research and Public Health18(21).


World Health Organization: Mental Health and Substance Use Team. (2011). Psychological first aid: Guide for field workers. WHO Press. Psychological first aid: Guide for field workers (


Ungar, M. (2018). Systemic resilience: Principles and processes for a science of change in contexts of adversity. Ecology and Society23(4).


UWMedicine Psychiatry. (2020, April 23). Psychological First Aid (PFA) for Leaders and Managers [Video]. Youtube. Psychological First Aid (PFA) for Leaders and Managers – YouTube

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