Promising Practices for Disaster Behavioral Health Response and Recovery

Psychological First Aid (PFA)
PFA is an evidence-informed1 modular approach to help children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism. Psychological First Aid is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping. Principles and techniques of Psychological First Aid meet four basic standards.

Psychological First Aid for Schools (PFA-S) 
The National Child Traumatic Stress Network and the National Center for PTSD are pleased to make the Psychological First Aid for Schools Field Operations Guide and accompanying handouts available. Psychological First Aid for Schools is an evidence-informed approach for assisting children, adolescents, adults, and families in the aftermath of a school crisis, disaster, or terrorism event.
Skills for Psychological Recovery (SPR)
SPR is an intervention that aims to help survivors gain skills to manage distress and cope with post-disaster stress and adversity. SPR is not a formal mental health treatment, but utilizes skills-building components from mental health treatment that have been found to be helpful in a variety of post-trauma situations. Research suggests that a skills-building approach is more effective than supportive counseling. SPR is appropriate for developmental levels across the lifespan, and is culturally informed.

PFA versus SPR

SPR is intended to provide psychological assistance to survivors of disasters and traumatic events after the initial crisis has subsided – in the recovery phase. Alternatively, PFA is intended to provide disaster survivors with assistance in the days and weeks after a disaster – in the immediate response and the initial period of the recovery phase.

The delivery of PFA is defined in terms of days or weeks after a disaster because the timing will depend on the circumstances of the post-disaster setting. SPR is intended to assist disaster survivors after safety, security, and other vital and immediate needs have been met and when the community is rebuilding. In some cases, SPR may be delivered one week after a disaster, as a follow up to the initial PFA response, and in other cases, it may be appropriate to provide this assistance weeks, months, or even years after a major event. The timing will be partially dependent on how devastating the disaster was to community resources and infrastructure.

SPR places greater emphasis on teaching specific skills to meet survivor needs, as well as on follow up to reinforce the use of SPR skills than PFA. PFA, in contrast, is often delivered in temporary settings where follow up may not be possible.