Psychological First Aid for Refugees and Internally Displaced Persons in Iraq: Guide for Field Workers

The document was prepared by USAID/Primary Health Care Project in Iraq, implemented by University Research Co., LLC, based on the guide of psychological first aid issued by the World Health Organization in 2012 and the Field Operations Guide issued by the National Child Traumatic Stress Network (NCTSN), National Center for PTSD in 2006. The guide was reviewed by the IDPs Technical Working Group and Health Promotion Specialists and Advisors in the Iraqi Ministry of Health. Psychological first aid (PFA) is a humane, supportive response to a fellow human being who is suffering and may need support. PFA involves providing practical care and support, assessing needs and concerns, helping people to address basic needs, listening to people, comforting them, and helping them connect to information, services, and social supports. PFA is not professional counseling, nor is it "psychological debriefing," which involves a detailed discussion of the event that caused the distress. PFA is for distressed people who have been recently exposed to a serious crisis event, including children and adults. However, not everyone who experiences a crisis event will need or want PFA. Field workers should make themselves easily available to those who may want support, but not force help on people who do not want it. In situations where someone needs more advanced support than PFA alone, field workers should know their limits and get help from others, such as medical personnel, colleagues, or local authorities. The guide emphasizes the importance of respecting safety, dignity, and rights when providing PFA. Field workers should adapt what they do to take account of the person's culture and be aware of other emergency response measures. They should also look after themselves, as providing PFA can be emotionally challenging. The guide provides a framework for supporting people in ways that respect their dignity, culture, and abilities. It covers both social and psychological support, and is written for people in a position to help others who have experienced an extremely distressing event. The guide gives information on how to approach a new situation safely and not cause harm. Psychological first aid is an alternative to "psychological debriefing," which has been found to be ineffective. PFA involves factors that seem to be most helpful to people's long-term recovery, including feeling safe, connected to others, calm, and hopeful; having access to social, physical, and emotional support; and feeling able to help themselves, as individuals and communities. The guide provides a comprehensive framework for providing PFA, including how to assess needs and concerns, provide practical care and support, and connect people to information, services, and social supports. It also emphasizes the importance of respecting safety, dignity, and rights, and adapting what is done to take account of the person's culture. In situations where someone needs more advanced support than PFA alone, field workers should know their limits and get help from others, such as medical personnel, colleagues, or local authorities. The guide provides a list of people who need more immediate advanced support, including those with serious, life-threatening injuries, those who are so upset that they cannot care for themselves or their children, and those who may hurt themselves or others. Overall, the guide provides a comprehensive framework for providing psychological first aid to refugees and internally displaced persons in Iraq, and emphasizes the importance of respecting safety, dignity, and rights, and adapting what is done to take account of the person's culture.