A Systematic Literature Search on Psychological First Aid: Lack of Evidence to Develop Guidelines

Abstract

BackgroundProviding psychological first aid (PFA) is generally considered to be an important element in preliminary care of disaster victims. Using the best available scientific basis for courses and educational materials, the Belgian Red Cross-Flanders wants to ensure that its volunteers are trained in the best way possible.ObjectiveTo identify effective PFA practices, by systematically reviewing the evidence in existing guidelines, systematic reviews and individual studies.MethodsSystematic literature searches in five bibliographic databases (MEDLINE, PsycINFO, The Cochrane Library, PILOTS and G-I-N) were conducted from inception to July 2013.ResultsFive practice guidelines were included which were found to vary in the development process (AGREE II score 20–53%) and evidence base used. None of them provides solid evidence concerning the effectiveness of PFA practices. Additionally, two systematic reviews of PFA were found, both noting a lack of studies on PFA. A complementary search for individual studies, using a more sensitive search strategy, identified 11 237 references of which 102 were included for further full-text examination, none of which ultimately provides solid evidence concerning the effectiveness of PFA practices.ConclusionThe scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.

Risk Factors for the Development of Psychopathology Following Trauma

“…Psychological first aid (PFA) [64] is an evidence-informed modular approach for assisting people in the immediate aftermath of disaster and trauma to reduce initial distress and to foster short and long-term adaptive functioning. It is based on the idea of addressing pragmatic needs: what does the individual need immediately after the trauma, how can their experience be normalized instead of pathologized, and how can they be encouraged to cope effectively?…”

“Pandemic fear” and COVID-19: mental health burden and strategies

“…17 Providing psychological first aid is an essential care component for populations that have been victims of emergencies and disasters, but there are no universal protocols or guidelines for the most effective psychosocial support practices. 24 Although some reports on local mental health care strategies have been published, more comprehensive emergency guidelines for such scenarios are unknown, 1,17,19 since previous evidence refers only to specific situations. 24 In Brazil, a large developing country with pronounced social disparity, low education levels and humanitarian-cooperative culture, there are no parameters for estimating the impact of this phenomenon on the population's mental health or behavior.…”

“…24 Although some reports on local mental health care strategies have been published, more comprehensive emergency guidelines for such scenarios are unknown, 1,17,19 since previous evidence refers only to specific situations. 24 In Brazil, a large developing country with pronounced social disparity, low education levels and humanitarian-cooperative culture, there are no parameters for estimating the impact of this phenomenon on the population's mental health or behavior. Will it be possible to implement effective preventive and emergency actions aimed at the psychiatric implications of this biological pandemic in broad spheres of society?…”

Nursing interventions for adults following a mental health crisis: A systematic review guided by trauma‐informed principles

“…Four articles focused on crisis response interventions in the context of disasters. Two systematic reviews specifically focused on the effectiveness of psychological first aid (PFA) as form of supportive response that can be carried out by any responders, from trained lay responders, to mental health specialists and presumably nurses (Dieltjens et al ; Fox et al ). PFA includes facets of trauma‐informed principles such as ensuring physical and psychological safety and building of strengths and skills (Dieltjens et al ; Fox et al ).…”