PFA
What are the 3 Ls?
Look- Listen- Link
What are the two most basic emotional needs of every child?
To feel safe and to feel loved
If you are concerned someone may be suicidal, how should you ask them?
Clearly and directly if they are thinking about killing themselves.
If someone sees or hears things others cannot, what type of symptom of psychosis is this?
A hallucination
What daily factor is the single strongest foundation for wellbeing?
Sleep
What is the very first step before approaching someone to provide PFA?
Ensure the environment is safe for both yourself and the affected person and that the immediate crisis is over.
What is the guiding principle in all decisions concerning children?
The best interest of the child
What is the most serious risk to watch for in the first weeks after starting antidepressant treatment?
Suicide
When talking with a person who is delusional, what is the correct way to approach them?
Stay calm and respectful, listen without directly challenging or agreeing with the delusion, and focus on the person’s feelings and safety rather than debating their belief.
According to stress management guidelines, what simple workplace habit reduces burnout risk?
Taking regular short breaks
In PFA, what does “Link” specifically involve?
Providing clear and honest information about options/services.
Respecting choice and obtaining consent before referrals.
Connecting to practical services (health, safety, psycho-social).
Referring to trusted agencies/providers/ community leaders as needed.
Encouraging reconnection with personal support networks.
When interviewing a child, what must you make clear about confidentiality?
You must make clear that what they share is private but not secret
When assessing suicide risk, what five key areas must you ask about to determine level of danger?
1. Suicidal thoughts (ideation)
2. Plan
3. Access to means
4. Past attempts
5. Current intent
What are the main potential causes of psychosis?
Primary psychiatric disorders (stress & vulnerability)
Substance use or withdrawal
Medical/neurological conditions, and psychopharmacological factors
Sever physiological stress
What is a hallmark early sign of vicarious trauma that is not just “stress”?
Intrusive images or avoidance specifically linked to clients’ traumatic material.
When should consent be taken in Psychological First Aid?
Every step of the way
A 17-year-old girl is brought to you by a community leader, deeply traumatized after being raped last night. What is the very first action you must take?
Ensure she is taken immediately for emergency medical care, including HIV post-exposure prophylaxis (PEP), emergency contraceptive, treatment of injuries, and protection, before providing any psychosocial support.
Why can self-harm become addictive?
Because self-harm triggers the release of endorphins and other neurochemicals that temporarily reduce emotional pain and create relief, which reinforces the behavior and leads to compulsive repetition.
Which features of psychosis always require urgent referral because they signal immediate danger?
Suicidal or homicidal command hallucinations, or delusions that drive the person to harm themselves or others.
What does moral injury mean?
Moral injury is the deep psychological distress that arises when helpers witness suffering they cannot prevent, are forced into actions that violate their moral or professional values, or feel guilt and shame for treating beneficiaries in ways that go against their principles.
According to international PFA guidelines, what are the five things you must not do when supporting a person in acute distress?
1. Do not pressure or force the person to share their story or relive the event.
2. Do not give false reassurance or make promises you cannot keep.
3. Do not judge, blame, or stigmatize the person for their reactions.
4. Do not force unwanted help or assume you know what they need.
5. Do not overlook your own limits — refer immediately if the person has urgent medical, safety, or mental health risks.
What are five questions you could ask a parent or guardian to help confirm whether their child may have PTSD?
1. Intrusion: Does your child have repeated nightmares or act out the scary event in play?
2. Avoidance: Do you notice your child avoiding places, people, or activities that remind them of what happened?
3. Mood/Thoughts: Has your child seemed more sad, fearful, guilty, or uninterested in things they used to enjoy?
4. Arousal: Is your child more jumpy, irritable, having tantrums, trouble sleeping, or difficulty concentrating?
5. Regression: Have you seen any changes like bedwetting, clinginess, or behaviors they had grown out of before?
Clinically, what is the key difference between these four presentations?
“I want to end my life because I see no way out.”
“I keep having intrusive thoughts telling me to kill myself, but I don’t want to.”
“A voice keeps commanding me to kill myself.”
“I cut myself so people notice how much I’m hurting, but I think I want to live.”
1. True suicidal ideation with intent → depression/substance-related, genuine wish to die.
2. Suicidal obsessions in OCD → intrusive, ego-dystonic thoughts without intent but may engage in compulsions.
3. Psychotic suicidality → command hallucinations/delusions driving suicidal acts.
4. Borderline/self-harm for affect regulation or attention → non-suicidal self-injury (NSSI), where the intent is to cope, regulate emotions, or signal distress, not to die.
What are the five main symptoms of psychosis?
1. Hallucinations (perceiving things that aren’t there, most often hearing voices).
2. Delusions (fixed false beliefs not shared by others).
3. Disorganized thinking or speech (incoherent, illogical, or tangential).
4. Grossly disorganized or abnormal behavior (including catatonia).
5. Negative symptoms (loss of motivation, flat affect, reduced speech or social withdrawal).
What single practice most strongly predicts resilience and balance by helping frontliners recover emotionally after work and re-engage in personal life?
Psychological detachment from work during off-hours.