Psychological first aid for lay helpers: look, listen, link

After a distressing event, people usually recover better when they feel safe, calm, connected and able to act, and when they have hope. These five points go back to a widely cited 2007 review by Hobfoll and colleagues. Psychological first aid strengthens exactly these factors – with simple means that anyone can learn.

The core is not analysing feelings or giving clever advice. It is about protection, practical help, listening and linking people to support. A blanket round the shoulders, a cup of water, a call to someone's daughter, a quiet corner to sit in – these are often the most effective things. They show: you are not alone, and someone is taking care.

The WHO guide for field workers summarises this in three action principles: “Look, Listen, Link”. Before that comes preparation, and afterwards a proper close. The guide is explicitly aimed at people without therapeutic training.

Prepare: briefly find out what has happened, which emergency services are present and which hazards remain. Introduce yourself by name and ask whether help is wanted – some people want to be left in peace, and that is fine.

Look: watch for safety, visible injuries and urgent basic needs such as warmth, water, a toilet or important medication. Look out for people with special needs: unaccompanied children, older people, people with disabilities or people who are very agitated. Listen: calmly ask about needs and concerns, and listen. Don't judge feelings, make no promises you cannot keep, and tolerate silence too.

Link: help people reach loved ones, get reliable information and find suitable services. Pass on only what you know for sure. Close: say when you are leaving and who takes over. Helpers who suddenly disappear can be unsettling.

With strong agitation a quieter place often helps – away from noise, onlookers and distressing sights. Speak slowly and in a calm voice. You can gently draw attention to breathing or the surroundings: “Can you feel your feet on the ground? Let's breathe out slowly together.” Don't hold the person or crowd them.

Avoid platitudes such as “It could have been worse” or “I know exactly how you feel”. They are well meant but often come across as dismissive. Simple, honest sentences are better: “That sounds very hard.” “I'm here.” “What do you need most right now?”

If a child is affected: get down to eye level, use simple words, and keep children with their caregivers where possible or help reunite them. Also be aware of cultural differences: how close people stand, whether they touch and how they talk about loss is not the same everywhere.

Only help if the place is safe. Don't enter danger zones reserved for emergency services – such as a burning house, an accident site in moving traffic or flooded areas. In medical emergencies, first aid and the emergency call (112 in the EU) come first, emotional support afterwards.

Don't push anyone to talk. Detailed questions about what happened (“What exactly did you see?”) can do more harm than good. Those who want to talk may talk; those who want to stay silent may stay silent. Don't make diagnoses or give treatment tips – that is not the job of psychological first aid.

If someone talks about taking their own life or harming themselves, endangers others or loses control completely: immediately call the local emergency number or a local crisis line and do not leave the person alone. Psychological first aid replaces neither the emergency call nor crisis services nor psychotherapy.

Supporting others in a crisis can also burden the helpers themselves. Images and stories can stay with you for days afterwards. Take that seriously: talk to someone you trust, give yourself breaks, sleep and food. If the strain persists, it makes sense to accept support yourself.

Besides the WHO guide there is the “Field Operations Guide” of the US National Child Traumatic Stress Network, which describes similar core actions. Both are written for helpers without therapeutic training.

No text replaces practice. Many relief organisations offer courses in which you learn psychological first aid through role-play. It is also worth roughly knowing the local services – crisis line, counselling services, psychosocial emergency care – so that in an emergency you know where to link people to.