Psychological First Aid Manual

From the outset, it is essential to define what is meant by Psychological First Aid (PFA). Although this concept will be explored in greater detail in Chapter Four, we wish to emphasize that PFA should not be considered as a clinical or therapeutic intervention. Instead, it refers to a series of evidence-informed actions based on fundamental psychological principles aimed at reducing initial distress and supporting the short- and medium-term recovery of individuals affected by acute stress. Therefore, it is not necessarily delivered by mental health professionals, yet can be implemented by trained personnel across diverse settings, including education, social care, and humanitarian response.
This manual advocates for the use of creative practices as tools within PFA. As we will see in the following chapters, we recognize that immediately following acute traumatic events creative interventions may not be appropriate for a number of reasons. However, some time later, when the initial stress has subsided but remains at a high level and carries the risk of becoming chronic (for example, generalized anxiety and hypervigilance weeks after an earthquake), creative practices developed in educational or social settings can serve as highly useful preventive tools. In this sense, and with a flexible approach, we understand them as instruments of PFA.
Stress and change are closely interconnected, particularly in today’s era of rapid global transformation. Since the 9/11 attacks in 2001, the world has faced ongoing crises—wars, terrorism, pandemics, economic instability, and shifts in geopolitics and democracy. These phenomena are driven by accelerated globalization and the digital revolution, affecting both our personal and professional lives. In this fast-paced and competitive environment, young people - amid identity formation and future planning- are particularly vulnerable. Across the world, including Europe, youth face acute stress from armed conflicts, online hate speech, terrorism, economic hardship, and natural disasters.
A recent Financial Times article (September 26, 2024) highlighted the growing number of young people unable to work due to mental health issues, noting a sharp rise in depression, anxiety, and serious health conditions among those aged 16 to 24. Similarly, The New Yorker (September 30, 2024) reported on the link between social media use and teen suicide, sharing stories of young lives lost.
Despite ongoing debates over specific figures, prevailing research consistently highlights a significant rise in stress levels worldwide. Everyone—especially those working with youth—should receive basic training in how stress affects the body and mind, and how to offer psychological first aid in traumatic situations.
This manual has been developed as part of the "Psychological First Aids and Creative Practices" (PACT) project, funded by the Erasmus+ program, in which six associations and two universities from the following countries participate: Armenia, Georgia, Italy, Greece, Lithuania, Moldova, Spain, and Ukraine. The manual is mainly aimed at volunteers or professionals who work with young people, according to the EU, individuals between 15 and 29 can be considered young. However, it could be useful for any citizen, with no prior psychological training, who wishes to acquire foundational competencies in this field, whether or not they work with young people. The manual consists of two parts. In the first, which is more theoretical in nature, we will explore the mental health situation of young people in Europe, essentially, and the risk scenarios they face. We will also explain in a rigorous but as simple as possible way how our body responds to stress. In another chapter of this first part, we will define what is meant by psychological first aid, its principles, and the most well-known models. In the final chapters, we will offer basic techniques and strategies that can be used in psychological first aid.
The use of artistic or creative practices in this domain warrants careful justification. In the following pages, we will try to explain why we believe they can be an effective tool in the field of psychological first aid. For this, we will rely on the existing evidence regarding the effectiveness of the arts as a tool for promoting and preventing mental health. While the evidence on the use of the arts in the specific field of psychological first aid is very scarce, in the general field of mental health, we have seen an exponential growth of empirical evidence in recent years. Our research group, the Laboratory of Human Activity—Identity, Health, and Social Change (LAH-ISCS), the Academy of Fine Arts of Naples, and other members of the Erasmus+ PACT project, have been working in this field for decades. We will briefly review the areas in which creative practices can be effective and the psychosocial processes that explain their beneficial effect on mental health or psychological well-being.