MHFA is a form of PFA. The Johns Hopkins RAPID model is also a form of PFA

The model with which I'm most familiar is the Johns Hopkins RAPID model of PFA. There are three content validation studies, two randomized controlled outcome trails, and one mixed methods study supporting its efficacy. I cannot speak to other models of PFA.

It really does not. In that PFA focuses upon the response to an incident it can be provided at any point in the trajectory of an incident for as long as there are adverse reactions manifest even including anniversary reactions.

Great question which no one has ever asked me. No. Depending upon the model that is used I believe it could be used at any point in the trajectory of a problem or symptom presentation. The brief "listen and refer" model will have less utility than the "listen, mitigate, and refer" models.

The question you are asking I believe has to do with mechanisms of action. As drugs have mechanisms of action, so do psychological interventions. Depending upon the type of PFA model you employ, the mechanisms of therapeutic outcome could be: cathartic ventilation, reassurance, explanatory guidance, anticipatory guidance, prescriptive guidance, cognitive reframing, or simple education.

PFA can be done remotely. Remember that crisis telephone hotlines date back to the early 1900s. Now with video conferencing capabilities PFA can be done very effectively in my experience. But formal training is of course required in my opinion.

There are many benefits in my opinion, but several come to mind:

1. Research suggests it saves the organization money through retention and perhaps lowered healthcare costs when applied as part of a continuum of care.

2. It demonstrates the organization values the human resource.

3. It fosters personal resiliency (and organizational resilience), which is imperative in times of crisis.

4. We believe it fosters organizational cohesion.

Thanks for your question. There are only 4 randomized controlled trials on CISD that adhered to the prescribed intervention guidelines. Three were conducted in the military, one was with emergency services personnel. The findings across all settings were consistent. All studies showed some evidence of positive outcome. No study showed any evidence of harm. Thus, it would seem reasonable to say the CISD intervention shows promise with homogenous (with regard to trauma exposure) groups of emergency service and military personnel. A similar conclusion was reached in a SAMHSA review. I know of no evidence that CISD should be applied to heterogeneous groups of civilians. I see no evidence that CISD is a "treatment" for trauma, nor should it be a substitute for treatment.

I shall avoid the discussion of clinical indicia and rather focus on the simple yet helpful notion of functionality. Simply said, if in the wake of loss or other adversity and although given some form of psychological support the person is incapable of doing the things they need to do or are in any way a potential threat to their own health or the health of others, it would seem referral/facilitation of access to higher level care would be indicated. Similarly, if despite intervention the person shows no sign of improvement referral would seem indicated.

Get formal training from an organization that specializes in such training: Green Cross and International Critical incident Stress Foundation offer such training throughout the world. Also check with you local university. I teach classes in disaster mental health, human resilience, and PFA at Johns Hopkins. There is an examination-based certification in critical incident stress management offered by the University of Maryland, Baltimore County Dept of Emergency Health Services

Great question, though beyond the scope of this forum. That said I suggest getting formal training so as to understand the difference between PFA and therapy. One technique that seems helpful is to imagine that you only have 15 minutes with each person you will contact. And that you can only see that person 2-3 times. Now ask yourself what would I do differently, if anything?

Yes, as long as you can maintain an objective distance. I do not recommend empathic approaches, rather perspective-taking seems as effective if not more so.

I think PFA training should be taught to all frontline supervisors in virtually all organizations, but especially high risk professions. I also think that occupations that are high risk for psychological injury should have "peer support" teams trained in PFA. I would consider mining a high risk occupation

I would recommend implementing two procudures: 1) training all supervisors in PFA and 2) establishing a peer support team all members of which would be training in PFA.

This is in my opinion an excellent idea. Please see the journal Crisis Stress and Human Resilience Vol. 1, #4 (open access online) wherein I discuss PFA as a means to achieve universal mental healthcare.

Staying connected is imperative. I highly recommend virtual support groups. I also recommend establishing a virtual "buddy system"

Focus on the response, not the incident. Believe it or not, the duration of the event is almost irrelevant except for personal planning during an ongoing event

I recommend providing tips on wellness practices: mindfulness, exercise, staying connected albeit remotely, writing a COVID journal, taking the opportunity to do things we lacked time for previously.

Yes, get formal training! Realign expectations as to what is a successful outcome. We have found that a significant impact can be made in a 15 minute contact but it requires rethinking the intervention process. Watch the countertransference.

At Johns Hopkins we employ a contiuum of care ranging from peers support, EAP, chaplaincy, and wellness to psychiatric interventions. We have just finished a series of videos for frontline leaders on building resilience-focused leadership as well.. We just published a paper in Annals of Internal Medicine describing our initial approach (Wu, Connors, Everly)

Learning how very different PFA is from therapy. Research has shown multi-session therapy in the acute phase of a disaster may actually be harmful.

Not until the importance of mental health is as appreciated. That said, it is gaining in recognition and popularity especially in the context of COVID-19

Many consider dealing with grief a specialty within mental health as it presents unique challenges. From a PFA point of view I would simply begin with a supportive and compassionate presence, resisting the temptation to quickly make it all better. Suggesting grief counseling might be appropriate.

If you are referencing the Johns Hopkins Cousera PFA class, it is asynchronous so you can take it anytime anywhere. I also teach PFA related classes for the International Critical Incident Stress Foundation. They have online classes as well but most of their classes are in person and offered over one or two days throughout the country

Great question, Sadly I will pass on that as I'm not a child psychologist nor do i work with children. So sorry.