THE INTERVENTION PYRAMID
Department of Health, Philippines
LEARNING OUTCOME
Demonstrate understanding of the Intervention
Pyramid
Describe the Kinds of Intervention that correspond
to each level of the Intervention Pyramid
Department of Health, Philippines
MHPSS
Any type or local outside support
Aims to promote or protect Psychosocial well-being and
or prevent/Treat Mental Disorder
Department of Health, Philippines
THE INTERVENTION PYRAMID
Spe
ciali
zed
servi
Focused,
ces non-
specialized supports
Community and family supports
Basic services and security
Department of Health, Philippines
THE INTERVENTION PYRAMID
PRESENTS THE INTEGRATED and LAYERED
APPROACH that DEFINES EFFECTIVE MENTAL
HEALTH PSYCHOSOCIAL PROGRAM
Provides SERVICE PROVIDERS with an
appreciation of the different need of affected
communities, as well as the role of each sectors
Department of Health, Philippines
LEVEL 1 (BASIC SERVICES and
THE WELL-BEINGSECURITY)
OF THE PEOPLE SHOULD BE
PROTECTED THROUGH THE FOLLOWING:
-(RE) ESTABLISHMENT OF SECURITY
ADEQUATE GOVERNANCE and SERVICES THAT
ADDRESS PHYSICAL NEEDS (FOOD, WATER,BASIC
HEALTH CARE)
-IN MOST EMERGENCIES, SPECIALIST IN SUCH
SECTORS PROVIDE BASIC SERVICES
Department of Health, Philippines
Level 1: Basic Services and Support
● At this earliest stage, the affected population are
already receiving some form of MHPSS intervention
by the basic services and security that responders
are providing them.
● Thus, the activities mentioned in this level help
alleviate basic psychosocial issues/ needs of the
affected population.
Department of Health, Philippines
Level 1: Basic Services and Support
Rapid MHPSS risk assessment is also done at the
beginning of the response and it is expected that
assessment should be done by ALL frontline
service providers in emergency settings.
Department of Health, Philippines
LEVEL 1
Provision of food packs and hygiene kits
Providing basic health care services (Health Caravan)
Controlling communicable diseases and preventing disease
outbreaks
Immediate evacuation assistance to affected population
Providing information
Advocating that these services are put in place with
responsible actors
Department of Health, Philippines
LEVEL 2 (Community and
Family Supports)
> Activities done in this level address the MHPSS
needs of family and communities that were NOT
initially addressed at the onset of Emergency
>Interventions should focus on boosting the SENSE of
CONNECTEDNESS in the aftermath of disaster.
Department of Health, Philippines
LEVEL 2 (Community and Family
Supports)
Activation of social networks, such as through women's group
and youth clubs
Establishment of child-friendly space and women-friendly space
“Libreng Ligo”, “Libreng Laba”, “Libreng Tawag”, “Libreng
Internet”
Provision of prayer room
Facilitate resumption of cultural and spiritual activities,
including grieving rituals
Family Tracing and Reunification
Department of Health, Philippines
LEVEL 3 (FOCUS, NON
SPECIALIZED SUPPORTS)
> OBSERVABLE RELATED CONCERNS ARE BEING
ADDRESSED BY SERVICE PROVIDERS, PARTICULARLY
INCREASING THE CAPACITY OF HEALTH FACILITIES IN
PROVIDING CARE TO THE POPULATION AND
PROVISION OF PSYCHOSOCIAL ACTIVITIES TO THE
INDIVIDUAL, FAMILY and COMMUNITY
Department of Health, Philippines
LEVEL 3 (FOCUS, NON SPECIALIZED
This levelSUPPORTS)
are not for the GENERAL
POPULATION, but for people who are:
a. Struggling to cope with their existing care
network
b. Unable to function as well as their peers
c. In need of activities that address their
PSYCHOSOCIAL needs more directly
Department of Health, Philippines
LEVEL 4 (SPECIALIZED SUPPORT)
• REFERRALS ARE THE BEST FORM OF
INTERVENTION PARTICULARLY FOR CASES
RELATED TO ABUSE, MENTAL,
NEUROLOGICAL and SUBSTANCE ABUSE
DISORDERS WHICH ARE BEING HANDLED BY
MEDICAL PROFESSIONALS
Department of Health, Philippines
LEVEL 4 (SPECIALIZED SUPPORT)
• Clinical social work or psychological
treatment
• Psychotherapy
• Drug or alcohol treatment
• Specialized mental health care
Department of Health, Philippines
Under NDRRMC Memorandum No. 62, responders are
expected to:
Coordinate the delivery of services
Conduct a rapid assessment of the needs of the affected
population, particularly vulnerable population,
infrastructure, services and risks according to available
tools prescribed
Provide immediate support based on the identified needs
of the population, regardless of sector, organization or
mandate.
Department of Health, Philippines
Department of Health, Philippines
SELF CARE IS ALWAYS A
GOAL,
But KNOW THIS IS ABOUT
PROGRESS, NOT
PERFECTION
Department of Health, Philippines
PSYCHOLOGICAL FIRST
AID
Department of Health, Philippines
LEARNING OUTCOMES
• Demonstrate knowledge of conducting
PFA
• Identify commonly seen signs of distress
resulting from disaster experience
• Demonstrate active listening
• Enumerate the services
Department of Health, Philippines
WHAT IS PSYCHOLOGICAL
FIRST AID?
Department of Health, Philippines
INTRODUCTION TO PFA
● feeling safe, connected to others,
calm and hopeful;
● having access to social, physical
and emotional support; and
● feeling able to help themselves, as
individuals and communities.
Department of Health, Philippines
WHO IS PFA FOR?
● PFA is for distressed
people who have been
recently exposed to a
serious crisis event. Help
may be provided to both
children and adults.
Department of Health, Philippines
WHERE IS PFA PROVIDED?
PFA may be offered wherever it is
safe enough to do so. This is often
in community settings, such as at
the scene of an accident, or places
where distressed people are
served.
Department of Health, Philippines
3 GOALS IN PROVIDING PFA
● Relieve both emotional and physical suffering
● Improve people’s short term functioning
● Accelerate the individual’s course of recovery
Department of Health, Philippines
Department of Health, Philippines
LOOK
Department of Health, Philippines
Distress Reactions to Crisis
• Physical symptoms: shaking, headaches, fatigue,
loss of appetite, aches and pains
• Anxiety, fear
• Weeping, grief and sadness
• Guilt, shame (for having survived, or for not saving
others)
• Elation for having survived
• Being on guard, jumpy
Department of Health, Philippines
* Anger, irritability
• Being immobile, withdrawn
• Disorientation: not knowing one’s name, where one is
from or what happened
• Inability to speak, or to respond to others
• Confusion, emotionally numbness, being in a daze or
state of disbelief
• Inability to care for oneself or one’s children (not
eating or drinking, or able to make simple decisions)
Department of Health, Philippines
LISTEN
Department of Health, Philippines
WHAT IS ACTIVE LISTENING?
• A way of listening and responding to another person that
improves mutual understanding
• A structured form of listening and responding that
focuses the attention on the speaker
• Conflict Research Consortium, University of Colorado.
“Active Listening.” 1998.
Department of Health, Philippines
LINK
Department of Health, Philippines
A referral is the process of directing a
client to another service provider because
s/he requires help that is beyond the
expertise or scope of work of the current
service provider.
Department of Health, Philippines
WHEN TO REFER?
● The person seems to be socially isolated
● When a person hints or talks openly of
● You have difficulty maintaining real contact
suicide
with the person
● If there is a possibility of child abuse or
● You become aware of dependency on
any criminal activity
alcohol and drugs
● The problem is beyond your training
● When the person is engaging in risky or
● The problem is beyond your capability
threatening behavior
● The problem does not fit the purpose of
● When you yourself become: restless,
the community responder program
confused, have negative recurring
thoughts, dream about the case and feel
you are the only one who can help
Department of Health, Philippines
LINKING GOALS
• Help people address basic needs and access
services.
• Help people cope with problems.
• Give information.
• Connect people with loved ones and social
support.
Department of Health, Philippines
ROLES OF PSYCHOLOGICAL FIRST AIDER
● Provide social support
● Educate about normal and abnormal stress reactions
● Teach stress management techniques
● Mobilize community resources
● Provide support and reassurance
● Aid in accessing appropriate services
● Undertake risk assessment to help prevent harm to self or to others
● Create a partnership and help find solutions
● Assist in early detection and intervention
Department of Health, Philippines
PFA CORE ACTIONS
● Contact and engagement – initiate non-intrusive, compassionate and helpful
manner.
● Safety and comfort – enhance ongoing safety, provide physical and
emotional comfort.
● Stabilization – calm and orient emotionally overwhelmed/disoriented
survivors.
● Information gathering – identify immediate needs and concerns – tailor PFA
interventions.
Department of Health, Philippines
PFA CORE ACTIONS
● Practical assistance – clarify the need, discuss action plan, act to
address the need
● Connection with social supports – enhance access, encourage
use, discuss support-seeking and giving, modeling support
● Information on coping – give basic information about stress
reactions, teach relaxation techniques, address negative emotions
● Linkage with collaborative services – provide link to additional
services, promote continuity of care
Department of Health, Philippines
Delivering PFA: Professional Behavior
● Operate only within the framework of an authorized disaster
response system
● Model healthy responses: calm, courteous, organized, helpful
● Be visible and available
● Maintain confidentiality
● Remain within the scope of your expertise and designated role
● Make appropriate referrals
● Be knowledgeable and sensitive (culture and diversity)
● Pay attention to your own emotional and physical reactions
● Practice self-care
Department of Health, Philippines
Dont’s in Delivering PFA:
● Do not make assumptions (about what the survivors are
experiencing or what they have gone through).
● Do not assume that everyone exposed to a disaster will be
traumatized.
● Do not pathologize (do not label “reactions” as symptoms).
● Do not talk down to or patronize the survivor, or focus on his
helplessness/weaknesses, mistakes, disability. Focus on what he
has done effectively to help others.
Department of Health, Philippines
Dont’s in Delivering PFA:
● Do not assume that all survivors want to talk or need to
talk to you (being physically present in a supportive, calm
way helps survivors feel safer and more able to cope).
● Do not “debrief” by asking details of what happened.
● Do not speculate or offer possibly inaccurate information
(know the facts before answering their questions).
Department of Health, Philippines
PFA AND CHILDREN
● Crisis events often disrupt children’s familiar world, including the
people, places and routines that make them feel secure.
● Children have different levels of vulnerability.
● How children react to the hardships of a crisis depends on
● their age and developmental stage.
● In general, children cope better when they have a stable, calm
adult around them.
Department of Health, Philippines
Department of Health, Philippines
Maraming salamat po!
