Safety-first disclaimer

What is Psychological First Aid (PFA)?

PFA is an evidence-informed, humane response for people in the minutes to days after a crisis. It focuses on practical, short-term support to reduce distress and enhance coping. The common brief framework is:

• Look — observe who needs help; check safety and immediate needs.
• Listen — offer calm, empathic, non-intrusive listening; identify concerns.
• Link — connect to practical help, basic needs, social supports and professional services.

PFA is not therapy. It aims to stabilise and connect people to ongoing supports.

Quick nervous-system primer

• Window of tolerance: the range in which a person can manage emotions and process information. When inside it, problem-solving and calm are possible.
• Hyperarousal: fight/flight — anxiety, racing heart, rapid breathing, agitation, hypervigilance.
• Hypoarousal: freeze/shut down — numbness, dissociation, low energy, difficulty speaking or getting out of bed.
• Regulation goal: use grounding and co-regulation to bring someone back toward their window of tolerance.

PFA tools (orienting, grounding, breathwork, practical aid) map directly onto nervous-system regulation tasks.

Where Reiki may fit — complementary aims

• Reiki can provide: a calm, focused presence, gentle touch or non-contact calming technique, and an opportunity to practise breath- and body-based regulation.
• Use-case: short, voluntary Reiki for people seeking comfort and relaxation after non-acute distress, when consent is explicit and clinical contraindications are absent.
• Do not use Reiki: as a sole treatment for acute psychiatric crises, active suicidality, psychosis, severe dissociation, or urgent medical conditions.

Practical sequence — PFA + brief regulation + optional Reiki (5–15 min)

Use clinical judgement. Keep initial contacts short and safety-focused.

1. Look — safety & scene: Ensure physical safety, check for medical needs, and screen quickly for acute risk. If danger exists, call emergency services first.
2. Introduce & get consent: “Hello, I’m [name]. I can sit with you for a few minutes if you like. Is that okay? I sometimes offer a short calming touch (Reiki) — would you like that?”
3. Listen — empathic, brief: Ask one open question: “What’s most worrying you right now?” Reflect and validate. Keep pacing slow; watch for dissociation or overwhelming affect.
4. Regulate — grounding & breath: Offer 3 grounding prompts (5-4-3-2-1 sensory), then 3–5 slow breaths (inhale 4 — exhale 6). Observe response.
5. Optional Reiki (only with explicit consent): If trained and the person agrees, offer low-intensity Reiki for 5–15 minutes. Use non-intrusive hand positions (hands slightly above shoulders/upper back or lightly on hands). Use neutral language and remind them they can stop anytime.
6. Link — practical help: Ask what practical assistance they need (call a family member, get water, transport, shelter, referral). Offer specific options and help make connections.
7. Close & document: Summarise, confirm immediate safety plan, provide contacts, and hand over to services or a clinician as needed. Document briefly per agency policy.

Consent & communication — sample phrases

• “May I sit with you for a few minutes? If anything I do feels uncomfortable, please tell me and we’ll stop.”
• “I use a gentle calming technique called Reiki sometimes. It involves light touch or hands held above the body. Would you like to try it? You can stop anytime.”
• “Would you prefer a breathing exercise or quiet company instead?”

Contraindications & red flags (do not use Reiki; escalate)

• Active suicidal or homicidal intent or plan — call emergency/crisis services immediately.
• Active psychosis or severe intoxication — seek psychiatric/medical oversight.
• Severe dissociation (blank stare, inability to orient) unless a clinician supervises the session.
• Open wounds, uncontrolled medical conditions where touch is contraindicated.

Safe practice checklist for helpers

• Be trained in PFA and have supervised Reiki training that covers boundaries and ethics.
• Always obtain explicit consent for any touch/energy practice and explain it’s complementary.
• Start with non-contact or light hand placement; avoid pressure, sensitive areas or wounds.
• Monitor for signs of increased distress or dissociation and stop immediately if observed.
• Document the encounter and coordinate handover to clinical services when needed.

Quick scripts & micro-interventions

Grounding (5-4-3-2-1):
"Name 5 things you see, 4 things you can touch, 3 things you hear, 2 things you smell, 1 thing you taste."

Breathing prompt:
"Let's try three slow breaths together. In… two… three… and out slowly. Notice your feet on the floor."

Reiki invite:
"If you'd like, I can place my hands gently above your shoulders for a few minutes while we breathe together. Say 'stop' at any time and I'll stop immediately."
        

Training, supervision & documentation

• Complete accredited PFA training (WHO / national versions) and a recognised Reiki program emphasising clinical boundaries.
• Practice under supervision; use role-plays and debriefs to build competence and reflexivity.
• Maintain reflective notes and follow organisational documentation standards for safety and continuity of care.

Evidence & limitations

PFA is recommended for early psychosocial support and is broadly accepted as feasible and acceptable. Evidence for Reiki shows subjective benefits (relaxation, reduced anxiety) in some studies, but high-quality clinical evidence for treating psychiatric disorders is limited. Use Reiki as an adjunct within clear safety protocols and continue to prioritise evidence-based referrals and treatments.

Resources & quick-reference