Stress First Aid

SFA for Health Care Workers Manual

Stress First Aid (SFA) is a framework to improve recovery from stress reactions, both in oneself and in coworkers. The model aims to support and validate good friendship, mentorship, and leadership actions through core actions that help to identify and address early signs of stress reactions in an ongoing way (not just after “critical incidents”).

The goal of SFA is to identify stress reactions in self and others along a continuum and to help reduce the likelihood that stress outcomes develop into more severe or long-term problems. The core actions of SFA are appropriate for many occupational settings during critical events as well as for ongoing care. 

Visit the National Center for PTSD website for:

    • SFA Health Care Workers Manual
    • SFA Health Care Workers Workbook
    • Instructor training materials
    • Webinars
The Stress Continuum Model
The 7 Cs of the Stress First Aid Model

Author and Development Information

The Stress First Aid for Health Care Workers Manual and materials, developed by Patricia Watson of the National Center for PTSD and Richard Westphal of the University of Virginia, are adapted from the original Combat and Operational Stress First Aid (COSFA) Field Operations Manual, with input from SFA versions that were developed for Rescue and EMS, Wildland, Law Enforcement, and Pre-Trial and Probation settings.

The SFA for Health Care Workers Manual and materials may be copied and distributed without permission. It was produced using public funding and resides in the public domain, but the work of the authors is still protected. The authors request that any subsequent use of this material be given appropriate attribution and acknowledgment.


Watson, P., & Westphal, R.J. (2020). Stress First Aid for Health Care Workers. National Center for PTSD. Available on: