Emotional First Aid -New Training Offering an Alternative to a Mental Health Perspective


With so many people using the familiar narrative that mental health is the same as physical health, it has appeared logical, and some consider it desirable, to treat first aid in emotional distress in the workplace in the same way. So, over the last few years more and more employers are training someone to take on the responsibility to respond to the ‘mental health needs’ of their colleagues.

When we started to look into supporting our staff, we found that this mental health first aid approach did not fit our values and way of seeing human distress. We also didn’t see how it was possible to train someone in two days to take on such a responsibility. For us, the emotional wellbeing of people was not the same as physical first aid. On further investigation we couldn’t find anything that represented us, we therefore set out to create something different and to offer it as a choice to other employers.

I had worked within services for people experiencing emotional distress for over 40 years, as a mental health nurse, Clinical Team Leader, and Service Manager within the NHS, spending 7 years in the voluntary sector and for the last 14 years with The Mavam Group within the independent sector. I have always been interested in exploring a range of perspectives, including the Hearing Voices movement, as well as other approaches that look at what people experience and what helps people, and the history of how societies and cultures view emotional distress. I was therefore happy to take on the challenge of designing the training.

Once I had created an outline, I shared it with a range of people. Some were professionals from different backgrounds, and we commissioned two experts by experience to give their views. Their input and guidance were invaluable to helping me to shape our training, which we call Emotional First Aid. Choosing this name to be clear that we want to talk about emotions, and we kept first aid in the name so that people would be aware that this was an option when considering first aid in the workplace.

In our version of Emotional First Aid, the first aid is for ourselves, it is designed for everyone to receive the training, and for everyone to be encouraged and supported to look after their emotional wellbeing.  We therefore encourage employers to create environments where people are trained and supported in looking after their emotional wellbeing; environments where those who already have responsibility towards their employees are supported in how they talk with and help those whom they lead or manage. Emotional First Aid, therefore, does not qualify an individual to take on a responsibility for the emotional needs of their colleagues.

Our Emotional First Aid training is designed to offer the freedom, the awareness, the knowledge, and the skills that people can utilise in order to look after themselves within their own unique emotional world. For it is our belief that where we create cultures and environments where people are supported and encouraged to self-care, we create emotionally intelligent spaces where people can feel safe and connected and are then in a better place to look after others.

At its core it reflects the perspective that there is a wide range of views and opinions about human emotions and experiences. However, there are no definitive answers. Therefore, the reality is that we are all free to explore what makes sense to us, what helps us and what doesn’t. This exploration could also include a mental health perspective.

The mental health perspective is, for us, one of many ways of seeing emotional distress in humans. It is one that many believe in and one that people report being helpful for them, and it is therefore likely to feature onpeople’s landscapes as a destination, or pathway, that is either very much part of their world or a potential avenue to explore. However, as it is only one of the many potential ways of understanding ourselves and others, we have chosen to use the term emotional, as opposed to mental. In this way, we aim to respect the full range of expertise and opinion within the world of human distress.

Professor Brian Cox said in a Tweet: “It’s not too hard, but let’s spell it out. Science is a satisfactory philosophy of ignorance. One starts in a position of not knowing and being comfortable and indeed delighted and excited in not knowing.” Emotional First Aid asks people to see themselves and others in this scientific way, and to engage in the excitement and delight of discovery. Imagine how things could change if everyone wassupported and encouraged to see themselves and others with the excitement and delight of discovery!

In the training, we ask people to reflect on the knowledge that there are around 8 billion people on earth. That our ancestors have been around for approximately 6 million years, with homo sapiens having been in existence for around 300,000 years. That those of us alive today share 99.6% of our DNA, and the humans of 300,000 years ago had the same DNA. This suggests that humans have been responding to feelings and experiences for a very long time, and that biologically it appears there is a lot more that unites us than divides us.

In fact, such is the complexity of our emotional world, we don’t believe that anyone can say with any certainty what is happening for people when they experience feelings. For, if you explore the biology of the human brain, the nervous system, the endocrine system, and all the many ways that our biology interacts within our bodies, it is clear that biological certainty is impossible.

There is then the interaction between our biology and our lives. Our bodies interact with the world around us every second of every day. How we make sense of our world emotionally will depend on every moment that has gone before, and every expectation that we have created for the future. With that being unique to every person. If you then consider that every human has feelings. What those feelings actually are, why they are present, how they are perceived and acted upon, will also vary according to each unique individual and every moment of their lives and how they perceive them. If you than layer on all the cultural, political, environmental, socio-economic and gender-based influences, you can see why adopting the scientific exploration of ignorance is the only sensible way to view human emotion, because definitive knowledge is too elusive. Instead, we can fill ourselves with the excitement and delight of discovery.

So, in our Emotional First Aid training, we ask people to start from the only place where we believe we have certainty. We all have bodies, we all have feelings and we all live lives, or:

Bodies + Feelings + Lives = Human.

With all three aspects of a person reacting and interacting every second of every day, influenced by our world and the sense we make of it, and affected by the climates within our world, the things that we have little or no control over. Therefore, while we are alike in so many ways, our complexity makes us unique. This means we are all free to wonder and make sense however we choose.

The Emotional First Aid that we have created, includes information from; the Power Threat Meaning Framework, Professor Joanna Moncrieff, Acceptance and Commitment Therapy (ACT), Transactional Theories, Professor Richard Bentall, Malcom Gladwell, Dr Gabor Mate, the World Health Organisation, Trauma Informed Approaches, The Polyvagal Institute, Harvard University, and Stanford University. It also uses exercises that help people to appreciate how many skills and resources they already possess, acknowledging that to be human means that we have so many qualities that we can draw upon to help ourselves and others. With all this information and awareness being provided, so that people are encouraged to explore and follow paths that make sense to them, while respecting everyone’s right to do the same.

When we describe Emotional First Aid, we start by asking people to imagine that they are looking at a map, in the dark, with a torch. With the torch close to the map only limited landmarks are visible; however, if we can lift it, new places and features come into view. If we can raise our torch high enough, we can see everything on the map; where we are, where we have been and where we could go. Sometimes, when we feel overwhelmed emotionally it can feel as if our torch has been pulled down very close to our map. Leaving us feeling trapped and limited in our options. Being able to have some tools, encouragement and awareness, at this time, to lift our torch can help us to explore the many options that exist for us.

We call the map our Life Landscape. We ask people to think about what theirs might look like, as everyone’s Life Landscape is unique to them. We ask them to think about what would be the features on it, the terrain, the places, or the landmarks? We ask them to also consider the climates that exist in their Landscapes. As justlike our own weather patterns, a Life Landscape will have climates. Some being benign, predictable, and helping to sustain. Whilst others may be violent, unpredictable, harsh and make living or surviving extremely difficult. Asking people to respect that in such harsh climates people do what they can to survive and that some of the attributes acquired in such environments require respect and recognition.

When it then comes to moving around our Life Landscape, we all require resources. We therefore ask people to consider what their resources are, as well as looking to provide them with more, to help them to navigate their world. We ask them to think of themselves as having a “Bag for Life,” which contains all of their resources; the skills, knowledge, and strategies they have developed, and those that all human beings naturally possess. In addition, we share knowledge from the experts and research that was mentioned earlier, so that they expand their range of options. Filling their Bag for Life so that moving around their Landscape can be more comfortable and successful. As opposed to telling people who they are, where they are and where they should go, we are not signposting but facilitating.

Just as in First Aid training where people are told to remember their ABC, Airway, Breathing and Circulation, in Emotional First Aid we ask people to remember the Three C’s of Compassion, Curiosity and Creativity. We encourage people to use the Three C’s as a compass while they travel their Life Landscape, for these three qualities have the power to keep our torches high. We explore how they do this and how all people can, and do, harness them in their lives.

We have designed Emotional First Aid so that the concept of Life Landscapes, Climates, our Bag for Life and The Three C’s, combined with a range of knowledge and evidence-based approaches, will help people to look after themselves and to aid themselves first. We hope it helps them to challenge systems and environments where the climates are emotionally unhealthy, or even toxic, and to explore what has happened, or is happening in their world, rather than going straight to an assumption that our struggles mean that there is something wrong with us. Armed with this knowledge, we can all be better placed to share this with others, with people encouraging and supporting one another. We can also collectively address the places and climates that are not conducive for humanity to thrive.

Our Emotional First Aid training was first created two years ago, we have piloted it with a range of people and employers and launched officially in March this year. With the feedback so far being very positive. With 100% of attendees saying that they would recommend it to others. Here are some of the things people have said;

  • I would describe it as a way to look after yourself to make you
    as strong as possible to then be able to help and support
    other people.
  • What you need to know!
  • I found the concept of EFA much more ‘natural’ than the concept of the MHFA
    training and much easier to see how the learning from it could be implemented as
    the concept allows you to tailor the delivery to your specific organisational needs.
  • Learning about self-care and how to use skills and techniques to look after yourself, which can then enable you to help others too.
  • An opportunity and permission to practice self-care as a way to help myself first,
    and others.

The Training is available across the United Kingdom, and we are beginning a collaboration with like-minded projects in India and the USA. For us, any training about the emotional worlds of human beings needs to have to potential to be understandable to anyone on the planet. It must therefore respect, honour and celebrate the many ways that people have made sense of what it is to be a human being and have emotions.

EFA Emotional First Aid – Why Choose our Training – Alternative Training to MHFA (emotional-firstaid.co.uk)



Johnstone, L. B. M., 2020. The Power Threat Meaning Framework. United Kingdom: British Psychological Society.

Moncrieff,  ., 2016. The Myth of the Chemical Cure: A Critique of Psychiatric Drug Treatment. United Kingdom: Palgrave Macmillan UK..

R.Bentall, 2009. Doctoring the Mind. United Kingdom: Penguin Books Limited.

Maté,  ., 2022. The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture.. United Kingdom: Ebury Publishing..

Karpman,  ., 2014. A Game Free Life: The Definitive Book on the Drama Triangle and the Compassion Triangle by the Originator and Author. United States: Drama Triangle Productions..

Gladwell,  ., 2013. David and Goliath: Underdogs, Misfits and the Art of Battling Giants.. United Kingdom: Penguin Books Limited..

Nations, W. H. O. &. U., 2023. Mental health, human rights and legislation: guidance and practice. Geneva: World Health Organization and the United Nations.

Institute, P., 2023. What is Polyvagal Theory. [Online]
Available at: https://www.polyvagalinstitute.org/whatispolyvagaltheory
[Accessed 29 November 2023].

R.Waldinger, M., 2023. The Good Life Lessons from the World’s Longest Scientific Study of Happiness. India: Simon & Schuster.

Stellar.J, K., 2017. Compassion in the automatic nervous system. In: Compassion: Concepts, Research and Applications. New York: Routledge, pp. 120-133.

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Matthew is the Director of Development at The Mavam Group. He has worked for last 37 years in roles related to helping people experiencing emotional distress, training as a Mental Health Nurse, working in the NHS, voluntary and independent sector. In his development role for the Mavam Group, he is currently working on developing Emotional First Aid training, an approach to helping people experiencing emotional distress that can be an alternative to Mental Health First Aid.