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The 2004 guideline described the failure of psychological debriefing as an effective strategy for preventing the later development of PTSD. There is hope that a new preventive approach for disaster survivors, called "psychological first aid," will prove effective (50). The essential principles of psychological first aid, including fostering safety, calmness, self- and community efficacy, social connectedness, and optimism in the aftermath of disaster, are supported by considerable empirical evidence, comprehensively summarized in 2007 by Hobfoll et al. (51). However, questions remain regarding how a public health intervention such as psychological first aid should be delivered, including which format and which type of responder (clinician responder compared with emergency responder compared with community leader) would be optimal (52). Thus, at the present time, psychological first aid must be considered an evidence-informed rather than evidence-based intervention. Further research is needed.

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