Psychological First Aid Cascade Training  

ISSA Member: For Our Children Foundation and Step by Step Center for Education and Professional Development, Bulgaria & Romania

What happened?
Following the outbreak of the war in Ukraine, Romania and Bulgaria saw the arrival of large numbers of refugee families with young children. Many of these children had experienced distressing events, and their caregivers were under significant stress. Early childhood professionals, while committed to supporting them, often lacked training in trauma-sensitive approaches that could help children feel safe, understood, and supported. 

What was needed? How did they respond?
As the war in Ukraine continued, many young refugee children in Romania and Bulgaria were showing signs of stress, anxiety, and trauma. Early childhood professionals working with them often lacked the skills to recognise these signs or to respond in ways that could create a sense of safety and support. 

In Romania, the Step by Step Center for Education and Professional Development (CEPD) delivered Psychological First Aid (PFA) training to 450 preschool and primary school educators. The training equipped them to identify trauma signals, create safe and supportive learning environments, and manage their own stress while working with displaced children. 

In Bulgaria, the For Our Children Foundation organised PFA cascade training in the country’s five largest cities. They trained 103 master trainers, who in turn provided foundational PFA training for local professionals working directly with children and families. This approach allowed the skills and tools to be shared quickly across different regions, ensuring a wider reach within the existing ECD workforce. 

Key challenges:

• Many professionals had no prior training in identifying or responding to trauma in young children.
• Refugee families often faced language barriers and uncertainty about the future, making trust-building difficult. 

Solutions:

• PFA training gave professionals concrete strategies to respond calmly to distressed children, foster a sense of safety, and maintain a supportive environment.
• Master trainers successfully tailored training to local contexts, ensuring relevance and uptake across different regions. 
  
  The success of both initiatives relied on collaboration between ISSA, local member organisations, and partners working in early childhood and psychosocial support. In Romania, CEPD worked closely with educators, adapting PFA content to the needs of teachers in mixed cultural and linguistic settings. In Bulgaria, the For Our Children Foundation coordinated with municipal and local partners to host training sessions and recruit professionals from diverse services. 
  
  This collaboration helped ensure that the trainings reached professionals embedded in communities, strengthening the capacity of local systems to support children in crisis. 

What's in place? What's missing?
These trainings in Romania and Bulgaria show that targeted, rapid capacity building can significantly improve professionals’ ability to respond to the emotional needs of children affected by crisis. However, embedding PFA and trauma-informed training into pre-service and in-service training curricula at the national level is essential to make such support universally available.  

Being part of a regional network: Advantages of ISSA membership
Being part of ISSA enabled both CEPD in Romania and For Our Children in Bulgaria to quickly access tested methodologies, adapt them to local contexts, and cascade them across their networks. ISSA’s regional platform turned individual initiatives into a coordinated response, showing the power of collective action in strengthening resilience and child protection systems.

Recommendations

National policymakers:
Authorities should formally integrate Psychological First Aid (PFA) and community-based psychosocial support into emergency response frameworks. This means ensuring that mental health is considered a basic service alongside food and shelter, allocating funds for early interventions, and supporting national dissemination of therapeutic storytelling and similar culturally adapted tools.

Local/national actors
Local actors can scale Psychological First Aid training  to staff and volunteer, creating safe spaces for children and families, and adapting resources like therapeutic stories to their communities. Coordination with schools, social services, and NGOs will help ensure continuity and prevent psychosocial support from being fragmented or overlooked.

Private donors
Donors can sustain impact by investing in training, resource development, and translation of psychosocial materials. Flexible funding for community-based mental health programs allows quick adaptation to evolving needs, while supporting innovation such as storytelling or play therapy ensures interventions remain child-centered and accessible.

Professionals/practitioners
Teachers, caregivers, and psychologists can integrate simple PFA techniques into daily interactions, use therapeutic storytelling as a classroom or family resource, and create spaces of empathy for refugee and local children alike. Practitioners can also serve as multipliers by mentoring peers and embedding these approaches in everyday practice.

Explore further:
Psychological First Aid Training in Romania: Creating a Climate of Safety and Support
Bulgaria’s five largest cities receive psychosocial support training

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