Humanitarian psychological support as an organized field is relatively young. Pioneers in the field were involved primarily in providing psychological support to refugees and internally displaced persons in conflict and nonconflict situations. This article describes basic principles for the design of psychological support programs and interventions. The International Federation of Red Cross and Red Crescent Societies (IFRC) began a psychological support program in 1991. The IFRC chose psychological first aid as its model for implementation in developing countries. Psychological first aid fits all the principles for psychological support program design and is adapted to individual communities. The first generation of psychological support programs differed dramatically depending on the countries in which they were developed. A second generation of psychological support programs evolved in response to the earthquake/tsunami of December 26, 2004. The Inter-Agency Standing Committee international guidelines consolidated the advances of second-generation programs and provided a clear indication of the wide acceptance of the importance of psychological support. A glimpse is provided of the third generation of psychological support programs, and an admonition is made for a more empirical evaluation of the effectiveness of interventions.