The SIX Cs model for Immediate Cognitive Psychological First Aid: From Helplessness to Active Efficient Coping

Acute stress reactions immediately after exposure to trauma or crisis have received growing attention in recent years and are gaining momentum in light of recent mass traumatic events worldwide including conflicts, terrorist attacks and natural disasters. Unlike routine life, traumatic or emergency situations are unexpected and unstructured events. Early helping responses in these situations is of utmost importance: immediate, focused and efficient interventions are beneficial for the reduction of acute stress reactions and a return to normal functioning as well as decreasing the risk for future onset of post-traumatic stress disorder symptoms. However, many early efforts were either found to be ineffective or are based on narrative expression and empathy alone. The aim of this paper is to present the SIX Cs model - a new psychological first aid approach - immediate cognitive-functional psychological first aid - for the global nonprofessional community as well as for first responders. The model addresses the need to standardize interventions during an Acute Stress Reaction and intends to help shift the person from helplessness & passiveness into active effective functioning, within minutes, in the immediate aftermath of a perceived traumatic event. The model is based on four theoretical and empirically tested concepts: (1) Hardiness, (2) Sense of Coherence, (3) Self-Efficacy, and (4) on the Neuro-psychology of the stress response, focusing on shifting people from a limbic system hyperactivity to a prefrontal cortex activation during stressful events. Preliminary results on the effectiveness of the SIX Cs model in terms of increasing resiliency, reducing anxiety and improving perceived self-efficacy are presented. To date, this approach has been recognized by the Israeli Ministry of Health as the Israeli national model for psychological first aid.