Health Psychology Research / HPR / Online First / DOI: 10.14440/hpr.0345
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RESEARCH ARTICLE

A Crisis Response Model for First Responders to Acute Stress Reactions Based on the Behavior–Affect–Sensation–Knowledge Framework

Thierry Morineau1* ,  Margot Taine2
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1 Psychology Laboratory: Cognition, Behavior, Communication, Southern Brittany University, Lorient 56100, France
2 Normandy Regional Medical and Psychological Emergency Unit, Public Institution of Mental Health, Caen-East Hub, Caen 14000, France
HPR, e81240050 https://doi.org/10.14440/hpr.0345
Submitted: 23 October 2025 | Revised: 10 December 2025 | Accepted: 12 December 2025 | Published: 13 February 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background

First responders, including emergency medical workers, firefighters, and police officers, are frequently confronted with victims experiencing acute stress reactions (ASRs). Although they are not mental health professionals, they are required to address these situations to ensure the well-being of victims, prevent escalation, and protect themselves from secondary trauma. Current crisis intervention models for non-mental health professionals rely on either generic guidelines or fixed interaction scripts when engaging with victims.

Objective

This study examines the potential of a rule-based model that links ASR symptoms to intervention techniques, grounded in the behavior–affect–sensation–knowledge (BASK) framework. We hypothesize that a BASK-based intervention model would be well-suited for non-professional healthcare providers.

Methods

After developing and operationalizing the model, an initial assessment was conducted to evaluate its accessibility to novices following a short training session. A sample of 43 students attended a lecture on acute stress, followed by a series of identification tasks. After a training phase, participants were asked to identify both behavioral ASR signs and intervention techniques.

Results

The results indicate high overall accuracy in identifying behavioral signs and intervention techniques. However, a lack of reliability was observed among items from the same BASK component.

Conclusion

A theoretical comparison between the BASK model and other approaches highlights the relevance of a rule-based model. However, the reliability of identifying the underlying BASK processes in victim behavior and intervention techniques still requires further development.

Keywords
Behavioral signs
Behavior–affect–sensation–knowledge framework
Crisis intervention
Dissociation
Psychological aid
Rescuer
Funding
This study is the preliminary phase of the IRIS research pro¬ject, which will be funded by the Fund for the Integration of Disabled People in the Public Service (Fonds pour l’Inser¬tion des Personnes Handicapées dans la Fonction Publique) starting in 2026 (Agreement n°UBS: OV: 2025_00825).
Conflict of interest
The authors declare that they have no conflict of interest.
References
  1. Alleaume B, Fouques D, Castillo MC, Goutaudier N. Direct and indirect traumatization in first responders: An exploratory qualitative study with firefighters and humanitarian workers. Eur J Trauma Dissoc. 2025;9(2):100521. doi: 10.1016/j. ejtd.2025.10052

 

  1. Cogan N, Craig A, Milligan L, et al. “I’ve got no PPE to protect my mind”: Understanding the needs and experiences of first respond­ers exposed to trauma in the workplace. Eur J Psychotraumatol. 2024;15(1):2395113. doi: 10.1080/20008066.2024.2395113

 

  1. ICD-11 for Mortality and Morbidity Statistics 2025-01. World Health Organization; 2025. Available from: https://icd.who.int/browse/2025-01/mms/en [Last accessed on 2025 Aug 17].

 

  1. Adler AB, Gutierrez IA. Acute stress reaction in combat: Emerging evidence and peer-based inter­ventions. Curr Psychiatry Rep. 2022;24(4):277-284. doi: 10.1007/s11920-022-01335-2

 

  1. Uhrecký B, Kučerová V, Paksi D. “You treat your stress by doing what you’re supposed to do”: A qualitative inquiry into emotion regulation of paramedics and paramedic students in critical inci­dents. BMC Emerg Med. 2025;25(1):1-12.

 

  1. Jannussis D, Mpompetsi G, Vassileios K. The role of the first responder. In: Emergency Medicine, Trauma and Disaster Management: From Prehospital to Hospital Care and Beyond. Cham: Springer International Publishing; 2021. p. 11-18. doi: 10.1007/978-3-030-34116-9_2

 

  1. Padmanabhanunni A, Pretorius TB. An explor­atory study of the mental health of first respond­ers: Depression, anxiety, and post-traumatic stress disorder. S Afr J Psychol. 2025;55(2):257-269. doi: 10.1177/00812463251317901

 

  1. Knobloch LK, Owens JL. Moral injury among first responders: Experience, effects, and advice in their own words. Psychol Serv. 2024;21(3):500-508. doi: 10.1037/ser0000838

 

  1. Baetzner AS, Wespi R, Hill Y, et al. Preparing medical first responders for crises: A system­atic literature review of disaster training pro­grams and their effectiveness. Scand J Trauma Resusc Emerg Med. 2022;30(1):76. doi: 10.1186/ s13049-022-01056-8

 

  1. Crane MF, Falon SL, Kho M, Moss A, Adler AB. Developing resilience in first responders: Strategies for enhancing psychoeducational service deliv­ery. Psychol Serv. 2022;19(S2):17-27. doi: 10.1037/ ser0000439

 

  1. Murphy LM, King EK. The lived experiences of first responders during emergency events involv­ing children: Child reactions, first responder roles, and additional needs. J Child Life. 2024;5(2). doi: 10.55591/001c.126258

 

  1. Sowers AF, Clapp JD, Freng SA, Stanton K. The folk psychiatry model: Developing a meas­ure of lay perceptions of PTSD. Psychol Assess. 2023;35(12):1120-1133. doi: 10.1037/pas0001274

 

  1. Murray CH, Contreras JL, Kelly CH, Padgett DK, Pollack HA. Behavioral crisis and first response: Qualitative interviews with Chicago stakehold­ers. Community Ment Health J. 2023;59(1):77-84. doi: 10.1007/s10597-022-00990-2

 

  1. Oliva JR, Morgan R, Compton MT. A practical overview of de-escalation skills in law enforce­ment: Helping individuals in crisis while reducing police liability and injury. J Police Crisis Negot. 2010; 10(1-2):15-29. doi: 10.1080/15332581003785421

 

  1. Raphael B. Crisis intervention: Theoretical and methodological considera­tions. Aust N Z J Psychiatry. 1971;5(3):183-190. doi: 10.3109/00048677109159643

 

  1. Arjmand HA, O’Donnell ML, Putica A, et al. Mental health treatment for first responders: An assessment of mental health provider needs. Psychol Serv. 2024;21(3):489-499. doi: 10.1037/ ser0000832

 

  1. Traumatic Events (Adult): Mental Health First Aid Guidelines. Revised 2019. Australia: Mental Health First Aid Australia; 2022.

 

  1. Facilitation Manual: Psychological First Aid During Ebola Virus Disease Outbreaks. World Health Organization; 2024. Available from: https://www. who.int/publications/i/item/9789240101234 [Last accessed on 2025 Aug 17].

 

  1. Hobfoll SE, Watson P, Bell CC, et al. Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry. 2007;70(4):283-315. doi: 10.1521/ psyc.2007.70.4.283

 

  1. Wang L, Norman I, Xiao T, Li Y, Leamy M. Psychological first aid training: A scoping review of its application, outcomes and implementation. Int J Environ Res Public Health. 2021;18(9):4594. doi: 10.3390/ijerph18094594

 

  1. Farchi M, Gidron Y. Effects of the six C’s psy­chological first aid model on acute stress responses in a simulated emergency situation. Prehosp Disaster Med. 2023;38(S1):S121-S122. doi: 10.1017/ S1049023X23003242

 

  1. Svetlitzky V, Farchi M, Ben Yehuda A, Adler AB. YaHaLOM: A rapid intervention for acute stress reactions in high-risk occupa­tions. Mil Behav Health. 2020;8(2):232-242. doi: 10.1080/21635781.2019.1664356

 

  1. Adler AB, Gutierrez IA, McCuaig Edge H, et al. Peer-based intervention for acute stress reaction: Adaptations by five militaries. BMJ Mil Health. 2024;170(6):425-429. doi: 10.1136/ military-2022-002344

 

  1. Farchi MU, Bathish L, Hayut N, Alexander S, Gidron Y. Effects of a psychological first aid (PFA) based on the SIX Cs model on acute stress responses in a simulated emergency. Psychol Trauma. 2024;17(4):897-903. doi: 10.1037/tra0001724

 

  1. Svingen E. PTSD and crime propensity: Stress systems, brain structures, and the nature of the relationship. Heliyon. 2023;9(7):e18381. doi: 10.1016/j.heliyon.2023.e18381

 

  1. Gidron Y, Farchi M, Arie E, Husien A, Berends K, Hubloue I. Effects of a memory struc­turing plus vagal breathing intervention on acute stress reactions: Three controlled trials. Ment Health Fam Med. 2018;13:699-707.

 

  1. Golan MR. Effects of the Memory Structuring Intervention With Vagal Breathing on PTSD Symptoms of ICU and ER Nurses. Master’s Thesis. University of Haifa; 2024.

 

  1. Mikaeloff Y, Perreaut-Pierre E. Accompagner les Soignants et les Aidants Avec Les Techniques d’Op­timisation du Potentiel [Supporting Caregivers and Healthcare Professionals with Potential Optimization Techniques]. Paris, France: InterEditions, Dunod Edition; 2025.

 

  1. Janet P. L’Automatisme Psychologique: Essai de Psychologie Expérimentale sur les Formes Inférieures de l’Activité Humaine [Psychological Automatism: An Essay in Experimental Psychology on the Lower Forms of Human Activity]. Paris, France: Alcan; 1889.

 

  1. Braun BG. The BASK model of dissociation: II. Treatment. Dissociation. 1988;1(2):16-23.

 

  1. Van Der Hart O, Nijenhuis ER, Steele K. Le Soi Hanté: Dissociation Structurelle et Traitement de la Traumatisation Chronique. Bruxelles: De Boeck Supérieur; 2024.

 

  1. Braun BG. The BASK model of dissociation. Dissociation. 1988;1(1):4-23.

 

  1. Van der Hart O, Dorahy MJ. History of the concept of dissociation. In: Gold SN, Dorahy MJ, O’Neil JA, editors. Dissociation and the Dissociative Disorders. 2nd ed., Vol. 1. London: Routledge; 2023. p. 13-38. doi: 10.4324/9781003057314-3

 

  1. Kluft RP. Toward the effective treatment of dissociative symptoms and dissociative dis­orders. Psychoanal Soc Work. 2023;30(1):3-31. doi: 10.1080/15228878.2022.2095876

 

  1. Solomon RM, Shapiro F. EMDR and the adap­tive information processing model-potential mech­anisms of change. J EMDR Pract Res. 2008;2(4): 315-325. doi: 10.1891/1933-3196.2.4.315

 

  1. Braude SE. The conceptual unity of dissociation: A philosophical argument. In: Gold SN, Dorahy MJ, O’Neil JA, editors. Dissociation and the Dissociative Disorders. 2nd ed., Vol. 1. London: Routledge; 2023. p. 13-38. doi: 10.4324/9781003057314-3

 

  1. Recommandations PSE. French Ministry of the Interior; 2023. Available from: https://mobile. interieur.gouv.fr/Le-ministere/securite-civile/ documentation-technique/secourisme-et-associ­ations/les-recommandations-et-les-referentiels [Last accessed on 2025 Jan 20].

 

  1. Morineau T, Taine M, Cainjo T. Towards a behavioural screening tool for primary psycho­logical triage. Int J Psychiatry Res. 2023;6(4):1-6. doi: 10.33425/2641-4317.1169

 

  1. Morineau T. Cognitive Aids to Support Health Professionals. United States: John Wiley & Sons; 2024.

 

  1. Vignaud P, Lavallé L, Brunelin J, Prieto N. Are psychological debriefing groups after a potential traumatic event suitable to prevent the symp­toms of PTSD? Psychiatry Res. 2022;311:114503. doi: 10.1016/j.psychres.2022.114503

 

  1. Schauer M, Elbert T. Dissociation following traumatic stress. Z Psychol. 2015;218(2):109-127. doi: 10.1027/0044-3409/a000018

 

  1. Caruso R, Antenora F, Riba M, et al. Aggressive behavior and psychiatric inpatients: A narrative review of the literature with a focus on the European experience. Curr Psychiatry Rep. 2021;23(4):29. doi: 10.1007/s11920-021-01233-z
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Health Psychology Research, Electronic ISSN: 2420-8124 Published by Health Psychology Research
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