Arrival to the emergency room (ER) can increase stress levels in patients and family members. Thus, there is a need for a short and effective form of PFA provided by ER staff members, to reduce acute stress responses (ASR). Past studies have shown that psychological interventions based on emotional expression do not help to regulate extreme emotional expressions nor does it prevent post-traumatic stress disorder (PTSD). Alternatively, the Six C's model adopts a neuropsychological approach that focuses on cognitive communication, challenging for efficient activation, organizing the event's chronological order and reduction in loneliness by committing to stay with them. This experimental design study examined the effectiveness of the Six C's model on reducing signs of ASR.

Sixty-three participants (mean age 41.8 years) voluntarily took part. They were randomly assigned to the Six C's intervention (experimental condition) or to supportive emotional expression (control condition). They listened to a three minute audio recording of a real emergency 911 phone call. Interventions (SIX C's or emotional) were provided before and after listening to the recording. Before, immediately after, and five minutes after the recording, participants' anxiety, heart-rate variability (HRV) and mental resilience levels were measured.

For all three outcomes, the Time x Group interactions were statistically significant. Following "simple effects", analysis revealed that The Six Cs participants showed lower anxiety and less reductions in HRV and resilience than controls immediately after the stressor. Furthermore, the Six C's participants recovered faster on all three outcomes compared to controls, five minutes after the stressor.

This study showed the Six C's model moderates people's ASR. Furthermore, the Six C's method helps people to "bounce back" faster psychologically and neuro-physiologically. These findings support using the Six C's model to reduce ASR and increase resilience, which is highly relevant to ER staff.