A CBT- informed therapeutic model of resilience for firstresponders and helping professionals: reactive-coping, appraisals, and the mediating role of hope

First-responders face continuous exposure to potentially-traumatic events often under stressful conditions. There is no universally recognised, model, framework or clear guidelines for resilience-building. The literature on stress is substantial, but knowledge of resilience and successful coping in emergency-professions, is underwhelming. What constitutes a ‘protective-factor’ and how these factors interrelate to protect individuals from mental-health difficulties, especially in high-risk settings, is not clear. The current study investigated the significance of hope as a predictor and mediator of resilience. The proposed model aimed to identify the CBT-informed, psychotherapeutic change-factors, most important as teachable skills, and the mediating effects of hope, as a factor which may also be fostered by therapists/institutions. The current study utilised a cross-sectional, cohort design. Convenience sampling was used to recruit 432 first-responders and helpingprofessionals, who voluntarily completed an online questionnaire. Mindfulnessbased-self-efficacy (MBSE), hope, nationality and time-in-service were significant predictors of resilience, accounting for 45% of the observed variance. Hope significantly mediated the relationships between self-compassion and resilience, meaning and resilience, and MBSE and resilience. The results supported the studies main predictions. The model suggests that emotion-oriented-coping behaviours, self-appraisals and appraisals of others/world influence an individual’s sense of hope (agency and pathway), and thus their general world-view appraisals, leading to improved capacity for dealing with negative-events (resilience). Developing generalizable positive-reappraisal and reactive-coping skills in unison, may be the most effective approach to resilience-building and trauma treatment. Paramedics and ambulance-personnel may be at increased risk of poorer outcomes than other emergency-workers. The current findings support the need for and propose recommendations for adequate training, psychotherapeutic education/intervention and more accessible support for Irish first-responders across their career.