In times of crisis, first responders are always the first line of defense, rushing towards
danger. Firefighters, paramedics, and police officers face high-stress situations daily, often
making split-second decisions that mean the difference between life and death. While their
physical bravery is often acknowledged the toll that these situations can take on their mental and
emotional wellbeing is often less visible and is unseen.
Traumatic exposure for responders is an unavoidable aspect of their occupation. Incidents
such as medical emergencies, acts of violence, mass casualties, child abuse and neglect cases, are
traumatic events that often place first responders at risk of death or severe injury (Haugen et al.,
2012). Constant exposure to these types of situations can lead to a range of mental health issues,
including post-traumatic stress disorder (PTSD), anxiety, depression, and substance abuse.
PTSD is a common affliction among first responders. Witnessing or experiencing
traumatic events can leave lasting psychological scars, manifesting as flashbacks, nightmares,
and severe anxiety. These symptoms can disrupt daily life and hinder job performance, creating a
vicious cycle of stress and trauma. Exposure to incidents where the first responder is at risk for
death or severe injury, such as backdrafts for fire fighters, being attacked with a weapon for
police officers, or assisting on a fatal motor vehicle collision for paramedics, can be considered
traumatic events (Flannery, 2015). Research has found that responding to these incidents may
result in 5.9-22% of first responders developing PTSD (Flannery, 2015). It is important to note
that exposure can be directly experienced by the first responder, indirectly witnessed, or through
repeated exposure to the distressing details, also referred to as vicarious trauma.
Research has identified evidence-based interventions, such as Cognitive Processing
Therapy (CPT) and Cognitive Behavioral Therapy (CBT) as effective forms of therapy to treat
PTSD among first responders. Cognitive theory emphasizes the role of negative beliefs and
maladaptive schemas in the development and maintenance of PTSD (Dalgleish, 2004). First
responders may develop negative beliefs about themselves, others, or the world. For example, “I
am not a good paramedic” or "If I drove faster, they would not have died". These negative
thoughts can influence a first responders’ interpretations of the traumatic event causing them to
have maladaptive thinking and beliefs about themselves. Using cognitive base therapy to target
first responders’ maladaptive thoughts and beliefs can help them reach a balanced and realistic
view regarding their trauma. This technique also provides first responders with the ability to take
an active role in their recovery. Using cognitive theory to address PTSD among first responders
allows for a comprehensive, individualized, and empirically supported framework which has
practical application for therapy.
Research has also found that the most important protective factor for first responders in
preventing the development of PTSD is their support systems (Diaz-Tamayo et al., 2022;
Flannery, 2015; Yuan et al., 2011). Creating and maintaining meaningful relationships can have a
beneficial impact on a first responders overall wellbeing and help protect them when stressful
situations occur. For first responders it is not a matter of if a traumatic event will happen, it is a
matter of when. Traumatic exposure for responders is an unavoidable aspect of their occupation.
For first responders developing adaptive coping strategies and building strong support systems is
as important as their basic training.
Recognizing and addressing the mental health challenges first responders face is not just
a matter of compassion but a necessity. By providing the necessary resources and support, we
can ensure that these brave heroes, along with their families, receive the care they deserve.
Taking care of their mental health is essential not only for their well-being but also for the safety
and resilience of the communities they serve.
If you or someone you know is in need of support from one of our skilled therapists, call us
today at 289-205-3505 or visit us at https://www.psychotherapyforyou.ca/
References:
Dalgleish, T. (2004). Cognitive approaches to posttraumatic stress disorder: The evolution of
metarepresentational theorizing. Psycholigcal Bulletin, 130(2), p. 228-260. DOI:
10.1037/0033-2909.130.2.228
Dias-Tamayo, A. M., Escobar-Morantes, J. R., Garcia-Perdomo, H.A. (2022). Coping strategies
for exposure to trauma situations in first responders: A systematic review. Prehospital and
Disaster Medicine, 37(4). DOI:10.1017/S1049023X22001479
Flannery, R. (2015). Treating psychological trauma in first responders: A multi-modal paradigm.
Psychiatic Quarterly, 86(2), p. 261-267. DOI: 10.1007/s11126-014-9329-z
Haugen, P., Evces, M., & Weiss, D. (2012). Treating posttraumatic stress disorder in first
responders: A systematic review. Journal of Trauma & Dissociation, 10, 451-468. DOI:
10.1016/j.cpr.2012.04.001
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