First Responders
What is a First Responder?
A person who is professionally trained to be among the first to arrive and provide assistance at the scene of an emergency, such as:
Law Enforcement Officer
Fire Fighter
Warden/Search & Rescue
EMT
Paramedic
Dispatcher
Why is therapy important for First Responders?
Stigma & Suppressed Emotions
First Responders are expected to stay strong & suppress emotions, which can lead to emotional numbing, isolation & difficultly coping.
Therapy can break down stigma, normalize expressing emotions and foster resilience.
Suicide Risk
Suicide risk for first responders is significantly high, exceeding that of the general public.
Police officers are 54% more likely to die by suicide than in the line of duty.
Firefighters/Paramedics have a suicide attempt rate over twice the general public.
Therapy creates a SAFE and CONFIDENTIAL place to talk openly about your thoughts of suicide. We can work on the underlying issues that may be making you feel this way (PTSD, anxiety, depression, moral injury)
Impact on Personal Relationships
Emotional disconnect/shut down at work can spill over into personal relationships resulting in:
Shutting out/disconnecting from friends, family, partner, children
Hypervigilence & Irritability - overly cautious, controlling (to create a sense of safety), mistrustful, easily startled
Intimacy Challenges - struggle with closeness, affection & sexual connection
Absent from home/family events - working overtime due to financial stress or because being at work feels more comfortable than being at home
High Risk for Moral Injury
Moral injury is a deep psychological wound that occurs when someone perpetrates, witnesses, or fails to prevent actions that violate their deeply held moral values or sense of what is "right”. It is especially prevalent with 1st responders, military and healthcare personnel.
Examples of Moral Injury:
Using force and later questioning whether it was justified
Being forced to choose who to rescue first, knowing others may die
How Therapy Helps:
Narrative therapy to make meaning of the experience
Trauma-informed therapy to address co-occurring PTSD or depression
Self-compassion work to reduce shame and guilt
Spiritual counseling for existential or faith-related pain
Chronic Exposure to Trauma
Can lead to:
Acute Stress
Compassion Fatigue
PTSD
Nightmares, flashbacks, avoidance, mistrust, irritable, angry, detached
PTSD Rates:
General Public 6%
Police 15%-20%
Paramedics/EMT 20%-25%
Firefighters 10%-20%
Substance Use
First responders may turn to alcohol or other substances as coping mechanisms. For instance, following Hurricane Katrina, police officers increased their alcohol consumption from an average of 2 to 7 drinks per day.
A study done during covid showed that:
40% of 1st Responders drank to relieve emotional distress
22% drank more than they meant to
21% reported not being able to cut down on substance use
7.2% reported neglecting responsibilities due to substance use
Barriers to Seeking Help:
First responders often hesitate to seek mental health support because of:
Stigma
Fear of appearing weak
Worries about cost
Fear of judgement from peers and therapist
Concerns about job security
Worries about opening pandora’s box of all the things stuffed down (compartmentalized) and then what?
Our Approach to Common Worries:
If I go to therapy people are going to think I’m not okay enough to help other people
You are human! We all need to process things and get support/guidance sometimes. It will make you even more equipped at helping other people and connecting with the people close to you.
What if the therapist gets all weird about me wearing my uniform/service weapon to sessions?
We welcome you to come as you are most comfortable
If I tell someone how I’m really feeling they’ll tell my job who will take my service weapon and put me on leave and then I’ll really have nothing
You are in charge of what you share with us. At your first session we will discuss how we navigate conversations around things like suicidal ideations and intrusive thoughts. You aren’t alone in having them. We will support you around navigating these types of feelings and thoughts.