Skip to main content

Treating Psychological Trauma in First Responders: A Multi-Modal Paradigm

Abstract

Responding to critical incidents may result in 5.9–22 % of first responders developing psychological trauma and posttraumatic stress disorder. These impacts may be physical, mental, and/or behavioral. This population remains at risk, given the daily occurrence of critical incidents. Current treatments, primarily focused on combat and rape victims, have included single and double interventions, which have proven helpful to some but not all victims and one standard of care has remained elusive. However, even though the need is established, research on the treatment interventions of first responders has been limited. Given the multiplicity of impacts from psychological trauma and the inadequacies of responder treatment intervention research thus far, this paper proposes a paradigmatic shift from single/double treatment interventions to a multi-modal approach to first responder victim needs. A conceptual framework based on psychological trauma is presented and possible multi-modal interventions selected from the limited, extant first responder research are utilized to illustrate how the approach would work and to encourage clinical and experimental research into first responder treatment needs.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Conner KR, Bossarte RM, He H, et al.: Posttraumatic stress disorder and suicide in 5.9 million individuals receiving care in the veteran health adminstration health system. Journal of affective Disorders 166:1–5, 2014.

  2. 2.

    Ramsay S: Breaking the silence surrounding rape. Lancet 11:354, 1999.

    Google Scholar 

  3. 3.

    Foa EB, Rothbaum BO: Treating the truama of rape: Cognitive-behavioral therapy for PTSD. New York, Guilford Press, 1998.

    Google Scholar 

  4. 4.

    Shapiro F: Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Preocedures. New York, Guilford Press, 1999.

    Google Scholar 

  5. 5.

    Foa EB, Keane TM, Friedman MJ (Eds.): Effective treatments for PTSD: Practice Guidelines from the International Society for Truamaitc Stress Studies. New York, Guilford Press, 2000.

    Google Scholar 

  6. 6.

    Gibbs MS, Drummond J, Lackenmeyer JR: Effects of disasters on emergency workers: A review with implications for training and postdiaster interventions. In Allen R (Ed.): Handbook of post-disaster interventions [Special Issue]. Journal of Social Behavior and Personality 8:189–212, 1993.

  7. 7.

    Duckworth DH: Psychological problems arising from disaster work. Stress Medicine 2:315–323, 1986.

    Article  Google Scholar 

  8. 8.

    Neria Y, DiGrande L, Adams BG: Posttraumataic stress disorder following the September 11, 2001, terroist attacks: A review of the literature among highly exposed populations. American Psychologist 66:429–446, 2011.

    PubMed Central  PubMed  Article  Google Scholar 

  9. 9.

    Gersons BPR, Carlier IVE, Van der Kolk BA: Randomized clinical trial of brief electic psychotherapy for police officers with posttraumatic stress disorder. Journal of Traumatic Stress 13:333–347, 1986.

    Article  Google Scholar 

  10. 10.

    Haughten PT, Splain AK, Weiss DS, et al.: Integrative approach for the treatment of postraumatic stress disorder in 9/11 first responders: Three core techniques. Psychotherapy 50:336–340, 2013.

    Article  Google Scholar 

  11. 11.

    American Psychiatric Association: Diagnostic Criteria from DSM-IV. Washington, American Psychiatric Association, 1994.

    Google Scholar 

  12. 12.

    Flannery RB Jr: Posttraumatic Stress Disorder: The Victim’s guide to healing and recovery. New York, American Mental Health Foundation, 2012.

    Google Scholar 

  13. 13.

    Kleim B, Westphal M: Mental health in first responders: A review and recommendations for prevention and intervention. Traumatology 17:17–24, 2011.

    Article  Google Scholar 

  14. 14.

    Waters JA: Police stress: History, contributing factors, symptoms, and interventions. Policing 30:169–188, 2007.

    Article  Google Scholar 

  15. 15.

    Dowdall-Thomae C, Gilkey J, Larson W, et al: Elite firefighter/first responder mind sets and outcome efficacy. International Journal of Emergncy Mental Health 14:269–281, 2012.

    Google Scholar 

  16. 16.

    Chae MH, Boyle DJ: Police suicide: Prevalence, risk, and protective factors. Policing 36:91–118, 2013.

    Article  Google Scholar 

  17. 17.

    Varvel SJ, He Y, Shannon JK et al.: Multidimensional, threshold effects of social support in firefighters: Is more support invariable better? Journal of Counseling Psychology 54:458–465.

  18. 18.

    Backteman-Erlanson S, Jacobsson A, Oster I, et al.: Caring for traffic accident victims: The stories of nine male police officers. International Emergency Nursing 19:90–95, 2011.

    PubMed  Article  Google Scholar 

  19. 19.

    Simeon D, Greenberg J, Nelson D, et al.: Dissociation and posttraumatic stress 1 year after the World Trade Center disaster: Follow-up of a longitudianal survey. Clinical Psychiatry 66:231–237, 2005.

    Article  Google Scholar 

  20. 20.

    Haughten PT, Evces M, Weiss DS: Treating postraumatic stress disorder in first responders: A systemtic review. Clinical Psychology Review 32:370–380, 2012.

    Article  Google Scholar 

  21. 21.

    Watson PJ, Fruedman MJ, Ruzek JI, et al.: Managing acute stress response to major trauma. Current Psychiatry Reports 4:246–263, 2002.

    Article  Google Scholar 

  22. 22.

    Wealin JM, Ruzek JI, Southwick S: Cognitive-behavioral therory and preparation for professionals at risk for trauma exposure. Trauma, Violence and Abuse 9: 100-113, 2008.

    Article  Google Scholar 

  23. 23.

    Chopka BA: Posttraumatic destress and growth: An empirical studay of police officers. American Journal of Psychotherapy 64:55–72, 2010.

    Google Scholar 

  24. 24.

    Benedek DM, Fullerton C, Ursano RJ: First responders: Mental health consequences of natural and human-made disasters for public health and public safety worker. Annual Review of Public Health 28:55–68, 2007.

    PubMed  Article  Google Scholar 

  25. 25.

    Chopko BA, Schwartz RC: The relationship between mindfulness and posttraumatic stress symptoms among police officers. Journal of Loss and Trauma 18:1–9, 2013.

    Article  Google Scholar 

  26. 26.

    Ruggero CJ, KotovR, Callahan JL, et al.: PTSD symptom dimensions and their relationship to functioning in World Trade Center responders. Psychiatry Research 210:1049–1055, 2013.

    PubMed  Article  Google Scholar 

  27. 27.

    Diene E, Geoffroy-Perez B, Cohidon C, et al: Psychotropic drug use in a cohort of workers 4 years after an indusrtial diaster in France. Journal of Traumatic Stress 27:430–437, 2014.

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Raymond B. Flannery Jr..

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Flannery, R.B. Treating Psychological Trauma in First Responders: A Multi-Modal Paradigm. Psychiatr Q 86, 261–267 (2015). https://doi.org/10.1007/s11126-014-9329-z

Download citation

Keywords

  • First responders
  • Multi-modal approach
  • Paradigm shift
  • Psychological trauma
  • Treatment interventions