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Rescuing Firefighters from Post Traumatic Stress

by Marcus
Rescuing Firefighters from Post Traumatic Stress

The Fire Product Search team wanted to find out more about Rescuing Firefighters from Post Traumatic Stress and the specialist support offered to firefighters, who face very distressing incidents throughout their career. We spoke to Vanessa Davies, a Psychological Therapist who works closely with Devon & Somerset Fire & Rescue Service. Her role includes treating firefighters suffering from Post Traumatic Stress Disorder and coordinating post incident psychological support.

What are the some of the most psychologically challenging examples of incidents that firefighters deal with and why?

An incident that is psychologically challenging generally will be one that involves the firefighter feeling helpless in some way. Helplessness is one of the gatekeepers of PTSD and is a distressing psychological place to be as well as somatically distressing (i.e. the body sensation of feeling helpless is very uncomfortable). Firefighters, by the nature of their work, are there to help and feeling and thinking that they cannot help is extremely difficult. Helping does not have to mean saving the person’s life, it can also mean assisting body recovery with dignity. Part of treating helplessness is to help the firefighter gain another perspective on what it was they did to help.

Incidents that involve children will always be psychologically challenging as it also restricts the full range of coping mechanisms that firefighters usually employ i.e. banter. A lot of firefighters are parents and so the inevitable link made with the casualty is automatic, whereas with other casualties a psychological distance can be created more easily. In some cases the firefighter is reminded of their own child so much so that it is hard for them to separate out the fact that it isn’t their child, even though they ‘know’ that their child is safe at home. Behaviours/rituals following deaths of children in accidents also can present the firefighter with different sets of behaviours i.e. checking on their own children when they get home.


Image: Rescuing Firefighters from Post Traumatic Stress

How do colleagues of affected firefighters assist with their recovery?

Firefighters work in teams and one of the most important aspects of this is that there is continual support. We teach colleagues in our organisation what to watch for in terms of psychological distress as it is often those close colleagues, friends or family that spot the signs of any trauma before the person suffering from it.

What are some of the most memorable moments of your career whilst working with firefighters and how can you be affected by them?

Thinking back over the last 18 years I guess the incidents that come to mind are those that have involved multiple fatalities, particularly of young people – a car with 6 teenagers in sticks in my mind. As a therapist who also has children (now adults) hearing about children dying always affected me more. It is just the same for therapists – any links will make us more at risk of developing secondary PTS. It is very poignant and humbling to sit with a firefighter who has dealt with the worst of what happens in life and to help them process the array of feelings around it and somehow make some sense of it, and in some cases come away with some positive from it.

How much more successful is diagnosis of Post Traumatic Stress Disorder today compared to previous decades, and how did affected individuals cope without modern support?

PTSD is a relatively new diagnostic category – about 25 years in existence. I still meet people who have not been diagnosed correctly even though they may have seen other health professionals about their symptoms. This is not a criticism but more psycho-education is required, particularly for those involved in working with the rescue services and GP’s as they are usually the first health professional people make contact with. Not having the correct diagnosis means that people can waste a great deal of time being treated for say, depression or anxiety when it is PTS, which requires a particular form of treatment. I strongly believe it should be part of a firefighter induction process – these are the signs, PTS is treatable and if caught early enough very quick to treat as well.

People will come up with all sorts of ways to cope or reduce the amount of symptoms associated with PTS – it is natural response to trauma. I have met people who have been undiagnosed for decades and have coped by adapting their life around the symptoms, some in maladaptive ways i.e. a man who reduced his life down to the bare minimum of social contact and a rigid structure to his day that required little psychological effort (no job, sleeping, eating, dog walking and so on).


Image: Rescuing Firefighters from Post Traumatic Stress

How is treatment improving into the future?

Treatment is currently very effective for those involved in the fire service. The fire service is well versed in risk assessment and so understands the need for a structures to be in place to educate firefighters and minimise risks at incidents and provide follow-on psychological support. There will always be firefighters who develop PTS, however the support network being in place can help prevent it or get people into treatment quicker.

In terms of how it will improve we evaluate our procedures – (every incident will be defused then evaluated by those who took part) and we aim to take on board any criticisms that are made. We are also starting a research project with the local University to see if what we are doing is working and whether it has an effect on sickness absence and so on. Although anecdotally we know what we are doing is helping, we would like to quantify this in some way.

How important is it to have more therapists like yourself working closely with the fire service?

The fire brigade that I work with have therapists located all over the two counties who are skilled and experienced at dealing with firefighters’ issues. We know PTS is a risk and that it can be treated, so having a system in place that can then support the person and get them back to work ASAP makes organisational sense. On an individual level it is vital to have immediate access to this kind of support as there is the risk to the firefighter at another incident on their next shift. Whilst there are therapists in the NHS unfortunately the access to it would inevitably take longer, which overall is not helpful to the brigade or to the individual.

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