The National Fallen Firefighters Foundation is working with the Medical University of South Carolina staff to prepare Web programs to meet this need
By Chief Ronald J. Siarnicki

Following is the last in a series of seven articles that describe a new approach to mental and behavioral health in the fire service. Read the other six articles:


• Keep Your Head in the Game
• Get the Help You Need After a Traumatic Event
• Understanding Psychological First Aid for First Responders
• Check Out What’s on the Horizon for Employee Assistance Programs
• Working on Peer Support Programs
• Finding Reliable Web-Based Behavioral Wellness and Self-Help

There are many approaches currently used to prevent and treat posttraumatic stress disorder, depression and other clinical conditions often associated with occupational factors to which firefighters and emergency medical workers are routinely exposed. Some of the most widespread techniques have been demonstrated to be ineffective at best and even counterproductive for some of those who need help the most. The techniques with the best evidence for their effectiveness, on the other hand, are not in wide use among the mental health professionals most frequently charged with treatment of firefighters and their families.

Fire departments are typically served by dedicated clinicians who truly desire to provide firefighters and their families with the best care possible. Like most practitioners, the majority of those assisting fire department members and families may not have the time and resources needed to learn all they might wish to know about firefighters and their occupation, nor may they have had time or opportunity to learn the latest in evidence-based treatments shown to be effective with occupationally engendered conditions. Few can afford to take significant time away from their practices to acquire complex new skills, especially if firefighters make up only a portion of their client population.

Another critical objective identified in retooling behavioral health for firefighters is the creation of an effective, cost-efficient and easily accessible Web solution that clinicians could use to learn about firefighters and their families, develop skills in applying evidence-based interventions in their work with fire service clients, and have a ready means of access to raise questions with established experts, exchange experiences and information, and learn about emerging approaches showing promise for enhancing care to fire service populations. Building on successful programs of the National Crime Victims Research and Treatment Center (NCVRTC) at the Medical University of South Carolina, the National Fallen Firefighters Foundation (NFFF) has contracted with NCVTRC staff to begin the process of preparing programs to meet this need.

NCVRTC has piloted a successful program training clinicians working with victims of child sexual abuse to utilize a variant of trauma-focused cognitive behavior therapy (TF-CBT), an intervention model with strongly established efficacy in dealing with the consequences of trauma. It has also recently released a similar program to instruct clinicians in cognitive processing therapy (CPT), another evidence-based approach with well-documented efficacy designed to help clinicians address the needs of military personnel and veterans (see http://cpt.musc.edu). These platforms can be readily adapted for use by clinicians serving fire service personnel and can provide our clinicians an easily accessible way to acquire skills in leading evidence-supported interventions at little or no cost. This project, once online, will be accessible through the Everyone Goes Home website. You can learn more about the progress of this effort at www.everyonegoeshome.com.

Chief Ronald J. Siarnicki is the executive director of the National Fallen Firefighters Foundation.

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