Info for Clinicians

Introduction

The purpose of this is to provide relevant clinical information about the First Responder Support Network (FRSN) and our programs the West Coast Post-trauma Retreat (WCPR) and Significant Others and Spouses (SOS) retreat, to assist clinicians in making appropriate decisions regarding referrals to FRSN retreats.

An Overview of our Program

WCPR is a residential program that combines clinical work, education and peer support into a six-day residential treatment model for first responders. Six people attend each program.

SOS is also a six-day program for spouses and significant others who have been impacted by their first responder partner’s emergency service work or may have their own trauma.

Our Goal

Our goal with WCPR clients is to return the individual to their previous level of functioning. We believe the pre-morbid functioning for first responder personnel who attend WCPR was at an appropriate level before their involvement in a critical incident. Our experience has demonstrated that in the aftermath of a critical incident the worldview of the first responder personnel is often challenged with negative consequences. These can include biased or inaccurate media coverage, the necessary administrative/legal investigation process, temporary suspension from full-duty status, stressful personal relations, second guessing their own actions during the critical incident and the undermining of confidence and beliefs about oneself. If left unchallenged, these altered worldviews can disrupt the lives of otherwise psychologically healthy individuals.

Our goal with SOS clients is to restore them to a previous level of functioning and provide them with tools to move forward with their lives. To teach them coping strategies for self-care, resilience, and reduced suffering. To move them from focusing on fixing their first responder to fixing their selves and showing them that they also matter and they count.

Our Treatment Model

WCPR and SOS utilize a psychosocial model designed to restore the equilibrium in a person's life by challenging faulty cognitive beliefs through education, peer support and clinical work. To accomplish this we utilize an in-depth intake process, individual and group therapy, peer counseling and support, critical incident debriefing protocols, Eye Movement Desensitization and Reprocessing (EMDR), and family of origin work. The psycho-educational portions of our program include classes on alcohol and substance abuse.

The educational segments for WCPR include the physiological effects of stress during and after a critical incident, First Responder personalities, the effect of stress on families, the First Responder Exhaustion Syndrome and goal planning and setting.

The education segments for SOS differ and are more appropriate for that population. These segments would include co-dependency, forgiveness, addiction, compassion fatigue, what is PTSD?, and others as appropriate. Also, goal planning and setting.

Our Staff

FRSN is fortunate to have psychologists/clinicians on staff that are current or retired career law enforcement officers. This provides an elevated level of cultural competence, which is called upon throughout the participant’s stay at the WCPR or SOS retreat.

We also have a large cadre of trained peer support members for both WCPR and SOS. As well as chaplains trained in critical incident debriefing and most if not all work at a first responder agency.

Why It Works

For WCPR: Our experience with the first responder population has shown that although they may engage in treatment, as a group they are prone to taking a “flight into health.” The six-day residential model ensures that such diversionary defenses are minimized and residents remain focused on their core issue(s). Also, the elevated level of cultural competence of the peers and clinicians results in the participant perceiving and evaluating the situation more realistically. The resulting therapeutic alliance(s) is strong and develops quickly. Towards the end of the week, this alliance is easily shared with outside clinicians that come to assist in EMDR or one on one therapy. The staff works with the clients to develop a written 90-day plan of action as part of their relapse prevention program.

For SOS: Our experience with this population has shown that the peer support format builds connections with others having similar experiences. Trauma focused clinicians, chaplains and peers help the SOS client navigate their own traumas as well as giving insights to their first responders traumas. They learn that they are not alone and what they are or have gone through is not unique to their situation, others have been where they are. Towards the end of the week, the alliances that had been built during the week are easily shared with outside clinicians that come to assist in EMDR or one on one therapy. The staff works with the clients to develop a written 90-day plan of action as part of their relapse prevention program.

The WCPR and SOS Participant

The WCPR participant has often received treatment in their community but has not responded favorably or sufficiently. Most of our participants have difficulties functioning at work and/or at home as a result of their involvement in one or a number of critical incidents. Participants are often diagnosed with depression, anxiety, adjustment, eating, sleeping and/or substance-related disorders. About 75% of our participants are diagnosed with Post Traumatic Stress Disorder.

The SOS participant is married or a partner to a first responder and seeks help either coping with vicarious trauma or other trauma issues. They are also experiencing depression, anxiety, isolation, suicidal thoughts, sleep problems, relationship stress, work difficulties, the loss of a spouse or partner, domestic abuse or violence, or addiction issues, and are having trouble coping with daily activities

Peer Support Format

The peer support format is key to challenging the participant's belief that their experience is unique. The peer support format allows the participant to realize that they are part of an association of people who have experienced and survived similar incidents. Throughout the program the participant listens to a variety of stories concerning each participant’s critical event and observes and learns from the reactions of others. Having first responders on staff that have experienced and recovered from critical incidents provides hope and recovery modeling to participants.

Why We’re Different

We recognize that there is conflicting literature on the efficacy of “revisiting the incident” for the trauma survivor. First Responders have been highly screened, extensively trained and tend to be more emotionally robust than the general public. Our experience with this population indicates that there is a need to revisit and “master” the situation for most first responders. Mastery can occur through education, cathartic reaction and/or peer support. Mastery occurs when the participant gains greater understanding about and begins to exercise some control over the effects of the critical incident. This allows the participant to reclaim parts of their lives that were taken by the event.

For the SOS participant we recognize that this program is one of it kind nationwide. The trauma focused clinicians, chaplains and peers that help the SOS client navigate their own traumas as well as giving insights to their first responders traumas, makes this program different, unique and successful.

The Next Step

The WCPR / SOS programs are not a "stand alone" program. We encourage participants to engage with mental health professionals in their community. We make ourselves available for follow-up consults. Our peer and clinical staff follow each participant's progress, by phone or email, for ninety days after the program's completion; if helpful, even longer.

Questions?

Our Clinical Director is Joel Fay, Psy.D ABPP and he can be reached at (415) 720-6653, or by email: joel.fay@gmail.com

Clinician Listing

FRSN offers a listing of clinicians who work with First Responders and their Significant Others or Spouses. Contact us if you'd like to be included on the list. 

For more information and articles about treating First Responders, visit our Resources area.