EMS Mental Health and Resiliency Training
June 25-30, 2022

As we enter 2022, the field of emergency medicine still grapples with the layers of stress caused by the Coronavirus, increased thoughts of suicide, and clinical levels of post-traumatic stress disorder (PTSD) that are 3 times higher than the public.  EMT’s are working long hours and as a result are prone to the ill effects of burnout and compassion fatigue.  These chronic stressors increase the risk of developing PTSD, not to mention the hidden danger of contracting the virus and bringing it home to family.  To make matters more challenging, the staple of crisis intervention, the cognitive-based Critical Incident Stress Management Model has been shown to be ineffective at reducing stress and preventing posttraumatic stress disorder. According to the World Health Organization, the poor outcomes associated with the CISD can interfere with normative trauma processing and post traumatic growth. These findings make a compelling case for rethinking how the field of EMS is supported in the wake of the coronavirus and in the aftermath of a traumatic event.  Research is clear, if we fail to desensitize the most recent traumatic event, we become more sensitive to future traumatic events (E. Shapiro, 2013).  This approach supports the use of EMDR both as a frontline intervention and a comprehensive trauma treatment for all frontline workers.

For these reasons, we are offering “Traumatic Stress Relief Training” (TSR) as the foundation of  the peer training. TSR was developed as the delivery system for the highly effective and evidenced-based stabilization and grounding skills of the widely known trauma treatment EMDR (Eye-Movement Desensitization and Reprocessing). These easily taught skills are called EMDR Early intervention (EI) techniques.  These techniques are used in the preparation of the EMDR trauma treatment and in the containment of traumatic memories after a treatment session. The EMDR-EI skills are specifically designed to address the acute nature of critical incident stress and other stress-provoking situations by calming the nervous system through the same physiological principles rooted in mindfulness, breath work, and concentration practices.

TSR and EI are forms of psychological first and second aid designed to be used shortly after a traumatic event for individuals or as a large group intervention.  Peers will be trained as “paraprofessionals” in using TSR and EMDR-Early Interventions.  EMDR-EI is emerging as the new paradigm in responder wellness and can be used in conjunction with the CISM model if needed.  The TSR training gives agencies the ability to train EMT’s in a skill-based, experiential learning format which can be delivered immediately after a critical event or months later.  The flexibility and adaptability of the TSR interventions make these skills a practical and effective standalone mechanism offering many possibilities for the emergency medical profession. 

EMDR-EI utilizes a two-pronged approach.  First, the skills are to be used as an immediate intervention after a stressful event to address and ideally prevent the onset of PTSD. This is critical for peer support, because peers can respond in real time to decrease the ill effects of intense or traumatic stress and provide immediate relief and resources.  Research also supports this early intervention, citing that even in the absence of clinically significant symptoms, the risk of developing PTSD remains with time (McFarlane, 2008). Since the repeated exposure to trauma sensitizes us to future exposures and increases the likelihood of increased distress and decreased mental health, the need for effective interventions like EMDR-EI is clear. Clinical evidence has also proven that best practice is to intervene early (E. Shapiro, 2018). Second, TSR and EI offer a large group intervention, called the group traumatic episode protocol (G-TEP) that has been proven to be safe, effective, and functions as a screening and assessment tool making sure that all participants receive the level of care needed.  TSR-EI and G-TEP provide safe, effective, and evidence-based techniques that can help reduce traumatic stress and increase posttraumatic growth.