"First responders, very much like the military, are trained to be the helpers. It's not easy to ask for help when you're supposed to be the helper," Beidel said. Some Pulse nightclub terror attack first responders say post-traumatic stress disorder triggers can show up in everyday settings, but the University of Central Florida's Dr. Deborah Beidel says they don't have to stop sufferers from living their lives.
Beidel and students in her psychology clinic are using a PTSD treatment program originally developed for military veterans and applying it for the first time to help first responders. Beidel said these professions experience the disorder "often more frequently ... because the possibility [of trauma] is there every day. UCF clinical psychology student Maddie Marks was an EMT in Connecticut when she heard the call for the Sandy Hook Elementary School mass shooting come over the radio.
"I know the two medics who went in and pronounced [the victims dead] and it turns out they aren't doing so well [mentally]," Marks said at a firefighter health conference in Orange County last month.
When she came to UCF, she jumped at the chance to apply the proven UCF RESTORES program — first created with a grant from the Department of Defense — to suffering first responders.
The program uses exposure therapy, which repeatedly puts PTSD sufferers in situations that make them anxious. When nothing bad happens, their fears of the triggers lessen, and the panic goes away over time. The technique is tried and true: to treat PTSD patients who may fear dogs after a bad bite, for instance, bring a dog into the room. But UCF's challenge is how to recreate the trauma military and first responders experience without sending patients into a war zone.
"The more cues, the better the therapy is going to work," Beidel said. "We want exposure therapy to be as close to what exactly what it sounded, looked, or smelled like."
To come close, UCF RESTORES developed a system using technology, donning patients with virtual reality headsets to mentally walk through a video of a traumatic event as triggering sounds and scents are played to re-create the experience. "The idea isn't to traumatize them again," Beidel said. "The idea is, later you don't have to battle those nightmares and those flashbacks and stay away from places because it makes you feel uncomfortable."
The program also offers counseling, mental-health education, anger management and sleep strategies for those with nightmares keeping them up at night. So far, they've treated about 260 military veterans and 40 first responders. Lt. Jeff Orrange with the Orlando Fire Department said firefighters and other first responders appreciate working with mental health-care providers who better understand the challenges of facing highly traumatic events.
"UCF has put in a lot of the work with veterans, so with their transition from veterans to firefighters there area a lot of similarities," Orrange said. "We see different things, but there's still that guarded, close-knit community. "I've heard of therapists crying at the end of a session with a firefighter," Orrange said. "Firefighters are stepping way out of their comfort zone just to get help. You only have one shot."
Beidel said it is too early to measure the success rate of firefighters participating in the program, but two studies of military personnel have proved successful. In the first study of 100 patients, just 2 percent relapsed; in the second, with 92 participants, one person — or 4 percent — relapsed. "PTSD is not a career-ending injury," Orrange said. "If you can go get help, you can have a long career and a long healthy life when it's done."
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