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First Responders – Stress & Grief in the Aftermath of Crises

The holiday season always presents special challenges for first responders but this December has been particularly difficult: first, the devastating horror and grief of responding to the Sandy Hook Elementary School followed by the senseless gunning down of firefighters responding to a blaze in Webster, New York resulting in the deaths of two firefighters and another two being wounded. Firefighters are certainly no strangers to Line of Duty deaths, giving their lives to save others – but being led into a violent ambush is indeed an uncommon and tragic occurrence.

Colleagues, communities, and surviving family members struggle to cope with the aftermath of these sad and tragic events. We've compiled support resources specifically aimed at first responders and their families:

Supporting Survivors During Line-of-Duty Deaths / Injuries

Rescuing the Rescuer: Critical Incident Stress Management

Remember to save yourself: The importance of managing critical incident stress (PDF)

Debriefing the Trauma Team: Taking Care of Your Own

Critical Incident Stress Management

Dealing with Workplace Violence: A Guide for Agency Planners

Rescue Workers – Psychological Aftermath of Disaster Rescue and Response

Dealing with the Death of a Co-Worker

Recovering from the Death of a Co-Worker

Grief in the workplace: Tips for supervisors

Complicated Grief

Sandy Hook Elementary School: Trauma Response Resources - Help for Parents, Teachers & the Community

National Center for PTSD
-- Common Reactions After Trauma
-- Acts of Violence, Terrorism, or War: Triggers for Veterans
-- Mobile APP: PTSD Coach

Post Traumatic Stress Disorder

Two Years Later: The Prolonged Traumatic Impact of a Fire Disaster

When Serving Becomes Surviving: PTSD and Suicide in the Fire Service

Support Networks
National Fallen Firefighters Foundation
-- Resources for Newly Bereaved Families of Fallen Firefighters
-- Fire Service Survivors Network

IAFF Fallen Fire Fighter Family Support after Line-of-Duty Deaths Guidelines

First Responder Support Network (FRSN)

Green Cross – Academy of Traumatology

Survivors of Homicide

International Critical Incident Stress Foundation

The American Psychological Association offers the following tips for managing distress in the aftermath of a shooting.

You may be struggling to understand how a shooting could occur and why such a terrible thing would happen. There may never be satisfactory answers to these questions.

We do know, though, that it is typical for people to experience a variety of emotions following such a traumatic event. These feelings can include shock, sorrow, numbness, fear, anger, disillusionment, grief and others. You may find that you have trouble sleeping, concentrating, eating or remembering even simple tasks. This is common and should pass after a while. Over time, the caring support of family and friends can help to lessen the emotional impact and ultimately make the changes brought about by the tragedy more manageable. You may feel that the world is a more dangerous place today than you did yesterday. It will take some time to recover your sense of equilibrium.

Meanwhile, you may wonder how to go on living your daily life. You can strengthen your resilience — the ability to adapt well in the face of adversity — in the days and weeks ahead.

Talk about it. Ask for support from people who care about you and who will listen to your concerns. Receiving support and care can be comforting and reassuring. It often helps to speak with others who have shared your experience so you do not feel so different or alone.

Strive for balance. When a tragedy occurs, it’s easy to become overwhelmed and have a negative or pessimistic outlook. Balance that viewpoint by reminding yourself of people and events which are meaningful and comforting, even encouraging. Striving for balance empowers you and allows for a healthier perspective on yourself and the world around you.

Turn it off and take a break. You may want to keep informed, but try to limit the amount of news you take in whether it’s from the Internet, television, newspapers or magazines. While getting the news informs you, being overexposed to it can actually increase your stress. The images can be very powerful in reawakening your feeling of distress. Also, schedule some breaks to distract yourself from thinking about the incident and focus instead on something you enjoy. Try to do something that will lift your spirits.

Honor your feelings. Remember that it is common to have a range of emotions after a traumatic incident. You may experience intense stress similar to the effects of a physical injury. For example, you may feel exhausted, sore or off balance.

Take care of yourself. Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals, get plenty of rest and build physical activity into your day. Avoid alcohol and drugs because they can suppress your feelings rather than help you to manage and lessen your distress. In addition, alcohol and drugs may intensify your emotional or physical pain. Establish or re-establish routines such as eating meals at regular times and following an exercise program. If you are having trouble sleeping, try some relaxation techniques, such as deep breathing, meditation or yoga.

Help others or do something productive. Locate resources in your community on ways that you can help people who have been affected by this incident, or have other needs. Helping someone else often has the benefit of making you feel better, too.

If you have recently lost friends or family in this or other tragedies. Remember that grief is a long process. Give yourself time to experience your feelings and to recover. For some, this might involve staying at home; for others it may mean getting back to your daily routine. Dealing with the shock and trauma of such an event will take time. It is typical to expect many ups and downs, including "survivor guilt" — feeling bad that you escaped the tragedy while others did not.

For many people, using the tips and strategies mentioned above may be sufficient to get through the current crisis. At times, however an individual can get stuck or have difficulty managing intense reactions. A licensed mental health professional such as a psychologist can assist you in developing an appropriate strategy for moving forward. It is important to get professional help if you feel like you are unable to function or perform basic activities of daily living.

Recovering from such a tragic event may seem difficult to imagine. Persevere and trust in your ability to get through the challenging days ahead. Taking the steps in this guide can help you cope at this very difficult time.

This tip sheet was made possible with help from the following APA members: Dewey Cornell, PhD, Richard A. Heaps, PhD, Jana Martin, PhD, H. Katherine O’Neill, PhD, Karen Settle, PhD, Peter Sheras, PhD, Phyllis Koch-Sheras, PhD, and members of Division 17.

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