First Responder Resilience

First Responder

EMS, police, and firefighters, are often the first people to deal with incidents that pose significant threats to health and life. These work-related exposures and stressors result in an increased risk for mental health conditions, in particular, the presence of posttraumatic stress. The incidence of PTSD among first responders is considerably higher than in the general population. And, there is an elevated risk for suicide among first responders. There are, however, protective factors that can be learned and practiced.

By practicing to be resilient, we take greater control of our challenges and we can make our families more resilient, too. Resilience encourages using positive-coping skills to manage stress in an optimal way. These positive-coping skills are considered protective factors because our intent is to take a personal challenge and create a more positive and less stressful outcome. Protective factors include recommendations of the World Health Organization for suicide prevention. Our objectives, therefore, are to develop social support systems, positive-coping skills for resilience, self-esteem, self-efficacy (believing you are capable of reaching a goal), and problem solving skills. An entirely educational approach is used for learning resilience using the theme of the "Hero's Journey." Common to many epic stories is the hero who, facing a challenge, goes on an adventure, is victorious, and returns as a transformed person. The Hero's Journey encourages us to recognize the importance of teamwork through a social support system. Like many sports, as we learn the game, we are also learning how to work as a team.

Basic Resilience Exercises

The Basic Resilience Exercises can be used for training at an agency level and have been used in academy, POST, and on-going service training. The learning is group focused though, minimally, two people can do the training together, such as two first responders or a first responder and family member. Solitary learning is not encouraged simply because social support is key to resilience.

This learning uses Problem Based Learning (PBL) by applying positive-coping skills to create less stressful outcomes to our real life challenges. We title these skills Belief, Persistence, Strength, Trust, and Adaptability for our learning. Each positive-coping skill has three exercises, "Tell your story" to build on your prior successes, "Collaborate" to build problem solving skills while working on a real challenge with a companion, and "Transformation" to reflect or think about how you have changed after working with the exercises.

The Basic Resilience Exercises can be completed orally. Alternatively, writing responses can often help to better organize thinking. If you have limited time, then consider completing the Belief and Trust skills. Then, go to the Strength Skill and practice a relaxation exercise, such as diaphragmatic breathing. Though each skill is unique, the learning exercises for each skill are nearly the same. This repeating of exercises is intended to build confidence. This, in turn, strengthens the idea we can be resilient and work comfortably with others as we deal with real life challenges. Basic Resilience Exercises PDF »

Resilience Supplements

Resilience App

Hero's Journey Logo A simple web-based application that parallels the five skills resilience, and further allows you to create your own resilience skills. The app permits exploration of a personal challenge using any of the skills. All data are stored locally on your computer or device. More »

Download Resilience Application.

Resilience App zip »

Resilience Vlog

Mike Grill, a career first responder and educator, provides an occasional Vlog focusing on resilience and the first responder. More »

How Do We Protect Ourselves: Mental Armor as PPE

On behalf of our dedicated team effort, Phil Callahan was honored to receive a Journal of Emergency Medical Services EMS10 innovation award for developing and introducing a resiliency-based behavioral health program to deal with PTSD and suicide. While this associated presentation is oriented to the first responder community, it also provides background on a completely educational approach to learn to be resilient, as an individual, family, and organization. (21 minutes) Video »

Case Study

An evidence-based resilience program for improving and sustaining first responder behavioral health. First Responder Behavioral Health, Journal of Emergency Medical Services (JEMS) »

Preventing suicide: A global imperative

World Health Organization report provides a global knowledge base on suicide and suicide attempts, and actionable steps for countries based on their current resources and context to move forward in suicide prevention. Link »

Those Providing Support

The following is a list of individuals and institutions who have graciously identified as providing support and resources to those in need. More »

Legacy Instruction (2023)

The following instructional material, though still useful, has since been rewritten. The content and theme remains much the same, but the newer instruction better meets the needs of a broader age and reading range. The older instruction will, however, be supported for many of you who have integrated it into your agencies programs.

The following two methods for learning resilience are oriented to your time constraints. The learning need not occur all at one time, but can be broken into smaller segments, for example, working on just one skill for about 30-45 minutes. Should you prefer printable resources, the following learning is also provided in the Resilience Exercises. Each exercise is organized into two double-sided pages allowing for easy use in group settings. Resilience Exercises PDF »

Comprehensive--All Skills

1. Pretest

A general resilience test before you begin the learning and again sometime after you complete the learning can measure personal change. The Response to Stressful Experiences Scale is for adults and available through GSA. RSES PDF »

2. Background

Brief two minute overview, for adults, of why we need to be resilient and how we can become resilient.

Resilience: Why and How, Part 1 of 3. Video »

3. Learning

This Comprehensive option has you work with all five positive-coping skills. Watch each video for an overview and then use the skill flashcards to work the exercises. (3 to 4 hours).

Resilience: Why and How, Part 2 of 3. Brief video on learning the Belief skill and developing a social support system. (4 minutes) Video »

Belief flashcard. Skill exercises. More »

Persistence flashcard. Skill exercises. More »

Strength flashcard. Skill exercises. More »

Resilience: Why and How, Part 3 of 3. Brief video on learning the Trust skill with mention of the Persistence, Strength, and Adaptability skills. (4 minutes) Video »

Trust flashcard. Skill exercises. More »

Adaptability flashcard. Skill exercises. More »

Resilience Workbook. The first section of the workbook provides for a much more in depth look at all skills and exercises. Workbook PDF »

3. Posttest

The same general resilience test is used sometime after learning to measure personal change. What has the testing shown you about your resilience?

Supplement

The Resilience App can add to your learning experience following the training.

Fast-track--Two Skills