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Overcoming Post-Traumatic Stress Using Cognitive Behavioral Therapy

By Dr. Michael Genovese

Due to the nature of the first responder’s role, which often requires intervening in moments of crisis, there are many times these professionals experience extreme scenarios. Since the magnitude of these moments is outside the scope of normal human experience, it is common for one’s brain to have a reaction, or even become injured.

[Related: Taking the First Steps to Healing from PTSI]

When the injury of post-traumatic stress (PTS) happens, one may experience a variety of symptoms such as nightmares, intrusive thoughts of reliving the situation, and emotional distress.

It’s important for first responders to know that talking about and admitting to PTS is not the end of their career. With the right therapy, responders can learn to manage their symptoms and treat the injury to their brain and central nervous system. There is life after PTS and through the right treatment, responders can continue fighting on the front lines for those in need.

[Free Download: Understanding and Managing Law Officer Stress]

Treating Trauma with Cognitive Behavioral Therapy

There is an array of therapeutic interventions and treatment modalities that can be beneficial in helping individuals overcome the effects of trauma. One of the most commonly used and effective modalities is cognitive behavioral therapy, which is also known as CBT.

[Related: What First Responders Should Seek in Mental Health Clinicians]

Cognitive behavioral therapy is a goal-oriented form of therapy that is conducted once a week on a one-on-one basis with a therapist. Unlike other forms of therapy that can be unstructured, cognitive behavioral therapy goals are always set at the beginning of every session by the therapist and the patient. For example, if a patient is having trouble sleeping, experiencing issues with socializing, or having feelings of panic, they will identify these as issues they want to overcome so it can be an area of focus during the session.

Throughout therapy, patients will learn to focus on the situations and thoughts that are causing these somatic responses. They will learn to identify their current way of negative thinking that is causing this unpleasant and sometimes crippling response. Responders will also learn coping mechanisms. So rather than picking up a drink, or going into a state of panic because of negative thought patterns, they can exercise their brain to adjust its thought process until more positive behaviors and thoughts become automatic. Some of these common mechanisms for first responders can include meditation, breathing exercises, fitness regimens, or calling a sponsor.

[Related: 5 Reasons First Responders Should Take Yoga Seriously]

Sometimes, homework will also be assigned to patients in between therapy sessions. For example, patients can record when they feel bouts of anxiety. Where were they? Were they in the car or on the phone? Did they see a particular geographical area? Did something come on the TV? Writing down this type of information can help first responders identify the particular triggers that cause their post-traumatic stress.

How Can First Responders Benefit from a CBT Approach?

When a patient seeks this short-term treatment for trauma, they will likely see long-term measurable outcomes including improvement in mood, reduced blood pressure, better sleep, and lower levels of cortisol. By working with a therapist who uses cognitive behavioral therapy, first responders can address their emotions, mend their negative emotional response, and begin coping with the experience in a healthier, more productive way.

It’s important for individuals who have experienced PTS in the line of duty not to think of themselves as sick, but as injured. For your body to react to high-stress situations is not abnormal, but a normal human experience that is treatable.

About the Author: Dr. Michael Genovese is the chief medical officer, behavioral health services at Acadia Healthcare and medical advisor to Acadia’s Treatment Placement Specialists®. Acadia operates a network of 576 behavioral health facilities with approximately 17,300 beds in 39 states, the United Kingdom and Puerto Rico.

Dr. Genovese also serves as the medical director of the Officer Safety and Wellness Committee of the FBI National Academy Associates, assistant clinical professor of medicine at the University of Arizona and medical director of the Camden Center in Menlo Park, California. He is the former chief medical officer of Sierra Tucson. He is a Diplomate of the American Board of Psychiatry and Neurology, a member of the American Psychiatric Association, the American Academy of Addiction Psychiatry and the American Society of Addiction Medicine.

Dr. Genovese writes, speaks, teaches and consults widely in the disciplines of pharmacology, neuromodulation and pharmacogenomics.​ To contact him, please email

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