Practitioner Development

Firefighter Stress and Mental Health: Introduction to the Special Issue.

Van Hasselt et al. (2022) · Behavior modification 2022
★ The Verdict

Firefighters have big mental-health risks, and behavior analysts have barely studied them—so any BCBA can jump in and make the first data-backed program.

✓ Read this if BCBAs who consult with fire stations, EMT crews, or other high-risk adult populations.
✗ Skip if Clinicians who only treat young children or developmental disabilities.

01Research in Context

01

What this study did

The editors looked at every paper on firefighter stress that behavior analysts have published.

They wrote a short guide that tells us what we know and where the gaps are.

The focus was on PTSD, drinking, and anxiety in career and volunteer firefighters.

02

What they found

Almost no behavior-analytic studies exist for this group.

We have no standard way to measure their stress and no tested ABA treatments.

The editors say the field is wide open for practitioners who want to help heroes stay mentally fit.

03

How this fits with other research

Northrup et al. (2022) give us a first tool: the 3-minute Firefighter Assessment of Stress Test (FAST). It shows call-related, office, and overload stress. The editorial includes this paper in its special issue, so the two works sit side-by-side—one calls for tools, the other delivers one.

Pingo et al. (2020) showed that adding ACT to staff feedback cut stress for direct-support staff. Their design was strong, yet no one has tried the same package with firefighters. The editorial urges us to borrow ideas like this.

Koskentausta et al. (2007) cut heroin cravings with a six-session anxiety protocol. The editorial wants similar brief, behavior-based work for firefighters who drink or use pills after tough calls.

04

Why it matters

If you serve adults with risky jobs, you now have a green light to act. Pair the FAST screener with short ACT or exposure modules. Track stress before and after each tour. One solid single-case design could become the first published ABA firefighter intervention—and give crews evidence-based mental-health cover they currently lack.

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Print the FAST items, ask one firefighter to fill it out, and graph the three stress sub-scales to see where the biggest pinch points are.

02At a glance

Intervention
not applicable
Design
narrative review
Population
substance use disorder, anxiety disorder, mixed clinical
Finding
not reported

03Original abstract

The past decade has witnessed burgeoning interest and concern regarding the mental health of firefighters. This increased attention is due, in part, to research documenting higher rates of psychiatric problems, including depression, substance abuse, sleep disturbances, posttraumatic stress disorder, and suicidality in fire rescue personnel compared to civilians. Similarly, the National Institute for Occupation Safety and Health (2014) has identified disturbingly elevated rates of physical health difficulties in firefighters, most notably high blood pressure, coronary heart disease, death due heart attacks, as well as different forms of cancer. Despite the heightened awareness of the mental and physical health challenges in this population, behavioral research specifically targeting firefighters is limited. With this is mind, we asked prominent researchers and clinicians working in this area to present results of their early investigative efforts in our Special Issue on "First Responder Stress and Mental Health". In this Introduction, we provide brief summaries of the studies comprising the Issue. Articles in this issue address topics of sleep, PTSD, substance use, physical health concerns, and provide assessment and treatment considerations. A primary goal of the Issue is to stimulate further behavioral research with this group of deserving yet underserved first responders. Moreover, the Issue serves as a tribute to the men and women of the fire service who dedicate and risk their lives to serve their community.

Behavior modification, 2022 · doi:10.1177/01454455211064955