VCU faculty train Richmond firefighters how to best help their fellow firefighters deal with emotional and mental stress of the job

June 1, 2017

Bailey Martin, a battalion chief with Richmond's Department of Fire and Emergency Services, and firefighter Betty Migliaccio participate in a roleplaying exercise as part of their peer-support training. 
photos by Brian McNeill, University Public Affairs

Two Virginia Commonwealth University professors are helping the City of Richmond Department of Fire and Emergency Services to launch a peer-support network that will allow Richmond firefighters to help their fellow firefighters struggling with the trauma, violence and other challenges they encounter on a routine basis.

“If you think about firefighters, their main call is to help people,” said Donna Gibson, Ph.D., a professor and counselor education program coordinator in the Department of Counseling and Special Education in the School of Education. “They are taking the step now to say, ‘We not only want to help the public, we want to help ourselves too. So let’s learn some additional ways to do that and help each other in a new way.’”

Gibson and Mary Beth Heller, Ph.D., an assistant professor and director of the Center for Psychological Services and Development in the Department of Psychology in the College of Humanities and Sciences, led a two-day training session last week at the fire department’s headquarters that taught 24 firefighters how to serve as an effective peer supporter.

As part of the peer support training, the firefighters learned how to conduct "motivational interviewing," a strategy for speaking with people about their problems that emphasizes making the space for others to work toward their own solutions.

“This peer-support network was envisioned as the type of thing that, if you’re trained to be a peer supporter, and you’re out back washing the truck, if I have something that I need to talk about with someone, I can wander out and start up a conversation with you,” Heller said. “It’s informal, but really accessible to all the members of the fire department.”

Nationally, one out of every five firefighters and paramedics have post-traumatic stress disorder — a rate on par with that of combat veterans, according to 2016 report by the International Association of Fire Fighters.

The job can take a mental and emotional toll not only because of the trauma that firefighters deal with on the job, but also because the fire service involves a demanding schedule, irregular sleep cycles and other challenges.

“The stuff we see on the job compiles and compiles and compiles, but that’s not all of it. The shift schedules that we work, the 24-hour schedules, and [at the same time] we’re normal people with family issues,” said Brian C. Turnage, interim deputy chief of the Richmond Department of Fire and Emergency Services. “It all compiles and compiles and it can really start to weigh on you. It’s an issue fire service-wide, and we’ve got that same issue here in Richmond.”

Turnage reached out to the VCU faculty members after attending a fire safety conference in early 2016 that focused heavily on firefighting and mental health.

“My initial thought on this conference was that we’d be going over fire scene safety and some safety in the station,” he said. “Probably 80, 85 percent of the conference was focused on behavioral health in the fire service, and how we are so far behind the problem [nationally] and how we’re trying to catch up to it.”

The idea behind a peer-support network, Turnage said, is that it would allow firefighters to informally talk through their problems with people who have experienced the same things.

“[Peer support] allows us to come to people who have been through what we’ve been through,” he said. “If you do this job, especially in the City of Richmond with the volume of calls that we do, you’re going to see some stuff, you’re going to experience some stuff, you’re going to be tired. You’re going to experience things that I’m going to know about, because I’ve experienced those things too.

“We are a family,” he added. “Sure, we’ve got that pain-in-the-butt uncle we don’t get along with, but he’s still part of the family. So it’s a comfort level of being able to talk to someone in the family. I might not be able to go out and talk to other people but I would be able to talk with someone that I trust and that I know.”

Bailey Martin, a battalion chief with the Department of Fire and Emergency Services, said the peer-support network will be an additional resource to help members deal with stress and minimize the chances of behavioral health problems.

In one exercise, the firefighters were paired off and role-played difficult situations, such as a scenario in which a baby died of cardiac arrest and a firefighter has been struggling to deal with witnessing it.

“We’ve all experienced some of the stress that comes with our job — whether it’s the schedule or it’s the critical incidents that we respond to,” Martin said. “We haven’t done a lot to give our employees the resources we need to deal with those stresses. Our hope is to offer them more resources, but also to do a lot more education and let them know that, hey, these are problems that everyone in our profession is facing. We want to get that out in the open and talk about it.”

For many firefighters, Martin said, it can be hard to ask for help. The informal nature of a peer-support network may make it likelier that some firefighters will receive the help they need, he said.

“We have a lot of pride in what we do — we’re problem solvers, we have an image of being tough, and it’s important. But for that reason, a lot of times, I think we don’t necessarily seek help,” he said. “We’re the ones who help people, we don’t often help ourselves. So it’s important to educate our people and give them resources so they can get the help that they need. That’s what this is all about.”

Beyond the peer-support training, VCU psychology professors Natalie Dautovich, Ph.D., and Joseph Dzierzewski, Ph.D., are planning to lead a sleep intervention study with Richmond firefighters that will begin this summer and will aim to minimize the impact of the work environment on both on-duty and off-duty sleep and to maximize healthy sleep behaviors.

“The job demands of professional firefighters can take a negative toll on both physical health and mental health functioning,” the researchers wrote. “Our research aims to identify and investigate sleep as a modifiable risk factor for negative emotional functioning. We plan to develop and test a sleep intervention with the goal of improving both sleep and emotional outcomes.

“Specifically, we propose to conduct a comprehensive evaluation of sleep and a parallel comprehensive evaluation of emotional functioning,” they added. “We will use the knowledge gained to design and test an intervention aimed at improving sleep in firefighters and examine whether improving sleep might have collateral improvements in emotional functioning.”

At last week’s peer-support training, Gibson and Heller led the firefighters through a number of exercises, including a roleplaying scenario in which the firefighters worked to serve as a peer supporter of a fellow firefighter dealing with the stress of responding to a call at which a a baby died from cardiac arrest.

“As I walked around and listened to you guys, it wasn’t like you were roleplaying. It sounded like actual conversations,” Gibson told the firefighters. “And that’s because you guys are living this every day.”

Gibson and Heller stressed that the peer-support skills were just more tools for the firefighters to add to their already well-developed tool kits. They focused on training aimed at building resilience and coping, as well training in how to be an active, nonjudgmental listener.

In one section, Heller provided an introduction to “motivational interviewing,” a strategy for speaking with people about their problems that emphasizes making the space for others to work toward their own solutions.

“I know that your first instinct is to help make things better and to help people when it seems like their lives are falling apart,” Heller said. “But that wanting to jump in and fix things for people is one of the biggest killers of motivation. Because you’re taking away from that person their ability to fix things themselves. It’s really about working together, it’s asking permission to give advice, it’s asking permission to give feedback.”

Donna Gibson, Ph.D., a professor in the School of Education, and Mary Beth Heller, Ph.D., an assistant professor in the Department of Psychology, train Richmond firefighters in how to be an effective peer supporter.