This study evaluates the effectiveness of a brief psychoeducation training program in reducing mental health stigma, both toward others and oneself, among public safety personnel, while also comparing the relative effectiveness of in-person and online training modalities. In total, 1686 public safety personnel in Florida received psychoeducation on the mental health impacts of public safety work. Participants completed pre- and post-training questionnaires assessing demographics, mental health knowledge, and mental health stigma toward others and themselves. Among the participants, 871 completed the training online, and 44 completed the training in-person. A paired samples t-test assessed changes in knowledge from pre- to post-test, and 2 × 2 repeated measures ANOVAs analyzed stigma-related data. Mental health knowledge increased and mental health stigma toward others decreased post-training, with no differences between training modalities. No changes in mental health self-stigma were found. Police officers reported significantly greater self-stigma than firefighters. Firefighters and dispatchers reported significantly less stigma toward others than police officers. This study found that both in-person and online psychoeducation can similarly improve mental health knowledge and reduce stigma toward others, which may help reduce barriers to seeking care.

Mental health professionals are only recently beginning to understand the risks for stress-related disorders experienced by first responders. For example, it is clear that first responders are at increased risk for Post-Traumatic Stress Disorder. Unfortunately, clinicians currently have a limited repertoire with which to treat these disorders. Treatments for PTSD have been developed for use with military patients, for the most part. It is not clear that these treatments are appropriate, and effective, for first responders. In this chapter, the authors describe a pilot study designed to evaluate whether one specific treatment approach creates similar clinical outcomes for first responders as have been observed for a military sample. The results indicate that clinical outcomes for first responders were nearly identical as those obtained with military personnel. The results are discussed in terms of future directions for research in this area.

Exposure therapy for posttraumatic stress disorder (PTSD) is efficacious for treating patients with multiple traumatic events. However, individuals with PTSD with exposure to multiple traumatic events are theorized to experience differences in emotional reactivity and fear extinction processes compared to those exposed to a single traumatic event. Thus, there is concern that individuals exposed to multiple traumatic events respond to exposure therapy differently than individuals reporting a single traumatic event. This study examined the impact of trauma frequency on exposure therapy processes, including within-session habituation, between-session habituation, and treatment outcomes in a sample of male veterans and active-duty military with combat-related PTSD engaging in Trauma Management Therapy (N = 81). Individuals in both groups demonstrated significant improvements in PTSD symptoms from pre- to post-treatment. Of primary interest, individuals presenting with multiple traumatic events and single traumatic events demonstrated similar within- and between-session habituation, length and number of exposure sessions, rates of fear activation, and symptom reduction. The only significant difference observed was slower within-session habituation during the first Trauma Management Therapy session for individuals exposed to multiple traumatic events compared to individuals exposed to a single traumatic event. Results indicate that PTSD resulting from multiple traumatic events are as responsive to exposure therapy as those whose PTSD was caused by a single event. These preliminary results suggest that clinicians can utilize evidence-based exposure therapies to treat veterans and military personnel with multiple traumatic event histories.