Here is some valuable information providing a differentiation of services available to Firefighters. Is there a difference between counseling and therapy? Is a Psychologist the same as a psychiatrist? How do I know which on I need? What can I expect? FireStrong provides the answers to your questions… here.
What is Counseling?
Each therapist is different, but they all are trained to help you with your issue. Look up different therapists using your insurance to ensure they are a licensed therapist. In order to find the right therapist for you read reviews online.
The initial thought of therapy can be intimidating, especially for those who have never really been into talking about their “feelings.” Finding a therapist that you mesh well with is a major key to success in getting the help you need. While searching for a therapist it is important to have a conversation with them beforehand. A phone call can help you determine if they are able to help you with your personal issues. If the conversation is awkward or does not feel natural at all, then that therapist might not be the best fit. It is completely normal for people to contact a couple of different therapists before picking the best one for them!
Therapy sessions are all about making sure you are comfortable with sharing your thoughts and feelings in a safe, protected, and relaxed environment. The ultimate goal of a therapy session is to have you leaving feeling more at ease every time prior to your previous session. While you won’t be lying down on a couch like you often see in commercials, you can often expect to be sitting on a comfy couch in a warm and inviting room.
What to expect when going to see a therapist:
Each therapist has a unique style, and a large part of therapy is the rapport between you and the therapist. If you don’t feel you can achieve this with the counselor you are seeing, you can always try out a new one. Most therapy can help and start to improve your life in less than 10 sessions (you have 30 sessions to work with!) The process of talking to a stranger about our issues/problems is foreign to many of us, but once you reach your comfort zone and start express yourself you can feel the weight of anxiety being lifted off your shoulders!
One therapy session won’t cure all of your problems overnight. Often in life we have to remind ourselves that good things take time! When first starting therapy, it is okay to feel lost or not even realize what some of your issues are. Once you start opening up about your hardships in life it will be easier to connect with your therapist and pin-point some events that might have triggered some personal issues. Sit back and be patient with this new experience.
3 Common Types of Talk Therapy:
•A therapist will help you change harmful ways of thinking. If you tend to see things negatively, it teaches you how to look at the world more clearly.
•Example: You drop by to see a friend, but he says he doesn’t have time to talk. Your first thought is that he’s angry with you. This makes you feel worried and anxious. Soon you are trapped in a flood of negative thinking.
•Cognitive therapy can help you focus on your reaction to your friend’s behavior. Perhaps what he said has nothing to do with you. Maybe he was having a bad day. Perhaps he was late for an appointment. Thinking of other reasons for his actions help you see the event in a more positive and accurate way.
•Helps you learn to relate better with others. You’ll focus on how to express your feelings, and how to develop better people skills. Might be helpful with strengthening relationships.
•Example: You and your wife are not getting along. The fighting seems to be getting worse, but you can’t break the cycle.
•Interpersonal Talk therapy can help you see your wife’s point of view and vice versa. Perhaps she feels you don’t spend time with her anymore. Finding new ways of talking to your wife may help you both feel better.
•Remember that talk therapy doesn’t have to be difficult. The simple act of discussing your feelings allows you to gain new insight and perspective. Talk therapy can also help to enrich your life by bringing the people that you love closer to you.
•Helps you change harmful ways of acting. The goal is to get control over behavior that is causing problems for you.
•Example: You were on a pediatric drowning, and now you are terrified of taking your family to the pool. This paranoia starts to affect your family life.
•Behavioral Talk therapy can help you to face your fears. Discussing your problems with a trusted person can help you to begin to overcome those fears and take control of your life.
What is the difference between a Counselor, a Therapist, Psychologist, and Psychiatrist?
A counselor is a person who is a master level licensed clinician who has completed a counseling focused program. They are trained to assess, diagnose, and treat numerous issues that people face. They cannot prescribe medication, however they work closey with physicians who can.
A Therapist is a person who has a Master’s or doctoral level degree in a counseling field and a license from a Board of Behavioral Health. Both the degree and license take years to achieve, so rest assure that the person should experience in talk therapy. They can’t prescribe medications, however they work closely with physicians who can.
A Psychologist is a person who has their Ph.D. in a counseling related field. Psychologists have more training and schooling than a therapist. They provide counseling, support, perform psychological tests. Psychologists cannot prescribe medication but work closely with psychiatrists and physicians if prescribed medication becomes necessary.
Psychiatrists are physicians who had to do a residency in the area they specialized, ie child psychology, neuropsychology. They can prescribe medication (prozac, ativan). Some provide talk therapy. Some will prescribe and provide both.
THE BIOLOGY OF SLEEP
Every person needs a different amount of sleep to awaken feeling refreshed. Individual sleep requirements are genetic and may be hereditary. Scientists consider six to 10 hours of sleep a normal range, with most people requiring 7.5 to 8.5 hours of sleep in a 24-hour period. At least four to five hours of uninterrupted core sleep is necessary to maintain minimum performance levels. Sleep requirements may change slightly with age and can be affected by general health. Illness, stress, and depression cause the body to require more sleep to heal and recuperate.
WHAT IS SLEEP DEPRIVATION?
Sleep deprivation occurs when a person does not get sufficient amounts of quality sleep. Work demands, family life, and lifestyle choices may cause a person to sleep fewer hours than his body needs to maintain wakefulness and energy levels. In the Fire Service most of us to Shift work and have to interrupt the body’s natural wake/sleep cycle. Over time deprivation of sleep can have both an acute and cumulative effect on our bodies and minds.
THE EFFECTS OF SLEEP DEPRIVATION
Sleep loss is cumulative and creates a sleep debt. Larger sleep debts require greater amounts of restorative sleep to return the body and mind to normal, rested levels. Sleep deprivation affects mental processes and intellectual abilities. It reduces performance on challenging tasks and negatively affects psychomotor skills. Mood, productivity, and communication skills suffer. Extended periods without sleep may cause hallucinations and paranoia. Lack of sleep may slow glucose metabolism by 30 to 40 percent and increase levels of the stress hormone cortisol. Sleep deprivation has also been linked to inadequate levels of the hormone leptin. Leptin signals the body to stop eating when it’s full. Decreased levels of leptin lead to increased carbohydrate cravings and eating.
“Physical and mental performances are not the only casualties of sleep deprivation. Even a minimal loss of sleep impacts general health. Chronic lack of sleep can contribute to serious health problems and even shortened lifespan. In a 1983 study at the University of Chicago, rats kept from sleeping became sick and died after two and a half weeks. Sleep-deprived rats that became ill but were then allowed to sleep, recuperated fully.”
Other effects of chronic sleep deprivation include:
• Adult-onset diabetes
•Menstrual and infertility problems
•Increased use of drugs and alcohol
•Impaired sexual function
•Less satisfaction in personal and domestic pursuits
•Increased appetite and weight gain
•Personality changes, particularly loss of humor and increased ill temper.
COUNTERMEASURES AND COPING STRATEGIES
“Firefighters need to get an adequate amount of uninterrupted sleep every off-duty night”
Quality sleep is the primary weapon in the battle against sleep deprivation. Firefighters must take advantage of opportunities for sleep, both on and off duty. Sleeping areas at home and at the fire station should be quiet and dark, and the room temperature should be cool. A comfortable, good-quality mattress is a must. Invest in comfortable bedding and pillows as well. Good sleep habits are essential. Firefighters need to get an adequate amount of uninterrupted sleep every off-duty night. Going to sleep and waking up at the same times every day, even on weekends, is important for maintaining the body’s natural rhythms.
Other tips for quality sleep include the following:
- Avoid eating, reading, and watching TV in bed.
- Restrict caffeine intake, and avoid caffeinated drinks at least six hours before bedtime.
- Eat healthful foods. Do not eat large meals within four to five hours of sleeping.
- Do not use alcohol to induce sleep. The effects of alcohol-induced drowsiness last only a few hours and cause poor-quality sleep.
- Avoid long-term use of over-the-counter sleeping pills. Habitual use can reduce effectiveness and lead to addiction.
- Reduce life stress as much as possible.
- Use relaxation techniques to relieve stress and invite sleep.
- Exercise, but not more than four hours before bedtime. For 24-hour shift workers, outdoor exercise during daylight hours can help the body maintain natural biological rhythms and increase sleep quality off-duty.
- Napping is an effective coping strategy that can be used in anticipation of a long night or during extended operations. Naps as short as 20 minutes can be effective. Two-hour naps during around-the-clock operations are highly restorative.
- Daytime sleep after a night shift is essential to staying well rested, but trying to sleep when the rest of the world is awake can be challenging at best. The shift worker must emphasize to friends and family the importance of restorative sleep. Go as far as having daytime sleep scheduled on the family calendar along with ballgames, school meetings, and other activities.
- Melatonin may help promote better sleep, particularly during the day. However, this supplement is not FDA-approved, and current research is contradictory on short-term and long-term effects.
- People who are regularly unable to sleep should consult their physicians to rule out underlying health problems. Doctors may also be able to prescribe medication to help with sleep. Sleep disorders can be aggravated by shift work. Shift workers with diagnosed sleep disorders need to work closely with their physicians to effectively manage their disorder.
A great insomnia program is available through Mindability. Please click on the link to learn more.
This article is provided as a service by FireStrong.org
As much as we like to think of ourselves as unbreakable, we break, and when we do it’s usually hard and fast. If this feeling of being in crisis comes we may not feel comfortable to reach out for support. It’s embedded in our DNA that we are firefighters and we are supposed to fix problems.
Our exposures to high stress calls and events have given us the ability to overcome our feelings and work through them. Over time we store up our issues until they may overflow into other parts of our life. Sure, we may use dark humor or sarcastic remarks to move past our own feelings and continue to do our jobs but what happens when the floor falls out from under us, and we or a friend needs help.
If we finally do decide to accept help we will need somebody we can trust. We will need to know what the help will look like. So if you or somebody you know is in crisis and you decide to ACCESS RESOURCES to get help. What can you expect to happen next?
‘What will a crisis intervention look like?’
Each program is different, but all professional licensed counselors adhere to regulations when it comes to crisis intervention. Crisis Intervention should not be confused with traditional Therapy or Counseling. Crisis Intervention is used in acute situations to assist those who are in urgent need of help.
- Their behavior constitutes a danger of inflicting serious physical harm upon oneself, including attempted suicide or the serious threat thereof, or if the threat is expected that it will be carried out.
- There is potential that the continued behavior can reasonably be expected to result in serious physical harm to others.
Behavior in which a person is likely to come to serious physical harm or serious illness because he/she is unable to provide for his basic physical needs.
- They are showing signs that they are suffering severe and abnormal mental, and emotional issues and that these issues are significantly impairing judgment, reason, behavior or capacity to recognize part of reality.
These four guidelines are reasons for a Crisis Intervention. It is after intervention and when the person is back to more stable that they would benefit from therapy or Counseling in hopes of creating a new healthy baseline.
A Crisis Specialist will ask a series of questions to identify relevant safety issues, and to assess if the person meets the criteria above. Some of these questions may seem intrusive when asked, but regulations dictate that the level of safety is assessed. Here are some sample questions to expect:
Safety Assessment Questions
- Have you had any thoughts or actions, now or in the past, to do anything to hurt yourself?
- Are you concerned about your ability to maintain your own safety?
- Is anyone else concerned about your ability to maintain your safety?
- What, exactly, are any thoughts you have had or are having to hurt yourself?
- Do you have a plan on what you would actually do to hurt yourself?
- Have you ever acted on these thoughts? What did you do?
- Regarding any past actions to hurt yourself, was your intention to hurt yourself, die, let someone know how bad things are?
- What were you trying to get away from or are you trying to get away from, by doing something to hurt yourself?
- How are you hoping hurting yourself/killing yourself will solve your problems?
- Do you have the means to hurt yourself? Do you have access to weapons or drugs?
- Has anyone in your family ever hurt themselves/committed suicide?
- What level of support do you have in your life?
- Are you willing to make a no-harm contract with me?
- Define the Problem. Explore and define the problem from the patient’s point of view. Use active listening, including open-ended questions. Attend to both verbal and nonverbal communications.
- Ensure Personal Safety. Assess lethality, criticality, immobility and seriousness of threat to patient’s physical, emotional and psychological safety. Assess internal impact as well as environmental situation.
- Provide Support. Communicate (by words, voice, and body language) a caring, positive, non-possessive, nonjudgmental, acceptant, personal involvement with the one in crisis and the family.
- Examine Alternatives. Assist in brainstorming choices available now. Search for immediate supports. These supports might include hospitalization or rehabilitation facility
- Plan. Develop a plan with your patient which: provides something concrete and positive for the patient to do now with definite action steps which the patient can own and comprehend.
- Ask the patient to verbally summarize the plan and commitment.
- Demonstrate your part of the commitment if you collaborate.
- Follow up on the patient’s performance or in obtaining assistance.
Click Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) to receive a FREE digital copy of suicide assessment guidelines put out by the Substance Abuse and Mental Health Services Administration (SAMHSA).
For Help or more information on Crisis Intervention please visit FireStrong.org.
Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness, or horror. PTSD can result from personally experienced traumas (e.g., rape, war, natural disasters, abuse, serious accidents, and captivity) or from the witnessing or learning of a violent or tragic event.
- While it is common to experience a brief state of anxiety or depression after such occurrences, people with PTSD continually re-experience the traumatic event; avoid individuals, thoughts, or situations associated with the event; and have symptoms of excessive emotions.
- People with this disorder have these symptoms for longer than one month and cannot function as well as they did before the traumatic event.
- PTSD symptoms usually appear within three months of the traumatic experience; however, they sometimes occur months or even years later.
Although the symptoms for individuals with PTSD can vary considerably, they generally fall into three categories:
– Individuals with PTSD often experience recurrent and intrusive recollections of and/or nightmares about the stressful event. Some may experience flashbacks, hallucinations, or other vivid feelings of the event happening again. Others experience great psychological or physiological distress when certain things (objects, situations, etc.) remind them of the event.
– Many with PTSD will persistently avoid things that remind them of the traumatic event. This can result in avoiding everything from thoughts, feelings, or conversations associated with the incident to activities, places, or people that cause them to recall the event. In others there may be a general lack of responsiveness signaled by an inability to recall aspects of the trauma, a decreased interest in formerly important activities, a feeling of detachment from others, a limited range of emotion, and/or feelings of hopelessness about the future.
– Symptoms in this area may include difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, becoming very alert or watchful, and/or jumpiness or being easily startled.
Risk Factors for Firefighters
A few studies have also looked at what factors might put firefighters at greater risk for the development of PTSD. A number of risk factors for PTSD among firefighters have been identified. These include:
- Being previously in treatment for another disorder.
- Starting work as a firefighter at a younger age.
- Being unmarried
- Holding a supervisory rank in the fire service.
- Proximity to death during a traumatic event.
- Experiencing feelings of fear and horror during a traumatic event.
- Experiencing another stressful event (for example, loss of a loved one) after a traumatic event.
- Holding negative beliefs about oneself (for example, feeling as though you are inadequate or weak).
- Feeling as though you have little control over your life.
Protective Factors for Firefighters
- Even though firefighters might be at high risk for stress as a result of their jobs, it is important to point out that most firefighters will not develop PTSD. In fact, several factors have been identified that may reduce the likelihood of developing PTSD among firefighters after the experience of multiple traumatic events.
- One of the most important protective factors found was having social support available either at home or through work.
- In addition, it has also been found that having effective coping strategies available may lessen the impact of experiencing multiple traumatic events.
- This is not surprising in that, among people in general, the availability of social support and effective coping strategies have consistently been found to reduce the risk for developing PTSD following a traumatic event.
For Information on Treatment Please visit FireStrong.org
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