Podcast Summary

Podcast: Private Practice Startup
Episode: 188: What Therapists Need to Know When Working with First Responders
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Amy Morgan, M.S., Director of Academy Hour
Release Date: May 30, 2020

Episode Overview

This episode explores the unique challenges and crucial skills therapists need when working with first responders, especially in the context of widespread crises like COVID-19. Guest Amy Morgan, expert in mental health training for first responders and creator of the Certified First Responder Counselor Program, shares insights into the culture of first responders, their mental health needs, and the importance of therapist specialization and cultural competency. The discussion covers trauma, trust issues, therapeutic boundaries, and practical training recommendations.

Key Discussion Points & Insights

1. Amy Morgan's Background and Motivation ([04:53])

• Amy worked as a training officer at the Oklahoma State Bureau of Investigation, organizing mental health training for agents exposed to trauma.
• She noticed a lack of mental health support for first responders: "They need mental health training. They need a mental health class. So I put together one class for them on PTSD, and it just has grown from there." – Amy Morgan [06:20]
• Amy launched Academy Hour to provide mental health classes for law enforcement, which evolved into the Certified First Responder Counselor Program.

2. Understanding First Responder Culture ([08:20])

• First responders have deep trust barriers: "They don't trust anybody who hasn't been a responder. They think there's no way anybody can get what they go through." – Amy Morgan [08:24]
• The job culture is insular; they're expected to be "heroes," leading to internalized pressure and a reluctance to be vulnerable.
• Emotional discussions are rare—sharing trauma stories, even with family, is uncommon: "They don't want to traumatize the therapist because they don't think the therapist is going to... understand what I've seen." – Amy Morgan [09:26]
• Trauma is cumulative and compounded by the inability (or learned reluctance) to process or talk it through.

3. Parallels and Differences with Other "Giving Professions" ([10:40], [32:02])

• First responders share similarities with military personnel and medical professionals: ongoing trauma exposure, isolation, and reluctance to share with outsiders or non-peers.
• Amy notes, "It’s only the people that are going through it with you that are truly really going to get it." – Amy Morgan [12:32]
• The emotional depletion experienced by first responders and healthcare workers during COVID-19 mirrors what police, firefighters, and paramedics experience regularly.

4. Therapist Pitfalls & Responsibility ([17:41])

• Therapists must avoid a "trial and error" approach; being unprepared can do lasting harm: "If you think you want to work with the responder, don't find out by taking one on as a client." – Amy Morgan [18:33]
• The importance of cultural fit: Not every trauma therapist is suited to work with first responders, even if trauma-informed or EMDR-trained.
• "Our first rule is do no harm... That may be the one chance, the one opportunity that they give to counseling and you’re it." – Amy Morgan [17:41]

5. Confidentiality and Trust ([19:44])

• Trust and confidentiality are paramount: Fear of losing career status or facing fit-for-duty exams keeps first responders from honestly sharing with therapists.
• "If a therapist freaks out and says, 'Oh my gosh, they told me that they're suicidal,' and they call the chief... that officer can lose their gun and badge and their career." – Amy Morgan [20:26]
• Crossing boundaries (e.g., sharing too much with the department) can permanently break trust.

6. About the Certified First Responder Counselor Program ([21:48], [27:47])

• 40-hour, 90-day online program teaching first responder culture, trauma, suicide, and therapeutic best practices.
• Features staged content release to avoid overwhelming trainees with traumatizing material.
• Includes real, recorded stories from first responders to increase realism and readiness.
• Requires a ride-along with a police officer or firefighter to experience their environment, build rapport, and assess personal fit: "I require a ride-along as part of the program because I want therapists to go and sit in that police car... so that they're actually seeing what they're going through." – Amy Morgan [24:28]
• Amy actively solicited feedback from first responders and is developing a more intense, updated version based on their input.

7. When to Refer Out ([17:01])

• Therapists should self-assess before taking on first responder clients; it's better to discover limitations before causing client harm.
• "If you are someone who says, you know, just all of a sudden, oh, I'm seeing responders need help, I think I'll try this. Don't try it with a client. Learn everything you can before you take on any, any population as a client." – Amy Morgan [30:13]
• Ride-alongs and exposure to real stories help assess capability and emotional resilience.

8. Important Gender Considerations ([32:02])

• Amy stresses that "giving professions" attract both men and women and that both are equally susceptible to depletion, regardless of gender: "They give of themselves till they have nothing left to give. So do firefighters, so do police officers, so do paramedics." – Amy Morgan [32:05]

9. Practical Advice for Therapists ([30:13], [31:39])

• Make it your area of expertise, not a hobby: "Don’t make it a hobby. Like, don’t be like, I think I'll try a couple of... because it's cool to go. I have cops as therapy clients."
• Be genuinely invested; first responders can spot inauthenticity easily: "They’re trained to see that you don’t [care]." – Amy Morgan [30:13]

10. Course Access and Discount ([32:50])

• The Certified First Responder Counselor Program is available at firstrespondercounselor.com
• Code "PPS 25" offers 25% off for podcast listeners.

Notable Quotes & Memorable Moments

• Amy Morgan: "I wanted to like, teach mental health, which I do, and then it turned into business. ... The counselor program, the certified first responder counselor program, came from me getting to know all of these first responders and officers who were saying ... there's a lack of trust." [06:15]
• Amy Morgan: "They're human beings. I mean, they feel, they experience, but they do get desensitized to a lot. ... They basically will have a horrific day ... and then ... go to the next one." [08:28]
• Amy Morgan: "You can do so much long-term harm there." [18:33]
• Amy Morgan: "They have a brotherhood, they’ve got their back, they’re an inner circle." [22:28]
• Amy Morgan: "You have to take all of these things into consideration. It’s like all of your most ... high need clients in one." [23:51]
• Amy Morgan: "They need their responders, need therapists, but they need good counselors who get them and who want to get them." [30:55]

Timestamps for Key Segments

• Amy’s Background & Spark for Specialization – [04:53]
• Understanding First Responder Culture – [08:20]
• Parallels with Other Professions & COVID – [10:40], [11:45]
• Therapist Pitfalls/Responsibility – [17:41]
• Confidentiality and Trust Issues – [19:44]
• Program Details & Ride-Along Requirement – [21:55], [24:28]
• When to Refer Out – [17:41]
• Gender Considerations – [32:02]
• Practical Advice & Takeaway – [30:13]
• Course Access & Listener Discount – [32:50]

Final Takeaway

Therapists aspiring to help first responders must undertake specialized training to truly understand and support this population. Success requires self-awareness, cultural competency, and a commitment not just to trauma work, but to the nuances of first responder life. Amy Morgan’s program offers comprehensive preparation and an honest glimpse into the challenges and rewards of this critical specialization.