Breaking the silence: A qualitative analysis of trauma narratives submitted online by first responders.

Abstract

Objective: Trauma narration is important to PTSD recovery and is widely used in clinical interventions. First responders experience high rates of exposure to trauma yet there are no studies with a primarily first responder population despite that trauma exposure is a chronic and unavoidable aspect of their occupation. The aim of the current study was to qualitatively examine trauma narratives posted online through a supportive website dedicated for first responders. Method: 30 trauma narratives of police officers, firefighters, and emergency medical personnel were randomly chosen for inclusion in the study. While some narrative posters remained somewhat anonymous, overall, there was moderate diversity in terms of age, sex, job field, number of years on the job, and the locations of the employer. Results: Online narration offered a less formalized opportunity for self-disclosure that allowed for authenticity, honesty, and vulnerability. Thematic analyses revealed 5 themes: idealization with the job, disillusionment with the job, on the job trauma, trauma sequalae, and coping with trauma. Conclusion: Findings suggest that first responders are exposed to trauma on the job that significantly alters their work and home lives. Although they experience psychopathology, and could benefit from formal treatment, their decision to seek treatment is impacted by stigma in the culture. Implications and future directions are discussed regarding the need to improve perceived connectedness and support and reduce stigma in online platforms and within the subculture to encourage healing. Clinical Impact StatementThis study suggests that first responders are exposed to chronic and cumulative trauma on the job that violates preemployment idealization with the profession and leads to disillusionment with their role and self-efficacy. It appears that some first responders reach out anonymously to support websites to share details of their trauma and receive support because this is perceived as somewhat safer and more acceptable than reaching out to familiar peers due to subcultural stigmata.

Doing Death Work: A Mixed Method Examination of Imprinted Events and Behavioral Responses of Medical Examiner's Office Employees

“…Eight of these prior studies acknowledged the role of professional and organizational culture in job-related stressors and behavioral, adaptive, and maladaptive responses (Adams, Anderson, Turner, & Armstrong, 2011;Buchanan & Keats, 2011;Carpenter, Tait, Quandrelli, & Thompson, 2016;Dabney, Copes, Tewksbury, & Hawk-Tourtelot, 2013;Howard, Tuffin, & Stephens, 2000;Koch, 2010;Vivona, 2014;Wayland, Cook, Cartwright, Ryan, Brondolo, Bassed, & Bugeja, 2021). In addition, recently, Casas and Benuto (2022) merged each of these factors (culture, job stressors, and behavioral, adaptive, and maladaptive responses) into one conceptual framework with five overarching themes: the idealization of the job, disillusionment with the job, on-the-job trauma exposure, trauma sequelae, and coping with trauma.…”

“…Table 1 below synthesizes prior research findings on death work professionals' sources of secondary occupational trauma, the nature of their trauma exposure, and their common behavioral and adaptive responses. To date, the most comprehensive conceptual framework concerning first responders that encounter death, including the views of their professions, job-related stressors, and adaptive and maladaptive behavioral responses, comes from Casas and Benuto (2022). Their mixed method, qualitative and quantitative analysis, noted that many first responders, defined in this study as police officers, firefighters, and paramedics, idealize the job, particularly by conceiving it as a public service profession ("helping others"), and as a result, these individuals are placed directly in the middle of the action (especially for young, new to the job, professionals).…”

“…Our overall strategy is similar to the Casas and Benuto (2022) subjected the open coding themes to axial coding. In addition, the authors utilized the Linguistic Inquiry and Word Count (LIWC) software for quantitative content analysis.…”

“…This study reports qualitative data from interviews with medical examiner employees to explore this under-examined population. In addition, following Casas and Benuto (2022), the study also presents quantitative results by applying the Language Inquiry and Word Count (LIWC) framework to identify language structure and psychological states through content analysis of the data.…”

“…Some individuals may not have children, or others may have adult children no longer present in the home. The study to most directly address some of this personalization of trauma is Casas and Benuto (2022). The authors defined "personalization of trauma" as "familiarity with the victim, finding resemblances of one's own family in the victim" (p. 6).…”