In the Line of Fire: Trauma in the Emergency Services

In the Line of Fire: Trauma in the Emergency Services

In the Line of Fire: Trauma in the Emergency Services

In the Line of Fire: Trauma in the Emergency Services


In the wake of disaster emergency responders are first on the scene and last to leave. They put concern for the lives of others over concern for their own lives, and work tirelessly to recover the bodies of the missing. Their heroic actions save lives, provide comfort to and care for thewounded and inspire onlookers, but at what cost to themselves? We now know that rescue workers who are exposed to mutilated bodies, mass destruction, multiple casualties, and life-threatening situations may become the hidden victims of disaster. The traumatic consequences of exposure can profoundlyimpact emergency responders, radiate to their families, and permeate the emergency organization. This much-needed new book, based on the authors' original research and clinical experience, describes the consequences of trauma exposure on police officers, fire fighters, and paramedics. Weaving datacollected in large-scale quantitative studies with the personal stories of responders shared in qualitative interviews, this much-needed account explores the personal, organizational, and societal factors that can ameliorate or exacerbate traumatic response. Stress theory, organizational theory,crisis theory, and trauma theory provide a framework for understanding trauma responses and guiding intervention strategies. Using an ecological perspective, the authors explore interventions spanning prevention, disaster response, and follow-up, on individual, family, group, organizational, andcommunity levels. They provide specific suggestions for planning intervention programs, developing trauma response teams, training emergency service responders and mental health professionals, and evaluating the effectiveness of services provided. Disaster, whether large-scale or small, underscoresour ongoing vulnerability and the crucial need for response plans that address the health and well being of those who confront disaster on a daily basis. In the Line of Fire speaks directly to these emergency response workers as well as to the mental health professionals who provide them withservices, the administrators who support their efforts, and the family members who wonder if their loved one will return home safely from work tonight.


This book provides an objective, original, enlightening, and thought-provoking analysis of the full range of emergency and trauma recovery services practiced by social workers and emergency services personnel throughout North America. Cheryl Regehr and Ted Bober have made a major and significant contribution to the mental health and human services literature. This is the most thoughtful, compassionate, inspiring, readable, insightful, and original book I have ever read on emergency services, crisis management, and trauma recovery. This book is so engaging and well-written that I could not put it down until I read every page at one sitting.

Dr. Cheryl Regehr and Ted Bober have been on the front lines of community disaster intervention as co-directors of the Critical Incident Stress Team at Toronto Pearson International Airport for over 15 years. In addition, the authors' two decades of clinical work, training workshops and seminars, and research on trauma and emergency services are evidenced throughout this timely book. I was also delighted to see an emphasis on evidence-based individual and group interventions.

This gem of a book is a rare combination of outstanding writing, stimulating case illustrations, and an integration of qualitative and quantitative research. In sharp contrast to other academic trade books, the valuable information in this original volume is both superbly researched and eminently readable. Catastrophic events, trauma and coping case exemplars, emergency services and the continuum of early interventions and long-term follow-up, and the everyday lifesaving and recovery work of police, paramedics, firefighters, and emergency mental health practitioners are highlighted throughout this book. The figures, models, and graphs add an important conceptual and practical dimension to the book.

In summary, this book is essential reading for almost every mental health practitioner because of the continued threat of community disasters, emergencies, terrorist attacks, and trauma-precipitating events. Every informed citizen, student, and practitioner interested in mental health and emergency services should purchase this book. It is a pathfinding and seminal . . .

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