3 Key Interventions For Therapists Working With The Military And First Responders

Deployments, weeks of training in austere environments, high intensity shift work, units with a high operational tempo (OPTEMPO) can wear down even the best of our military and first responders. How do these professionals maintain over a long career and what kind of impact does this type of lifestyle produce? What happens when they realize realize resetting to a prior way of life may not be possible? Here are 3 key interventions for therapists working with military or first responders clients looking to reset.

Often, especially in the military, these organizations use the terms “reset” or “recover” to describe the part of the training or deployment cycle where the tempo and intensity slows in order to provide the opportunity to recover. This is described as the recovery phase or the reset period. How effective are these times? Can soldiers truly reset?

Many in our warrior cultures carry the expectation that a reset is possible during this period. Resetting and refitting equipment and supplies is one thing, but resetting emotionally and relationally may be another. What happens when the equipment and supplies are reset, but the individual warrior does not?

Having lived this lifestyle myself, and assisted soldiers and their families in navigating the high OPTEMPO world of multiple deployments and training cycles, I came to the conclusion that a reset is not possible. Those reset and recovery periods were helpful, but my anecdotal personal experience showed that these experiences felt more cumulative than resetting back to a baseline. When these warriors found themselves not able to reset they began to question their professionalism and competence often keeping these concerns to themselves. This began to eat away at them from the inside out, and this was especially true when their work and personal lives began to deteriorate.

I recently came across a great research study that confirmed what I knew anecdotally. Kayla Ree-Fitzke and Mallory Lucier-Greer (2019) examined the role of cumulative combat experiences and how those experiences impacted young soldiers in The Buffering Effect of Relationships on Combat Exposure, Military Performance, and Mental Health of U.S. Military Soldiers: A Vantage Point for CFTS. This study is a must read if you work with our military, and contains helpful information that I do not cover here.

Here are 3 key interventions therapists can use to support our military and first responders as they navigate the cumulative effects of their high OPTEMPO lifestyles:

1. Normalize their experience. For example, unpacking phrases like these may be helpful while normalizing your client's experience.

• “You are experiencing normal reactions to abnormal circumstances.”

• “Less than 1% of our society serves, or has served, in this capacity like you.” If your client has experienced direct combat, then it may be helpful to point out that this number is even less.

• “You cannot go into the cave with the dragon without getting burned.” I came across this quote probably 10 years ago and wish I had the foresight to write down the source. This quote helps me communicate how living a warrior lifestyle is similar to going into the cave with the dragon where it is next to impossible to not get burned, or at least not come out of the cave smelling like smoke!

2. Offer the option to move into a new normal as a helpful alternative. This is the journey you are well-positioned to assist your client in undertaking! The process of joining with your client through normalizing their experience and empathically connecting with their struggle of not being able to reset provides a powerful foundation for continued work.

3. Assist in strengthening your client’s relationships with their families and their work colleagues. “Supportive relationships cannot be understated . . . supportive, reliable relationships buffer the adverse influence of combat stress and may be a key leverage point for treatment . . .” (Ree-Fitzke & Lucier-Greer, p. 331, 2019).

What has been helpful for you when working with military and first responder clients when they discover a reset may not be possible and the life they once knew is no longer accessible?