The selfless people who work as first responders are often exposed to traumatic images and experiences that linger long after the event is over. Trauma is a common experience among first responders and can result in long-term challenges with physical and emotional health. Mental health conditions like post-traumatic stress disorder (PTSD) impact around 30% of first responders, compared to 20% of the general population. Treatment can make a big difference for people working on the front lines. 

What Is CBT?

Cognitive-behavioral therapy (CBT) is a treatment method that helps people recover from a range of emotional health challenges. CBT helps people learn to recognize their emotional triggers and understand the impact of their experiences on their thoughts, feelings and behaviors. 

CBT first originated in the 1960s. Psychiatrist Aaron Beck developed this theory of how thoughts, feelings, behaviors and interpretations of these events intersect to create the lived experience of humans. Since then, CBT has helped people manage and recover from a variety of mental health challenges, including:

  • PTSD
  • Substance use disorders (addiction)
  • Depression
  • Anxiety
  • Personality disorders
  • Obsessive-compulsive disorder
  • Bipolar disorders
  • Eating disorders
  • Psychotic disorders
  • Insomnia

Types of CBT

Cognitive-behavioral therapy is a flexible therapy option that meshes well with varying types of treatment. There are seven common types of CBT that mental health professionals use, and each of these types can benefit a variety of client needs. 

Cognitive Therapy

The premise behind cognitive therapy is the idea that our thoughts influence our moods and behaviors. Cognitive therapy helps people correct faulty thoughts in order to impact mood and behaviors for a better quality of life. 

Dialectical Behavioral Therapy (DBT)

DBT was developed by Marsha Linehan in the 1960s to help people who struggled with emotion regulation, self-acceptance and suicidal ideation. DBT treatment is based on a curriculum in which participants learn and practice skills to reduce the impact of emotional health challenges.

Acceptance and Commitment Therapy (ACT)

ACT helps people identify and accept their thoughts and feelings while working toward behavioral changes that will help reduce emotional symptoms. A core theme of ACT is cognitive flexibility, which helps people accept their challenges and recognize the parts of those challenges that can be changed. 

Mindfulness-Based Cognitive Behavioral Therapy (MBCBT)

Mindfulness-based CBT works to manage the physiological aspects of PTSD. Mindfulness skills can help ease some of the most problematic PTSD symptoms.

Rational Emotive Behavioral Therapy (REBT)

REBT is a type of CBT treatment that is based on philosophy. It considers the variety of influential factors (like thoughts, feelings, experiences and outlooks on life) that shape how a person chooses to live their life. 

Multimodal Therapy

Multimodal therapy combines several types of evidence-based treatment methods to get the best results for clients. Multimodal therapy may include medication, case management and talk therapy, depending on the treatment needs of the individual.

CBT for PTSD

When first responders are traumatized as a result of their work, it can have devastating outcomes for long-term emotional and physical health. Cognitive-behavioral therapy can help reduce and manage symptoms of PTSD that can be disruptive to daily life. Practicing CBT with a trained professional can help first responders:

  • Identify symptoms of trauma exposure
  • Recognize early signs and triggers
  • Manage intrusive thoughts and distressing emotions to improve quality of life
  • Use mindfulness skills to get relief from trauma symptoms 

CBT for Alcohol and Drug Addiction

Alcohol and drug addiction can have devastating effects on first responders and their loved ones. When trauma has negatively impacted one’s life, however, substance use can feel like an escape. CBT can help people struggling with addiction find new coping strategies. They’ll identify automatic thoughts and replace them with more helpful ones, and understand the ways their thoughts and feelings impact their choices. When people start to recognize how their inner experiences shape substance use, it can help shift perceptions, and new patterns can be developed.

CBT Treatment for First Responders

The FORTITUDE program at The Recovery Village Columbus was developed specifically for first responders as an evidence-based treatment for substance use disorders and co-occurring mental health conditions like PTSD. Clinicians and therapists in FORTITUDE provide trauma-informed care with years of experience understanding how first responders think, feel and work.

CBT is an important part of this specialty track: it helps first responders learn new ways of managing difficult emotions and traumatic memories. Clients may go through CBT as part of their individual therapy sessions and in group sessions with other first responders.

If you or a loved one is a first responder who has experienced trauma and substance use challenges, reach out to the FORTITUDE program for support and healing.

Melissa-Carmona-1
Editor – Melissa Carmona
As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
Paula-Holmes
Medically Reviewed By – Paula Holmes, LCSW
Paula Holmes is a licensed clinical social worker, psychotherapist and freelance writer who lives and works in midcoast Maine. She received her master's degree in Social Work in 2008 from the University of Maine. Read more
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Substance Abuse and Mental Health Services Administration. “First Responders: Behavioral Health Conc[…]esponse, and Trauma.” May 2018. Accessed October 30, 2021.

Chand, Suma; Kuckel, Daniel; Huecker, Martin. “Cognitive Behavior Therapy.” StatPearls, August 2021. Accessed October 30, 2021.

Kar, Nilamadhab. “Cognitive behavioral therapy for the tre[…] disorder: a review.” Neuropsychiatric Disease and Treatment, April 4, 2011. Accessed October 30, 2021.

Rupke, Stuart; Blecke, David; Renfrow, Marjorie. “Cognitive Therapy for Depression.” American Family Physician, January 2006. Accessed October 30, 2021.

Chapman, Alexander L. “Dialectical  Behavior Therapy: Current […] and Unique Elements.” Psychiatry, 2006. Accessed October 30, 2021.

Dewane, Claudia. “The ABC’s of ACT — Acceptance and Commitment Therapy.” Social Work Today, September/October 2008. Accessed October 30, 2021.

Roychowdhury, Dev. “Mindfulness-Based CBT for Treatment of PTSD.” Journal of Psychology and Clinical Psychiatry.” February 2, 2017. Accessed October 30, 2021.

Dryden, Windy; David, Daniel; Ellis, Albert. “Chapter 8: Rational Emotive Behavior Therapy.” Handbook of Cognitive Behavioral Therapies, Third Edition, 2010. Accessed October 30, 2021.

National Academies of Sciences, Engineering, and Medicine. “Multimodal Therapy: Overview of Principl[…], and Opportunities.” Developing Multimodal Therapies for Brain Disorders: Proceedings of a Workshop, November 18, 2016. Accessed October 30, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.