Direct and indirect traumatization in first responders: An exploratory qualitative study with firefighters and humanitarian workers

Objective: First responders are exposed to traumatic events.These professions share common characteristics, both in traumatic exposure and in recovery or growth processes. The aim of this exploratory study is to qualitatively analyze these parameters in a sample of firefighters and humanitarian aid workers. Method: Fifteen firefighters and 15 humanitarian workers participated to the study. After completing a LEC-5, each participant participated to a semi-structured interview. Lexicometric discourse analysis was performed. Results: The sample of 30 first responders had a huge proportion of occupational exposures (234 on 605 total traumatic events). Discourse analysis identified three semantic classes: (1) Factors shared by both populations (37.98%); (2) A class specific to firefighters (33.77%); and (3) A class specific to humanitarian aid workers (28.34%). The results tend to converge on 3 strong similarities among first responders: (1) a significant and sustained exposure to traumatic events; (2) the presence of a complex and dynamic set of phenomena for coping with adversity; (3) institutional and organizational factors, leading a strong entitativity. Conclusions: It is important to systematically include impacts of internal resources and external resources to prevention and psychotherapy. The results tend to reinforce the idea that professional adversive events and multifactorial resources can be considered as part of an constantly changing equilibrium in this type of population. Public relevance: By gaining a better, qualitative understanding of the adversities and resource mechanisms of the first responders, it is possible to develop a model of post-traumatic growth in these particular populations, and a fortiori, to propose appropriate lines of therapy and prevention.