ART for first responders: police, fire, EMS and dispatch

Accelerated Resolution Therapy (ART) can be used with police officers, firefighters, EMS crews and dispatchers for the memories from calls that will not settle, but no published study has tested ART in first responders. What exists comes from military and civilian PTSD studies. Therapies such as Cognitive Processing Therapy, Prolonged Exposure and EMDR have far more research behind them for PTSD, and they are the guideline-recommended first choices.

What the job can leave behind

Most people meet traumatic events only occasionally. First responders meet them as part of the job, sometimes several in a week, and are expected to be back in service on the next call. A review of 28 studies covering more than 20,000 rescue workers worldwide estimated that about 1 in 10 met criteria for current PTSD, with higher estimates in ambulance personnel than in firefighters and police.

It often shows up as one call that stuck when hundreds of others did not. Sometimes it is the accumulation. Common patterns include:

• A particular call replaying, often a child, a colleague, or someone who looked like family
• Dread or a physical reaction when a certain address, call type or tone comes over the radio
• Sleep that is broken by shift work and then by the memories themselves
• Irritability, drinking more, or going numb at home
• For dispatchers, a call you heard but never saw the end of, and the images your mind supplied instead

Plenty of people in these jobs never tell anyone at work. Needing help after a call is a normal response to an abnormal amount of exposure, not a verdict on whether you can do the job.

How ART is used for call-related memories

ART works on one memory at a time. You hold a specific scene in mind for a short period while I guide sets of about 40 side-to-side eye movements, and we pay close attention to what your body does. When the physical charge has settled, a step called Voluntary Image Replacement lets you change the distressing images to something you choose. The facts stay. You will still know what happened on that call.

You do not have to describe the call to me. For people who have already given a statement, sat through a debrief and filed the report, not having to tell it again is often the reason they look at ART. If you want to talk it through, you can.

Where there are many calls rather than one, we would usually start with the few that come back most often. How many sessions that takes is decided after assessment, and I will not promise a number. The how many sessions page shows what the studies actually used.

What is recommended first

First responders with PTSD are treated with the same therapies that PTSD guidelines recommend for adults generally. The 2023 VA/DoD guideline gives its strongest recommendation to Cognitive Processing Therapy (CPT), Prolonged Exposure (PE) and EMDR. The 2025 American Psychological Association guideline names CPT, PE and trauma-focused cognitive behavioral therapy as first-line, with EMDR among its second-line options. The VA/DoD guideline rates the evidence for ART as insufficient to recommend for or against.

One of those therapies is the better first choice if you want the best-studied route, if your department's program or an in-network therapist offers it, or if you do well with structure and between-session practice. ART is sometimes considered by people who will not describe calls out loud, who have tried a first-line therapy without enough change, or who have one or two specific memories that keep returning. ART compared with other trauma therapies lays out the differences.

Practical and safety points

• Confidentiality. Ask at the first session exactly what stays private and the legal limits to that. If you are worried about what could reach your department, ask before you start rather than holding back.
• Alcohol and sleep aids. Heavy drinking or ongoing substance use changes what is safe to take on in trauma work. Some anxiety medications may also blunt the response to ART. Say what you are using.
• Timing around shifts. A few people in the ART trials felt low or anxious, or slept badly, after a session. It was uncommon and not serious, but it is sensible not to book a session just before a long shift.
• Current risk. Thoughts of suicide or not feeling safe come first, before any memory work.

ART sessions often run longer than a standard 50-minute appointment, and the length is agreed in advance. For a first course I generally recommend meeting in person.

Next steps

If there is a call you keep coming back to, it is worth talking to someone about it whichever therapy you choose. If you want to ask whether ART, EMDR or another approach makes sense for you, get started here. The questions to ask a provider page is useful wherever you end up.