Dr. David Green learned the value of intensive therapy for his PTSD patients because, like any good psychologist, he was listening. A group of firefighters from a nearby department were talking about a PTSD retreat that seemed to help—and he could see that they were right.
Green received his PhD in clinical psychology from Michigan State and was a fellow in psychology at Harvard Medical School’s Department of Psychiatry before founding Collaborative Transformations Psychology, a six-person group in California specializing in worker’s comp cases that sees more than 100 patients a week. Intrigued, he contacted The 11th Hour Trauma Retreat, which offers intensive therapy to first responders and military personnel suffering from Post-Traumatic Stress Disorder (PTSD) and other trauma.
Green spoke at length with the founder, Rachael Starr, and discovered that she was offering Eye Movement Desensitization and Reprocessing therapy (EMDR) in an intensive setting, a PTSD retreat that often lasted a week or more. He eventually referred a patient. Then, another. After several years and roughly two dozen referrals, Green has reliably seen patients recover and, in many cases, return to work.
“I've been doing this for more than 30 years and the results are strikingly better for first responders who go there, to an almost uncanny degree,” he said.
Starr said that specializing in first responders has allowed her team to gather special insight into how to relate to PTSD patients in an intensive setting. Starr herself has gone so far as to ride along with police and firefighters to get a sense of their environment and experiences.
“Police, firefighters and other first responders work in a very unique environment,” she said. “They experience trauma—sometimes very extreme trauma—regularly, and yet the culture requires them to simply endure. Even today, as departments become more aware, we still see too many cases where first responders are asked to deal with this alone and without any tools.”
The 11th Hour retreat allows first responders to spend a full week or more working one-on-one with a licensed therapist and undergoing treatment, all of which can be paid for by worker’s comp. The retreat provides food, accommodations and all other needs, allowing patients to focus on therapy. It’s an approach that has helped scores in public safety recover from job-related trauma, return to their profession and lead healthier lives.
“It's hard to do it in outpatient therapy, when life is going on around them,” Green said. “Children are crying, everything is topsy turvy because they're not at work and they're worried about their claim not being accepted. Half the therapy is explaining to them why worker comp is so frustrating.”
Green recommends immersive therapy at 11th Hour for patients with multiple traumatic events, many of whom are also dealing with issues that extend beyond work. First responders have childhood issues. They have families and mortgages. They are parents and spouses. They experience traumatic events outside the workplace.
“My experience is that it is going to be more effective,” he said. “If you allow the person to have this immersive experience, this undistracted, one-on-one, curated psychotherapy with experts in first responder culture who readily connect to the person, it will take fewer sessions and fewer dollars.”
That expertise and that connection, Green said, are important in a profession that can stigmatize acknowledging harm, fear, guilt or vulnerability in the face of human tragedy. As he put it, “An average therapist doesn't have any idea what it's like to be with a bunch of guys who just saw a few people bleed out, and then went to the bar.”
Green also places great value on Eye Movement Desensitization and Reprocessing therapy, a well-established technique that helps people better process and then transcend traumatic events.
“With EMDR, you can resolve and integrate all the disparate, dissociated, overwhelming feelings and thoughts you had at the moment that you were traumatized, the ones you couldn't process due to being under the influence of fighter-flight and having to make life-or-death decisions,” Green said.
Green says EMDR allows first responders to recontextualize memories, emotions and self image in a natural way. “Memories are no longer unbearable because they become part of a new narrative,” he said. “You get to viscerally feel what it's like to have a different experience while you're having the same memory. So the memory changes. It's no longer looping and it's no longer splintered.”
Ultimately, Green hopes that departments will integrate information on PTSD and its treatment into basic training so that all first responders have some knowledge of how to address problems when and if they surface, including the option of intensive therapy.
“It should just be taught as part of the training,” he said. “This is what your colleagues might be going through, here are the symptoms and here's why you should get EMDR or some other evidence-based therapy. You should get therapy that's specially tailored to PTSD from an experienced therapist right away. And if you don't, you should get an immersive experience.”
The 11th Hour Trauma Retreat serves first responders and military personnel on a referral basis, working with doctors, police departments, fire departments and other public agencies to provide people with the care they need. To learn more about our program, or to refer a patient, call (772) 837-5988 or email rstarrmsw@gmail.com. Let’s talk.
