Date of Conferral

10-16-2025

Degree

Ph.D.

School

Psychology

Advisor

Lisa Scharff

Abstract

Firefighters are 5 times more likely than civilians to experience depression and post-traumatic stress disorder. Firefighters have suicidal ideation and attempt rates that are 2 to 3 times higher than the general population, yet most do not seek treatment. The purpose of this qualitative Delphi study was to develop an expert consensus on psychological assessment and treatment practices with firefighters through the lens of an expert panel of 19 psychologists who work with this population. Siebert’s normative theory was used with the assumption that the panelists would provide feedback based on their clients’ best interests. The expert panel was recruited through online postings to health and wellness resources. Three rounds of surveys were used to reach consensus. Microsoft Excel and thematic analysis were used to code and analyze the data, with a 75% consensus agreement. Seven assessment instruments, including the Posttraumatic Stress Disorder Checklist, and eight treatment approaches, including dialectical behavior therapy, were agreed upon as best practices when working with firefighters. Eleven symptoms were identified as important to assess for when working with this population. Six themes were identified as critical for professionals working with this population, including being knowledgeable about fire culture and recognizing that rapport building with firefighters looks different. By shaping mental health assessment and treatment toward standardization in the firefighter population, the current study may promote acceptance of mental health care within the firehouse and lead to social change that benefits firefighters, their families, fire departments, and the communities that depend on emergency responders.

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