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In the Line of Fire

Trauma in the Emergency Services

by (author) Cheryl Regehr & Ted Bober

Oxford University Press
Initial publish date
Dec 2004
Social Work
  • Hardback

    Publish Date
    Dec 2004
    List Price

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In the wake of disaster emergency responders are first on the scene and last to leave. They put concern for the lives of others over concern for their own lives, and work tirelessly to recover the bodies of the missing. Their heroic actions save lives, provide comfort to and care for the wounded and inspire onlookers, but at what cost to themselves? We now know that rescue workers who are exposed to mutilated bodies, mass destruction, multiple casualties, and life-threatening situations may become the hidden victims of disaster. The traumatic consequences of exposure can profoundly impact emergency responders, radiate to their families, and permeate the emergency organization. This much-needed new book, based on the authors' original research and clinical experience, describes the consequences of trauma exposure on police officers, fire fighters, and paramedics. Weaving data collected in large-scale quantitative studies with the personal stories of responders shared in qualitative interviews, this much-needed account explores the personal, organizational, and societal factors that can ameliorate or exacerbate traumatic response. Stress theory, organizational theory, crisis theory, and trauma theory provide a framework for understanding trauma responses and guiding intervention strategies. Using an ecological perspective, the authors explore interventions spanning prevention, disaster response, and follow-up, on individual, family, group, organizational, and community levels. They provide specific suggestions for planning intervention programs, developing trauma response teams, training emergency service responders and mental health professionals, and evaluating the effectiveness of services provided. Disaster, whether large-scale or small, underscores our ongoing vulnerability and the crucial need for response plans that address the health and well being of those who confront disaster on a daily basis. In the Line of Fire speaks directly to these emergency response workers as well as to the mental health professionals who provide them with services, the administrators who support their efforts, and the family members who wonder if their loved one will return home safely from work tonight.

About the authors

Cheryl Regehr is a professor in the Faculty of Social Work, with cross-appointments to the Faculty of Law and the Institute of Medical Science at the University of Toronto.

Cheryl Regehr's profile page

Ted Bober's profile page

Editorial Reviews

"A readable, practical, well-organized and well-researched guide. It is comprehensive in scope and should be mandatory reading for all mental health professionals and peer supporters who provide services to emergency responders." -- Ellen Kirschman, Ph.D., author of I Love a Cop: What Police Families Need to Know and I Love a Fire Fighter: What the Family Needs to Know

"Based on Regehr and Bober's original research and combined 40 years of clinical experience in emergency service organizations, In the Line of Fire adeptly addresses the interpersonal, organisational and societal factors affecting police, firefighters, paramedics and other first-responders during the course of their daily work. The book is clearly articulated, well researched and coherently organised.In the Line of Fire is suitable for a wide audience, including social workers, other mental health professionals, emergency workers, their family members and administrators who provide the structural support for their life-saving efforts. This book can also serve as an excellent introductory social work text on disaster work.Regehr and Bober are to be commended for their groundbreaking contribution to the trauma literature."--Carol Tosone, International Journal of Social Welfare

"[The authors] offer practical advice to help prevent emergency responders from falling prey to work-related stressors; and they provide emergency medical, fire, and police departments the tools needed to build and strengthen a safety net to not only catch responders who fall, but to prevent them and their departments from sustaining serious permanent injury."

"In the Line of Fire is written by two professionals who have an impressive amount of experience working with front-line emergency services in Canada....They use case histories to bring to life the stressful events that emergency staff experience and refer to research evidence that convincingly builds a model that they refer to as a 'trajectory towards health or illness.' This gives us encouragement that many parts of a range of interventions may nudge those exposed to traumatic events towards healthy coping." -- Anna Higgitt, Mental Health Branch of the Department of Health, UK, in the British Journal of Psychiatry

"A hint at the wisdom of this ambitious book can be found on its opening page, in which the authors dedicate their work 'to those important individuals in our lives who have taught us about resilience, grace and gratitude.'...What sets this book its understanding of the contextual nature of trauma...Regehr and Bober do an excellent job of defining and expanding on the conventional views of occupational stress and trauma theory."--The Lancet

"...concise and compelling...The combined use of qualitative (personal testimony) and quantitative (incidence and prevalence) data makes this book eminently powerful and readable....There is something of value for everyone in this book: the emergency professional, family members of those who work in emergency services, and managers and administrators of emergency services organizations." -- Elizabeth M. Plionis, Ph.D., Associate Professor Emeritus, National Catholic School of Social Service, in Brief Treatment and Crisis Intervention

"...the most comprehensive book written on the subject of trauma among emergency personnel. This book is full of gems in understanding the rescuers' culture...written so we are in a better position to help these men and women do their job without sacrificing their mental well-being."--Social Work Today

Other titles by Cheryl Regehr