How Therapy Can Benefit EMTs And Paramedics

Medically reviewed by April Brewer , DBH, LPC
Updated February 15, 2023by BetterHelp Editorial Team

Content Warning: Please be advised that this article mentions trauma, substance use, and other potentially triggering topics. Read with discretion. 

A first responder's career may cause complicated emotions to rise under pressure. EMTs and paramedics often witness distressing scenes while facing the profound demands of their work. It can take mental fortitude to face the emotional highs and lows of emergency calls and continue to feel healthy and positive. 

Because of these unique challenges, contact with comprehensive mental health providers can be vital to a first responder's overall well-being. Learning how therapy can help EMTs, paramedics, and other first responders process the emotions that come with the job and address trauma can be beneficial. 

Work Can Bring Unique Challenges And Complex Emotions

What Are EMTs And Paramedics? 

EMTs and paramedics are trained to provide medical treatment to those involved in a crisis. They are often one of the first to arrive at the scene of an accident, a crime, or another emergency. The nature of their job may expose them to potentially traumatic events. Additionally, the pressure they are typically under to provide emergency services quickly and efficiently can strain their mental health. 

Research shows that up to 22% of paramedics and EMTs have been diagnosed with post-traumatic stress disorder (PTSD). This statistic compares to the 7-12% of the general population diagnosed. Workplace trauma may be referred to as vicarious trauma because the EMS professional may not be experiencing the trauma firsthand but witnessing a traumatic event. However, they might also experience trauma that directly impacts them. 

Public safety employees may not discuss traumatic events in an attempt to avoid them or feel safe. However, it could make it difficult for them to express their emotions healthily and lead to increased stress over time, in addition to symptoms of mental health conditions like anxiety. By utilizing mental health services, EMTs and paramedics can manage their emotions and confront the potential stress of their careers.

Healthy Coping Techniques 

For those procuring productive, healthy outlets for their emotions, a few options can connect them with guidance and support. 

Workplace Support 

A first responder's specific department may have mental health services staffed by individuals familiar with the challenges inherent to an EMT or paramedic's job. Talking about trauma or other concerns with an empathetic listener could allow employees to sort through their feelings and develop tools for addressing stress and trauma responses in the future. 

Peer Support 

Some public safety departments may have specially trained staff called peer support representatives trained in active listening skills and chaplains on staff who can provide spiritual guidance and support. 


In addition to expressing themselves through counseling, EMTs and paramedics can engage in physical activity to reduce stress or other trauma-related feelings. Research has shown that traumatic stress can be carried in the body for long periods. Exercise, whether running, yoga, biking, or other activities, can help reduce stress's physical and mental impacts. 


Regular meditation can also help EMTs and paramedics move past work-related trauma. It may be uncomfortable initially, but meditation has been shown to reduce the intensity and frequency of flashbacks caused by exposure to work-related trauma. However, you may benefit from talking to a meditation coach or therapist before practicing. 

Unhealthy Coping Methods

Trauma can bring physical and emotional symptoms that may be challenging to confront. Experiencing trauma can impact a person's immune system and cause sleeplessness, hypervigilance, disorientation, and the need for control over situations. Because of this, some people turn to coping mechanisms that may provide temporary relief, which can negatively affect them in the long run.  

Some EMTs and paramedics use substances to cope with the emotional distress from their job. Repeated use of this coping mechanism may lead to medical issues and worsening mental health concerns. Some people living with trauma might turn to alternative behaviors like gambling.

At times, first responders may try to avoid addressing their concerns in the hopes that they will eventually pass. Repressing your feelings, however, can negatively impact your emotional health in the long run.   

If you're struggling with substance use, consider reaching out to the SAMHSA National Helpline at (800) 662-4357.

The Benefits Of Therapy

EMTs and paramedics living with mental health challenges may find that therapy is a valuable source of support and advice. A therapist can help the individual better understand and address the sources of their concerns and teach them coping mechanisms that can help them during stressful times. 

Research shows that specific therapy modalities, such as cognitive-behavioral therapy (CBT), can reduce symptoms of PTSD. CBT often works by helping the individual identify negative thought patterns that may lead to maladaptive behaviors. A therapist may help the individual recognize and replace thoughts that may contribute to unwanted responses. 

If a first responder is experiencing suicidal thoughts, seeking emergency treatment is crucial. Suicide rates among first responders are high. Research shows that EMS professionals are 1.39 times more likely to die by suicide than the general population. This statistic further highlights the need for early mental health care interventions that may help prevent individuals from feeling like they do not have options. 

If you are experiencing thoughts or urges of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. They are available 24/7 to offer support. 

Work Can Bring Unique Challenges And Complex Emotions

Counseling Options 

While many emergency services departments may offer free services like grief or trauma counseling to first responders, they might not be long-term solutions. While no single situation may work for everyone, having regular contact with an experienced professional may be a healthy way of managing the symptoms of stress, trauma, or other mental health challenges. If your schedule doesn't open up much room for in-person sessions, you can consider online therapy for flexible treatment. 

Recent research points to online therapy as an effective method of providing mental healthcare to those who may have experienced trauma in their job. For example, a study of 96 participants living with PTSD found that online cognitive-behavioral therapy could reduce distress and lead to a positive therapeutic alliance. Researchers noted that the positive results of treatment were sustained after three months and that comorbid anxiety and depression were also reduced after five weeks. 

An online therapy platform like BetterHelp can provide valuable resources and support as you work through emotions related to your career or other aspects of your life. With online therapy, you may not have to set aside time to travel to an office. Because many platforms have thousands of therapists with various specialties and areas of expertise, your chance of matching with someone specializing in your specific concerns may be higher. 


First responders often provide supportive life-saving work that can benefit countless lives. However, their job can also cause serious mental health challenges. When those who provide emergency services require assistance, therapy can be a source of guidance. If you're seeking mental health care for trauma or related concerns, consider reaching out to a professional to manage your stress, focus on what matters, and improve your emotional well-being.

Frequently Asked Questions 

Below are frequently asked questions on the topic of first responders and mental health. 

Do Ambulances Have EMTs Or Paramedics?

Professional medical technicians work in emergency medical services (EMS). EMTs and paramedics are both types of EMS workers but have different duties. Both experts have the knowledge, skills, and equipment to provide health treatment and life support during critical incidents. However, the difference is in how much education each professional has had. For example, paramedics often have more education than EMTs. A comprehensive ambulance service will offer both or be managed by a healthcare facility with trained staff on deck.

How Much More Do Paramedics Make Than EMTs?

According to the Bureau of Labor Statistics, health professionals with an EMS education can expect a competitive salary. On average, EMTs earn around $38,800 per year. Care providers with EMS mental health training can make more. Paramedics take home an average salary of about $65,000 each year. Individuals in these careers might find more reward in helping people than getting paid. States with the highest-paid disaster response teams are Delaware, Nevada, Maryland, Washington, and Alaska.

Are Counselors Considered First Responders?

Some professional counselors are considered first responders because they support mental, emotional, or behavioral emergencies. They may offer life support in a non-physical way or work with suicide prevention, emergency room triage, or other forms of mental healthcare. 

First responders with clinical mental health counseling experience may offer mental health support on an emergency scene to support EMTs and paramedics in determining the cause of an emergency. EMS mental health calls account for a percentage of emergency room visits, so mental health counselors often help doctors make mental health evaluations. 

Is An Advanced EMT The Same As A Paramedic?

There are many differences between an advanced EMT and a paramedic. Both trained medical technicians can transport patients, offer on-site health treatment, and provide emergency services. However, paramedics require higher education. 

The National EMS Scope of Practice models that describe these careers find the following EMS licensure distinctions to be more definitive:

  • Level One: Emergency Medical Responder (EMR)

  • Level Two: Emergency Medical Technician (EMT)

  • Level Three: Advanced Emergency Medical Technician (AEMT)

  • Level Four: Paramedic

Each role represents a different level of patient care that can be provided. For example, an advanced EMT may be able to offer pediatric care and general health treatment but might not be allowed to put in an IV or offer advanced medical care. 

What Can Paramedics Do That EMTs Cannot?

Paramedics offer health services that EMTs cannot. Both professionals can provide life support and health treatment to patients and their families during critical incidents. However, each expert has a specific job, and some tasks cannot overlap.

EMTs can administer CPR on the scene, give emergency glucose and oxygen, and provide basic first aid. Paramedics may also perform more complex procedures. They're responsible for administering controlled substances, starting IVs, and performing pre-surgical care en route to an equipped healthcare facility.

Paramedics and EMTs are not allowed to provide mental health treatment without the support of a licensed therapist or psychologist. However, they may provide resources for suicide prevention and alert hospitals or law enforcement of a code green to prevent further accidents or injuries.

How Much Does An Advanced EMT Make?

The salary for an advanced EMT may vary depending on several factors, including location, training, and hours worked. However, the average professional may gain around $37,138 a year before taxes, bonuses, or holiday pay. Training for additional health treatment may affect an AEMT's earnings. For example, they may be eligible for higher pay if they gain experience with emotional wellness or stress management.

Why Is EMT Pay So Low?

EMTs may not make a significant salary due to the lesser educational requirements than doctors or medical professionals. They may be plentiful in urban areas due to the minimal certification requirement, and higher-paid positions might be found in smaller cities or remote towns with limited contact with physical or mental health EMS. 

What Is The Hourly Pay For An EMT?

Hourly wages may vary based on several factors. For example, certification, experience, location, and education can play critical roles in what an EMT earns. Additional training may enhance health treatment abilities, creating more lucrative health service opportunities. Holiday pay, overtime, and employee bonuses may also affect the hourly average.

What Can Advanced EMTs Do?

An advanced EMT, or AEMT, is a health EMS professional with special training to perform specific tasks during various emergencies. Their responsibilities might include the following: 

  • Providing basic life support

  • Performing CPR

  • Giving first-aid

  • Administering glucose

  • Offering supplemental oxygen

  • Installing laryngeal airway devices

  • Using CPAP machines

  • Employing a defibrillator

  • Assessing patient conditions

When a health treatment requires an additional medical consultation, advanced EMTs may perform interventions until support arrives. They're often trained to use all the equipment in an ambulance and provide critical information to healthcare staff.

What Is The Difference Between An EMR And An EMT?

EMR stands for "emergency medical responder," and EMT stands for "emergency medical technician." Both professionals respond to emergent situations with a basic understanding of rapid healthcare. However, an EMR's primary function is to manage stress and provide immediate care for other responders and people on the scene.

An EMR and EMT may work side-by-side to offer on-site health treatment to pre-hospital patients during critical junctures. However, they do not offer the same level of healthcare because each position plays a unique role inside the ambulance. Moreover, an EMT certification requires more education, so they're allowed to offer support an EMR may not. 

Emergency medical responders are not necessarily responsible for transporting patients to hospitals or administering medications. Instead, they may provide instant aid and intervention while patients wait for EMTs, AEMTs, and paramedics to arrive.

How Many Hours Is Advanced EMT Training?

EMT certification may require 113 or more hours. However, you might also be required to have a basic EMT certification to qualify, and certain employers may require additional training. Often, AEMT training courses teach the proper procedures for administering various health treatments to critical care patients. Students may learn hands-on practices in a guided step-by-step course. 

EMTs often enroll in a program that meets or exceeds the National Emergency Medical Services Education Standards and then successfully passes their state-approved Emergency Medical Technician course.

What Is The Purpose Of Mental Health Counseling?

Clinical mental health counselors work with their clients or patients to develop strategies and approaches to improve mental health symptoms, behavioral and emotional concerns, professional worries, and any other issue a person might confront. 

Duties may include monitoring clients, crisis intervention, treatment planning, substance use counseling, and administering educational programs. Many clinical mental health counselors choose to become board certified. 

What's The Difference Between A Mental Health Counselor And A Therapist?

A therapist can be licensed and certified in therapeutic techniques to assess and address mental health and emotional issues in diverse populations. Many mental health professionals use the title "therapist" to identify themselves, although their educational background and real-life experience can vary. For example, a therapist might be a: 

  • Licensed mental health counselor

  • Psychologist

  • Psychiatrist

  • Social worker

  • Mental health or substance use adviser

  • Certified healer providing mental health counseling and mental health services

  • Licensed professional counselor providing group sessions or school counseling

What Types Of Mental Health Concerns Do Counselors Treat? 

Providers of mental health counseling can assess and treat several mental health challenges impacting a person's overall well-being, including the following: 

  • Major depressive disorder

  • Anxiety disorders

  • PTSD

  • Phobias

  • ADHD

  • Bipolar disorder

  • Anger concerns

  • Marriage and family conflict 

  • Substance use

How Do I Become A Mental Health Counselor Without A Degree?

Many individuals may have the desire and vocation to support others but may not want to invest time and money pursuing a bachelor's or master's degree. However, you cannot practice therapy or counseling without a degree. You may be able to support individuals with their mental health in other ways. 

You might complete a few certifications if you pursue a mental health counseling career without a college education. A few positions you can research in your area include the following: 

  • Life skills coach 

  • Human development coach 

  • Personal development coach 

  • Community outreach worker

  • Sponsor 

  • Peer support 

  • Youth worker

  • Group home staff 

  • Career coach 

What Are The Four Types Of Mental Illness?

Hundreds of mental health diagnoses may affect a person's overall wellness. Many can be treated with mental health counseling by a licensed provider. Four common types of mental health conditions include: 

  • Anxiety disorders, such as generalized anxiety disorder, specific phobias, and panic disorder

  • Mood disorders, including depression and bipolar disorder

  • Personality disorders, such as borderline personality disorder and histrionic personality disorder.

  • Eating disorders, including anorexia, binge eating disorder, and bulimia

If you're experiencing a mental health condition or distressing symptoms, consider reaching out to a provider for support.

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