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This page is for the people who go toward it. Firefighters, police officers, EMS crews, dispatchers, corrections officers, search and rescue, and veterans anywhere in Arizona.
We’re licensed across the state and we work entirely by secure video, so you can be seen from home, from the station on a long shift, or from your vehicle in a lot somewhere. Nobody watches you walk into a building. We’re a private practice, we’re not contracted to any department, and we work with adults, 18 and over.
Start with the part nobody tells you.
Before anything else, find out what’s already available to you. A lot of people in this field assume they’d be paying out of pocket and never check.
Most agencies contract an Employee Assistance Program. What it covers varies a great deal from one city and one department to the next, so the only way to know your situation is to ask about your situation. Worth finding out:
Your HR department, your union representative or your peer support team can usually answer all of that quickly. Peer support in particular tends to know how it works in practice rather than on paper.
Some people use the EAP and it works well. Others would rather go outside it and pay privately, usually for privacy reasons, and that’s a legitimate choice rather than a paranoid one. Either way, knowing your options beforehand beats deciding you can’t afford help and stopping there.
We’re a private practice. We are not your department’s EAP and we’re not contracted with your agency, which means what you discuss here stays here under the same standards that cover every licensed clinician in Arizona.
We’re in network with Blue Cross Blue Shield of Arizona, Aetna, Cigna, United Healthcare and Optum, and our associate-level sessions run $85 to $100. The pricing page sets out the full picture, including exactly what to ask your insurer and how out-of-network reimbursement works if we’re not listed on your plan.
Dispatchers, this applies to you too, and it’s worth saying because you get left out of these conversations constantly. More on that below.
It’s rarely one call. That’s the biggest misunderstanding about this work.
Occasionally there’s a single incident that changes everything, and people expect that. Far more often it’s accumulation. Fifteen years of calls, most of them routine, a handful that weren’t, and no point at which anybody said stop and deal with that one. It stacks. Then something ordinary happens, a call that shouldn’t have bothered you, and suddenly you’re not sleeping.
The signs we hear about most:
None of that means you’re broken or unfit. It means you’ve been exposed to more than any nervous system is built for, which is the actual job description.
Wildland fire is part of the picture here in a way it isn’t in most states. Arizona’s fire seasons are long, the deployments pull crews away for weeks, and the work is physically brutal on top of everything else. Crews come home to a household that reorganized itself without them, repeatedly.
The state also has a large veteran population and multiple active installations, including Davis-Monthan in Tucson, Luke in Glendale and Fort Huachuca in Sierra Vista, plus Yuma. A lot of Arizona’s firefighters and officers served first, which means two careers’ worth of exposure in one nervous system.
And Arizona is big. If you’re in Yuma, Sierra Vista, Show Low, Payson or anywhere rural, the odds of finding a therapist locally who understands this work are close to zero. Nearly four in ten rural Arizona counties have no mental health provider at all. That’s exactly the gap virtual sessions close.
Dispatchers are routinely left out of the conversation about this work, and it’s worth pausing on why that’s wrong.
You take the call. You hear it happen. You talk someone through CPR on their own child, or you listen to a scene go bad over an open mic, and then the call ends and you never find out what happened. Then the next one comes in, because the queue doesn’t care.
Dispatchers get the trauma without the resolution and without the crew. Crews at least debrief in the truck on the way back. You’re in a room, headset on, already on the next one.
The specific things we hear from this group: intrusive audio rather than images, which is its own kind of haunting. Guilt about calls where you did everything right and it still went wrong. Hypervigilance at home, especially around your own kids. And a persistent sense that you’re not entitled to be affected because you weren’t physically there.
You were there. Being on the other end of a phone line doesn’t insulate anyone, and the work you do belongs in this conversation as much as anyone else’s.
These two come up together often enough to be worth addressing directly.
Shift work wrecks sleep on its own. Add adrenaline that hasn’t cleared by the time you get home, and a lot of people in this field land on the same solution, which is a few drinks to come down. It works, at first. That’s the problem.
Alcohol does get you to sleep faster and it makes the sleep worse, specifically the deep and REM stages that process emotion and consolidate memory. So you sleep more and recover less, which makes the next shift harder, which makes the drinking more necessary. That loop is extremely common in this population and it usually gets described as “I just have trouble winding down.”
Nobody here is going to lecture you about drinking. But if you’ve noticed the amount creeping up, or that you can’t get down without it, that’s worth naming out loud. It’s one of the more fixable parts of this, and it tends to be the thing that’s quietly making everything else harder to treat.
“It’ll end my career.” Getting treatment is not what ends careers in this field. Untreated PTSD ends careers. It ends marriages, it ends livers, and at the far end it ends lives. Getting ahead of it, early and quietly, is what keeps people in the job.
“My department will find out.” We’re a private practice. We’re not your department’s EAP, we don’t report to your chief, and your sessions are confidential under the same standards that cover every licensed clinician. If you ever decide to involve your employer or your insurer, that’s your call, and we’ll explain exactly what that does and doesn’t mean before you make it.
“A civilian therapist won’t get it.” Fair concern, and often true. Ask directly in the consultation. Ask what experience the clinician has with this population, how they handle shift work, what they know about critical incident exposure. A therapist who gets defensive about being asked that has told you something useful.
“I don’t have time.” Sessions are fifty minutes by video from wherever you are. Between shifts, from the station on a slow night, from your truck. No drive, no waiting room, nobody sees you go in.
“Other people had it worse.” Everybody in this field says this. It’s not a useful measurement and it keeps a lot of people from getting care they’ve already earned.
For trauma that keeps intruding, EMDR is often the right tool. It helps the brain reprocess a memory so it stops carrying the same charge, and it doesn’t require narrating the event in exhaustive detail, which for this population frequently makes it more tolerable than talk therapy.
ACT is useful where you’ve already tried to out-think or out-work something for years. CBT builds concrete skills for interrupting the cycles, particularly around sleep and hypervigilance.
Pacing matters more here than almost anywhere. Moving too fast into traumatic material is counterproductive, not brave. You set the speed, and you’re never required to discuss a specific call before you’re ready.
We also work with spouses. Often the spouse calls first.
People hear “eye movement therapy” and reasonably assume it’s nonsense, so here’s the plain version.
A traumatic memory gets stored differently from an ordinary one. It doesn’t file itself away as something that happened. It stays live, which is why a smell or a radio tone can drop you straight back into it years later.
EMDR works on that storage problem. You hold a piece of the memory in mind while doing something that occupies part of your attention, usually following a moving target with your eyes or alternating taps. In practice it seems to let the brain reprocess the memory so it files properly. The event still happened, you still remember it, and it stops carrying the same charge.
The practical advantage for this population: you don’t have to narrate the call in detail. A lot of first responders will not describe certain jobs out loud to a civilian, and with EMDR that’s largely not required. That’s frequently what makes it tolerable when talk therapy hasn’t been.
It’s recognized in clinical practice guidelines as an effective trauma treatment. It isn’t magic and it isn’t fast for everyone, but it’s a real tool with real evidence behind it.
Often the spouse makes the first call, and that’s a legitimate way in.
Living with someone in this work has its own shape. You learn not to ask about the shift. You manage the household around sleep schedules that make no sense. You notice the drinking before they do. You handle the version of them that comes home from a bad run and says nothing for two days, and you explain to the kids that dad or mom is tired.
Partners in this field often describe a specific loneliness: being married to someone who’s physically present and emotionally somewhere else, while everyone around you treats your spouse as a hero and you as lucky.
We work with spouses individually and we do couples sessions. If your partner won’t come in, individual work still changes things, because relationships are systems and moving one part of a system moves the rest.
Retirement hits this population harder than almost any other, and almost nobody prepares for it.
You spend twenty or thirty years with a clear identity, a crew that understands you without explanation, a schedule that structures your week and a sense that what you do matters. Then it stops, all at once, usually on a Friday.
What follows surprises people. Loss of purpose. Loss of the crew, which turns out to have been most of your social life. Sometimes, for the first time, the memories catch up, because the job’s pace was doing a lot of work to keep them at bay. Plenty of people who held it together for an entire career fall apart eighteen months after the last shift.
That isn’t weakness and it isn’t too late. It’s a predictable transition and it’s very workable, especially if you start before the pension paperwork rather than two years after.
A free 15-minute consultation. Not a session, not an assessment, no paperwork, no cost. Ask whatever you want, including all the questions above.
If you’re in crisis, call or text 988. Veterans press 1 for the Veterans Crisis Line. Firefighters and EMS can reach the Fire/EMS Helpline, and there are peer support lines staffed by people who’ve done the job. Any of those is a better call than sitting with it alone at 3am.
You’ve spent a career being the person who shows up when somebody else can’t cope. That doesn’t make you exempt.
This work sits alongside the rest of what we do. Our services page covers individual therapy, couples work, clinical supervision and performance coaching, and explains which one suits which situation.
We’re licensed across Arizona and work by secure video, so where you live doesn’t limit access. The locations page covers how the pressures differ between the Valley, Tucson, northern Arizona and the rural counties.
Fees are published openly on the pricing page. When you’re ready, book a free 15-minute consultation.
A free 15-minute consultation, outside your department and off the record. No cost, no obligation, and nobody told.
