A systematic review of PTSD treatments for first responders found the most consistent reductions in symptoms in studies of eye movement desensitization and reprocessing and cognitive behavioral therapy.

Researchers reviewed 15 randomized and quasi-experimental studies involving police officers, firefighters, emergency medical services personnel, disaster workers, and other emergency-service professionals. The studies varied in size, occupation, treatment, and length of follow-up.

EMDR and CBT produced the most consistent results across the studies. The review did not establish that one treatment was better than the other, and it should not be read as a direct comparison between them.

Other approaches produced less uniform findings. Group-based interventions were helpful in some studies but showed limited or no effect on PTSD symptoms in others. Resilience and mindfulness programs were more often associated with short-term improvements in psychological well-being, with less evidence that the benefits continued over time.

The evidence base was uneven. Seven of the 15 studies were rated at low risk of bias. The remaining studies had methodological limitations of varying severity, and evidence on long-term outcomes was limited.

The research gap was particularly noticeable for emergency medical services. Although the review was intended in part to inform EMS care, much of the underlying evidence came from broader first-responder populations.

That distinction matters. Police officers, firefighters, paramedics, dispatchers, and disaster workers may share repeated exposure to difficult events, but their roles, workplace cultures, and patterns of exposure are not identical. Findings from mixed first-responder samples may not apply equally to every occupational group.

The review places EMDR and CBT among the most promising approaches currently studied for PTSD in first responders. It does not settle which treatment is most appropriate for a particular occupation, whether benefits continue over the long term, or how well the findings apply specifically to EMS personnel.

Answering those questions will require stronger EMS-specific studies, clearer descriptions of the populations being treated, consistent outcome measures, and longer follow-up.

Reader Questions

What did the review find about EMDR and CBT?

Across the 15 included studies, EMDR and CBT showed the most consistent pattern of PTSD symptom reduction. The review described a promising evidence signal, not a final ranking of treatments.

Did the review show that EMDR works better than CBT?

No. The review was not a direct head-to-head comparison and did not establish that either treatment was superior.

How strong was the evidence?

Seven studies were rated at low risk of bias. The others had methodological limitations, and the studies varied in occupation, intervention, sample size, outcome measures, and follow-up.

What did the review find about group, resilience, and mindfulness programs?

Group interventions produced mixed PTSD findings. Resilience and mindfulness programs were more often linked to short-term improvements in psychological well-being, with limited evidence of lasting PTSD benefit.

Do the findings apply specifically to EMS personnel?

Only cautiously. EMS personnel were part of the review's focus, but much of the underlying evidence came from broader first-responder groups. More EMS-specific research is needed.

Selected Sources

• Jebreel A, Al-Wathinani AM, Gilkaramenthi R, et al. Interventions for post-traumatic stress disorder among first responders: implications for public health response and system resilience. International Journal of Emergency Medicine. Published online July 1, 2026. Checked July 21, 2026.
• PubMed record for the systematic review. Checked July 21, 2026.