The Vermont Research Trial Protocol: A Mixed-Methods Study of Group

First responders experience disproportionately high rates of PTSD, complex PTSD, and moral injury. Standard trauma-focused treatments inadequately address the shame, guilt, and existential distress characteristic of moral injury, while occupational cultures of stoicism create significant barriers to help-seeking.

This mixed-methods feasibility study evaluates an intensive group intervention integrating EMDR, delivered via the Acute Stress Adaptive Protocol (ASAP), with Compassion-Focused Therapy (CFT) for First Responders and Law Enforcement Officers, including frontline healthcare workers. Three cohorts are recruited through the Vermont Centre for Responder Wellness. ASAP's trauma processing sequence provides a mechanistic bridge to CFT-derived Compassionate Mind Training components targeting shame, self-criticism, and moral-emotional distress. A within-culture peer to-peer delivery model employs trained peer supporters as active therapeutic agents alongside accredited clinicians. Validated outcome measures are administered at baseline, post-intervention, and at 1-, 3-, and 6-month follow-ups, with quantitative data analysed using Linear Mixed Models with FIML estimation.

The study will establish feasibility parameters, recruitment and retention rates, safety signals, fidelity data, and preliminary effect sizes to inform a future definitive RCT and will assess the scalability and cultural fit of peer-delivered, integrated trauma care in occupational settings.