Trauma Screening Questionnaire (Tsq) Template (Page 2 of 2) in pdf

Occupational Stress Exposure Protocol

The National Fallen Firefighters Foundation

Recommended Protocol for

Exposure to Occupational Stress

he stress to firefighters that is created

assessment will often help firefighters put the

by exposure to traumatic events is very

event into perspective. After a brief “time out,”

real. These kinds of experiences happen with

they may elect to return to service.

unfortunate regularity because they are an

TSQ screening: The Trauma Screening

essential part of what the fire service does. No

Questionnaire (TSQ) is a straightforward and

matter the size or type of the organization, it is

easily scored instrument to identify who is

important that firefighters be prepared to deal

progressing well, and who may need additional

with the impacts of these exposures, and that

help down the road. Used 3-4 weeks after

fire departments provide access to resources

the PTE, it consists of ten simple questions

that can make a difference.

about recent symptoms. More than six positive

The actions recommended in the model shown

responses suggest that a more complete

in the flowchart (on Page 1) reflect best practices

screening by a competent behavioral health

based on current research, and should fit easily

professional may be warranted.

into the operations and support systems that most

Complete assessment: This can typically be

fire departments have in place. The key elements

accomplished by a referral to a department or

of this model include:

jurisdiction’s Behavioral Health Assistance Program

Determination of a Potentially Traumatic

(BHAP) or other competent behavioral health

Event (PTE): A trauma for one responder may be

professional. BHAP counselors can often help

a routine event for another. Reaction to a trauma

with managing specific symptoms and dealing

is subjective, driven by an individual’s experience,

with other non-event related stressors of daily

sensibilities and personal situation. After exposure

living (such as marital problems, financial issues,

to a PTE, members should be asked if they require

etc.) that might be interfering with a member’s

assistance. If so what type? If not, expression of

recovery from exposure to a traumatic event.

support may be all that is required.

Treatment by specialty clinician: If more

Time out/hot wash: This concept is borrowed

intensive care is needed, it should be provided

from the military as an element of After Action

by a specialist (psychiatrist, doctoral-level

Review (AAR). It is a mechanism that allows those

psychologist, licensed clinical social worker or

affected by an event to review what happened,

licensed professional counselor) with advanced

what was successful, what could have gone better

training and supervised clinical experience in

and how they might improve the next time they

specific evidence-based treatment for PTSD,

respond to a similar situation. This post-incident

anxiety disorders and depression.

Firefighter Life Safety Initiative #13:

Firefighters and their families must have access to counseling and psychological support.

To learn more about the National Fallen Firefighters Foundation’s FLSI #13

Behavioral Health Protocol and for information regarding training in its use, visit

Trauma Screening Questionnaire (Tsq) Template Page 2

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