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August 4, 2025 15 mins
When we talk about taking care of our mental health, we don’t often talk about the people who take care of us. What are the unique mental health challenges for first responders and how might their treatment and approach be different? Our guest is Dr. Brendan Guarino, clinical psychologist at Baker Street Behavioral Health, specializing in treatment for athletes and first responders.
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Speaker 1 (00:01):
Welcome to get connected with Nina del Rio, a weekly
conversation about fitness, health and happenings in our community on
one oh six point seven light FM.

Speaker 2 (00:12):
Welcome to get connected. But we often talk about mental
health on the show, usually around children and families. This
conversation will center on mental health for first responders and athletes.
Our guest is doctor Brendan Guarino, clinical psychologist at Baker
Street Behavioral Health, specialized in this area where people face
unique and complex challenges. Doctor Brendan Guarino, thank you for

(00:35):
being on the show.

Speaker 3 (00:36):
Thank you for having me today.

Speaker 2 (00:37):
You can find out more at bakerstreetpsych dot com. I
think an interesting place to start with just to be
talking about mental health and first responders. There's been that
stigma around the general public seeking treatment for mental health
for years. That's kind of dropping a little bit. But
where is it among police officers and fire and the like,

(00:57):
these professions that have so much much about, you know,
taking control of yourself and machismo and all this other stuff.

Speaker 4 (01:05):
Sure, so first responders, you know, they're they face unique
challenges daily and and maybe something that we as civilians
on the other side, don't normally see on a daily basis,
so they face high intense stress, high stakes environments that
requires them really to make decisions really fast and quick

(01:27):
under pressure. So for for them to be able to
come see a person who is not a first responder
is really difficult, and that's what I've heard. It's really
difficult because they don't we don't understand what they go through.
A part of stigma is definitely education, So educating the person,
educating the clinician on the first responders responsibility, also educating

(01:51):
the first responder on what therapy is like, the process
and how it can help them long term.

Speaker 2 (01:57):
It's also I guess educating perhaps psychologists and therapists. You
work in this area, this is where you specialize, but
also not every therapist is the same.

Speaker 4 (02:06):
Yeah, yeah, absolutely, So there's a wide variety of different
modalities and depending on the need of the person, there's
different techniques and different strategies on how to help them.
And the term that I'm thinking of as cultural competency
and being competent in understanding what the unique challenges are
for first responders is really important in helping them because

(02:27):
you need to be able to work with them in
a way that is helpful for them, especially with their
shift work and the changes in their schedules.

Speaker 3 (02:36):
And need to be flexible. You also need to.

Speaker 4 (02:38):
Understand that part of their life is who they are,
is who is their first responder role. So knowing that
and knowing there and being flexible with them will definitely
go a long way and joining and forming a relationship.

Speaker 2 (02:51):
You in fact, grew up in a family of first responders,
so you came to work with this community, I'm assuming,
with a lot of that in your bag of tricks,
but also being able to kind of meet them on
their own level.

Speaker 3 (03:03):
Absolutely.

Speaker 4 (03:04):
I mean I come from a large family first responders.

Speaker 3 (03:07):
Like like you said, my uncle, my.

Speaker 4 (03:09):
Father, my godfather, my my cousin are all first responders.

Speaker 3 (03:14):
And I'm also I was also a collegiate athlete.

Speaker 4 (03:17):
So not comparing or paralleling the two, but comparing the
stressful environments and living through that stressful environment just vicariously
through my family, my friends who are now first responders,
who are police officers. I hear stories and I learned,
but I also like to learn from them. I like
to learn from what they what they see, what they do,
how you know the hiring process happens, and what the

(03:39):
pension process looks like so it just gives me a
good understanding like full you know, a broader understanding of
the first responder atmosphere and community.

Speaker 2 (03:50):
Since you bring up athletes, what might be the overlap
between first responders and athletes and how they approach their
jobs and the stress that comes with it.

Speaker 4 (03:58):
So first respond and athletes are, in my book, are
both higher performers, right, So they perform at the highest level.
They have to operate under pressure. There it's requiring decision making, stamina,
consistent delivery under stress, and like athletes, first responders have

(04:19):
to do that consistently while they're performing. Right, So we
need to be able to understand how to cross ref
or cross those two skills. So whether it be just
breathing and learning how to control your breath when you're
going into a fire versus when you're going into a
game or a play, obviously very different circumstances, but in

(04:39):
the same process of understanding that I need to regulate
myself be able to then be able to perform, to
be able to help somebody and help my team.

Speaker 2 (04:48):
We're speaking with doctor Brendan Burrino. He is clinical psychologist
at Baker Street behavioral health. In a conversation about first
responders and athletes and their mental health. You can find
out more Baker Streets you're listening to get connected on
one O six point seven light FM. I'm Mina del Rio.
As you mentioned before, so many of us identify ourselves

(05:09):
by our job. What comes up in the first responder
community when people are without their uniform.

Speaker 3 (05:16):
That's a great question.

Speaker 4 (05:18):
So a lot of times I see, and again this
is another cross for athletes, is you go through a
period of time where you're doing something, you're doing, You're
in a career, you're playing a sport for your whole
entire life, and then one day that goes away, whether
it be a retirement, injury, being forced out of the job,

(05:39):
whatever it may be, you kind of lose your sense
of identity because you've identified so.

Speaker 3 (05:44):
Much with this portion of your life.

Speaker 4 (05:46):
Right so, whether it be twenty years, ten years, five years,
you're still that's still a part of you. And I
often see a lot of people struggling with that transition
process of working regularly or training regularly and then not
doing that again or not doing that. I'm sorry after

(06:06):
and then tried to find out who am I like,
who am I beyond my uniform?

Speaker 3 (06:11):
Who am I beyond my badge?

Speaker 4 (06:13):
I struggled with that a little bit when I graduated
college and it was just a graduation and I couldn't
And I wrestled since I was six years old. So
I wrestled all the way through high school as a younger,
young kid, and then in college. I finished college and
I was like, what next, What do I do next?
I wrestled all my life, and I worked out pretty
much all year around. Now I don't have to work out,

(06:35):
I don't have to hit go to the gym, I
don't have to do these things. So I had to
trip try to find what my next thing was, and
I found jiu jitsu, and jiu jitsu is my equivalent
of wrestling. It scratches the itch of competition and testing,
you know, my mental fortitude and my stamina and all
that stuff, and it keeps me in shape. So for

(06:56):
first responders, whether it be volunteering or being a pure
support member or helping the next generation of firefighters or
police officers, after their retirement or after they're done with this,
they could still form an identity beyond being that person
that firefighter.

Speaker 2 (07:14):
What do you mean by training your brain actually training
your brain.

Speaker 4 (07:19):
Yeah, So, as we know, practice is something that we
have to do often with a lot of different things,
and that term of practice makes perfect I don't really.

Speaker 3 (07:27):
Subscribe to that.

Speaker 4 (07:28):
I'm more or less ascribed to practice makes you better.
So over time, if you build habits, small small little habits,
they build and they grow. So if we train our
body like we're going to work out, like you're going
to train your muscles, you should do the same thing
with your brain. Where if you're practicing a skill, say
you're practicing how to breathe, and that's like maybe a

(07:50):
foreign concept for people because we breathe normally. But if
you practice how to regulate your breathing often and you
do it consistently, over time becomes a process that just
comes that just is natural to you. So when you
are not when you don't need that time to breathe
and regulate yourself, you then could use it because you've

(08:10):
practiced it when you didn't have to didn't need it.

Speaker 2 (08:12):
This sounds like you're almost leading into meditation and things
like that.

Speaker 4 (08:17):
Yeah, I mean there's a there's a very big connect
with meditation there. It doesn't need to doesn't need to
have to be meditated, or it doesn't have to be meditation.
It could just be, Hey, I'm gonna practice box breathing.
So box breathing is a technique that you would do
to regulate your breathing, and you would trace a box
in your mind, and it's a four four four four

(08:37):
technique of breathing in, holding, breathing out, and holding again,
and you keep doing that until your body and your
your breath is regulated.

Speaker 2 (08:46):
You mentioned functional journaling. What is functional journaling?

Speaker 4 (08:51):
So functional journaling is something that I often like to
give to people as homework assignments. And so journaling in general, right,
we're just writing. It's kind of like a diarrhea or
you know, a dear diary type thing. But functional journaling
is more targeted. So when we journal, most of the
times it's free flowing. It's just whatever comes to our mind.
But if you're functioning, if you're journaling for a purpose,

(09:14):
let's say you're journaling to understand you understan like a
to do list essentially, right, I have to do this
the next day, you might journal or you might write
in your journal like what do I have to do
for the next day, and how can I get it done?
And it helps you prepare and helps you cope ahead
for the day that you have. This is my goal,
How do I get to that next step? That's that
would be functional journaling. So it's a there's a structured

(09:36):
element to it that helps people get from point A
to point B and and beyond and then and then
that can create a blueprint for the next time you
need to do it again.

Speaker 2 (09:47):
How does being on all the time again affect people's
mental health and their personal and family life.

Speaker 4 (09:53):
That's a really great question being on all the time,
and I'm sure a lot of people can attest this.
This is not unique to just first responders. This could
be for anybody. It definitely puts you in a position
to be burnt out very quickly. And I know it's
not always reasonable to say that we could shut ourselves
off or shut our mind off and just completely go

(10:15):
you know, dark, and be away from everything, because you know,
people have kids, and some people are single parents, and
some people work. You know, our single parenting, but the
other parent is working. But to be able to shut
off for a little bit and disconnect and separate ourselves
from our work and from the chaos of the world
and the day is really really important because that preserves

(10:39):
us to be able to have energy to do the
other things that we like to do, whether it be
our hobbies or spending time with family, connecting with our
values and stuff like that.

Speaker 2 (10:48):
Someone who's also accustomed to being in high gear when
they're entering treatment or trying to deal with that, they
might want to see progress quickly. What does progress actually
look like, or most of the time look like in treatment?

Speaker 4 (11:00):
Yeah, well, I always say progress is definitely different for
every single person. It's not, it's not it doesn't look
the same, and it's not linear at all. So progress
can look like a somebody climbing a mountain. It could
look like somebody climbing a mountain and falling backwards but
then getting back up to climb that mountain. But progress,

(11:21):
progress definitely is how is what you make of it
in your in your treatment, right, It's how you frame it.
So I look at failures as almost like as a
as a feedback. Right, So if I fail, what did
I do that made me fail or or inkurt or
helped me fail? I should say, and what can I
do differently next time to get beyond that failure? Or

(11:42):
beyond that little that adversity.

Speaker 2 (11:44):
Reframing failure might be a more natural approach for an athlete.
You lose a game, you've got to figure out what
you did wrong, you move forward. But how might the
approach be different when you're working with someone, say a paramedic,
and failure.

Speaker 4 (11:58):
Sure, so it's it's definitely a different it's definitely different frame,
definitely differently framed for.

Speaker 3 (12:05):
For first responders because of failure.

Speaker 4 (12:07):
Can mean like somebody passing or I didn't save somebody.
But I think if we look at the concept of
I I was prepared, and I did my best, and
I tried, and this is what ended up happening as
a result of it, it definitely is probably a different
a different way of a different way for them to
cope through it. But it's still in the same way

(12:29):
of like, Okay, I what what did I do? What
what ended up happening that caused me to fail? And
how can I next time ensure that or or make
myself or understand that Hey, like maybe this is something
that actually comes with the territory of working in this field.

Speaker 2 (12:44):
It's not necessarily your fault at all.

Speaker 4 (12:46):
Yeah, and it's a very difficult thing, and and and
again I would not I would not say that framing
that failure as uh as your fault or you know,
unless something truly did happen that could be labeled that.
But you've done every thing you could, so hey, let's
let's let's figure out like what ended up happening, Like
was there a systematic thing that happened. Was it just
like a malfunction of a machine or something like that?

Speaker 2 (13:08):
Right? What would you say to people who are having
an issue, having issues trying to figure out where to
go forward, and they're wary of having these conversations.

Speaker 4 (13:19):
I would say, start off small. Talk to your supports
if you're if you're struggling with with with something, right,
talk to your support, see what see what they say.
And I think having a solid support system first and
then therapy and then maybe therapy later might be something
that could be really important for people. And also in

(13:41):
tandem with therapy and talking to somebody else. But I
would say, try try it out, like, come come to us,
come talk to us. And if it doesn't work out,
it doesn't work out, it's not you know, it's not
like it's not a thing that we're gonna we're gonna
be mad at us therapist that you don't feel comfortable
or don't want to talk about it. But I know
that from experience that once people come and they understand

(14:04):
that hey, we're trying to we want to help you,
and also we're trying to learn, we're all and we're
here for you and there's no judgment here, people tend
to open up a lot more.

Speaker 2 (14:14):
Finally, you also lead the Guardians for Guardians program. Can
you talk about that a little bit and how it
supports the community.

Speaker 3 (14:20):
Absolutely.

Speaker 4 (14:21):
So, Guardians for Guardians is house within Baker Street Behavioral Health.
It is an outpatient mental health program that supports first
responders and their families. So Guardians for Guardians we aim
to normalize the help seeking behavior within the first responder
community and provide support for those individuals that give their
all to the communities. We have anything from individual therapy

(14:45):
to medication management, to couple's therapy to family work and
then more broadly throughout Baker Street we have a Gerald
Psyche program for our older adult population and p dietary
for those of you that want to have some prevent
get some preventative care for your feet.

Speaker 2 (15:03):
Why feet in particular.

Speaker 4 (15:05):
We we try to treat people from the head, from
head to toe.

Speaker 3 (15:08):
Oh that's our that's our model.

Speaker 4 (15:10):
That's why model put onto.

Speaker 2 (15:12):
Baker Street sounds fantastic. Our guest is doctor Brendan Guarino.
You can find out more at bakerstreetpsych dot com. He's
from Baker Street Behavioral Health. Thank you for being on
to Get Connected.

Speaker 3 (15:24):
No, thank you very much for having me.

Speaker 1 (15:27):
This has been Get Connected with Nina del Rio on
one oh six point seven light Fm. The views and
opinions of our guests do not necessarily reflect the views
of the station. If you missed any part of our
show or want to share it, visit our website for
downloads and podcasts at one oh six to seven lightfm
dot com. Thanks for listening.
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