May 18, 2025 • 15 mins
Original Air Date: May 18, 2025
Dr. Brendan Guarino, who grew up listening to Q104.3, thanks to his parents, is a clinical psychologist who specializes in the mental health of first responders. 5/17 begins EMS Week.
Dr. Brendan Guarino, who grew up listening to Q104.3, thanks to his parents, is a clinical psychologist who specializes in the mental health of first responders. 5/17 begins EMS Week.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Sunstein Sessions on iHeartRadio, Conversations about issues that matter.
Here's your host, three time Grasie Award winner, Shelley Sunstein.
Speaker 2 (00:10):
In recognition of Mental Health Awareness Month, which is the
month of May, and in honor of National EMS Week,
which we are kicking off today, I want to introduce
you to doctor Brendan Guarino. He's a clinical psychologist at
Baker Street Behavioral Health. He specializes in the mental health
(00:32):
treatment of first responders also athletes, but he is also
the leader of Guardians for Guardians program at Baker Street
Behavioral Health, and that's initiative focused on supporting police, fire, military,
EMS proficient professionals and their families. And before we begin,
doctor Guarino, I don't know if you are aware, but
(00:55):
I am on the advisory board of Friends of Firefighters
for New York City. I don't know if you're familiar
with them, but they were formed after September eleventh, two
thousand and one, and they provide free mental health therapy
not just for New York City firefighters, but also for
(01:18):
their families and also for retirees and their families. So
we are like minds.
Speaker 3 (01:27):
Absolutely.
Speaker 2 (01:28):
So you got into this specialty because you come from
a family of first responders. Correct.
Speaker 3 (01:36):
Yeah, absolutely, So I come from a large family of
first responders. My father was a fireman. My cousin is
a where my father was a fireman in loada New Jersey. Okay,
my cousin is a fireman in loada New Jersey. And
my uncle was a fireman in load of New Jersey
as well. And that's where I grew up, That's where
I live currently. And yeah, I have a family, and
(02:00):
I also have a lot of friends who are police
officers in New Hampshire, Rhode Island, Vermont. So I I
essentially learned vicarous vicariously through them the things that they
go through each day. Uh, you know, the shift work
and the family issues and having to take take over
time because of making money and how that puts a
(02:22):
toll on them and not not you know, not to
not to also talk about the the trauma that they
see daily. But I got into this because I was
a collegiate athlete.
Speaker 1 (02:36):
Uh.
Speaker 3 (02:36):
And I went through and I went to Rhode Island
College in Providence, Rhode Island. I wrestled there for four
years and I went through a lot of uh, difficulties
in college, just having to be on constantly and and
all for four years of my life and even more
than that, I've been wrestling since I was five. I
had this body where I was this time of this
(02:59):
time of my life where I to beyond constantly, and
I kind of understand from that perspective of performance what
it really how it really takes a toll on your
body over and over, just keep wearing and tearing, and
to the point where we actually say that first responders
are high performers, right, So they are the they're the
high performers outside of the elite well I'm sorry, outside
(03:21):
of the athletic context. So they have to be on constantly,
they have to be aware, they have to be working
to their highest ability, and if they're not, they can
get injured, and you know, there are a lot of
other things that could happen.
Speaker 2 (03:38):
Tell us talk in general about the mental health issues
that first responders face. I don't think the public, you know,
even sees this as as an issue. And by the way,
as as we air this, I mean, we've had recently
a flood of police suicides in the state of New
(03:59):
York and particularly on Long Island.
Speaker 3 (04:03):
Yeah, absolutely so. First responders. First responders, they they they
go through a lot a lot of different traumas each day,
or they go through a lot of different things that
they have to they have to be on. They again,
they have to be on. They have to be alert. Uh,
they're they have high stakes environments, right, They go through
(04:25):
high stakes environments. Whether you're a fireman or a police officer,
or an EMS worker or ESU, whatever law enforcement you're
in the environments, they have to be quick decision They
have to have quick decision making that perform under pressure,
often exposed to traumatic events like life threatening situations, unpredictable
shift work, chronic stress, burnout, post traumatic stress symptoms like
(04:49):
hyper vigilance. But it's really hard for them to shut
that off and separate work and home life. You know,
thinking about oh, going off for a twenty four hour shifts.
As a fireman, you have to be on, you have
to be alert. You have to be taking care of
yourself and your and your and your brothers when you
(05:11):
go home, that's something you also have to do. You
have to try to keep your family safe. So it's
difficult to shut that that mind off, that portion of
your mind off in when you're not working. And I
think with mental health that part of that is it
impacts the family because when you come home, you don't
want to unload on your family. You don't want to,
(05:33):
you know, dump all the stuff that you've seen or
heard or been through on your family. You are the gatekeeper,
per se to the bad stuff that has happened because
not normally civilians don't see the things that the first
responders go through. So they keep it inside and they
allow themselves they push it down. And I give this
analogy of a garbage bag all the time and people
(05:55):
laugh at it. But if you keep shoving garbage in
a garbage bag, it's just going to break, it's gonna smell,
it's gonna it's gonna pop, it's gonna pop it when
you try to pull it out at any point in time.
So you don't want to shove all that garbage in
and let it blow over. You want to be able
to take out the garbage in the trash when you
need it. So that's what therapy does for you. As
you come to therapy and you unload and you kind
(06:17):
of theent to people, and it's really cathartic for certain people.
Speaker 2 (06:22):
Is it your opinion that perhaps all first responders should
be getting some therapy because in a sense, that is
training that is currently missing in the first response. You know,
I'm seeing it. You know, people see therapy as oh,
something's wrong, but perhaps therapy could be used as a
(06:44):
preventive tool of coping. I mean, this just dawned on me.
So should this be happening in the first responder community?
Speaker 3 (06:53):
Absolutely, the biggest, the biggest push I am pushing for
right now is preventative care of first respond even when
they get into the academies or they start to think
about becoming becoming first responders, firemen, ms how, whatever, whatever position,
I think there needs to be some preventive care of
how to take care of yourself because that is a lack.
(07:15):
There's lacking that is lacking in this profession where uh
they in a sense like we want to try to
keep we want to try to promote resiliency in our
first responders, but we do it a little late where
where we put them in, we put them in harm's
way and they say, okay, now be resilient versus let's
let's teach you how to how to cope with these things.
(07:36):
Let's teach you how to buffer the blow of the
things that you're going to see. And I think with
with with therapy, it's not this dark, you know, mysterious
thing that if you come in there's something wrong with you.
If you're coming in, you're coming to therapy to get
to get help, or you're coming to therapy to prevent
yourself from having to get help. The more help in
(07:56):
the future. So we we at we at Baker Street
really try to normalize the helping the help seeking behavior
across the board. And it's not just with first responders.
I think it's with everybody.
Speaker 2 (08:08):
I'm speaking with doctor Brendan Guarino. He leads the Guardians
for Guardians program at Baker Street Behavioral Health. It's an
initiative focused on supporting police, fire, military, EMS professionals and
their families. As we begin National EMS Week. How would
(08:28):
people contact you, doctor.
Speaker 3 (08:31):
Yeah, so you can go to Baker Street psych dot
com or you can call us at A three three
nine three seven twenty seven twenty four. And when you call,
you're going to get a real person on the line.
You're not going to get an automated system. Somebody will
be there to walk you from your first question to
your intake to setting up the appointment, through paperwork, through insurance.
(08:53):
They'll be able to help you out with all those
all those questions, and we are we really pride ourselves
on at twenty four to forty eight hour turnaround, so
we try to get people in quickly because we know
the urgency. And we also are fairly and pretty flexible
with our schedules because we know that first responders have
unpredictable schedules. You know, they could be working one hour,
(09:14):
twenty four hours and then have to take an overtime
or something like that, So we really are flexible in that.
But you can call us, you can go to our website.
When you call, just let them know that you are
active or retired, or you were a first responder. And
even if you have a family member that needs help,
we really try to support the family because the family
is the first front line for these people. So you
(09:38):
can give us a call and just let us know
what you need and then we can try to help
you from there.
Speaker 2 (09:43):
Does Baker Street Behavioral Health take insurance?
Speaker 3 (09:46):
So we are an out of network provider, which means
that we build the out of network for you. We
build a provider for you through out of network, through
your out of network benefits. But within the program, we
to try to push for people to come and get
the help that they really need.
Speaker 2 (10:04):
So how much cost would be incurred, what's changed?
Speaker 3 (10:08):
It all depends on the insurance. It really all depends
on the insurance of what you have, and you know
it depends on United or whatever insurance that they have
what they have through their either their union or their
personal insurance. But we really try to work with people
and try to help them out because we know how
imperative this is and we don't want people to not
(10:31):
come to therapy because of because of financial issues.
Speaker 2 (10:34):
But going back to what we discussed a couple of
minutes earlier, in a perfect world, should the police departments,
the fire departments, the ems is, the military, In a
perfect world, would those organizations be providing therapy or using
(10:55):
therapy as part of the training.
Speaker 3 (10:58):
Yeah, I do think that in a per world that
they well, yes, I do think in a perplect world
that therapy should be involved. I know a lot of
first responders who don't want to come to therapy if
they know that their organization has a therapist there because
of conflict of interest or things might be getting back
to them, but I think that also reinforces the stigma,
(11:20):
and that's like a double edged sword. I do like
I do think that because we are a third party,
we are we are a person outside of that organization.
I think people are more willing to come to us
and talk to us because it won't get back to
their their commander, their chief, their you know, their their lieutenant,
it won't get back to them. But in a way,
(11:42):
like I do think that this needs to be looked
at more as a as a thing that needs to
be put into place when you're in when you first
start to become a first responder, uh, you know you're
going to become a fireman. I think in the academy
there should be there should be some there should be
some courses on mental health and what you know, what
(12:02):
the impact is and how to help yourself. And I
think there needs to be something like that. So I
also teach. I teach at Felician University in Lowda, New Jersey,
and I preach to my students all the time about
taking care of themselves in self care because this program
is really long and it's you know, sometimes four to
five years, and it takes a toll on you. If
you don't take care of yourself throughout the program, it's
(12:25):
going to be hard to withstand.
Speaker 2 (12:28):
For those who may be a bit reluctant or not
yet ready to make the call to get therapy. What
are some of the coping skills you think people should
know about that that can help them day to day
to prevent a crisis.
Speaker 3 (12:44):
Absolutely, so, I think it falls back. It always falls
back on forming good habits either, whether it be sleep, eating, exercise.
So those three things, I think you always got to
fall back on them, because if you're not taking care
of your body, taking care of your well, taking care
of your mind as well. If you're not taking care
(13:05):
of your body in your mind, it's really hard to
do any anything else, especially with eating, sleeping, and drinking
you know, appropriate amounts of water. But I think on
a on a different level, some of the things that
you could do for yourself, and I've spoken about this
a lot, is just really setting goals for yourself and
really being understanding about that. Small wins sometimes are small
(13:27):
steps in the right direction or are can make big changes.
So if we're if we're setting a goal for ourselves
in terms of Let's say I want to go to
the gym five times a week, but I haven't been
to the gym in two years. I might not go
to the gym five times a week in that first week.
I might set a goal for twice a week, and
then intentionally set another goal for three times a week,
and then four times five so go on from there.
(13:50):
But really setting setting yourself up for success along the
way and creating essentially a blueprint for yourself so then
you could replicate it and replicate it and replicate it.
So the major things there is just really taking care
of your body. Train your body, train your brain, set
some goals for yourself, and be consistent with those goals.
Speaker 2 (14:09):
And I would imagine there should be achievable goals, because
you know, it's like a New Year's resolution. You know,
it has to be achievable or else it becomes meaningless.
Speaker 3 (14:21):
Yeah, well it has to be meaningful too. So there's
an acronym that that people have probably heard. It's called
smart goals so s m ART. So it's specific, measurable, attainable, relevant,
and time bound. So it has to be specific. You
have to understand what you're going to do that goal
you want to do measurable? So how am I going
(14:44):
to measure it? How am I going to measure the success? So?
Did I go to the gym twice this week? Check boom?
Measure attainable? Is it something that I could actually do?
Do I have the resources? Do I have the gym membership?
Do I have the gym near me? What's my work
schedule look like? Is it relevant right? Why is it
relevant right now? I'm trying to get into shape. I
want to lose a little bit of weight and then
time bound boom time time needs commed in factor.
Speaker 2 (15:08):
Thank you so much, Doctor Brendan Guarino, who leads Guardians
for Guardians, the program at Baker Street Behavioral Health.
Speaker 1 (15:16):
You've been listening to Sunstein sessions on iHeartRadio, a production
of New York's classic rock Q one O four point
three
Welcome to Sunstein Sessions on iHeartRadio, Conversations about issues that matter.
Here's your host, three time Grasie Award winner, Shelley Sunstein.
Speaker 2 (00:10):
In recognition of Mental Health Awareness Month, which is the
month of May, and in honor of National EMS Week,
which we are kicking off today, I want to introduce
you to doctor Brendan Guarino. He's a clinical psychologist at
Baker Street Behavioral Health. He specializes in the mental health
(00:32):
treatment of first responders also athletes, but he is also
the leader of Guardians for Guardians program at Baker Street
Behavioral Health, and that's initiative focused on supporting police, fire, military,
EMS proficient professionals and their families. And before we begin,
doctor Guarino, I don't know if you are aware, but
(00:55):
I am on the advisory board of Friends of Firefighters
for New York City. I don't know if you're familiar
with them, but they were formed after September eleventh, two
thousand and one, and they provide free mental health therapy
not just for New York City firefighters, but also for
(01:18):
their families and also for retirees and their families. So
we are like minds.
Speaker 3 (01:27):
Absolutely.
Speaker 2 (01:28):
So you got into this specialty because you come from
a family of first responders. Correct.
Speaker 3 (01:36):
Yeah, absolutely, So I come from a large family of
first responders. My father was a fireman. My cousin is
a where my father was a fireman in loada New Jersey. Okay,
my cousin is a fireman in loada New Jersey. And
my uncle was a fireman in load of New Jersey
as well. And that's where I grew up, That's where
I live currently. And yeah, I have a family, and
(02:00):
I also have a lot of friends who are police
officers in New Hampshire, Rhode Island, Vermont. So I I
essentially learned vicarous vicariously through them the things that they
go through each day. Uh, you know, the shift work
and the family issues and having to take take over
time because of making money and how that puts a
(02:22):
toll on them and not not you know, not to
not to also talk about the the trauma that they
see daily. But I got into this because I was
a collegiate athlete.
Speaker 1 (02:36):
Uh.
Speaker 3 (02:36):
And I went through and I went to Rhode Island
College in Providence, Rhode Island. I wrestled there for four
years and I went through a lot of uh, difficulties
in college, just having to be on constantly and and
all for four years of my life and even more
than that, I've been wrestling since I was five. I
had this body where I was this time of this
(02:59):
time of my life where I to beyond constantly, and
I kind of understand from that perspective of performance what
it really how it really takes a toll on your
body over and over, just keep wearing and tearing, and
to the point where we actually say that first responders
are high performers, right, So they are the they're the
high performers outside of the elite well I'm sorry, outside
(03:21):
of the athletic context. So they have to be on constantly,
they have to be aware, they have to be working
to their highest ability, and if they're not, they can
get injured, and you know, there are a lot of
other things that could happen.
Speaker 2 (03:38):
Tell us talk in general about the mental health issues
that first responders face. I don't think the public, you know,
even sees this as as an issue. And by the way,
as as we air this, I mean, we've had recently
a flood of police suicides in the state of New
(03:59):
York and particularly on Long Island.
Speaker 3 (04:03):
Yeah, absolutely so. First responders. First responders, they they they
go through a lot a lot of different traumas each day,
or they go through a lot of different things that
they have to they have to be on. They again,
they have to be on. They have to be alert. Uh,
they're they have high stakes environments, right, They go through
(04:25):
high stakes environments. Whether you're a fireman or a police officer,
or an EMS worker or ESU, whatever law enforcement you're
in the environments, they have to be quick decision They
have to have quick decision making that perform under pressure,
often exposed to traumatic events like life threatening situations, unpredictable
shift work, chronic stress, burnout, post traumatic stress symptoms like
(04:49):
hyper vigilance. But it's really hard for them to shut
that off and separate work and home life. You know,
thinking about oh, going off for a twenty four hour shifts.
As a fireman, you have to be on, you have
to be alert. You have to be taking care of
yourself and your and your and your brothers when you
(05:11):
go home, that's something you also have to do. You
have to try to keep your family safe. So it's
difficult to shut that that mind off, that portion of
your mind off in when you're not working. And I
think with mental health that part of that is it
impacts the family because when you come home, you don't
want to unload on your family. You don't want to,
(05:33):
you know, dump all the stuff that you've seen or
heard or been through on your family. You are the gatekeeper,
per se to the bad stuff that has happened because
not normally civilians don't see the things that the first
responders go through. So they keep it inside and they
allow themselves they push it down. And I give this
analogy of a garbage bag all the time and people
(05:55):
laugh at it. But if you keep shoving garbage in
a garbage bag, it's just going to break, it's gonna smell,
it's gonna it's gonna pop, it's gonna pop it when
you try to pull it out at any point in time.
So you don't want to shove all that garbage in
and let it blow over. You want to be able
to take out the garbage in the trash when you
need it. So that's what therapy does for you. As
you come to therapy and you unload and you kind
(06:17):
of theent to people, and it's really cathartic for certain people.
Speaker 2 (06:22):
Is it your opinion that perhaps all first responders should
be getting some therapy because in a sense, that is
training that is currently missing in the first response. You know,
I'm seeing it. You know, people see therapy as oh,
something's wrong, but perhaps therapy could be used as a
(06:44):
preventive tool of coping. I mean, this just dawned on me.
So should this be happening in the first responder community?
Speaker 3 (06:53):
Absolutely, the biggest, the biggest push I am pushing for
right now is preventative care of first respond even when
they get into the academies or they start to think
about becoming becoming first responders, firemen, ms how, whatever, whatever position,
I think there needs to be some preventive care of
how to take care of yourself because that is a lack.
(07:15):
There's lacking that is lacking in this profession where uh
they in a sense like we want to try to
keep we want to try to promote resiliency in our
first responders, but we do it a little late where
where we put them in, we put them in harm's
way and they say, okay, now be resilient versus let's
let's teach you how to how to cope with these things.
(07:36):
Let's teach you how to buffer the blow of the
things that you're going to see. And I think with
with with therapy, it's not this dark, you know, mysterious
thing that if you come in there's something wrong with you.
If you're coming in, you're coming to therapy to get
to get help, or you're coming to therapy to prevent
yourself from having to get help. The more help in
(07:56):
the future. So we we at we at Baker Street
really try to normalize the helping the help seeking behavior
across the board. And it's not just with first responders.
I think it's with everybody.
Speaker 2 (08:08):
I'm speaking with doctor Brendan Guarino. He leads the Guardians
for Guardians program at Baker Street Behavioral Health. It's an
initiative focused on supporting police, fire, military, EMS professionals and
their families. As we begin National EMS Week. How would
(08:28):
people contact you, doctor.
Speaker 3 (08:31):
Yeah, so you can go to Baker Street psych dot
com or you can call us at A three three
nine three seven twenty seven twenty four. And when you call,
you're going to get a real person on the line.
You're not going to get an automated system. Somebody will
be there to walk you from your first question to
your intake to setting up the appointment, through paperwork, through insurance.
(08:53):
They'll be able to help you out with all those
all those questions, and we are we really pride ourselves
on at twenty four to forty eight hour turnaround, so
we try to get people in quickly because we know
the urgency. And we also are fairly and pretty flexible
with our schedules because we know that first responders have
unpredictable schedules. You know, they could be working one hour,
(09:14):
twenty four hours and then have to take an overtime
or something like that, So we really are flexible in that.
But you can call us, you can go to our website.
When you call, just let them know that you are
active or retired, or you were a first responder. And
even if you have a family member that needs help,
we really try to support the family because the family
is the first front line for these people. So you
(09:38):
can give us a call and just let us know
what you need and then we can try to help
you from there.
Speaker 2 (09:43):
Does Baker Street Behavioral Health take insurance?
Speaker 3 (09:46):
So we are an out of network provider, which means
that we build the out of network for you. We
build a provider for you through out of network, through
your out of network benefits. But within the program, we
to try to push for people to come and get
the help that they really need.
Speaker 2 (10:04):
So how much cost would be incurred, what's changed?
Speaker 3 (10:08):
It all depends on the insurance. It really all depends
on the insurance of what you have, and you know
it depends on United or whatever insurance that they have
what they have through their either their union or their
personal insurance. But we really try to work with people
and try to help them out because we know how
imperative this is and we don't want people to not
(10:31):
come to therapy because of because of financial issues.
Speaker 2 (10:34):
But going back to what we discussed a couple of
minutes earlier, in a perfect world, should the police departments,
the fire departments, the ems is, the military, In a
perfect world, would those organizations be providing therapy or using
(10:55):
therapy as part of the training.
Speaker 3 (10:58):
Yeah, I do think that in a per world that
they well, yes, I do think in a perplect world
that therapy should be involved. I know a lot of
first responders who don't want to come to therapy if
they know that their organization has a therapist there because
of conflict of interest or things might be getting back
to them, but I think that also reinforces the stigma,
(11:20):
and that's like a double edged sword. I do like
I do think that because we are a third party,
we are we are a person outside of that organization.
I think people are more willing to come to us
and talk to us because it won't get back to
their their commander, their chief, their you know, their their lieutenant,
it won't get back to them. But in a way,
(11:42):
like I do think that this needs to be looked
at more as a as a thing that needs to
be put into place when you're in when you first
start to become a first responder, uh, you know you're
going to become a fireman. I think in the academy
there should be there should be some there should be
some courses on mental health and what you know, what
(12:02):
the impact is and how to help yourself. And I
think there needs to be something like that. So I
also teach. I teach at Felician University in Lowda, New Jersey,
and I preach to my students all the time about
taking care of themselves in self care because this program
is really long and it's you know, sometimes four to
five years, and it takes a toll on you. If
you don't take care of yourself throughout the program, it's
(12:25):
going to be hard to withstand.
Speaker 2 (12:28):
For those who may be a bit reluctant or not
yet ready to make the call to get therapy. What
are some of the coping skills you think people should
know about that that can help them day to day
to prevent a crisis.
Speaker 3 (12:44):
Absolutely, so, I think it falls back. It always falls
back on forming good habits either, whether it be sleep, eating, exercise.
So those three things, I think you always got to
fall back on them, because if you're not taking care
of your body, taking care of your well, taking care
of your mind as well. If you're not taking care
(13:05):
of your body in your mind, it's really hard to
do any anything else, especially with eating, sleeping, and drinking
you know, appropriate amounts of water. But I think on
a on a different level, some of the things that
you could do for yourself, and I've spoken about this
a lot, is just really setting goals for yourself and
really being understanding about that. Small wins sometimes are small
(13:27):
steps in the right direction or are can make big changes.
So if we're if we're setting a goal for ourselves
in terms of Let's say I want to go to
the gym five times a week, but I haven't been
to the gym in two years. I might not go
to the gym five times a week in that first week.
I might set a goal for twice a week, and
then intentionally set another goal for three times a week,
and then four times five so go on from there.
(13:50):
But really setting setting yourself up for success along the
way and creating essentially a blueprint for yourself so then
you could replicate it and replicate it and replicate it.
So the major things there is just really taking care
of your body. Train your body, train your brain, set
some goals for yourself, and be consistent with those goals.
Speaker 2 (14:09):
And I would imagine there should be achievable goals, because
you know, it's like a New Year's resolution. You know,
it has to be achievable or else it becomes meaningless.
Speaker 3 (14:21):
Yeah, well it has to be meaningful too. So there's
an acronym that that people have probably heard. It's called
smart goals so s m ART. So it's specific, measurable, attainable, relevant,
and time bound. So it has to be specific. You
have to understand what you're going to do that goal
you want to do measurable? So how am I going
(14:44):
to measure it? How am I going to measure the success? So?
Did I go to the gym twice this week? Check boom?
Measure attainable? Is it something that I could actually do?
Do I have the resources? Do I have the gym membership?
Do I have the gym near me? What's my work
schedule look like? Is it relevant right? Why is it
relevant right now? I'm trying to get into shape. I
want to lose a little bit of weight and then
time bound boom time time needs commed in factor.
Speaker 2 (15:08):
Thank you so much, Doctor Brendan Guarino, who leads Guardians
for Guardians, the program at Baker Street Behavioral Health.
Speaker 1 (15:16):
You've been listening to Sunstein sessions on iHeartRadio, a production
of New York's classic rock Q one O four point
three
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