Date of Award


Document Type


Degree Name

Doctor of Philosophy


College of Education and International Services


Counseling Psychology, Ph.D.

First Advisor

Dennis Waite

Second Advisor

Jimmy Kijai

Third Advisor

Harvey Burnett



Private sector Emergency Medical Technicians (EMTs) are first responders who respond to traumatic incident scenes along with firefighters and police officers. However, news agencies and the public do not acknowledge private sector EMTs with the same vigor or accolade as public sector EMTs, nor are the risks to life, health, and mental well-being recognized among this population. Thus, the research literature has been sparse regarding how private sector EMTs experience PTSD, and what unique risk factors and needs may be present.

Purpose Statement

The purpose of this study was to examine the relationship between PTSD symptoms and coping skills, emotional intelligence, attachment, and resilience among private sector EMT workers.


Utilizing a mixed-methods design, 50 private sector EMTs recruited through social media, word of mouth, and Michigan State DHHS completed the: PTSD Checklist (PCL-5), Brief COPE, Schutte Emotional Intelligence Scale (SEIS), Measure of Attachment Qualities (MAQ), and Connor Davidson-Resilience Scale (CD-RISC) to explore the relationship between PTSD and coping skills, emotional intelligence, attachment, and resiliency among private sector EMTs. Three private sector EMTs participated in qualitative interviews to identify their experiences, risk factors, and needs as private sector EMTs.


Thirty percent of the EMTs (21% of EMT-Basics; 40% of EMT-Paramedics) met PCL-5 criteria for PTSD. Based on DSM-5 criteria, 36% of the EMTs (40% of EMT-Basics; 30% of EMT-Paramedics) meeting criteria for PTSD. Results showed no difference in the severity in which EMT- Basics and EMT- Paramedics experience PTSD. Both EMT- Basics and EMT- Paramedics use Positive Thinking as their primary method of coping. Fifty-eight percent of EMTs fell into the average range on emotional intelligence, and 30% fell into the unusually high range. The EMTs demonstrated the greatest struggle in being able to utilize their own emotions, finding it much easier to perceive emotions and to manage their own and others’ emotions. The EMT- Paramedics fell into the highest 25% and EMT- Basics fell into the lowest 25% of the population on resiliency, EMT- Basics were nearly one-and-three-fourths times less resilient than EMT- Paramedics. Most of the EMTs were securely attached; however, EMT- Basics demonstrated significantly more ambivalent attachment and significantly more anxious attachment. The most significant factors predicting PTSD were the use of avoidance coping and having ambivalent and anxious attachment styles. Regression analysis suggested that higher PTSD scores would be seen in EMTs with higher scores in Avoidance Coping and Ambivalence Merger (Anxious) Ambivalence but lower scores in Ambivalence-Worry (Ambivalent) Attachment scores, with the most important predictor being Avoidance Coping. Individual interviews revealed five overarching themes related to the experiences of private sector EMTs: work environment, work quality/altruism, disenfranchisement/societal acknowledgement, resiliency, and contributors to PTSD.


The experience of private sector EMTs is clearly one of disenfranchisement, which is likely to impact their rates of PTSD. Additional research needs to be undertaken and public education initiated in relation to this population, as well as therapeutic focus on the disenfranchisement component in conjunction with the PTSD treatment.

Subject Area

Post-traumatic stress disorder; Emergency medical technicians; Emergency medical services


Files over 3MB may be slow to open. For best results, right-click and select "save as..."