The men and women who work in law enforcement and emergency services-the "tough jobs"-are exposed to special kinds of traumatic events and daily pressures that sometimes overwhelm defenses and result in maladaptive psychological syndromes. By dint of attitude, training, and social norms, these "tough guys" are often resistant to psychotherapy in its traditional forms, and so special therapeutic approaches are required. This article describes the types of stresses and problems experienced by police officers, firefighters, and paramedics, and outlines the psychotherapeutic strategies that may prove most effective in helping the helpers.Every time we dial 911, we expect that our emergency will be taken seriously and handled competently. The police will race to our burgled office, the firefighters will speedily douse our burning home, the ambulance crew will stabilize our injured loved one and whisk him/her to the nearest hospital. We take these expectations for granted because of the dedication of the workers who serve the needs of law enforcement, emergency services, and public safety.These "tough guys"-the term includes both men and women-are routinely exposed to special kinds of traumatic events and daily pressures Correspondence regarding this article should be addressed to Laurence Miller,
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