Therapy for First Responders
You run toward the worst day of someone’s life. Who checks on you?
You see things most people never will, and then you drive home and you’re expected to act normal. Trauma doesn’t care how tough you are. It finds a way through, usually at 3 a.m. or in the middle of dinner with the people you love.
I’m Adrienne M. Koller, a licensed trauma therapist. I went through the police and corrections academy, and I come from a military and first responder family, so I know the job and I know what it does to the people waiting at home.
I offer online therapy for police officers, firefighters, EMS, dispatchers, and other first responders in California, Texas, South Carolina, Florida, Utah, Maine, Idaho, Ohio, and Vermont.
You see the worst, and you’re expected to walk it off
People assume you’re built for it. You probably assumed it too. Then something stops working.
Flashbacks, nightmares, or a call that replays when you’re trying to sleep
Numbness, a short fuse, or going quiet in your own house
Needing a drink or something else just to come down
Guilt or shame after an incident, even when you did everything right
Feeling distant from your family, your body, and your own life
The quiet fear that one mistake could cost you everything
You’re not broken. You’ve been carrying a lot, for a long time, mostly alone.
When the shift ends, your nervous system stays on duty
You can take off the uniform, turn off the radio, and walk through your front door. Your body doesn’t always get the memo.
After years of scanning rooms, clocking exits, and listening for what could go wrong, hypervigilance becomes second nature. It keeps you sharp on the job. At home, it can mean you can’t relax, can’t sleep, and can’t be fully present with the people who love you.
You might notice:
You’re on edge when nothing is wrong.
Ordinary noise and interruptions feel like threats.
It takes hours, or a drink, to switch from work mode to family mode.
You’re tired all the way through but can’t rest.
The people closest to you say you’ve gone somewhere else.
You don’t have to give up the instincts that make you good at your job to get your life back outside of it.
Therapy can help you notice when your system is still in survival mode, practice ways to bring it down, work through the calls and experiences you’ve been carrying, and reconnect with the parts of life that aren’t the job.
I know this world, and I know what it costs
I went through the police and corrections academy as a young mom. I come from a military and first responder family, and I’m the mother of a police officer. I know the culture of silence. I know why you don’t tell anyone, what it costs you when you do, and why “talk about your feelings” has never sounded like help.
That’s not what this is. We won’t talk feelings to death. I help you take your power back.
Therapy with me focuses on:
Processing traumatic calls and the weight of cumulative stress
Redefining strength without silence
Setting boundaries that don’t feel like weakness
Reconnecting with your body, your values, and life outside the job
Anything else, personal or work related, you want to focus on
How we do the work
We pick the approach based on your history, your symptoms, and what you want out of this.
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Process traumatic memories so they stop hijacking the present.
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Work through the stuck beliefs about blame, guilt, and safety that trauma leaves behind.
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Gradually approach the memories and situations you’ve been avoiding.
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Change the thought and behavior patterns that keep stress and anxiety going.
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Tools to regulate emotions, tolerate distress, and communicate under pressure.
Families of First Responders
You didn’t wear the uniform, but you carry it too.
You deserve support too. You’re holding more than anyone sees, and you don’t have to hold it alone.
I’m a military and first responder family member myself. I know what it’s like to be the emotional landing zone for trauma that never gets said out loud, stress that never gets put down, and silence that fills the house. You’re expected to be patient, understanding, and strong. Where’s your space to fall apart?
I work with:
Spouses and partners dealing with anger, silence, and distance
Parents and kids affected by secondary trauma or fear
Families living with the aftermath of high-risk work
You deserve support too. You’re holding more than anyone sees, and you don’t have to hold it alone.
What first responders come to therapy hoping for
Being more present and less reactive at home
Less grip from flashbacks, shutdown, and guilt
More range than “on” or “off”
Relationships where you don’t have to explain the job
Sleeping without a drink or a replay
Resting without crashing
I can’t promise how fast or how far you’ll get. I can promise to be straight with you about how it’s going.
What happens when you reach out
I confirm the appointment and send an invitation to my patient portal to complete intake paperwork.
You schedule online
We go over what’s going on, what you’ve tried, and what you want. When it helps, we use short screenings for things like trauma symptoms, anxiety, and depression. Nobody needs to perform here.
We talk
We start with whatever you need first, whether that’s getting steady, processing a specific call, or building skills. You set the pace.
We build a plan
Frequently Asked Questions
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Yes. You spend your working life anticipating danger and making split-second decisions, so it makes sense that your system doesn’t flip back to normal when you walk in the door. Over time, that alert state can get stuck.
Therapy can help you understand hypervigilance, notice when your nervous system is still in survival mode, and build practical ways to come down. The goal isn’t to lose the instincts that protect you on duty. It’s to get you back to being able to relax, connect, and be present when you’re off.
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Yes, with the legal and ethical exceptions that apply to all mental health treatment. I’m private pay, which means there’s no insurance claim for your treatment, and that can add a layer of privacy. It doesn’t remove the documentation and disclosure requirements the law puts on me. You deserve a place where you can say what’s true without holding it together the way the job requires.
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Not from me, unless you sign a written release or the law requires it. Those legal exceptions include serious risk of harm to yourself or someone else, suspected abuse of a child or vulnerable adult, and a court order. If your agency has fitness-for-duty or clearance rules, I’m glad to talk through how those usually work, though your department’s own policy has the final word.
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Not at all. You don’t need a PTSD diagnosis or one defining incident. A lot of first responders come in for cumulative stress, hypervigilance, irritability, exhaustion, bad sleep, strain at home, anxiety, or burnout. Sometimes it’s not one call that gets you. It’s the weight of hundreds of them, plus a lot of hard decisions you never had the chance to process.
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I use evidence-based approaches matched to your symptoms, history, and goals. Depending on what you need, that may include EMDR, Cognitive Processing Therapy, Prolonged Exposure, CBT, and DBT skills. We might focus on processing specific calls, easing PTSD symptoms, working through guilt or self-blame, or getting better control of stress on and off duty. We’ll decide together.
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Yes. Years of exposure to danger and trauma change how you react and how you connect. You may get irritated faster, pull away from family, dodge conversations, or feel far from the people you love. Therapy can help you figure out what’s underneath those reactions, get better at noticing and regulating what you feel, and find ways to talk and reconnect that actually work.
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Peer support and EAPs can be good starting points, and I’m not here to replace the people who already have your back. Therapy goes further when you want to work on the trauma itself, not just get through the week. Some people also prefer a place outside their agency, where nobody they work with is on the other end.
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I offer online therapy in California, Texas, South Carolina, Florida, Utah, Maine, Idaho, Ohio, and Vermont. You need to be physically in one of those states at the time of your session. If you’re in Ventura, Oxnard, or Malibu, ask me about Walk & Talk sessions.
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Online sessions are $225 for 50 minutes, plus a one-time $250 intake. Please inquire about Walk and Talk pricing.
I’m private pay and provide superbills you can submit for out-of-network reimbursement. I keep a limited number of sliding-scale spots.
You’ve spent your life serving others. It’s time to take care of you.
You don’t need to have the words yet. Reach out and we’ll start where you are.
If you’re in crisis, call or text 988 or call 911.