# Policy - Psychological Health and Safety
> Fire Service Safety Management System, version 0.3.3 (2026-10-25). The Human Factor. Document FSSMS-POL-10.
>
> Canonical: https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety
>
> Licence: CC BY-NC-SA 4.0 with the Adopting Agency Grant (https://creativecommons.org/licenses/by-nc-sa/4.0/)
>
> General information only, not legal, medical or other professional advice. Verify every requirement against the current official text of the law, standards and manufacturer instructions that apply to you. Obtain your own legal review and consult your joint health and safety committee before adopting anything. You adopt, adapt, implement and rely on this material entirely at your own risk and on your own responsibility. Full terms: Terms of Use, thehumanfactor.ca.
> **Warning: Adoption without implementation increases legal exposure**
>
> Adopting this policy without the training, equipment, supervision, verification and resources to carry it out as written increases municipal and command liability in a regulatory investigation or a fatality inquiry. See [00a Copyright, Licence and Legal Notices](https://thehumanfactor.ca/library/fire-service-safety/copyright-licence-and-legal-notices).
> **Warning: Before adoption**
>
> This model policy requires review by the department’s legal counsel and against the collective agreement and the volunteer by-law before adoption. It is general information, not legal advice. Where it conflicts with a statute, regulation or agreement, the statute, regulation or agreement governs. Section numbers are cited as of October 2026; confirm each before adoption.
## How to use this model
**Format.** Adopt as a policy approved by the fire chief and endorsed by the municipality, because the National Standard expects a visible organizational commitment (CSA Z1003-13), with the peer support and critical incident procedures as standard operating guidelines under it. Keep the numbering.
**Drafting conventions.** **Shall** is mandatory; **should** is expected unless a documented reason exists; **may** is permitted. Placeholders in double curly braces, such as `{{Department}}`, are completed by the department. Drafting notes appear in callouts and are removed before adoption.
**Keep intact:** the distinction between psychological health and psychological safety (4(d), 5.1), confidentiality and its limits (5.5, 5.10), the voluntary nature of critical incident sessions and the exclusion of mandatory single-session debriefing (5.6), the learning firewall (5.8), inclusion of volunteers, dispatch and families (2.1). **Adapt:** governance, the resilience program chosen, the peer team size, the clinician arrangement.
## Policy header
| Field | Entry |
|:---|:---|
| Policy title | Psychological Health and Safety |
| Number | FSSMS-POL-10 ({{Department}} number: {{Policy number}}) |
| Approved by | {{Fire Chief}} (role); endorsed by {{Council or CAO}} |
| Effective date | {{Effective date}} |
| Next review date | 12 months after the effective date, then every three years |
| Policy owner | {{Deputy Chief}} (role), through the program manager of the Psychological Health and Peer Support Program Improvement Team |
| Consulted | {{JOHSC}}; {{Union}}; {{Volunteer Association}}; clinical adviser; counsel |
## 1. Purpose
1.1 To commit the department to protecting and promoting the psychological health of every member on the National Standard of Canada (CSA Z1003-13) and its paramedic-service edition, the nearest emergency-service model (CSA Z1003.1:18), inside the department’s safety management system (ISO 45003:2021).
1.2 To commit the department to psychological safety as a working condition: that it is safe to speak up, ask, admit error and challenge, because nearly every support in this policy is reached by someone speaking.
1.3 To set out the commitments, who is accountable, and where the program and procedures are.
## 2. Scope and application
2.1 This policy applies to every member: career, volunteer and paid-on-call firefighters and officers, dispatchers and communications staff, investigators, mechanics, administrative staff, chaplains and auxiliary members; and, for the family program and the assistance program, to members’ families. No one is excluded on the ground that they are not an employee.
2.2 It applies to work at incidents, training, stations, offices and the communications centre, and to the psychological effects of work that follow members home.
2.3 Harassment and violence are governed by [Policy - Workplace Violence and Harassment](https://thehumanfactor.ca/library/fire-service-safety/policy-workplace-violence-and-harassment); fitness for duty where impairment is in question by [Policy - Occupational Medical, Fitness and Wellness](https://thehumanfactor.ca/library/fire-service-safety/policy-occupational-medical-fitness-and-wellness) and the impairment procedure; learning from events by [Incident Investigation and Learning Program](https://thehumanfactor.ca/library/fire-service-safety/incident-investigation-and-learning-program). This policy relies on each.
## 3. Definitions
Terms in bold are used as defined here and in [06 Glossary and Acronyms](https://thehumanfactor.ca/library/fire-service-safety/glossary-and-acronyms).
- **Critical incident**: an event with the potential to overwhelm a member’s usual coping.
- **Employee and family assistance program (EFAP)**: the contracted confidential counselling and referral service for members and families.
- **Learning firewall**: the commitment that information gathered for learning is not used for discipline.
- **Peer support**: structured, confidential support by trained members within defined limits and with clinical supervision [(MHCC, 2013)](https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety#ref-mhcc-2013).
- **Post-vention**: the planned organizational response after a suicide or attempt.
- **Psychological first aid**: a supportive, practical, non-clinical response to a person in distress after an event.
- **Psychological health**: the member’s mental health, protected through the 13 psychosocial factors of the National Standard (CSA Z1003-13).
- **Psychological injury**: a diagnosed mental disorder arising from work.
- **Psychological safety**: the shared belief in a team that it is safe to speak up, ask, admit error and challenge [(Edmondson, 1999)](https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety#ref-edmondson-1999).
- **Psychosocial hazard**: an aspect of the design, organization or management of work, or its social context, that can cause harm (ISO 45003:2021).
- **Stigma**: attitudes and behaviours that make a member hide distress rather than seek help.
## 4. Principles
1. **People are the solution we build around, not the problem to fix.** Members who are affected by the work are not weak and are not a liability; they are the people the department exists to keep.
2. **Procedures describe work as done, written with the people who do it.** The peer support, critical incident and after-the-call procedures are designed with learning teams of members, dispatchers and volunteers.
3. **Learning comes before blame, and learning information is never used for discipline.** What is said in a learning review, a learning team or a peer contact stays there.
4. **Psychological safety is a condition of safety, so speaking up is expected and protected.** Psychological safety is created by leaders’ behaviour, meeting norms and the response to the last report; it is distinct from psychological health and it is how members reach the supports for it.
5. **Confidential by design.** The department holds no clinical or peer content; the limits of confidentiality are few, written and told to every member in advance.
6. **Evidence over tradition.** The department offers what the evidence supports and does not mandate what it does not [(Rose et al., 2002)](https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety#ref-rose-2002).
7. **Leaders go first.** Stigma is reduced from the top; the fire chief and officers attend the training, use the supports and say so.
## 5. Policy statements
### 5.1 Commitment and the distinction
5.1.1 The department **shall** implement a psychological health and safety management system on the National Standard, assess its psychosocial hazards against the 13 factors and the operational exposures of emergency service, act on the results, and evaluate annually. Accountable: {{Fire Chief}}.
5.1.2 The department **shall** treat psychological safety as an organizational condition it creates and measures, distinct from the psychological health it protects, and **shall** include at least one psychological-safety measure in every program’s indicators.
### 5.2 Governance
5.2.1 A joint committee of management, the union, the volunteer association, the peer team lead, the clinical adviser and a dispatch representative **shall** govern the program, meet at least quarterly, report to the JOHSC, and bring safety-sensitive changes to formal JOHSC consultation. Accountable: {{Deputy Chief}}.
### 5.3 Hazard assessment
5.3.1 The department **shall** survey its psychosocial hazards with a validated instrument at least every two years, segmented by station, platoon, career and volunteer status and dispatch, reported at cell sizes of 10 or more, fed back to every station within 30 days, and turned into an action plan with owners and dates.
### 5.4 Training
5.4.1 Every member **shall** complete a recognized first-responder mental health literacy and resilience program at recruit level and every three years; every officer **shall** complete the leader version, psychological first aid and learning-review facilitation; every member **shall** complete suicide awareness and harassment prevention training.
### 5.5 Peer support
5.5.1 The department **shall** maintain a peer support team selected by written criteria, trained to the national peer support guidelines [(MHCC, 2013)](https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety#ref-mhcc-2013) and the public safety personnel guidelines (CIPSRT, n.d.), supervised by a clinician, reachable 24 hours a day, covering every district, every platoon, volunteer stations and dispatch. Accountable: {{Deputy Chief}}.
5.5.2 Peer supporters **shall** keep confidence except for imminent risk of harm to self or others, abuse of a child or vulnerable person, a court order, or the member’s written consent, and **shall** tell every member these limits at the start of every contact.
5.5.3 Peer support records **shall** contain counts and types only, no names and no content, **shall** be held outside the human resources and records management systems, and **shall** be reported only in aggregate.
### 5.6 Critical incident response
5.6.1 After a critical incident the department **shall** provide a crew welfare check by the officer, peer contact within 24 hours, an optional group session at three to seven days, individual referral on request, and follow-up at two to four weeks, including dispatchers and, where appropriate, families.
5.6.2 Attendance at any session **shall** be voluntary. The department **shall not** use mandatory single-session psychological debriefing [(Rose et al., 2002)](https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety#ref-rose-2002).
### 5.7 Clinical pathway and assistance program
5.7.1 The department **shall** maintain a vetted network of clinicians with first-responder competence with a first appointment available within five business days, and an EFAP that covers members, volunteers and families, provides a course of treatment, includes addiction pathways, and reports utilization in aggregate. Accountable: {{Fire Chief}} with corporate human resources.
5.7.2 The department **shall** support members and survivors in workers’ compensation claims for psychological injury, including the presumptive claim where the law provides it ([J32 Workers' Compensation and Firefighter Presumptions](https://thehumanfactor.ca/library/fire-service-safety/j32-workers-compensation-and-firefighter-presumptions)).
### 5.8 After-the-call learning and the firewall
5.8.1 Company officers **shall** hold a short, non-blaming after-action review after every significant call within 24 to 72 hours, separate from discipline and from any formal investigation, and **shall** hand off to peer support when distress surfaces.
5.8.2 Information gathered in learning reviews, learning teams and program evaluation **shall** not be used for discipline. Conduct concerns **shall** go to a separate process run by different people, and the member **shall** be told which process they are in.
### 5.9 Suicide prevention, substance use, families and chaplaincy
5.9.1 The department **shall** maintain a suicide prevention and post-vention protocol, exercised at least every two years, with crisis contacts, including the crisis lines for the department’s province or territory ([J28 Psychological Health and Safety](https://thehumanfactor.ca/library/fire-service-safety/j28-psychological-health-and-safety)), posted at every station and in every apparatus.
5.9.2 The department **shall** treat substance use as a health matter with a confidential pathway to help and protection from discipline for seeking it, and **shall** manage impairment at work as a separate safety matter under CSA Z1008 principles (CSA Z1008:21).
5.9.3 The department **shall** provide a family orientation and family access to the EFAP, and **shall** set terms of reference for chaplains within the peer team’s confidentiality rules.
### 5.10 Privacy
5.10.1 Clinicians, the EFAP provider and treating practitioners are the custodians of health information under the applicable health information statute ([J10 Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/j10-privacy-and-health-information)). The department **shall** hold only fitness-for-duty determinations, aggregate statistics at cell sizes of 10 or more, and what the member consents to in writing, under a written information-sharing protocol. Accountable: {{Division Chief, Safety}}.
### 5.11 Return to work
5.11.1 A member with a psychological injury **shall** have the same graduated return-to-work support as a member with a physical injury, planned with the treating clinician (CSA Z1011:20; CSA Z1011.1:22).
### 5.12 Speaking up
5.12.1 Every member is expected to speak up about their own or a colleague’s wellbeing and about any behaviour or condition that harms it, and is protected from reprisal for doing so.
5.12.2 Any member’s concern under this policy **shall** receive an answer within 10 working days through the route in the program; a concern about an officer’s behaviour goes to that officer’s supervisor.
## 6. Roles and responsibilities
Only the differences from [01 Roles and Responsibilities](https://thehumanfactor.ca/library/fire-service-safety/roles-and-responsibilities).
6.1 **Fire chief**: owns the commitment and the stigma; attends the training; uses the supports visibly; resources the program.
6.2 **Deputy chief**: accountable for governance, the peer team, the clinician network and the evaluation.
6.3 **Program manager and peer team lead**: run the program, the team, the aggregate log and the appraisal.
6.4 **Clinical adviser**: supervises the peer team; advises on critical incident response and post-vention; vets clinicians.
6.5 **Company officers**: the welfare check, the activation, the after-the-call review, the follow-up; the fixed reply when a member speaks up.
6.6 **Dispatch supervisors**: inclusion of dispatchers in every element.
6.7 **Members**: complete the training; look out for each other; speak up.
6.8 **Corporate human resources**: the EFAP contract; compensation claims; return to work; harassment investigations under the separate policy.
6.9 **JOHSC**: consulted on the program and every change; receives the survey results and the aggregate report.
6.10 **Union and volunteer association**: co-govern; represent members; partners in the peer team.
## 7. Program and procedures this policy requires
- [Psychological Health and Safety and Peer Support Program](https://thehumanfactor.ca/library/fire-service-safety/psychological-health-and-safety-and-peer-support-program) (with the peer team charter, the critical incident procedure, the officer checklist, the Z1003 self-assessment worksheet and the aggregate log)
- [Incident Investigation and Learning Program](https://thehumanfactor.ca/library/fire-service-safety/incident-investigation-and-learning-program) (the after-the-call review and the learning firewall)
- [Policy - Workplace Violence and Harassment](https://thehumanfactor.ca/library/fire-service-safety/policy-workplace-violence-and-harassment)
- [Policy - Records, Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/policy-records-privacy-and-health-information)
- [Medical, Fitness and Wellness Program](https://thehumanfactor.ca/library/fire-service-safety/medical-fitness-and-wellness-program) (the mental-health screen in the medical; the return-to-work workflow)
- [Form - Peer Support Activity Log (Aggregate)](https://thehumanfactor.ca/library/fire-service-safety/form-peer-support-activity-log-aggregate)
## 8. Records, confidentiality and disclosure
8.1 The department holds: the policy and its approvals; committee minutes; survey results in aggregate; training records; the peer support aggregate log; critical incident activation counts; EFAP aggregate utilization; compensation claim counts; the post-vention file; the evaluation report.
8.2 The department does not hold: clinical records, peer contact content, names of members who used peer support or the EFAP, or survey responses that could identify a person.
8.3 Every record is written expecting access-to-information disclosure under the applicable municipal legislation ([J10 Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/j10-privacy-and-health-information)): roles, not names.
8.4 Retention per [05 Document Control and Records](https://thehumanfactor.ca/library/fire-service-safety/document-control-and-records).
## 9. Reporting
9.1 Quarterly: the program indicators, in aggregate, to the senior leadership team and the JOHSC.
9.2 Within 30 days: survey results to every station.
9.3 Annually: the program appraisal to the management review and, through the annual health and safety report, to council.
9.4 Immediately: any suicide or attempt, to the fire chief and the clinical adviser; a line-of-duty death to the fire chief, who activates the post-vention and family support plans.
## 10. Training requirements
| Role | Minimum training | Refresh |
|:---|:---|:---|
| All members including volunteers and dispatch | First-responder mental health literacy and resilience; suicide awareness; harassment prevention; the supports | Every three years (harassment training sooner where the applicable law requires; see [J27 Workplace Harassment](https://thehumanfactor.ca/library/fire-service-safety/j27-workplace-harassment)) |
| Company officers and above | Leader module; psychological first aid; critical incident checklist; after-the-call review facilitation; recognizing and referring | Every three years |
| Peer supporters | Core course of at least two days; suicide intervention; quarterly supervision | Annual refresher |
| Peer team lead | Team leadership; post-vention | Annual |
| Chaplains and family volunteers | Confidentiality and boundaries; psychological first aid | Every three years |
| Dispatch supervisors | Activation path; dispatch inclusion | Annual |
## 11. Legal and standards basis
- The applicable occupational health and safety statute and regulations, which differ by province and territory, including the workplace violence and harassment prevention duties ([J26 Workplace Violence](https://thehumanfactor.ca/library/fire-service-safety/j26-workplace-violence); [J27 Workplace Harassment](https://thehumanfactor.ca/library/fire-service-safety/j27-workplace-harassment)) and any provision on psychological health, with the crisis resources for each jurisdiction ([J28 Psychological Health and Safety](https://thehumanfactor.ca/library/fire-service-safety/j28-psychological-health-and-safety)).
- The National Standard of Canada on psychological health and safety in the workplace (CSA Z1003-13); its paramedic-service edition as the nearest emergency-service model (CSA Z1003.1:18); the guideline for managing psychosocial risks (ISO 45003:2021).
- Management of impairment in the workplace (CSA Z1008:21); work disability management (CSA Z1011:20) and its paramedic-service edition (CSA Z1011.1:22).
- [MHCC (2013)](https://thehumanfactor.ca/library/fire-service-safety/policy-psychological-health-and-safety#ref-mhcc-2013) peer support guidelines; CIPSRT (n.d.) public safety personnel guidelines; Peer Support Canada (n.d.) certification.
- Rose et al. (2002) on psychological debriefing.
- Workers’ compensation legislation, including any presumption for PTSD or other psychological injury ([J32 Workers' Compensation and Firefighter Presumptions](https://thehumanfactor.ca/library/fire-service-safety/j32-workers-compensation-and-firefighter-presumptions)); personal health information and municipal privacy legislation ([J10 Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/j10-privacy-and-health-information)). The Jurisdiction requirements table at the end of this policy lists what to confirm for your province or territory.
- Accreditation: CPSE (2019, criteria 11B.4, 11B.5, 11B.6) (paraphrased).
## 12. Review and approval
12.1 This policy is reviewed 12 months after adoption and then every three years; after any suicide, line-of-duty death or critical incident of unusual scale; after any change in the law or the standards; and at the JOHSC’s request.
12.2 Approved: {{Fire Chief}} (role), date. Endorsed: {{Council or CAO}}, date. JOHSC consulted: date. Union and association consulted: date.
## 13. Adoption checklist
| Step | Lead | Done |
|:---|:---|:---|
| Counsel review against the statutes and the collective agreement | {{Division Chief, Safety}} | |
| Joint committee chartered | {{Deputy Chief}} | |
| Clinical adviser engaged | {{Deputy Chief}} | |
| Peer team selection criteria agreed with the union and association; team selected and core-trained | Program manager | |
| Critical incident procedure and officer checklist issued to every cab | Program manager | |
| EFAP contract amended to cover volunteers, families and addiction pathways | Human resources | |
| Clinician network vetted and published | Clinical adviser | |
| Crisis contacts posted at every station and apparatus | Station officers | |
| Information-sharing protocol signed with custodians | {{Division Chief, Safety}} | |
| First psychosocial survey scheduled | Program manager | |
| Resilience training program chosen and scheduled | Training division | |
| Post-vention plan drafted | Clinical adviser | |
| JOHSC, union and association consultation recorded | {{Division Chief, Safety}} | |
| Policy approved, endorsed, posted; members briefed; the fire chief attends the first training cohort | {{Fire Chief}} | |
| 12-month review scheduled | Policy owner | |
## 14. Consulting the JOHSC and bargaining agents
| They will ask | Honest answer |
|:---|:---|
| Where do peer support records go? | Counts only, no names, no content, held by the team lead outside HR and the RMS. The charter says so and you can audit it. |
| Who chose the clinicians and the EFAP? | The clinical adviser vets clinicians for first-responder competence; the EFAP contract is reviewed by the joint committee you sit on. |
| Are volunteers and dispatchers covered? | Yes, in every element, including the EFAP and families. |
| Will we be made to sit in a debriefing circle? | No. Sessions are voluntary and mandatory single-session debriefing is not used, because the evidence does not support it. |
| Can something I say in a learning review be used against me? | No. The learning firewall is in this policy and in the learning program. Conduct concerns go to a separate process and you will be told if you are in it. |
| What does the chief do? | Attends the training, uses the supports and says so, answers concerns within 10 working days, and reports what changed. |
Put the agreements in a letter of understanding; where you disagree, record it, adopt what you can, and review at 12 months.
## 15. Customization and sector variants
> **Note: Customize**
>
> Complete every placeholder in double curly braces; choose the resilience program, the survey instrument and the clinical adviser; set the peer team size; decide which deputy chief holds the owner row; check each row of the Jurisdiction requirements table against your province’s or territory’s topic pages; delete the drafting callouts.
> **Tip: Volunteer and composite departments**
>
> Volunteers respond in their own community; build the peer roster so every member can choose a supporter from another station. Pay or credit time for training and survey feedback at station nights.
> **Information: Delivery note**
>
> Bring the clinical adviser and the draft charter to the first consultation. The answer to “where do the records live?” settles most of the room.
**Closing disclaimer.** This model policy is general information prepared by The Human Factor for adaptation by the adopting department. It is not legal advice and it is not a mental health service. The department remains responsible for compliance with the law that applies to it. Confirm every citation with counsel before adoption.
*End of model policy.*
## Jurisdiction requirements
This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it.
| Topic | What to check in your jurisdiction | Page |
|:---|:---|:---|
| Privacy and Health Information | Which statute makes clinicians and the assistance program custodians of personal health information, and which freedom-of-information statute governs the department’s records | [J10 Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/j10-privacy-and-health-information) |
| Workplace Violence | Whether the workplace violence regulation applies to the department, and what its risk assessment and prevention plan must contain | [J26 Workplace Violence](https://thehumanfactor.ca/library/fire-service-safety/j26-workplace-violence) |
| Workplace Harassment | What the harassment prevention policy must contain, how complaints are reported and investigated, and any training interval the law sets | [J27 Workplace Harassment](https://thehumanfactor.ca/library/fire-service-safety/j27-workplace-harassment) |
| Psychological Health and Safety | Any statutory provision on psychological health at work, and the crisis lines and resources to post for your province or territory | [J28 Psychological Health and Safety](https://thehumanfactor.ca/library/fire-service-safety/j28-psychological-health-and-safety) |
| Workers’ Compensation and Firefighter Presumptions | Whether a PTSD or psychological injury presumption covers career and volunteer firefighters and dispatchers, the diagnosis and claim-window rules, and coverage of gradual-onset psychological injury | [J32 Workers' Compensation and Firefighter Presumptions](https://thehumanfactor.ca/library/fire-service-safety/j32-workers-compensation-and-firefighter-presumptions) |
## References
Canadian Institute for Public Safety Research and Treatment \[CIPSRT\]. (n.d.). *Resources for public safety personnel: Peer support guidelines, moral injury guide and PSPNET* \[Web page\].
Center for Public Safety Excellence \[CPSE\]. (2019). *Fire and emergency service self-assessment manual* (10th ed.). Commission on Fire Accreditation International.
CSA Group. (2013). *CAN/CSA-Z1003-13/BNQ 9700-803/2013 (R2022), Psychological health and safety in the workplace: Prevention, promotion, and guidance to staged implementation* (free to read from CSA Group and the Mental Health Commission of Canada).
CSA Group. (2018). *CSA Z1003.1:18 (R2025), Psychological health and safety in the paramedic service organization*.
CSA Group. (2020). *CSA Z1011:20 (R2024), Work disability management system*.
CSA Group. (2021). *CSA Z1008:21, Management of impairment in the workplace*.
CSA Group. (2022). *CSA Z1011.1:22 (R2026), Work disability management in the paramedic service organization*.
Edmondson, A. C. (1999). Psychological safety and learning behavior in work teams. *Administrative Science Quarterly, 44*(2), 350–383. https://doi.org/10.2307/2666999
International Organization for Standardization. (2021). *ISO 45003:2021, Occupational health and safety management: Psychological health and safety at work: Guidelines for managing psychosocial risks*.
Mental Health Commission of Canada \[MHCC\]. (2013). *Guidelines for the practice and training of peer support*.
Peer Support Canada. (n.d.). *Peer supporter certification* \[Web page\].
Rose, S., Bisson, J., Churchill, R., & Wessely, S. (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). *Cochrane Database of Systematic Reviews*, (2), Article CD000560. https://doi.org/10.1002/14651858.CD000560