Date of Graduation


Document Type


Degree Type



College of Education and Human Services


Counseling, Rehabilitation Counseling & Counseling Psychology

Committee Chair

Jeff Daniels, PhD

Committee Co-Chair

Margaret Glenn, EdD

Committee Member

Margaret Glenn, EdD

Committee Member

Christopher Scheitle, PhD

Committee Member

Carla Brigandi, PhD


Emergency medical technicians (EMT) and firefighters respond to critical incidents and provide emergent care. As the opioid crisis continues and drug overdose rates increase, first responders administer first aid to substance users, including Naloxone, more frequently. This study examined the influence of repeated exposure to drug-related critical incidents and provision of care to substance users on EMTs' and firefighters' secondary traumatic stress (STS) level, world assumptions, and substance use stigma. First responders' world assumptions, STS, burnout, and exposure to drug-related overdoses were analyzed for their power in predicting substance use stigma. Results suggest that occupational burnout, rather than STS, is more predictive of substance use stigma. Also, a firmer belief in the just world assumption was more predictive of substance use stigma than both Benevolence of World and Benevolence of People World Assumption subscales. Analyses point to a potentially useful and harmful function in an overreliance on the just world belief. EMTs with a firmer belief in the just world were found to have lower STS and burnout scores; conversely, they were also found to hold greater negative attitudes toward substance users. Findings have implications for future research, programmatic management, and educational training targeting substance use stigma and mental health concerns.