The Vermont Research Trial Protocol: A Mixed-Methods Study of Group EMDR Integrated with Compassion-Focused Therapy for PTSD, Complex PTSD, and Moral Injury in First Responders and Law Enforcement Officers

First responders experience disproportionately high rates of posttraumatic stress disorder, complex posttraumatic stress disorder, and moral injury. Standard trauma-focused treatments inadequately address the shame, guilt, and existential distress characteristic of moral injury, while occupational cultures of stoicism create marked barriers to help-seeking. This mixed-methods feasibility study evaluates an intensive group intervention integrating eye movement desensitization and reprocessing, delivered via the Acute Stress Adaptive Protocol, with compassion-focused therapy for first responders and law enforcement officers, including frontline healthcare workers. Three cohorts are recruited through the Vermont Centre for Responder Wellness. Acute Stress Adaptive Protocol’s trauma processing sequence provides a mechanistic bridge to compassion-focused-therapy-derived compassionate mind training components targeting shame, self-criticism, and moral–emotional distress. A within-culture peer-to-peer delivery model uses trained peer supporters as active therapeutic agents alongside accredited clinicians. Validated outcome measures are administered at baseline, postintervention, and at 1-, 3-, and 6-month follow-ups, with quantitative data analyzed using linear mixed models with full information maximum likelihood estimation. The study will establish feasibility parameters, recruitment and retention rates, safety signals, fidelity data, and preliminary effect sizes to inform a future definitive randomized controlled trial and will assess the scalability and cultural fit of peer-delivered, integrated trauma care in occupational settings.