Background First responders experience sustained operational stress that affects family relationships, communication and wellbeing. Families often provide early informal support, yet organisations rarely integrate them into occupational mental health systems. This study explores experiences of a family-focused, simulation-informed psychological first aid programme (HUGS@Home), designed to strengthen supportive conversations and relational wellbeing. Methodology We adopted a qualitative design informed by constructivism and community-based participatory research. We purposively recruited adults who had completed the programme, comprising family members, first responders and emergency service leaders. We generated data through 11 semi-structured interviews and one focus group with five participants, conducted six to nine months after training. We de-identified transcripts and analysed them inductively using reflexive thematic analysis and relational coordination theory as a sensitising lens. Results We developed four themes: (a) Communicating with care and confidence; (b) navigating the ‘not normal’; (c) creating an open and understanding culture; and (d) sustaining support beyond the programme. Participants reported increased confidence in starting difficult conversations, listening without trying to resolve distress and applying practical strategies to manage transitions from work to home. The programme facilitated recognition of cumulative occupational stress, challenged stigma and cultural expectations and strengthened family and peer relationships. Participants also identified ongoing gaps in family support, referral pathways, organisational integration and programme sustainability. Discussion Our findings indicate that family-inclusive psychological first aid strengthens individual confidence and relational capacity across home, peer and organisational contexts. Shared knowledge, mutual respect and accurate, timely, problem-solving communication helped participants to coordinate support effectively, although benefits coexisted with ongoing occupational and relational burdens. Conclusion The HUGS@Home programme appears to improve supportive communication, help-seeking and relational resilience within first responder communities. Sustainable implementation requires formal recognition of families, accessible referral pathways and integration into routine organisational and national support structures.
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O’Toole et al. (2026) studied this question.
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