The study proposes adapting an existing PTSD treatment, Skills Training in Affective and Interpersonal Regulation-Narrative Therapy (STAIR-NT), by integrating Goal Management Training (GMT), an intervention aimed at improving executive functioning. The goal is to assess the effectiveness of this combined approach in treating both TBI and psychological conditions in a population at high risk for both. The study will also evaluate the feasibility of implementing this intervention within first responder settings, which present unique challenges, such as irregular work hours and a tendency to underutilize mental health services. The researchers will adapt STAIR-NT for first responders, ensuring it is tailored to their specific needs. The study will focus on short-term outcomes such as reductions in PTSD, anxiety, depression, and substance use behaviors. Additionally, the implementation process will be closely monitored to ensure that the intervention is feasible and acceptable within the target population. Collaboration with the Invisible Wounds Project, a nonprofit organization serving first responders and veterans, will help facilitate recruitment and support. This research holds potential significance for military health, as a large number of veterans transition into first responder roles after their service. If successful, the adapted STAIR-NT could improve the standard of care for veterans and first responders alike, offering dual benefits to both military and civilian populations. This study also aligns with the Department of Defense's efforts to enhance care for those with co-occurring trauma-related psychological conditions and TBI.