This chapter presents a comprehensive framework for occupational trauma risk management tailored to the fire service. Firefighters encounter repeated exposure to potentially traumatic events (PTEs), yet psychological outcomes vary based on individual, cultural, and organizational factors. This chapter challenges reactMilligan-Savilleive, pathologizing approaches by advocating for proactive, peer-led, and evidence-based systems grounded in psychological first aid (PFA) and trauma risk management (TRiM). It emphasizes psychological triage, informed peer support, and ethical boundary setting to sustain recovery and mitigate risk without overmedicalization. The chapter addresses complex constructs such as moral injury, organizational betrayal, and relational strain—factors increasingly implicated in long-term dysfunction and suicide risk. Special attention is given to training in soft skills, coping strategies, and stress physiology. By embedding trauma-informed leadership and resilience-building practices into fire department operations, the chapter advances a multidimensional strategy for supporting psychological health across a firefighter’s career span.