Naval Reserve Officers
Training Corps
Operational Stress Control Part 2
1
Objectives
• Review the common reactions to operational stress
in self and others as identified in the Stress
Continuum Model.
• Identify common barriers to successfully
navigating stress.
• Identify methods or tools to help navigate stress.
• Define the steps involved in Combat and
Operational Stress First Aid (COSFA).
• Identify resources to get help with stress.
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Stress Continuum Model
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Key Stress Indicators to
Watch and Listen for
Key Indicators
Sources of Information
Watch for:
Listen for:
Recent
Stressors
Stressors during
deployment or
training
Personal or
home-front
stressors
Levels of
Distress
Uncharacteristic
Troubling
and intense
thoughts like
negative emotions guilt or shame
Level of
Functioning
Changes in job
performance, selfcare, or getting
along with others
Physical
symptoms, sleep
problems, or loss
of self control
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Operational Stress Control
Decision Matrix
OSC Decision Matrix
Green Zone (Ready):
• Strengthen Sailors and command
through tough, realistic training
•Build unit cohesion
•Monitor for signs of distress
no
Are there signs of
DISTRESS or LOSS OF
FUNCTION?
yes
Yellow Zone (Reacting)
•Ensure adequate sleep & rest
•Encourage/communicate/listen
•Do after-action reviews
•Refer to counselor, chaplain or
medical if problems worsen
Red Zone (Ill):
• Refer to medical
•Ensure treatment compliance
•Mentor back to duty if possible
•Transition to VA if necessary
•
•
•
•
•
Difficulty relaxing and sleeping
Loss of interest in social or recreational activities
Irritability, worry, or anger
Cutting corners, lack of focus
Any change from normal personality
Severe Distress or Loss of Function:
no
Is the DISTRESS or
loss of function
SEVERE?
yes
Orange Zone (Injured):
•Keep safe and calm
•Rest & recuperation 24-72 hrs.
•Refer to counselor, chaplain, or
medical
•Mentor back to full duty and function
Distress or Loss of Function may include:
no
Has the distress or
loss of function
PERSISTED?
•
•
•
•
•
•
•
Loss of interest in activities
Can’t fall or stay asleep; persistent nightmares
Social withdrawal; weight changes
Loss of emotional control; numbness
Panic / rage episodes
Loss of concern for usual beliefs / values
Substance abuse
Persistent Distress or Loss of Function:
• Stress problems that last after the stressful
event of post-deployment period
• Stress problems that don’t get better over time
• Stress problems that get worse over time
yes
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Personal Experience with
Stigma
•
Have you ever had a personal problem you
were afraid to tell anyone else about, even
though telling the right person might have
helped fix the problem, just because you felt
embarrassed or ashamed about it?
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Common Barriers to
Navigating Stress
• Stigma
• Prejudice
• Stereotype
• Understanding
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Common Barriers to
Navigating Stress
• Internal Barriers
– Self Stigma
• External Barriers
– Unit or Command level
• Institutional Barriers
– Navy or DoD-wide policies
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Methods or Tools to Help
Navigate Stress
• Relaxation techniques
– Deep breathing
– Deep muscle
relaxation
• Physical activity
• Stress-reducing
activities
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What Can You Do to Identify
and Reduce Stressors?
• Identify the cause
• Monitor your moods
• Make time for yourself
• Walk away
• Set reasonable standards
• Analyze your schedule
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Combat and Operational
Stress First Aid (COSFA)
• Aims:
– Preserve life
– Prevent further harm
– Promote recovery
• Abilities:
– Quick assessment
– Matching response to
need
– Ensuring further
treatment
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COSFA
Check
and
Coordinate
Distress or
loss of function
due to stress
Check
And
Coordinate
Seven C’s of
Stress First Aid
1. Check
Assess and Observe
2. Coordinate
Get help refer as needed
3. Cover
Get to safety ASAP
4. Calm
Check
and
Coordinate
Relax, slowdown, refocus
5. Connect
Check
And
Coordinate
Get support from others
6. Competence
Check
And
Coordinate
Continue to
Check and
Coordinate
Restore effectiveness
7. Confidence
Restore self esteem and
hope
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COSFA Seven Cs
Check
and
Coordinate
Check
And
Coordinate
Check
and
Coordinate
Check
and
Coordinate
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and
Coordinate
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Check
and
Coordinate
Check
And
Coordinate
Cover
Check
and
Coordinate
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and
Coordinate
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Check
and
Coordinate
Check
And
Coordinate
Calm
Check
and
Coordinate
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and
Coordinate
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Check
and
Coordinate
Connect
Check
And
Coordinate
Check
and
Coordinate
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and
Coordinate
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Check
and
Coordinate
Check
And
Coordinate
Competence
Check
and
Coordinate
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and
Coordinate
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Check
and
Coordinate
Check
And
Coordinate
Confidence
Check
and
Coordinate
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and
Coordinate
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COSFA Confidence
Confidence
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Ask for Help
• When:
– You feel trapped, like there's nowhere to turn.
– You worry excessively and can't concentrate.
– The way you feel affects your sleep, your
eating habits, your job, your relationships, or
your everyday life.
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Where To Get Help
• Shipmates
• Family members
• Chain of Command
• Chaplains
• Medical staff member
• Student Counseling
Center
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Resources for Help
• Websites:
– Navy Operational Stress Control (OSC) blog
(www.NavyNavStress.com)
– Navy & Marine Corps Public Health Center
(www-nehc.med.navy.mil)
– The Naval Center for Combat and Operational Stress
Control (http://www.nccosc.navy.mil)
– USMC COSC (www.usmc-mccs.org/cosc )
– Navy Safe Harbor
(www.npc.navy.mil/CommandSupport/SafeHarbor )
– Military OneSource (www.militaryonesource.com)
– VA Centers (www.vetcenter.va.gov )
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Maintain Resources
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Summary
Now that you have completed this NROTC – OSC
Module, you should be able to:
• Review the common reactions to operational stress in self.
and others as identified in the Stress Continuum Model.
• Identify common barriers to navigating stress.
• Identify methods or tools to help navigate stress.
• Define the steps involved in Combat and Operational
Stress First Aid (COSFA).
• Identify resources to get help with stress.
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Naval Reserve Officers
Training Corps
Scenarios
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Scenario #1
A Sailor or Marine working
on antennas in the
superstructure of a ship
suddenly becomes immobile
and begins to shake and
cling to whatever is nearby.
Using your knowledge of
COSFA, what actions would
you take?
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Scenario #1 cont.
• Possible actions you might take:
– Assess the situation.
– Call for assistance below.
– Use verbal encouragement to help
the Sailor stay calm and decide
what to do.
– If Sailor responds to voice
commands, give the Sailor simple
directions regarding how to get to a
safe position.
– If necessary, physically assist the
Sailor down from superstructure
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Scenario #2
An intoxicated military
spouse begins waving a
kitchen knife while engaged
in an angry dispute with her
husband at home.
How would you deal with this
situation using COSFA?
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Scenario #2 cont.
• Possible actions you
might take:
– Calmly, but persistently,
urge military spouse to
put the knife down.
– If necessary, call the
police to ensure safety.
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Scenario #3
A Sailor with a significant Orange Zone life threat
stress injury has recently returned to the command
and has expressed concerns about his ability to
perform his duties.
What are some things the command can do to
help reintegrate the sailor?
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Scenario #3 cont.
– Apply elements of the COSFA model.
– Restore this individual’s competence and confidence.
– Restructure the Sailor’s work assignment and responsibilities.
– Gradually resume the Sailor’s responsibility for doing work
that requires clear thinking, planning, and decision making.
– Continually reassess mental capacity and give the Sailor
regular feedback on his or her progress.
– Mentor Sailor as needed.
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Scenario 4: COSFA in Action
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