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Naval Reserve Officers Training Corps
Naval Reserve Officers Training Corps
Operational Stress Control Part 2Operational Stress Control Part 2Operational Stress Control Part 2Operational Stress Control Part 2
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ObjectivesObjectives
• 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.
• 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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Key
Indi
cato
rs
Key Stress Indicators to Watch and Listen for
Key Stress Indicators to Watch and Listen for
Level of Level of FunctioningFunctioning
Physical Physical symptoms, sleep symptoms, sleep problems, or loss problems, or loss of self control of self control
Changes in job Changes in job performance, self-performance, self-care, or getting care, or getting along with others along with others
Uncharacteristic Uncharacteristic and intense and intense negative emotionsnegative emotions
Levels of Levels of DistressDistress
Stressors during Stressors during deployment or deployment or training training
Personal or Personal or home-front home-front stressors stressors
Troubling Troubling thoughts like thoughts like guilt or shame guilt or shame
Listen for:Listen for:Watch for:Watch for:
Sources of Information
Recent Recent StressorsStressors
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Operational Stress Control Decision Matrix
Operational Stress Control Decision Matrix
Red Zone (Ill):• Refer to medical•Ensure treatment compliance•Mentor back to duty if possible•Transition to VA if necessary
Green Zone (Ready):• Strengthen Sailors and command through tough, realistic training•Build unit cohesion•Monitor for signs of distress
Are there signs of DISTRESS or LOSS OF
FUNCTION?
no
Yellow Zone (Reacting)•Ensure adequate sleep & rest•Encourage/communicate/listen•Do after-action reviews•Refer to counselor, chaplain or medical if problems worsen
Is the DISTRESS or loss of function
SEVERE?
no
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
Has the distress or loss of function PERSISTED?
no
OSC Decision Matrix
yes
yes
Distress or Loss of Function may include:
• 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:
• 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
Personal Experience with Stigma
• Have you ever had a personal problem you Have you ever had a personal problem you
were afraid to tell anyone else about, even were afraid to tell anyone else about, even
though telling the right person might have though telling the right person might have
helped fix the problem, just because you felt helped fix the problem, just because you felt
embarrassed or ashamed about it?embarrassed or ashamed about it?
• Have you ever had a personal problem you Have you ever had a personal problem you
were afraid to tell anyone else about, even were afraid to tell anyone else about, even
though telling the right person might have though telling the right person might have
helped fix the problem, just because you felt helped fix the problem, just because you felt
embarrassed or ashamed about it?embarrassed or ashamed about it?
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Common Barriers to Navigating Stress
Common Barriers to Navigating Stress
• Stigma
• Prejudice
• Stereotype
• Understanding
• Stigma
• Prejudice
• Stereotype
• Understanding
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• Internal Barriers
– Self Stigma
• External Barriers
– Unit or Command level
• Institutional Barriers
– Navy or DoD-wide policies
• Internal Barriers
– Self Stigma
• External Barriers
– Unit or Command level
• Institutional Barriers
– Navy or DoD-wide policies
Common Barriers to Navigating Stress
Common Barriers to Navigating Stress
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Methods or Tools to Help Navigate Stress
Methods or Tools to Help Navigate Stress
• Relaxation techniques
– Deep breathing
– Deep muscle relaxation
• Physical activity
• Stress-reducing
activities
• 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?
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
• 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)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
• Aims:– Preserve life– Prevent further harm– Promote recovery
• Abilities:– Quick assessment– Matching response to
need– Ensuring further treatment
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COSFACOSFA
Seven C’s of Stress First Aid
1. CheckAssess and Observe
2. Coordinate Get help refer as needed
3. CoverGet to safety ASAP
4. CalmRelax, slowdown, refocus
5. ConnectGet support from others
6. CompetenceRestore effectiveness
7. ConfidenceRestore self esteem and hope
COVER
Distress or loss of function due to stress
Stressor
Stressor
Prim
ary
Aid
Check and
Coordinate
Check And
Coordinate
CA
LM
Check and
Coordinate
CO
NN
EC
T
Check And
Coordinate
COMPETENCE Check And
Coordinate CONFIDENCEContinue to Check and Coordinate
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Check and
Coordinate
Check and
Coordinate
COSFA Seven CsCOSFA Seven Cs
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
Check and
Coordinate
Check And
Coordinate
Check And
Coordinate
Continue to Check and Coordinate
COVER
Prim
ary
Aid
Cover
15
CA
LM
Check And
Coordinate
Check and
Coordinate
Check And
Coordinate
Check and
Coordinate
Check And
Coordinate
Continue to Check and Coordinate
Prim
ary
Aid
CalmCalm
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Check and
Coordinate
Check And
Coordinate
Check and
Coordinate
Check And
Coordinate
Check And
Coordinate
Continue to Check and Coordinate
Connect
CO
NN
EC
T
Prim
ary
Aid
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Competence
COMPETENCE
Prim
ary
Aid
Check and
Coordinate
Check And
Coordinate
Check and
Coordinate
Check And
Coordinate
Check And
Coordinate
Continue to Check and Coordinate
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Prim
ary
Aid
Confidence
Check and
Coordinate
Check And
Coordinate
Check and
Coordinate
Check And
Coordinate
Check And
Coordinate
Continue to Check and CoordinateCONFIDENCE
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Ask for HelpAsk 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.
• 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 HelpWhere To Get Help
• Shipmates
• Family members
• Chain of Command
• Chaplains
• Medical staff member
• Student Counseling
Center
• Shipmates
• Family members
• Chain of Command
• Chaplains
• Medical staff member
• Student Counseling
Center
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Resources for HelpResources 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 )
• 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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SummarySummary
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.
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.
25
Naval Reserve Officers Training Corps
Naval Reserve Officers Training Corps
ScenariosScenariosScenariosScenarios
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Scenario #1Scenario #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?
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.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
• 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 #2Scenario #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?
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.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.
• 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 #3Scenario #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?
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.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.
– 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.