Caregiver Occupational Stress Control (CgOSC)
CDR Jean Fisak, NC, USNPMHCNS-BC
Deputy Director, NCCOSC
DisclaimerThe opinions expressed in this article are the author's own and do not necessarily reflect the view of the United States Government, the United States Department of Defense, The United States Navy, or The United States Navy Bureau of Medicine and Surgery.
The study protocol was approved by the Naval Medical Center San Diego Institutional Review Board in compliance with all applicable Federal regulations governing the protection of human subjects.
I am an employee of the U.S. Government. This work was prepared as part of my official duties. Title 17 U.S.C. §105 provides that ‘copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C §101 defines U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.
Objectives• Understand the roles of CgOSC trainers and
team members
• Describe the tools available and capabilities of CgOSC teams
• Identify key roles of mental health and pastoral care professionals within CgOSC teams
Introduction• Standardized primary prevention and recognition
program• Targets improved patient care and safety• 3 Core Objectives
• Early recognition of caregivers in distress
• Breaking the code of silence r/t occupational stress reactions
• Engaging caregivers in early help as needed to maintain mission and personal readiness
Navy and Marine Corps Combat and Operational Stress Control Doctrine
OSC N170D
Navy Medicine CgOSC Program
InstructorTrainers
Local CgOSC Teams
Program Evaluation
and ReportingSustainment
OSC N170D
CgOSC Instructor Trainer
CgOSC Team
Development
Trainer Refresher
Program Effectiveness
Reporting Requirements
CgOSCInstructor
Trainer
CgOSC Trainer Tools• Stress Continuum Model
• Core Leader Functions
• Caregiver Occupational Stress First Aid (BLS for Stress)
• Resilience Building
• Self-Care
• Work Environment or Unit Assessment Skills
• Buddy-Aid or Peer-to-Peer Training Assessment
Three Key Components of CgOSC
Combat and Operational Stress First Aid (COSFA)
Five Core Leader Functions
Stress Continuum Model
Relationship:Resilience, CgOSC, COSC
CgOSC
COSCResilience
Relationship
CgOSC
COSCResilience
Promotion
Universal
Selective
Indicated
Cas
e Id
entif
icat
ion
Stan
dard
Tre
atm
ent f
or
Know
n D
isor
ders
After-care
(including Rehabilitation)
Promotion
Prevention
Treatment
Maintenan
ce
Compliance
with
Long-term
Treatment
(Goal: R
eduction in
Relapse
and
Recurre
nce)
Resilience Adaptation of cognitive-behavioral principles designed to address values, attitudes/beliefs and behaviors
Targets six evidence-informed factors:• Values• Flexible Thinking• Acceptance & Strength• Optimism• Behavioral Control• Positive Coping
Emphasizes multimodal learning skills acquisition and application strategies
Seven Cs of Stress First Aid
Primary Aid 3. Cover Get to Safety ASAP 4. Calm Relax, Slow Down, Refocus
Secondary Aid 5. Connect Get Support from Others 6. Competence Restore Effectiveness 7. Confidence Restore Self-Esteem and Hope
Continuous Aid 1. Check Assess, Observe and Listen 2. Coordinate Get Help, Refer as Needed
Combat and Operational Stress First Aid(COSFA)
Three Levels of Prevention Interventions
Universal Selective IndicatedEveryone in a
population (before or after exposure)
Subgroups of the population at
heightened risk (e.g., deployed units)
Individuals identified to be suffering subclinical distress or impairment
Prevention Interventions:
Target populations with no or subclinical
symptoms
Treatment Interventions:
Target populations with
diagnosable mental
disorders
Best bang
for the
buck*
*Feldner, Monson, &
Friedman, 2007
Self-Care• Burnout• Compassion Fatigue• Compassion Satisfaction
Work Environment/Unit Assessment• Leader Request• Stress Assessment• Assessment Scales• Focus Groups• Findings and Recommendations to Leaders
Buddy Aid (Peer-to-Peer)• Recognize the array of interventions methods for stress reactions
and promote early intervention for individuals
AssessmentsScales• Individual
• Work Center • Environment
or Unit
OSC N170D
Navy Medicine CgOSC Program
InstructorTrainers
Program Evaluation
and ReportingSustainment
Local CgOSC Teams
OSC N170D
CgOSC Team Development
CgOSC Team
Development
Trainer Refresher
Program Effectiveness
Reporting Requirements
CgOSC Instructor
Trainer
CgOSC Team Development Team Composition
• Officer, Enlisted, Civilian• Chaplains and RPs• Mental Health
Activities as Outlined in Instructor Trainers Tools
Command Orientation Briefs, Command Training and Assessments
Mental Health and Spiritual Wellness ProfessionalsKey roles within CgOSC Teams• Lead work environment or unit assessment
• Assist with peer-to-peer assessment and training
• Mentor team members
• Facilitate further care
OSC N170D
Navy Medicine CgOSC Program
InstructorTrainers
Local CgOSC Teams
Sustainment
Program Evaluation and
Reporting
OSC N170D
CgOSC Program Effectiveness
CgOSC Team
Development
Trainer Refresher
Program Effectiveness
Reporting Requirements
CgOSC Trainer
Program EffectivenessAssessment and Program Evaluation• Various Assessment Tools
• Stress-O-Meter
• Individual Assessments
• Program Assessments
OSC N170D
CgOSC Reporting Requirements
CgOSC Team
Development
Trainer Refresher
Program Effectiveness
Reporting Requirements
CgOSC Trainer
Reporting RequirementsLocal CgOSC
• Provide monthly reports/status to Executive Officer
Commands• Quarterly reporting to Regional Commander
Regions
• Quarterly status to BUMED M9 via M95
OSC N170D
CgOSC Trainer:Training Refresher
CgOSC Team
Development
Training Refresher
Program Effectiveness
Reporting Requirements
CgOSC Trainer
Master Trainers
Local CgOSC Teams
Assessment, Program
Evaluation, and ReportingSustainment
SustainmentIngrained within Commands
Instruction
Training Evaluation
Program Evaluation
Training Refresher for Instructor Trainers
NCCOSC SME Guidance and Assistance
Key Points• Stress as a continuum
• Core Leader Functions
• COSFA
• Sustainment
• Good leaders are the best medicine
Caregiver Occupational Stress Control (CgOSC)CDR Jean Fisak, NC, USN
PMHCNS-BCDeputy Director, NCCOSC
Questions?
Caregiver Occupational Stress Control (CgOSC)CDR Jean Fisak, NC, USN
PMHCNS-BCDeputy Director, NCCOSC
Thank You