1 Naval Reserve Officers Training Corps Operational Stress Control Part 2.

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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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Stress Continuum ModelStress Continuum Model

Stressor

Stressor

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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


• 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



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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


COVER

Prim

ary

Aid

Cover

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CA

LM

Check And

Coordinate

Check and

Coordinate

Check And

Coordinate

Check and

Coordinate

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


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


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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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COSFA ConfidenceCOSFA Confidence

ConfidenceConfidence

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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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Maintain ResourcesMaintain Resources

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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.

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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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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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• 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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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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– 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.

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Scenario 4: COSFA in ActionScenario 4: COSFA in Action

1 Naval Reserve Officers Training Corps Operational Stress Control Part 2.

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