1. US Coast Guard
Operational Stress Control

2. What the Stats tell us…. Stress on the Force is Increasing
Other contributors:
Unpredictable ops/job duties
Separation from family
Not enough time for home responsibilities
Long work hours pre/post deployment
Increase in workload
KEY MESSAGES
Results from 2010 Navy OSC BHQP.
For the 2nd year in a row, lack of personnel continues to be the #1 reported stressor.
SCRIPT
• We believe the E7-E9 increase may be related to “perform to serve”, but additional assessment is needed to confirm this.
• Although not direct indicators, suicides; abuse and divorce are indirect indicators of increased stress on the force.
# 1 Stressor: Lack of personnel to do the job
Largest increase in stress: E7-E9
Most stressed are least likely to seek help; they expect negative consequences (stigma) 2

3. OSC Objectives Knowledge: Apply:
Understand positive and negative effects of stress
The Five Core Leadership Functions (Strengthen, Mitigate, Identify, Treat, and Reintegrate) 
Understand skills for navigating stress
After Action Reviews (AARs) to mitigate stress
Replenish resources
Understand sources of operational stress
Combat Operational Stress First Aid (COSFA)
Understand stress zones, impacts of stigma and what leaders can do
Stress Continuum (Ready, Reacting, Injured, Ill)
Decision Matrix to identify stress reactions, injuries and illnesses
Know where and when to get more help when needed
Resources
KEY MESSAGES:
This course will provide you with increased knowledge regarding the pluses and minuses of the effects of stress.
It will also provide you with the skills to more effectively navigate stress for yourself and your Sailors.
SCRIPT:
Let’s hear what the MCPON has to say….. 3

4. What We Will Cover Stress Decision Matrix Stress Continuum Combat and
KEY MESSAGES:
There is joint maritime (USN/USMC) COSC/OSC Doctrine: (NTTP 1-15M/MCRP 6-11C;Combat and Operational Stress Control).
We will discuss individual roles and responsibilities.
Hands-on application, case studies and discussions.
Navy OSC Leader tools.
SCRIPT:
The Navy and USMC have been working for the last several years to develop a joint maritime COSC/OSC doctrine, which was signed in December (NTTP 1-15M/MCRP 6-11C; Combat and Operational Stress Control) The essence of the doctrine is the 5 core leader functions and the other practical tools represented here to help you apply in every day practice.
-Question: Have you seen these tools before? Which ones? (Allow responses)
For the remainder of the day, we will talk about your individual roles and responsibilities, and the tools you need to do your job.
We will discuss Navy OSC-Lead principles and tools with an emphasis on hands-on application, case studies and discussion.
Some of the tools you will learn to use include:
The Stress Continuum
The Five Core Leader Functions
The Stress Decision Matrix
Combat and Operational Stress Control First Aid (COSFA)
And some others….
-Question: Are there any questions over anything we have covered to this point? (Allow response, answer questions)
This concludes Module 1; we will now take a ______ minute break – please be back in your seat NLT ________
Stress Continuum
Combat and
Operational
Stress
First Aid
(COSFA)
5 Core Leader
Functions 4

5. Where Is the Coastie on the Stress Continuum?
READY
REACTING
INJURED
ILL
Good to go
Well trained
Prepared
Fit and focused
Cohesive units, ready families
Distress or impairment
Anxious, irritable, or sad
Physical or behavioral changes
Mild and temporary
More severe or persistent distress or impairment
May leave lasting memories, reactions, and expectations
Stress injuries that don’t heal without help
Symptoms persist, get worse, or initially get better and then return worse
KEY MESSAGES:
The Stress Continuum is a tool for identifying stress levels in individuals and units.
Understand the characteristics of each zone and how to identify where a Sailor is on the continuum.
Stress tends to push Sailors toward the Yellow and Orange Zones.
Our goal is to keep Sailors moving toward the Green (Ready) Zone.
SCRIPT:
Here is the first tool that is available for Navy Leaders to use. This is the foundation for everything we will do. We will be using this to discuss some scenarios.
This graphic is called the stress continuum. This tool is used to identify stress levels in individuals and units. It is an easily understood tool providing a common language. Historically in the Navy, you were either good to go or no go. Now we know that’s not true, stress reactions happen over a continuum.
Because you as leaders work closely with your Sailors every day, you are able to observe and learn their personality traits and normal behaviors. This gives you the ability to detect when something is bothering a Sailor, and your observations will help you to assess where the individual is on the stress continuum scale.
The stress continuum has four zones: Ready, Reacting, Injured, and Ill. The zones of the continuum shown here are of equal size; however, in reality the Green (Ready) is the largest, with each zone decreasing in size and the red zone being much smaller in size.
The Green (Ready) Zone:
Majority of the leaders’ time should be spent in the core leader function of strengthening sailors to keep them in or get them back to the Green Zone.
Green (Ready) is the zone of adaptive coping, optimal functioning and personal well-being.
It does NOT represent the absence of stress – but rather effective mastery without significant distress or impairment in social or occupational functioning.
-Question: What does a Sailor who is in the Green (Ready) Zone look like? (allow responses)
As stated earlier, the ability to remain Green (Ready) while enduring stress and/or to return quickly to Green (Ready) after enduring stress are two crucial aspects of resilience.
-Question: What do you do to be “ready” as an individual? (Unit?; Family?) (allow responses)
-Question: Are there any questions on the Green (Ready) Zone?
The Yellow (Reacting) Zone:
It is normal for us to move from Green (Ready) to Yellow (Reacting) and back repeatedly almost every day.
Yellow (Reacting) is the zone of mild and temporary distress or loss of function due to stress.
By definition, Yellow Zone reactions are usually temporary and reversible, however, while they are occurring, it is difficult to know whether they will be temporary and leave no lasting “scars”.
Yellow Zone reactions are common for everyone – especially in response to new challenges.
Stressor
Individual, Shipmate, Family Responsibility, Unit Leader
Individual
Responsibility
Caregiver
Responsibility 5

6. Four Sources of Stress Injury
WEAR AND TEAR
LOSS
KEY MESSAGES:
Stressors from one or more of the following categories may result in a stress injury
Life Threat – a trauma injury
Loss – a grief injury
Inner Conflict – a beliefs injury
Wear and Tear – a fatigue injury
If a Sailor has experienced one or more of these, don’t ignore it; engage them to see how they are doing.
SCRIPT:
- The four sources of stress injury:
<Text labels will appear automatically after loading this slide>
The first thing to look at is what was the sources of the stress? Certain stresses change us more than others. Severe stresses fall into four main categories:
Life threat – due to exposure to lethal force or its aftermath in ways that exceed the individual’s capacity to cope normally at that moment, thus provoking feelings of terror, horror, helplessness or shock
Wear and tear – due to the accumulated effects of smaller stressors over time, including from non-operational sources, without sufficient sleep, rest and restoration of resources
Loss – due to the death of close comrades, leaders or other cared for individuals, or the loss of relationships, aspects of oneself or possessions by any means
Inner conflict (also referred to as “Moral Injury”) – due to moral damage from carrying out, or bearing witness to acts or failures to act that violate deeply held beliefs
<Consider asking students to describe when they have experienced any of these four sources of stress injury>
-Any one or a combination of these sources of stress could immediately put a Sailor into the Orange/Injured zone.
-If you know that one of your Sailors experienced one of these stressors, don’t ignore it, but engage them as a fellow Sailor and Navy OSC-Leader and Mentor, to see how they are doing. 6
LIFE THREAT
INNER CONFLICT 6

7. Four Sources of Stress Injury
-By talking to them about these stresses, it normalizes their experience and helps them get back in the fight.
-You won’t always know that something has happened to a Sailor, so you always need to be vigilant in watching them. You need to ask, “Is this Sailor acting like their usual self? Do they seem to be getting better or not?”
View Notes Page for inserted table here
LIFE THREAT
Sources of Orange Zone Stress
In the Field
Underway
In the Home
Life Threat
Being seriously injured in combat
Nearly being killed
Seeing someone else die up close
Handling bodies or body parts
Multiple casualty events like IED blasts or ambushes
Being seriously injured in an accident
Nearly being killed in an accident
Being seriously injured in an accident or disaster
Nearly being killed in an accident/disaster
Being physically or sexually assaulted
Loss
Death of a close friend
Death of a unit member or leader
Loss of valued possessions
Death of a shipmate or leader
Relationship breakup
Death or serious injury of a spouse or child
Inner Conflict
Leaders failing to live up to core values
Failing to save the life of a unit member
Killing or witnessing the killing of a woman or child
Violations of rules of engagement
Friendly fire
Failing to save the life of a shipmate
Seeing foreign nationals living in squalor
Betrayal of trust by spouse or significant other
Failing to prevent the injury or death of a family member
Wear and Tear
Too much Yellow Zone stress for too long
WEAR AND TEAR 7
LOSS
INNER CONFLICT

8. Four Sources of Stress Injury
View Notes Page for inserted table here
Examples of Orange Zone Losses of Control
Body
Heart pounding, even at rest
Shaking, even when not in danger
Sweating, even at rest and when not feeling hot
Loss of control of bladder or bowels
Part of one's body going numb
Being unable to move part of one's body
Transient loss of vision or hearing
Thinking
Loss of ability to recall memories
Memories that keep intruding on thinking, even when trying not to remember them
Memories that are so vivid they seem like they are happening now rather than in the past
Painful thoughts or images that keep popping into awareness, and can't easily be pushed aside
Violent images or thoughts that keep popping into awareness, and can't easily be pushed aside
Loss of ability to mentally concentrate and focus
Losing track of where and when someone is
Feeling
Intense and uncharacteristic anger
Sudden outbursts of rage
Intense and uncharacteristic fear
Sudden attacks of panic
Recurring, painful feelings of guilt or shame
Intense and persistent sadness
LIFE THREAT
WEAR AND TEAR 8
LOSS
INNER CONFLICT

9. Core Leader Functions READY REACTING INJURED ILL KEY MESSAGES:
We use the Five Core Leader Functions to move Sailors toward the Green (Ready) Zone.
SCRIPT:
-Now that you understand the stress continuum, let’s discuss what we do as leaders to keep our Sailors resilient and ready to fight. We call these the Five Core Leader Functions.
<Slide automatically builds.>
-The five Core Leader Functions are Strengthen, Mitigate, Identify, Treat, and Reintegrate.
-Navy OSC Leaders apply these Five Core Functions throughout the stress continuum to keep moving our Sailors towards a state of full readiness.
-The Core Leader Functions are the way we put OSC into day-to-day practice, how we move our Sailors towards the green.
-Let’s discuss each of these core leader functions in more detail. 9

10. Strengthen: 1st Core Leader Function
Chow
Exercise
Rest
Social Cohesion
Body
Family
Sports
KEY MESSAGES:
The first Core Leader Function is Strengthen.
Strengthen is not just physical. It’s also mental, spiritual or social.
Navy strategy for building strength is:
Tough, realistic training
Social cohesion
Effective leadership
Strengthening is a defensive weapon against stress.
SCRIPT:
The first Core Leader Function – strengthen.
Strengthening is a defensive weapon to fend off stressful events that may occur.
-Question: What do we do to strengthen our Sailors and keep them ready?
Possible Answers: Training, equipment, rest, chow, unit cohesion, family readiness, ROE, mission focus, building confidence and competence, trust in the leadership and their fellow Sailors, spiritual readiness, stress inoculation, etc.
<<After receiving some answers, click and the slide automatically builds (12 images)> >
Some of the things shown on the slide relate to individuals but many are unit specific.
-Question: How many of you have been in a Command that has had poor unit cohesion?
So it is also important to strengthen the unit.
-Question: What is the last missing piece for strengthening?
[Answer: LEADERSHIP – Because effective leadership pulls it all together]
When you boil it all down, each of the things we have listed directly correlate to the three components of the Navy’s strategies for building strength:
Tough, Realistic Training
Building Unit (Social) Cohesion
Effective Leadership   
All strength is built the same way – physical strength, mental strength, spiritual strength, and social strength.
You build strength in a unit and a family the same way you build strength in an individual.
Navy OSC Leaders promote and help build not only physical strength, but also mental strength in individuals and their units.
Mind
Spirit
Personal Grooming
Strengthen 10 10 10

11. Core Leader Functions READY REACTING INJURED ILL KEY MESSAGES:
We use the Five Core Leader Functions to move Sailors toward the Green (Ready) Zone.
SCRIPT:
-Now that you understand the stress continuum, let’s discuss what we do as leaders to keep our Sailors resilient and ready to fight. We call these the Five Core Leader Functions.
<Slide automatically builds.>
-The five Core Leader Functions are Strengthen, Mitigate, Identify, Treat, and Reintegrate.
-Navy OSC Leaders apply these Five Core Functions throughout the stress continuum to keep moving our Sailors towards a state of full readiness.
-The Core Leader Functions are the way we put OSC into day-to-day practice, how we move our Sailors towards the green.
-Let’s discuss each of these core leader functions in more detail. 11

12. Strengthen: 1st Core Leader Function
Chow
Exercise
Rest
Social Cohesion
Body
Family
Sports
KEY MESSAGES:
The first Core Leader Function is Strengthen.
Strengthen is not just physical. It’s also mental, spiritual or social.
Navy strategy for building strength is:
Tough, realistic training
Social cohesion
Effective leadership
Strengthening is a defensive weapon against stress.
SCRIPT:
The first Core Leader Function – strengthen.
Strengthening is a defensive weapon to fend off stressful events that may occur.
-Question: What do we do to strengthen our Sailors and keep them ready?
Possible Answers: Training, equipment, rest, chow, unit cohesion, family readiness, ROE, mission focus, building confidence and competence, trust in the leadership and their fellow Sailors, spiritual readiness, stress inoculation, etc.
<<After receiving some answers, click and the slide automatically builds (12 images)> >
Some of the things shown on the slide relate to individuals but many are unit specific.
-Question: How many of you have been in a Command that has had poor unit cohesion?
So it is also important to strengthen the unit.
-Question: What is the last missing piece for strengthening?
[Answer: LEADERSHIP – Because effective leadership pulls it all together]
When you boil it all down, each of the things we have listed directly correlate to the three components of the Navy’s strategies for building strength:
Tough, Realistic Training
Building Unit (Social) Cohesion
Effective Leadership   
All strength is built the same way – physical strength, mental strength, spiritual strength, and social strength.
You build strength in a unit and a family the same way you build strength in an individual.
Navy OSC Leaders promote and help build not only physical strength, but also mental strength in individuals and their units.
Mind
Spirit
Personal Grooming
Strengthen 12 12 12

13. Strengthen: Building Resilience
ILL
INJURED
Original Orange Zone Boundary
KEY MESSAGES:
Repeated, controlled application of stress + recovery + motivation builds strength and resilience
This expands the green and yellow zones – our stress capacity
The result is stronger Sailors, better able to navigate operational stress
TALKING POINTS:
-Repeated, proper application of stress, along with recovery, and motivation are what we use to increase capacity of Sailors to stay within the yellow and green zones and avoid stress injury.
-Picture the graph on the screen as the stress continuum turned sideways with Green/Ready as the base.
<click to show graphic of building resilience demonstrated by green/yellow expanding>
-If the right amount of stress is applied, followed by proper recovery and motivation, then the next time, the individual will be able to handle an increased amount of stress. As this process repeats, the individual is progressively able to handle increasing amounts of stress
-It is important to notice (pointing to the middle of the graph), that this used to be the point where the Sailor was injured. Now, with the same amount of stress, it is well within the yellow zone.
-The expansion of the green and yellow zones equates to acquired strength, which translates into resiliency.
-It does not mean that the Sailor cannot be injured, but it does mean that the Sailor has an increased capacity to handle the stress.
Strengthen equals stress, plus recovery, plus motivation.
-Question: After seeing this illustration for building strength and resiliency, what does it reveal to you about a leader’s responsibilities for developing strength and resilience in the unit?
(Possible responses: knowing when to back off; allowing adequate rest and recovery)
-Question: Are there any questions about the First Core Leader Function Strengthen?
REACTING
READY 13

14. Mitigate: 2nd Core Leader Function Replenish Resources
KEY MESSAGES:
Mitigate also means replenishing resources that have been depleted by stress
Physical
Mental
Social
Spiritual
SCRIPT:
Discuss concept of a leaky bucket:
Mitigation replenishes your resources.
Stress continually drains your bucket of resources or causes it to leak.
Unit and family members are the resources that fill your bucket:
The key point: Balance of all of these different things.
-Question: What are the things that drain the bucket?
[Answers – day-to-day stressors related to family/friends/shipmates, work, environment, etc.]
-Question: What are the things that fill the bucket?
[Answers – recognizing and rewarding hard work, encouragement, time off, rest/recovery, family time, proper nutrition, exercise, reading, quiet time/meditation/prayer, mastering new challenges, etc.] 25 14

15. Military Operations Change Us
KEY MESSAGES:
Navy operations change everyone – often for the better through experience.
Occasionally, highly stressful events or evolutions cause Sailors to experience stress injuries or illnesses.
Know your Sailors, look for changes in function or behavior that might indicate a stress injury or illness.
Extreme, prolonged, repetitive stress can impact individual and command readiness.
SCRIPT:
Navy operations change everyone, often for the better through experience, but not always. Reactions may be temporary or sometimes, more persistent. Most of the times, Sailors will not tell you that they are having a problem. So it is up to you as leaders to identify those Sailors who have been negatively affected by stress.
Some changes are easy to spot, however, sometimes, despite everything you’ve done as a leader to strengthen your crew and reduce avoidable stress, some people will have stress reactions.
We must recognize that military operations can and will change us and be able to identify when our shipmates are having problems or stress issues.
-Question: How many of you were involved in humanitarian relief operations for Hurricane Katrina, the Indonesian Tsunami, or the Earthquake in Haiti, or know someone who was? (show of hands) 
-Follow-on Question: For those of you who were personally involved in one of the humanitarian relief missions or know someone who was, did that mission have a noticeable effect on you/your shipmates? (allow discussion)
-Question: What changes did you notice?
-Question: What kind of navy operations changed you?
SCRIPT:  
It’s important that leaders get to know their Sailors to find out if they have experienced operational missions that might have caused them to change. 15

16. Identify: 3rd Core Leader Function Look For Changes in Function or Behavior
KEY MESSAGES
The third Core Leader Function is Identify
You may not always know right away when a Sailor has experienced a highly stressful event
If you know your Sailors well enough, you will know when something is not right
SCRIPT:
You won’t always know that something has happened to a Sailor, you need to be vigilant. What is their baseline? You need to ask, “Is this Sailor acting like his/her usual self? Do they seem to be getting better or not?”
Goal is to identify problems while people are still in the yellow zone – looking for subtle changes in function or behavior.
-Question: How many of you know when one of your shipmates is undergoing stress? (show of hands)
You won’t always know and that’s okay. But how many of you know when a Sailor is not behaving as his/her normal self?
How well do you know your people? If you know them well enough, then you will know when something is not right.
Identify 16

17. Identify: Stress Tachometer
KEY MESSAGES:
The difference between Yellow (Reacting) and Orange (Injured) can be compared to some of the indicators in your car
Sailors move freely from Green to Yellow and back every day – it’s normal
An Orange Zone injury will persist even after the stress is removed and requires intervention in order to heal
The Red Zone indicator would illuminate only if a stress injury did not heal properly over time – this can only be determined by a medical or mental health professional
SCRIPT:
<See Stress Tachometer and Stress Decision Matrix in student handout and OSC Pocket Guide>
The difference between orange and yellow is like some of the indicators in your car.
For example, the tachometer; you can run it up to a certain speed and back and it’s not a problem. The car is able to handle the “stress” and recovers just fine.
However, if you overstress the engine and the orange indicator, the “check engine light,” comes on and lets you know that it is time to get professional help.
-Question: What might happen if you ignore the “check engine” light and continue to drive the vehicle? (allow responses)
-Follow-on Question: Is there any similarity between ignoring the “check engine” light in a car and ignoring a significant stress event in one of your Sailors? (allow responses)
TALKING POINTS:  
If every Sailor had a stress tachometer on their forehead, it would be easy to see how they were doing but it doesn’t work that way. You have to know your people.
That’s where good leadership and cohesive units come in. Without them, the Sailor’s potentially serious stress reaction might go undetected and lead to debilitating health problems down the road
To help you identify problems early, you can utilize the next Navy OSC Leader tool; the Stress Decision Matrix. 17

18. Identify: Stress Decision Matrix
Sailor Under Stress
Are there signs of DISTRESS or LOSS OF FUNCTION?
Green Zone (Ready):
Good to Go. Continue to monitor for signs of distress or loss of function in the future if concerned NO
Distress or Loss of Function:
Difficulty relaxing and sleeping
Loss of interest in social or recreational activities
Unusual and excessive fear, worry, or anger
Recurrent nightmares or troubling memories
Hyperactive startle responses to noises
Difficulty performing normal duties
Any change from normal personality
YES
Yellow Zone (Reacting):
Ensure adequate sleep & rest
Manage home-front stressors
Discussions in small units
Refer to chaplain or medical if problems worsen NO
Is the distress or loss of function SEVERE?
SEVERE Distress or Loss of Function:
Inability to fall asleep or stay asleep
Withdrawal from social or recreational activities
Uncharacteristic outbursts of rage or panic
Nightmares or memories that increase heart rate
Inability to control emotions
Serious suicidal or homicidal thoughts
Loss of usual concern for moral values
KEY MESSAGES:
The Stress Decision Matrix can help leaders decide what zone a Sailor is in and what to do about it
If you believe a Sailor is in the Orange Zone or may be in the Red Zone, get them to a Chaplain or Medical professional as soon as possible
Only Medical personnel can determine if a Sailor is in the Red Zone
SCRIPT:
<Instructor to students: “Get out your OSC Leader pocket guide and flip to the “Decision Matrix” tab and follow along.”>
This is going to look complicated, but it’s not. All you’re really doing is deciding ‘What zone do I think this Sailor is in?’ and ‘What do I need to do about it?’
We’re not trying to turn you into a doctor; you’re not diagnosing, you’re just taking care of a shipmate.
The first thing you need to decide is if they are in the yellow zone by looking at these indicators. If so, look at the Yellow zone box and see what you should do.
If the distress or loss of function is severe, check to see if they are in the orange zone.
If they are in the orange zone, you need to refer to them a Leader, Chaplain, or medical personnel.
The red zone is for medical staff to determine, but if you think that they are in the red zone, help them get the help they need, immediately.
YES
Orange Zone (Injured):
Keep safe and calm
Rest & recuperation hrs.
Refer to medical or chaplain
Mentor back to full duty and function
Has the distress or loss of function PERSISTED? NO
PERSISTENT Distress or Loss of Function:
Stress problems that last for more than several
weeks post-deployment
Stress problems that don’t get better over time
Stress problems that get worse over time
YES
Red Zone (Ill):
Refer to medical
Ensure treatment compliance
Mentor back to duty if possible
Reintegrate with unit 18

19. Identify: Discussion
A boat crewman of yours was exposed to smoke from a burning fiberglass fishing vessel. He has heard that exposure to burning plastic can cause cancer. Although exposed for only a short time, he talked to the doc who reassured him that short term exposures are usually nothing to worry about. He seems anxious, is having trouble sleeping, but he’s still motivated and seems to be getting better.
What stress zone is he in?
What should you do about it?
One of your best crew members who used to take the lead with any task, is now staying in the shadows and seems reluctant to engage. His performance has deteriorated markedly, he seems increasingly worn out, says he can’t sleep at night, constantly complains about his wife, and is not getting better.
What stress zone is he in?
What should you do about it?
KEY MESSAGES: Students experiment applying stress continuum concept.
SCRIPT:
Now that you have some of the basic OSC tools, let’s look at a couple of scenarios.
Refer to the decision matrix in your pocket guide.
<Click to reveal first scenario>
First scenario:
The Sailor is in the yellow zone because he still is having some symptoms of being shaken, having trouble sleeping, and troubled thoughts.
It looks temporary.
Action: rest and recuperate. Watch to ensure that he gets better.
<Click to reveal second scenario>
Second scenario:
The Sailor is in the orange zone, because he is avoiding responsibility, seems worn out, can’t sleep, constantly complains, and it seems to be persistent.
Action: refer to Medical or a Chaplain.
The difference is that the first Sailor seems to be recovering, the second Sailor does not seem to be recovering and is impacting his ability to do his job. 19

20. Identify: Discussion
A Sailor of yours was involved in a diesel fuel spill that saturated on of his trouser legs. He has heard rumors that exposure to fuel can be toxic. Although he changed clothing rapidly and cleaned up with soap and water he was concerned enough to talk to the Safety Officer reassured him that short term exposures are usually nothing to worry about. He seems anxious, is having trouble sleeping, but he’s still motivated and seems to be getting better.
What stress zone is he in?
What should you do about it?
One of your best Sailors who used to take the lead with any task, is now staying in the shadows and seems reluctant to engage. His performance has deteriorated markedly, he seems increasingly worn out, says he can’t sleep at night, constantly complains about his wife, and is not getting better.
What stress zone is he in?
What should you do about it?
KEY MESSAGES: Students experiment applying stress continuum concept.
SCRIPT:
Now that you have some of the basic OSC tools, let’s look at a couple of scenarios.
Refer to the decision matrix in your pocket guide.
<Click to reveal first scenario>
First scenario:
The Sailor is in the yellow zone because he still is having some symptoms of being shaken, having trouble sleeping, and troubled thoughts.
It looks temporary.
Action: rest and recuperate. Watch to ensure that he gets better.
<Click to reveal second scenario>
Second scenario:
The Sailor is in the orange zone, because he is avoiding responsibility, seems worn out, can’t sleep, constantly complains, and it seems to be persistent.
Action: refer to Medical or a Chaplain.
The difference is that the first Sailor seems to be recovering, the second Sailor does not seem to be recovering and is impacting his ability to do his job. 20

21. Operational Stress Control
<OSC Cartoon to segue into next module> 21

22. Treat: 4th Core Leader Function Take Action/Intervene
KEY MESSAGES:
The Core Leader Function “Treat” refers to intervention that you as a leader can perform.
It’s not about being a Doctor or a Corpsman.
“Treat” may involve you personally accompanying a Sailor to see a Chaplain, Doctor, Counselor or Mental Health provider.
SCRIPT:
Now that you’ve identified what stress zone your Sailor is in, it is time to take action.
When we use the term “Treat” here, we are not talking about being a corpsman or a doctor.
We are not trying to turn you into a mental health professional, just showing a little compassion and caring may resolve the problem – in fact, the Sailor may resolve it on his own.
This is about early intervention that you as a leader can take. This is basic leadership.
-Question: As leaders, what are some of things that you do to help your Sailors get through operational stress problems?
[Possible Answers – Engage, Listen, Give permission, Problem solve, Refer, Provide resources, Help refocus on the mission– keep them in the fight, as long as it is safe, Continually monitor risks – does this Sailor look good-to-go?]
Don’t stand by and do nothing. Navy OSC Leaders take action!
Treat 22

23. Reintegrate: 5th Core Leader Function Reality of Reintegration
KEY MESSAGES:
The fifth Core Leader Function is Reintegrate.
Reintegration requires consideration.
SCRIPT:
If Sailors do get help for a stress-related problem, sometimes they may perceive some stigma about returning to their unit.
They may lack confidence in themselves, or may be worried about what others might say or think about them.
-Question: If you send a Sailor out for treatment, do you think it’s possible to reintegrate them? (allow discussion)
-Follow-on Question: Is it different if you keep a Sailor in the unit while they receive treatment? (allow responses)
-Question: Who is responsible for setting the appropriate tone?
[Answer - The Chief]
Why? (allow discussion)
-Question: What is the current climate towards shipmates dealing with stress reactions? (allow discussion)
-Question: What happens if we don’t accept the Sailor back into the unit? (allow discussion)
[Answer - No one will come forward asking for help again]
-Question: How can you use your OSC training to improve reintegration? (allow discussion)
The ‘bottom line’
Reintegration requires consideration before, during and after treatment.
How you send your Shipmate away for help can affect whether they can be reintegrated back into the unit.
Reintegrate 23

24. Good Leaders Stop, Look, and Listen
KEY MESSAGES:
Know your Sailors; Understand how to communicate- Boomers/Gen X vs Gen Y and Millenials.
Listen and observe.
The result will be better situational awareness.
Good leadership is inconvenient.
SCRIPT:
-Good leaders stop, look and listen. This is the basis of everything we’ve been talking about today.
-As a Navy Leader, you always need to listen and observe for stress problems. You also need to know who your good listeners are. The result is you have better situational awareness.
-Question: What makes a good listener?
-Question: Ask yourself, do I listen well?
-What could make me a better listener? What signals am I sending? What is my body language saying?
-While you are listening, you need to observe their body language, such as gestures and behaviors.
-Repeat what you hear so you’re on the same wavelength.
-Listen to clarify and problem solve only later.
-Give your full attention and use open ended questions.
-Their story will help them fill in their ‘blanks’ and answer their questions.
-To understand , imitate their body language.
-Question: What kinds of body language do you look for in a Sailor to determine their stress level?
-Everything we talked about here is people skills. How would you rate your people skills? Think about ways to improve them.
-Bottom line, you need your Sailors to trust you if they are going to talk to you.
-When interviewers talk to those who were contemplating suicide but did not carry through, the primary point that made a difference to them was that someone listened and cared about them. Your body language and tone of voice can play a huge part in it.
- Gen Y/Millenials are more comfortable communicating electronically, for example, tweeting and other social media. They are not as comfortable with face to face. 24

25. 1: Scenario
You’ve noticed lately that one of your best coxswains is just not his usual self. You’ve heard he has family problems and that his girlfriend recently broke up with him. Now he goes off by himself and is reported to be playing video games late into the night, not sleeping, and isolating himself. When asked how he is doing, he says he is fine, but seems irritable and will not make eye contact. You are concerned about this crew member.
Key Messages
What are the issues? This Sailor doesn’t seem to be himself, he’s withdrawing and exhibiting behaviors out of norm for him.
What stress zone is this Sailor in? Yellow zone since he is reacting.
What are the risks? Behaviors could get worse if stressors not addressed and resolved. That they will continue to do this or get worse.
What should you do? Talk to the Sailor and find out what’s bothering them, listen to his/her concerns, reassure him you’re there for him, continue to monitor, and advise chain of command.
Which of the five core leader functions applies to this scenario and why? Mitigate. Although you can’t change the circumstances or problems this Sailor has experienced, by talking to him about his concerns, you may be able to help prevent things from getting worse. 25

26. 2: Scenario
A PSU member, ME1 Smith, has a family with 2 children and completed three extended deployments over a couple of years. The first deployment went well, but by the second deployment the older daughter's grades began to drop and Mom has to go to work to help pay bills. When Dad returns he's often irritable. By the third deployment, the daughter begins failing at school, isolates from her family, and begins having nightmares. The son starts acting out at school. The mother becomes overwhelmed and depressed. When Dad returns he is constantly angry, resorts to yelling and screaming, and completely withdraws from the family.
Key Messages:
What are the issues? Child's falling/failing grades, nightmares, and social isolation; child's acting out; financial problems; Mom's depression; Dad's anger (verbal abuse?).
 What stress zone is this Sailor in? Early, green; middle, yellow; late, orange. Sailor and family are in these zones, not just the individuals but the whole family unit.
What are the risks? Worsening problems with children both in school and psychologically; untreated depression in Mom and further deterioration of the family unit; Dad's career (finances, anger).
What should you do? As a leader, encourage Sailors to attend pre- and post-deployment seminars and offer incentives to those who do. Ask about the family and how they are handling frequent deployments. Hold family events so you can observe how the families interact and spot potential problems. Create an atmosphere where your Sailors can come to you with problems. Have a ready list of resources available. In this case, this family needs to be referred for counseling.
Which of the five core leader functions applies to this scenario and why? At this last stage, Identify and Treat. 26

27. 3: Scenario
BM3 Ramirez completed alcohol treatment a month ago and is preparing to deploy again. His car is about to be repossessed because he can’t make his car payments and his girlfriend dumped him recently. He began drinking again and his performance is deteriorating. BMC Massey is concerned about this crew member.
Key Messages:
What are the issues? Financial, alcohol treatment failure, risky behaviors, relationships, loss of focus, and poor performance.
What stress zone is this Sailor in? Orange zone, at risk for red.
What are the risks? Immediate: Further deterioration of performance, command having to deal with legal problems, and deployment risk, alcohol issues get even worse
What should BMC Massey do? Attempt to find out what’s really going on with PO3. A kick in the butt, evaluate his fitness for duty and suitability for deployment, help him get into financial counseling, and refer to SACO.
Which of the five core leader functions applies to this scenario and why? Treat. It is obvious Ramirez has problems. He needs counseling and appropriate referral. 27

28. 4: Scenario
MKC Jones has recently been through Operational Stress Control Training and has been “mentoring” one of his young Petty Officers on a stress issue. He has decided that the Petty Officer has PTSD and has been telling other Sailors. MKCM Stewart overhears MKC Jones telling other crew members that the Petty Officer has cracked, and has PTSD.
 Key Messages:
Leaders, you are not here to diagnose. Your job is to assess risk and provide support.
What are the issues? MMC is overstepping his boundaries, performing unqualified diagnosis, breaching confidentiality, and creating stigma. Petty Officer needs professional help.
What stress zone is the Petty Officer in? We don’t know, but someone should find out.
What are the risks? Petty Officer’s health and reputation. He also loses trust in his chain of command and probably won’t seek further help in the future.. MMC’s actions jeopardize OSC Program credibility.
What should MMCM do? Talk to MMC and tell him diagnosing is not part of his job and counsel him on the negative results of breaking confidentiality. Talk to the Petty Officer to find out how he is doing and do damage control, if required.
Which of the five core leader functions applies to this scenario and why? Mitigate, Identify 28

29. 5: Scenario
An FS2 has just reported aboard your command. At an awards ceremony he receives a Coast Guard Achievement Medal for actions conducted during the Haitian earthquake response. He saved two critically injured civilian children. You also know that despite his best efforts, a third injured child died. While the citation is being read, he starts trembling, breathing heavily, and appears to be zoning out. You are concerned about this shipmate.
Key Messages:
What are the issues? Seems to be having a stress reaction maybe caused by reliving the event.. May be he’s never really dealt with the death of one of his Marines in his care, exposure to a traumatic event.
What stress zone is this Sailor in? Orange plus zone.
What are the risks? Not getting better, may get worse. Possible loss of a good corpsman. Family alienation.
What should you do? Utilize COSFA: check, coordinate, cover, and calm. Refer him to medical and/or a chaplain and inform senior leadership.
Which of the five core leader functions applies to this scenario and why? Identify 29

30. Operational Stress Control
-OSC Cartoon to segue into next module 30

31. Ready to Go? 31 KEY MESSAGES:
You have the tools you need to strengthen your shipmates and take action when you detect operational stress issues.
Inspire your shipmates to get help when they need it.
It’s not just for them, but for their shipmates and family.
Be part of the solution.
This knowledge you have gained cannot stop with you – you need to teach this to your trusted subordinates.
You know who your contacts are for the “Petty Officer Underground.”
Your trusted subordinates are your eyes and ears.
SCRIPT:
After the panel members have told their stories:
-It’s ok to talk, it’s not a weakness. These are strong Sailors who can talk about their tough times and they understand what your shipmates are going through.
-This is the essence of a Navy OSC-Leader. Providing someone for Sailors to talk to when they are experiencing stress.
-Question to the panel: If you could say one thing to your Sailors to motivate them to deal with operational (or combat) stress and get back into the fight, what would it be?
-Question to the audience: What would you want to say to your leaders?
-When you see it, hear it, sense it and you know it is operational stress—take action right now because you have the tools and know how to mentor.
<Dismiss panel with thanks.> 31

32. To Maintain a Ready Force, Leaders Must:
READY (Green)
REACTING (Yellow)
INJURED (Orange)
ILL (Red)
Move Our People toward the GREEN
Key Messsages:
The goal of Navy OSC Lead is to keep Sailors, families and commands moving toward the Green (Ready) Zone.
Script:
-Remember, the goal of Navy OSC Leaders is to keep our Sailors, our Units, and our Families moving towards the GREEN!
Individual
Responsibility
Caregiver
Responsibility
Individual, Shipmate, Family Unit Leader Responsibility, 32

33. End of Operational Stress Control
<Last Course Slide>
KEY MESSAGES:
Complete evaluation forms to help improve the course for future sessions.
Please provide your feedback.
Say thank you’s and any closing comments.
SCRIPT:
Each instructor offers closing comments.
Take any questions or comments from the audience. 33