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

2. 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.

3. Stress Continuum Model
Stressor 3

4. Key Stress Indicators to Watch and Listen for
Sources of Information
Watch for:
Listen for:
Recent Stressors
Stressors during deployment or training
Personal or home-front stressors
Levels of Distress
Uncharacteristic and intense negative emotions
Troubling thoughts like guilt or shame
Key Indicators
Level of Functioning
Changes in job performance, self-care, or getting along with others
Physical symptoms, sleep problems, or loss of self control

5. 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
Are there signs of DISTRESS or LOSS OF FUNCTION?
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 no
yes
Yellow Zone (Reacting)
Ensure adequate sleep & rest
Encourage/communicate/listen
Do after-action reviews
Refer to counselor, chaplain or medical if problems worsen
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
Is the DISTRESS or
loss of function
SEVERE? no
yes
Orange Zone (Injured):
Keep safe and calm
Rest & recuperation hrs.
Refer to counselor, chaplain, or medical
Mentor back to full duty and function
Has the distress or
loss of function PERSISTED?
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 no
yes
Red Zone (Ill):
Refer to medical
Ensure treatment compliance
Mentor back to duty if possible
Transition to VA if necessary

6. 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? 6

7. Common Barriers to Navigating Stress
Stigma
Prejudice
Stereotype
Understanding

8. Common Barriers to Navigating Stress
Internal Barriers
Self Stigma
External Barriers
Unit or Command level
Institutional Barriers
Navy or DoD-wide policies

9. Methods or Tools to Help Navigate Stress
Relaxation techniques
Deep breathing
Deep muscle relaxation
Physical activity
Stress-reducing activities

10. 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 10

11. 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

12. COSFA Continuous Aid Primary Aid Secondary Aid Seven C’s of
Distress or
loss of function
due to stress
Seven C’s of
Stress First Aid
Check
and
Coordinate
Stressor
COVER
Primary Aid
Check
And
Coordinate
Check
Assess and Observe
2. Coordinate
Get help refer as needed
3. Cover
Get to safety ASAP
4. Calm
Relax, slowdown, refocus
Connect
Get support from others
6. Competence
Restore effectiveness
7. Confidence
Restore self esteem and hope
CALM
Continuous Aid
Check
and
Coordinate
CONNECT
Secondary Aid
Check
And
Coordinate
COMPETENCE
Check
And
Coordinate
Continue to
Check and Coordinate
CONFIDENCE

13. COSFA Seven Cs Check and Coordinate Check and Coordinate Check And
Continue to
Check and Coordinate

14. Cover Continuous Aid Primary Aid Secondary Aid COVER Check and
Coordinate
COVER
Primary Aid
Check
And
Coordinate
Continuous Aid
Check
and
Coordinate
Secondary Aid
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and Coordinate

15. Calm Continuous Aid Primary Aid Secondary Aid CALM Check and
Coordinate
Primary Aid
Check
And
Coordinate
CALM
Continuous Aid
Check
and
Coordinate
Secondary Aid
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and Coordinate

16. Connect Continuous Aid Primary Aid Secondary Aid CONNECT Check and
Coordinate
Primary Aid
Check
And
Coordinate
Continuous Aid
Check
and
Coordinate
CONNECT
Secondary Aid
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and Coordinate

17. Competence Continuous Aid Primary Aid Secondary Aid COMPETENCE Check
and
Coordinate
Competence
Primary Aid
Check
And
Coordinate
Continuous Aid
Check
and
Coordinate
Secondary Aid
Check
And
Coordinate
COMPETENCE
Check
And
Coordinate
Continue to
Check and Coordinate

18. Confidence Continuous Aid Primary Aid Secondary Aid CONFIDENCE Check
and
Coordinate
Confidence
Primary Aid
Check
And
Coordinate
Continuous Aid
Check
and
Coordinate
Secondary Aid
Check
And
Coordinate
Check
And
Coordinate
Continue to
Check and Coordinate
CONFIDENCE

19. COSFA Confidence
Confidence 19

20. 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. 20

21. Where To Get Help Shipmates Family members Chain of Command Chaplains
Medical staff member
Student Counseling Center 21

22. Resources for Help Websites:
Navy Operational Stress Control (OSC) blog (
Navy & Marine Corps Public Health Center (www-nehc.med.navy.mil)
The Naval Center for Combat and Operational Stress Control (
USMC COSC ( )
Navy Safe Harbor ( )
Military OneSource (
VA Centers ( ) 22

23. Maintain Resources

24. 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.
If additional time is available, utilize supplemental COSFA scenarios. 24

25. Naval Reserve Officers Training Corps
Scenarios

26. 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?

27. 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

28. 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?

29. 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.

30. 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? 30

31. 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.

32. Scenario 4: COSFA in Action