84 terms

COSC 108

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COS (Combat Operational Stress)
Expected, predictable emotional, intellectual, physical or behavioral reactions of SM who have been exposed to stressful events in war. Combat stress reactions vary in severity as a function of operational conditions, such as intensity, duration, rules of engagement, leadership, effective communication, unit morale, unit cohesion, and perceived importance.
COSR (Combat Operational Stress Reaction)
Physical, emotional, cognitive, or behavioral reactions, adverse consequences or psychological injuries of S who have been exposed to stressful or traumatic events in combat.
COSC (Combat Operational Stress Control)
Programs/actions by military leadership to prevent, id, and manage adverse COSR units. Optimizes mission performance, conserves the fighting strength and prevents adverse effects of COSR on SM and their physical psychological intellectual and social health. Its goal is to return SM to duty quickly.
COSC Consultant:
a mental health pro with training and expertise in COSC mgmt./consults with the Combatant Command Surgeon, Combatant Commander and Unit Commanders about combat stress such as unit cohesion, unit morale, resilience, leadership effective communication and perceived mission importance. Completion of grade appropriate professional Military Service or Joint Staff education is recommended prior to appointment as COSC consultant.
COSC Personnel:
Active and Reserve behavioral personnel including enlisted specialists and admin support personnel who are trained in COSC principles, including combat and op stress first aid and application of principles to enhance combat effectiveness. Senior experienced COSC personnel serve as ADVISORS to line commanders on leadership, communication, unit cohesion, morale, and training factors that prevent or minimize COSRs.
CSF (Combat Stress Facility):
Provide treatment for those military members id'd as having mild to moderate combat stress. Treatment will be focused on promoting combat readiness by enhancing the adaptive stress response of military members and preventing maladaptive stress reactions. Treatment for home front stressors.
COSI (Combat Operational Stress Injuries):
Wounds to the mind or brain caused by intense or prolonged stress (FOUR TYPES)
1. TRAUMA
2. FATIGUE
3. GRIEF
4. MORAL INJURY
COSFA (Combat Operational Stress First Aid)
Set of tools with 3 AIMS:
1. Preserve LIFE
2. Prevent further HARM
3. Promote RECOVERY
Potentially Traumatic Event:
event that causes individuals or groups to experience intense feelings of terror, horror, helplessness, hopelessness. Perceived and experienced as a threat to ones safety or to the stability of ones world.
What are the SEVEN Risk Factors (causes) of COS:
1. WMD
2. Imminent danger
3. Exposure to be killed/wounded
4. Potential involvement in conflict
5. 360 degree battlefield
6. Asymmetrical Warfare(unknown enemy)
7. Fear of unknown
What are the SIX Mission Effects of COS:
1. conflict in the unit or home front
2. Focused stress is vital to mission accomplishment. Intense or prolonged COSR that impairs ability to function effectively.
3. Stressors that cause misconduct that require discipline
4. Stress that cause Battle/Non-battle injuries and fatalities through inattention, clumsiness and reckless behavior
5. Stress that causes increase in disease by disrupting hygiene, immune defenses
6. maladaptive overlapping stress behaviors
What are 6 emotional symptoms of stress:
1 Fear / Anxiety
2 Irritability
3 Anger/rage
4 Grief
5 Self-doubt
6 Guilt
What are 5 behavioral symptoms of COS:
1 Heightened Alertness 2 Increased tolerance to hardship 3 Loyalty to buddies 4 Courage/Heroic Acts
Maladaptive Behavior Symptom:
Ranges from minor breaches or orders/regulations to serious violations of the UCMJ and the Law of the Land Warfare.
What is the purpose of COSC:
Preserve mission effectiveness and warfighting capabilities and mitigate the adverse physical and psychological consequences of exposure to severe stress.
T/F: Combat stress reactions are not clinical disorders but instead are consequences associated with either prolonged exposure to high demand environments or exposure to single or repeated intense or traumatic events.
TRUE
What is the first step in preventing complications arising from combat and operational stress?
Emphasize the importance of psychological first aid.
What are some important EXPECTATIONS of COSC?
All mental health, medical, line personnel and the chaplain corps will be trained AND consult with units on psychological principles that enhance combat effectiveness and to evaluate, identify and differentiate combat stress reactions from diagnosable mental health conditions.
AF What is Pre-Exposure Preparation?
an educational approach 2 prepare individuals to deal with stress reactions expected when exposed to traumatic events emphasizing the typical and normal stress responses and basic techniques in stress management.
Who plans, supervises and monitors the activities of the medical detachment?
Detachment HQ
What is BICEPS? COSC management principles
Brevity - 1-3 days
Immediacy - cosc measure ASAP
Contact - warfighter encouragement
Expectancy - normal reaction to stress encourage
Proximity - separate from medical
Simplicity - brief methods (5Rs)
What are the 5Rs (COSR control)
Reassure - of normality
Rest - break from combat
Replenish - 3 hots, cot
Restore - purpose and confidence
Return to Duty -
What
S.
What are the levels of the Navy Stress Continuum Model:
GREEN (Ready) adaptive coping distress
YELLOW (Reacting) temporary distress
ORANGE (Injured) persistent distress
RED (ILL) disabling distress
What are the 5 core leader functions? (SMITR)
Strengthen
Mitigate
Integrate
Treat
Reintegrate
What zone encompasses adaptive coping, effective functioning in all spheres and personal well being?
READY ZONE: GREEN
What are the 3 aims of COSFA?
1. Preserve Life
2. Prevent Harm
3. Promote Recovery
BHTs quickly ID what stress zone a member is in by assessing:
1. Recent Stressors
2. Level of Distress
3. Level of Functioning
What is OSCAR?
Operational Stress Control and Readiness
What are BHT 9 Roles and Responsibilities for Joint Combat and Operational Stress Control?
1. Triage Casualties
2. Provide Counseling and Group
3. Unit consult/training/education
4. AA Debriefs
5. Supervise traumatic event debriefs
6. Communications
7. Utilize 5 Rs
8. Transport to higher
9. Documentation
What are the 2 COSC Triage components?
1. Assessment
2. Disposition
Causers are treated with the 5 R's?
Reassure
Rest
Replenish
Restore
Return
What are the categories of COSC disposition?
1. Help in Place
2. Rest Cases
3. Hold Cases
4. Refer Cases
What are the types of operational consultants?
1. Problem Oriented Consultation
2. Educational Consultation
What are educational consultations?
Present classes on various mental health subjects:
Smoking prevention/cessation
p fitness
stress management
alcohol and drug abuse prevention
SI prevention
What is the 5th step in Performing and Operational Consultation?
Step 5: ID Solutions; the problem/solutions remaining will then be ranked on priority list with the unit commander and the final decision
What are 2 types of common reactions to traumatic events?
1. Physical - fight or flight or freeze
2. Psychological - hypersensitivity to event and contradicting some aspect of the victims world view
What are disaster?
State of massive collective stress caused by an external calamity over which neither the affect individual nor the society has control
What is terrorism?
calculated use of violence political religious or ideological
What are the 4 key elements of terrorism?
1. Calculated use of violence
2. Installation of fear
3. Intimidation of audience
4. Pursuit of political, religious or ideological
What is "shell shock" or now "war neurosis":
characterized by physical ailments, paralysis, and a host of psychiatric symptoms.
What is "Neurasthenia":
A condition with symptoms of fatigue, anxiety, HA, impotence, neuralgia and depression THAT is the result of exhaustion of the central nervous systems energy reserves.
Where did French treat service members :
Close to the front and then were expected to return to duty RTD.
What was the RTD rate for US Troops?
70%
What did psychoneurosis become in ww2?
"Exhaustion" bc it best described the appearance of most psychiatric casualties and most combat participants.
What are COSR (AF) behavior examples:
Fear, anxiety, panic
anger, rage
somatic complaints
depression, indecision
exhaustion
hyper-alertness
What are AF End/Post Deployment Reintegration categories:
Preparing to return home
maintain communication
don't overwhelm
be patient rebuilding relationships
make time to rest
limit use of alcohol
ensure financial stability
know when to seek help
Who provides direct support combat and operational stress control prevention and treatment services for bigade combat team, division/corps and joint or combined forces on an area basis
Army - Main Support Section CSC Det
What does the Main support section of CSC Detachment consist of?
18 BH Personnel, 6 - 3 person teams with on BH Officer, one BH NCO and one BH jr specialist
Who provides prevention and limited fitness activity support to maneuver brigades and area support to units?
CSC Forward Support Section
What does the Forward Support Section consist of?
18 BH Team; section leader and 5 BH Officers, 6 BHT NCOs or OCC health NCOs, and 6 BH jr specialists.
What is COSC Triage?
process of sorting SMs with COSR and BH disorders based upon where they can best be managed.
What is SM Restoration?
1 - 3 day management of SM with COSR or BHDOs normally near a MTF.
What is SM Restoration Program?
24-72 hour program in which SM with COSR receive treatment
What is SM Reconditioning?
Therapy, military activites, pt and psychotherapy up to 7 days or more.
What zone encompasses mild and temporary distress or loss of function due to stress?
REACTING ZONE: YELLOW
What are characteristics of the YELLOW ZONE?
Feeling anxious, worrying, cutting corners, being grouchy, trouble sleeping, whacky appetite
What are characteristics of the ORANGE ZONE?
more sever and persistent forms of distress.
What are the 2 Goals of COFSA?
1. Augment and promote the repair of social support that may have been damaged by trauma
2. Troubleshoot the recovery process.
The BHT quickly identifies what stress zone a member is in by assessing:
1. Recent Stressors
2. Level of Distress
3. Level of Functioning
Operational Stress Control Decision Matrix:
tool used to identify zones, maximize performance and minimize risk for damage to the mind brain or spirit from excessive stress.
What are some OSCAR capabilities?
Consulting with military leaders on the management of unit level stress challenges.
What are 3 common reactions to Terrorism Disaster?
1. Debilitating Stress Reactions due to loss of control
2. Hostile feelings, dependence on authority, feelings of powerlessness, etc
3. High acute, chronic and delayed PTSD in addition to possible medical injuries
What are 9 stress control strategies?
1. Provide pre-incident psychological resiliency trng
2. Door knock/walk about promote wellness in community/military
3. Provide honest info and what happened
4. Mediate between victims and families/law enforcement
5. assist victims, family, staff, and resuers
6. inform of facts related to incident
7. Do not overreact in front of victims
8. assure victims it is normal reaction to stress
9. assist in re-establishing normal lifestyle
What are the 3 treatment goals of crisis intervention?
1. Stabilize symptoms of acute distress
2. Reduce the level of functional impairment
3. Restore Functioning
What are 3 prevention methods for crisis intervention treatment?
1. Primary - Education/Drills
2. Secondary - event debriefs
3. Tertiary - rehab
What are 5 Crisis Intervention Treatments?
1. Prevention
2. Skills Building
3. Resource Enhancement
4. Developmental Level
5. Integration of Strategies
What is a Potentially Traumatic Event? TEM
event that causes individuals or groups to experience intense feelings of terror, horror, helplessness, and or hopelessness. It is an event that is perceived and experienced as a threat to ones own safety.
What is a TEM facilitator?
TEM facilitators include any trained individual designated to assess the potential impact of PTE exposure to military units and personnel, crafting a support plan and executing measure to enable successful transition through the PTE incident
what is TEM
The approved US Army term used to define any support activities taken to assist in the transition of military units and soldiers who are exposed to PTE's.
What are the 4 goals of TEM?
1. Successfully transition units and individuals to full mission readiness
2. Build resilience
3. Promote resiliency, and increase in coping skills, a more rapid return to baseline, and greater unit cohesion
4. Quickly restore and or enhance unit cohesion and effectiveness
What is WRAIR?
Walter Reed Army Institute of Research that has developed event-driven, time-driven, and post deployment PD protocols that are considered military specific.
Which Protocols have been effective with individuals returning from combat operations who have been exposed to traumatic events?
WRAIR Debrief
Which models are recognized by the US Army Med Deprt as a best practice endorsed for use with military populations?
WRAIR event driven, time driven, post deployement PD models.
What are BHT TEM Responsibilities?
1. Conduct leadership consultation and education
2. Update unit TEM SOP
3. Establish Rapport with unit leaders
4. Collect collateral info
5. Conduct practical exercises in responding to a PTE
6. Determine the possible interventions
What is consulate and educate?
An intervention
What is a TBI:
disruption in brain function, directly caused by a physical force directed at the head.
What are the 3 types of TBIs:
1. object striking head
2. head striking object
3. blast wave pressure
What are mechanisms of physical force to the Brain?
1. Penetrating Wound
2. Intracranial Bleeding
3. Intracranial Contusion
4. Stretching of Nuerons
What are categories of TBI?
1. Mild - less than 30 minutes
2. Moderate - 30 min to 6 hours
3. Severe - 6 hours to 24 hours
What are moderate symptoms of TBI:
1. Persistent HA
2. repeated nasea
3. convulsions
4. inability to waken
5. dilation of one or both pupils
6. slurred speech
7. weakness/numbness
What are 3 TBI Assessment Tools?
1. Glasgow Coma Scale
2. MACE military acute concussion evaluation
3. ANAM Automated Neuropsychological Assessment Metrics
What is the purpose of Reintegration?
to provide positive and sustained care, control and discipline upon return from deployment.
Support in an ongoing process, not a homecoming event.
to provide continuous, integrated support from the AOR to home station and facilitate positive transition to family and work life.
What are Transition resources?
MFLC
One SOurce
Chaplain
BHS
Health Care Svcs
Legal/JAG
Family Readiness
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