mobile care team
DESCRIPTION
Combat and Operational Stress Control (COSC) training with a focus on thecare giver in support of deploying Mobile Care Team (MCT) members.The MCT are Directed by Vice Chief of Naval Operations and Deputy SurgeonGeneral to emphasize preventive mental health, surveillance, and commandconsultation by engaging in routine site visits outside traditional medicalsettings in an effort to reduce mental health stigma and remove barriers tocare. MCT members visit Navy IAs and administer a Behavior Health Needs AssessmentSurvey (BHNAS) which evaluates the psychological health and readiness of"Boots on ground" IA sailors. They focus on mental health challenges (PTSD,anxiety and depression), mental health care stigma, combat exposure;deployment related stressors, attitudes toward leadership, sleep problems,positive effects of deployment, unit cohesion, and morale.TRANSCRIPT
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MOBILE CARE TEAM
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www.nccosc.navy.mil
COSC Doctrine
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www.nccosc.navy.mil
NCCOSC Mission:To build and preserve the psychological health of Sailors, Marines and their families
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Components of CGOSC
Combat and Operational Stress First Aid (COSFA)
Five Core Leader Function
Stress Continuum Model
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www.nccosc.navy.mil
What is Stress?The process by which we respond to challenges to our minds and bodies.
Stress is good, stress is normal, stress keeps us sharp, stress keeps us focused.BUT…
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Operational Stress Control Program Core Objectives
Early Recognition
Breaking the Code of Silence
Engage Caregivers in Early Help
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Course ObjectivesDescribe the Caregiver Occupational Stress (CGOSC) concepts used by the Navy and Marine Corps.
Recognize stress reactions and injury sources using the Stress Continuum Model.
Describe Combat and Operational Stress Control Five Core Leader Functions.
Describe assessment and intervention methods using Combat/Operational Stress First Aid (COSFA).
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Definitions
Combat Stress
Operational Stress
Occupational Stress
Compassion Stress
Vicarious Trauma
Compassion Fatigue
Burnout
Compassion Satisfaction
Caregiver Resilience
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Symptoms of Stress
Physical
Emotional
Behavioral
Work-Related
Interpersonal
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Components of OSC
Combat and Operational Stress First Aid (COSFA)
Five Core Leader Function
Stress Continuum Model
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Ready Reacting Injured Ill
Good to Go
Well-Trained
Fit and Focused
Cohesive Units
Ready Families
Distress or Impaired
Mild and Temporarily Anxious,
Irritable or Sad
Physical or Behavioral Changes
More Severe or Persistent Stress or
Impairment
May Leave Lasting Memories, Reactions
and Impressions
Stress Injuries That Don’t Heal
Without Help
Symptoms Persist > 60 Days, Get Worse or Initially Get Better Then Return Worse
The Operational Stress Continuum
Unit LeaderResponsibility
CaregiverResponsibility
Individual, Shipmate, FamilyResponsibility
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READYGreen Zone“Fit and Focused”
Well-Trained and Qualified
Positive Command Climate
High Morale
Unit Cohesion
Balanced HealthPhysicalEmotionalSpiritual
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Yellow Zone - REACTING
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REACTINGYellow ZoneAnxious, Irritable, Sad
Poor Concentration
Sleep Difficulties
Appetite Changes
Apathy
Negative, Pessimistic
Interpersonal Conflict
Poor Decision Making
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INJUREDOrange ZonePoor Emotional Control
Major Sleep Difficulties
Guilt, Shame, Fear
Loss of Interest
Challenge to Moral Values
Substance Abuse
Decreased Confidence
Poor Morale
Family Disruptions
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ILLRed ZoneChronic and severe distress
Substance dependence
Major disruptions of sleep, appetite, mood
Significant problems at work
Panic, anger, rage or shame
Injuries that don’t heal without help
Family/relationship violence or abuse
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www.nccosc.navy.mil
What is Stress?The process by which we respond to challenges to our minds and bodies.
Stress is good, stress is normal, stress keeps us sharp, stress keeps us focused.BUT…
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Physiological Effects of Stress
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What is an Orange Zone Indicator?
Recent Stressor Events: Recent exposure to events with high potential to cause trauma, grief or moral injury
Verbalized Distress: significant and persistent distress, such as fear, anger, anxiety, sadness, guilt or shame
Changes in Function: significant and persistent changes in physical, mental, social or spiritual responses
How to Recognize Who Needs Help:Orange Zone Indicators
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Many Causes vs. Only FourYellow Zone Reactions vs. Orange Zone Reactions
Lack of Sleep
Family Separation
Loss of Possessions
Boredom
Peer Conflicts
Hard Work
Relationship Problems
Money Problems
Physical Injury
Life Threat
Wear and Tear
Loss
Inner Conflict
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www.nccosc.navy.mil
Combat and Operational Stress First AidCOSFA
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Reacting Injured Ill
Where COSFA Falls on the Stress Continuum
Promotes a Sense of Safety Promotes Calming Promotes Connectedness
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Check
Coordinate Coordinate
Coordinate
Check Check
Continuous Aid
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Check
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Check
DangerousNeeds Stress Zone
1-to-1 InteractionsCollateral Information
Response to InterventionsChange in Functioning
Distress Stressors
Decide Observe
Keep TrackExamine
Check
LookListen
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Coordinate
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Coordinate
Collaborate Get Help
ReferInform
CoordinateTo Manage CrisisTo Get Information
To Promote Recovery
Direct Hand-OffRecommended ResourcesConsultation
Chain of CommandFamilyPeers
To Ensure SafetyTo Promote RecoveryTo Follow Up
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Primary Aid
Primary Aid (Cover and Calm) is a rescue response to a dangerous situation.
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Cover
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Stand By Make Safe
Make Others
Safe
EncourageFeelings of
Safety
Cover
Authoritative PresenceWarn
ProtectAssist
Disarm
ProtectWarn
Calm PresenceReduce DangerReduce Chaos
Ready to AssistHold AttentionWatch and Listen
Cover
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Calm
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Calm
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Calm
Rest Quiet
SootheCompose
Calm
Stop Physical ExertionSlow Down Heart Rate
Reduce HyperalertnessRelax
Reduce Emotional IntensityListen Empathically
Draw Attention OutwardDistractRefocus
Time OutSleepRecuperate
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Secondary AidRestore Function, Reduce Distress:
Connect
Competence
Confidence
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Restore Function, Reduce Distress:
Connect
Competence
Confidence
Secondary Aid
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ConnectProvide Support
Promote Social Interactions
Facilitate Rituals
Remove Problem-Solving Obstacles
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Connect
Be With Comfort
ReduceIsolation
ReduceAlienation
Connect
AcceptEncourage
Soothe
InvitePlayTalk
Include
UnderstandingCorrect MisconceptionsRestore Trust
Eye ContactPresenceListenEmpathize
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CompetenceMentor to Full Function
Problem-Solving Strategies
Manage Stress Reactions
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Competence
Competence
OccupationalSkills
SocialSkills
Well-BeingSkills
Problem-Solving SkillsHygieneFitness
Managing Trauma and Loss Reminders
Develop Family RelationshipsDevelop Peer Relationships
Brief Operational PauseMentor Back to Duty
RetrainReassign
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ConfidenceTaking the Previously Mentioned Steps Will Help You:
Get Back Into a Routine
Rebuild Confidence and Trust in Yourself and Others
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Confidence
Hope Self-Worth
MeaningTrust
Confidence
Belief in SelfAccurate Self-Concept
Self-Respect
FaithMaking Sense
HonorPurpose
Trust in PeersTrust in EquipmentTrust in LeadersTrust in Mission
Forgiveness of SelfImagining the FutureForgiveness of Others
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www.nccosc.navy.mil
Combat and Operational Stress First AidCOSFA
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Five Core Leader Functions
StrengthenLeadership that is Firm, Fair, a Source of Courage, Communicates Plans and Listens
Expose to Tough, Realistic Training
Foster Unit Cohesion
MitigateRemove Unnecessary Stressors
Ensure Adequate Sleep and Rest
Conduct After-Action Review (AAR) in Small Groups
IdentifyKnow Crew Stress Load
Recognize Reactions, Injuries and Illness
TreatRest and Restoration (24-72 Hours)
Chaplain
Medical
ReintegrateKeep with Unit if at all Possible
Expect Return to Full Duty
Don’t Allow Retribution or Harassment
Communicate with Treating Professionals (Both Ways)
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SummaryStress is a Continuum
Four Sources of Stress
Caregivers Use COSFA
One Size Does Not Fit All
Good Leaders are the Best Medicine