THOMAS A. GASKIN, PH.DOSCAR PROGRAM MANAGER

19 May 2010

USMC OSCAR ProgramUSMC OSCAR Program2010 Navy/USMC COSC Conference

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BackgroundBackgroundBackgroundBackground

• Combat operational stress can happen to the strongest Marine or Sailor• Many problems can result from stress

– Job performance problems– Family problems– Uncharacteristic alcohol and drug abuse– Uncharacteristic misconduct– Mental Health problems– Suicidal behavior

• Stress problems impact:– Force preservation– Mission readiness– Long-term health

• Most stress problems do not need to become mental health problems• Early intervention saves you time• OSCAR is a tool for leaders to prevent and manage stress in their units

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OSCAR EfficacyOSCAR EfficacyOSCAR EfficacyOSCAR Efficacy

Do you have the tools you need to help identify and manage combat operational stress in your Marines?

100%

0%

52%

48%

Pre-OSCAR-Training Post-OSCAR-Training

YesNo

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OSCAR TestimonialsOSCAR TestimonialsOSCAR TestimonialsOSCAR Testimonials

• This training, if it saves even one Marine or Sailor, it will be cost effective. I tell you now - OSCAR is cost effective, ten times over.

• – SgtMaj, 1st Marine Division

• Stress impacts every Marine differently over time. Some get help and some find other ways. For me, I’d love to have some of my friends back.

• – 1stSgt, 11th Marine Regiment

• Collaboration amongst brothers is sometimes all you need.

• – SgtMaj, 7th Marine Regiment

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How OSCAR Teams WorkHow OSCAR Teams WorkHow OSCAR Teams WorkHow OSCAR Teams Work

OSCAR-trained Marine leaders and peers

(Collateral)

OSCAR-trained medical providers, chaplains, corpsmen, and RPs

(Collateral)

OSCAR-trained mental health providers and psych techs assigned to operational units

(Full-time)

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STRESS CONTINUUMPractical Knowledge: Practical Knowledge: Stress Can Be GoodStress Can Be Good

Practical Knowledge: Practical Knowledge: Stress Can Be GoodStress Can Be Good

READYREADY

REACTINGREACTING

INJUREDINJURED

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STRESS CONTINUUMPractical Knowledge:Practical Knowledge:Causes of Stress ProblemsCauses of Stress Problems

Practical Knowledge:Practical Knowledge:Causes of Stress ProblemsCauses of Stress Problems

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-80%

-40%

0%

40%

80%

120%

160%

Str

ess

Level

Stress InjurySymptoms

Time Tra

um

ati

c even

t

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STRESS CONTINUUMPractical Tools: Core Leader Practical Tools: Core Leader Functions and Stress Continuum Functions and Stress Continuum

Practical Tools: Core Leader Practical Tools: Core Leader Functions and Stress Continuum Functions and Stress Continuum

READYREADYREADYREADY REACTINGREACTINGREACTINGREACTING INJUREDINJUREDINJUREDINJURED ILLILLILLILL

Unit LeaderResponsibilityUnit LeaderResponsibility

Chaplain & MedicalResponsibility

Chaplain & MedicalResponsibility

Individual ResponsibilityIndividual Responsibility

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STRESS CONTINUUMPractical Tools:Practical Tools:Stress Decision FlowchartStress Decision Flowchart

Practical Tools:Practical Tools:Stress Decision FlowchartStress Decision Flowchart

Orange Zone (Injured):

Red Zone (Ill):

Yellow Zone (Reacting):

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

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

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

Is the distress or loss of function

SEVERE?

Is the distress or loss of function

SEVERE?

Green Zone (Ready):•Continue to monitor for signs of distress or loss of function

• Refer to medical• Ensure treatment compliance• Mentor back to duty if possible• Reintegrate with unit

• Keep safe and calm• Rest & recuperation 24-72 hrs.• Refer to medical or chaplain• Mentor back to full duty and

function

• Ensure adequate sleep & rest• Manage home-front stressors• Discussions in small units• If problem worsens, discuss with

senior Mentors or Extenders

Marine Under Stress

Are there signs of

DISTRESS or LOSS OF

FUNCTION?

Are there signs of

DISTRESS or LOSS OF

FUNCTION?

Has the distress or

loss of function

PERSISTED?

Has the distress or

loss of function

PERSISTED?

IDENTIFY TAKE ACTION

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STRESS CONTINUUMPractical Tools:Practical Tools:COSFACOSFA

Practical Tools:Practical Tools:COSFACOSFA

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STRESS CONTINUUMPractical Tools:Practical Tools:AARs for COSCAARs for COSCPractical Tools:Practical Tools:AARs for COSCAARs for COSC

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STRESS CONTINUUMPractical Skills:Practical Skills:OSCAR Listening and InterventionOSCAR Listening and Intervention

Practical Skills:Practical Skills:OSCAR Listening and InterventionOSCAR Listening and Intervention

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Practical Knowledge: Practical Knowledge: Working with Medical ProvidersWorking with Medical Providers

Practical Knowledge: Practical Knowledge: Working with Medical ProvidersWorking with Medical Providers

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STRESS CONTINUUMPractical Tools:Practical Tools:Checklists and AssessmentsChecklists and Assessments

Practical Tools:Practical Tools:Checklists and AssessmentsChecklists and Assessments

Resilience Training Checklist

Psychological Fitness Checklist

Stress Mitigation Checklist

Deployment Health Assessments

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Implementation ScheduleImplementation Schedule

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

Train MEF/MFR Trainers

Ongoing Training and HQMC Sustainment

Develop and Test Training

CY 2010

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• Command OSCAR Team Training– Approx 50 Marines and Sailors from each battalion (or equivalent)– Takes 1 day

• Trainers– Approx 100 to be trained for each MEF and MARFORRES – Takes 1 week– Best trainers become OSCAR Master Trainers

• Timeline– I MEF: May– II MEF: June– III MEF: July– MARFORRES: August

Training RequirementsTraining Requirements

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SustainmentSustainment

• Program management and oversight– Staffing, compliance, quality, basic training, annual updates

• Training for Navy specialists– Medical providers, chaplains, corpsmen, RPs– BUMED, Chief of Chaplains, TECOM

• Advanced courses for Marine OSCAR Mentors– Higher level knowledge, skills, and techniques

• Program updates– New tools, best practices, and resources

• Similar program for families and spouses– Early identification and intervention skills

• Program evaluation– Training team metrics, RAND Corp longitudinal study

Questions?Comments?Questions?Comments?

www.manpower.usmc.mil/cosc