Session Descriptions
Conference Video Presentations
Tuesday, 12 August 2008
Keynote Speakers
LtGen Samuel T. Helland, Commanding General, I Marine Expeditionary Force 
SgtMaj Dennis W. Reed, Sergeant Major, I Marine Expeditionary Force
Plenary
Words Matter: Brief History of Combat Stress Labels and Theories from Antiquity to Today
William P. Nash, M.D., USN–USMC Combat and Operational Stress Consultant
Characteristic distress or impairment arising during or after military operations has been evident in fiction and historical and scientific literature since antiquity. Although similar in nature throughout the ages, combat and operational stress reactions have been described using a succession of different labels, each reflecting the prevailing theoretical conception of the day. In this presentation, this historical succession of labels and theoretical models for combat and operational stress reactions is traced, and the societal and cultural forces, both inside and outside the military, that have shaped these conceptions are explored. Most importantly, the contribution of labels and theories to the social stigma surrounding combat and operational stress, both intentional and as an unintentional side effect, is highlighted. The role of the Marine Corps–Navy Combat and Operational Stress Continuum model in reducing stigma is described.
LtCol William Swan, XO, 11th MEU
Tri - MEF Letter
Tri - MEF Letter
This presentation will summarize how the three MEF commanders envision our COSC program; provide the background of the September 2007 Tri-MEF Conference; and discuss the development of the COSC Continuum model.
Thomas Gaskin, PhD; Combat Operational Stress Control Coordinator, HQMC
Introduction of the new Marine Corps Combat Operational Stress Control (COSC) Program, including requirements of the new COSC Marine Corps Bulletin, COSC Continuum Model, Marine Operational Stress Training (MOST) Program, Five Core COSC Leadership Functions, COSC Decision Matrix, and other tools and concepts.
Angela Drake, PhD; Defense and Veterans Brain Injury Center, Naval Medical Center San Diego
The presentation will provide important information on concussion and TBI. Discussion of the common psychiatric disorders seen following TBI, including PTSD and Depression will also be reviewed. Information related to the time course of recovery and the likelihood of return to duty will be discussed.
TRACK A & C
1300 – 1400: Session 1
Thomas Gaskin, PhD; Combat Operational Stress Control Coordinator, HQMC
What Marine leaders can do in their units to help prevent combat operational stress in their Marines, recognize when it occurs, and provide early intervention to reduce risk of long-term complications.
1400 – 1500: Session 2
William P. Nash, M.D., USN–USMC Combat and Operational Stress Consultant
Neil Greenberg, Surgeon Commander, Academic Centre for Defence Mental Health, Royal Marines
The British Royal Marines, as with the rest of the UK Armed Forces, consider that the psychological welfare of troops is primarily a chain of command responsibility. All Marines receive considerable psychological preparation during initial training and both Officer and NCO command courses include psychological management as one of the key topics. The Trauma Risk Management (TRiM) system is seen as a command tool to formalise psychological resilience in the face of highly stressful events. Although behavioural health providers, medical staff and padres have a strong advisory role in the management of operational stress, a flexible application of TRiM and forward psychiatry methods maximise the opportunity for Marines to remain operational whatever stressors they have to face. Lastly the homecoming process includes a period of decompression whereby those who fight together unwind together; decompression includes both social and psychological elements.
1500 – 1600: Session 3
CAPT Paul Hammer, MC USN, Director, Naval Center for Combat and Operational Stress Control
Current USMC COSC doctrine encourages leaders to do After Action Reviews following particularly stressful incidents, but there is little out there to tell them how to do it. This presentation will describe the AAR, when and how to conduct it as well as provide helpful tips and techniques for leaders.
William P. Nash, M.D., USN–USMC Combat and Operational Stress Consultant
Combat and Operational Stress Control (COSC) in the USMC and USN is founded on the Combat and Operational Stress Continuum Model, the central framework for leaders at all levels to promote psychological health in their service members, families, and units. Five core functions have been identified as crucial for military leaders to effectively manage the Stress Continuum, with support from their unit and installation chaplains and medical and mental health professionals: strengthening, mitigating, identifying, treating, and reintegrating. This presentation describes Combat and Operational Stress First Aid (COSFA), a set of tools developed specifically to serve the five core functions of COSC in operational environments. COSFA is comprised of six core functions grouped into three types of first aid: (1) Basic Stress First Aid (for self and buddy aid), (2) Advanced Stress First Aid (for leader and care-giver aid), and (3) Continuous Stress First Aid (for ongoing assessment and referral, as needed).
1600 – 1700: Session 4
COSC Challenges Unique to Marine Forces Reserve
CAPT Rom A. Stevens, MC, USN, I MEF Surgeon
Service in the Marine Corps force reserve generates unique risks upon deployment. These derive from training structure, culture, and redeployment management. Independent of the consequences for career, finances, and social acceptance, combat operational stress exposure management is signally affected. The authors review force organization, describe available COS management, and specify the risks, drawing attention to ready areas of remediation.
Donald R Smith, MA, Regional Manager RCS Western Mtn Region 4A and Marty Chaisson, Outreach Program Technician, Greenville Vet Center, Greenville, N.C.
This workshop will describe the organizational structure, mission, and services, provided by the Department of Veterans Affairs, Readjustment Counseling Service Vet Center Program. We will provide a description of the rationale used to determine how a vet center is staffed, the location process used when determining where to establish a vet center and most importantly the types of services offered to combat veterans, (i.e., Readjustment Counseling, PTSD Counseling, Sexual Trauma Counseling, Bereavement Counseling etc.) After attending the workshop attendees will have a much clearer understanding of the Vet Center Program and all that we as a program have to offer to our veterans.
TRACK B
1300 – 1400: Session 1
When War Comes Home: Solutions for Wives of Combat Vets
Marshéle Carter Waddell, One Hope Ministry
Waddell’s husband, CDR (ret) Mark Waddell, USN SEAL, was deployed to Iraq four times and was diagnosed with Post-Traumatic Stress Disorder in 2005. She shares a moving testimony of her family’s difficult journey from identifying the disorder, recognizing and managing its symptoms, and equipping countless other families and support organizations through her public speaking, published articles and books
1400 – 1500: Session 2
LT Scot E. Sroka, CHC, USN; Battalion Chaplain, 3d Supply Battalion, CLR-35, 3d MLG
This workshop takes the participants on a virtual warrior transition experience which addresses the whole person and family member(s). It focuses on spirituality, family relationship dynamics, and story telling as vehicles which assist returning warriors to achieve increased personal and family readiness. It also discusses the chaplain’s role in identifying potential serious combat operational stress reactions and injuries so that warriors feel safe and free to seek mental health services when needed.
1500 – 1600: Session 3
LCDR Bob Marietta, Psychiatrist 3rd Marine Division
Marine Corps and Navy families are facing unprecedented challenges related to the high operational tempo associated with repetitive deployments and long training cycles; special challenges of individual augmentee assignments; and for some, deployments to OIF/OEF based out of overseas duty stations. Data shows that family discord, divorce, and child misbehavior has increased as a result of these stressors. Readiness of our Marines and Sailors depends on a stable and supportive family environment. Much of mental health training has been focused directly to the warrior, but the need for mental resiliency of family members, coping skills, improved communication and networking practices, and improved understanding of the stresses involved has been identified. A program referred to as “Psych First Aid for Military Families” was developed by the 3d Marine Division OSCAR team, integrated into the Division’s Family Readiness Program and delivered to family members to help them face the unique challenges of military life.
1600 – 1700: Session 4
Patricia Montes Barron, Director, Youth Initiatives Department, National Military Family Association
With the Global War on Terror approaching its 7th year, many military families are experiencing multiple and extended deployments. Little research has been done on the effects of experiencing long and repeated separations from loved ones. Less has examined the effects on children. Given this fact, the National Military Family Association (NMFA) partnered with RAND Corporation to perform a study to gain a better understanding of the impact of deployment on children and families during a time of war. The pilot study “Understanding the Impact of Deployment on Children and Families” included Active Duty and Reserve Component children and caregivers. This presentation will highlight the findings of this study and issues requiring further research. It will offer insights into what programs are being offered to help children of all ages deal with deployment. An overview of the NMFA Operation Purple® camp program will be included as well.
FOCUS Project: Implementing a Family Resiliency Training Demonstration Program for Military Families
Patricia Lester, MD; Director, FOCUS Project; UCLA Child and Family Trauma Psychiatry Service
This presentation will provide an updated overview of the impact of parental wartime deployment on children and families and the evidence base for family centered secondary prevention in the context of parental traumatic stress and physical injury. Describe USMC and US Navy FOCUS service demonstration project core components and delivery strategies, including individual family services; group level skill building; provider consultation; and community level outreach & marketing; demonstrate the application of COSC continuum model in the context of family centered training to identify strengths and challenges for families; describe adaptation, outreach, implementation and evaluation components of the FOCUS project; and discuss strategies for successful collaborations across military communities, university partners and national service networks to enhance access to prevention services for military children and families.
TRACK D
1300 – 1400: Session 1
Brian K. Hontz, Family Advocacy Representative, Fleet and FamilySupportCenter, NAS JRB Willow Grove, Pa
This presentation will provide an in-depth look at state of the art research in the area of stress as a precipitator in addiction, relapse, and domestic violence. How stress affects neurotransmitters in the brain which can actually predispose one towards these factors will be examined in detail. The effects of diet, physical activity, and sugar will also be examined as contributing factors. Finally, treatment and proactive education will be examined as a therapeutic tool in working with this client population.
CDR Wayne C. Boucher PsyD, ABPP; 7th Marines
In an effort to comply with the spirit of the Blue Diamond Letter, the Psychologist with the 7th Marines took over the PTSD Screening process from the Battalion Surgeons. A protocol was developed for screening the Marines and Sailors who were in the process of Involuntary Separation for Misconduct and had deployed to OIF at least once. Marines & Sailors who had equivocal PCL-M scores were administered the DAPS. PCL-M scores were compared based on refusal or acceptance of treatment. Though limited by sample size, the data suggest that the PCL-M may seriously underestimate the rates of PTSD and thus may not be an appropriate instrument for screening by Battalion Surgeons. This study suggests that Psychologists were better suited than Physicians to carry out the intention of the Commanding General; assuring that all Marines and Sailors being receive proper care through the active duty or VA system.
1400 – 1500: Session 2
LT Nausheen Momen, Naval HealthResearchCenter, San Diego
The purpose of the study is to develop and administer a survey to assess Combat Operational Stress Control (COSC) program awareness, utilization, satisfaction, and needs in a sample of U.S. Marine Corps (USMC) Officers and Enlisted personnel. This study is being conducted at the request of the Combat and Operational Stress Control Adviser to the Deputy Commandant for Manpower and Reserve Affairs, U.S. Marine Corps, Quantico, VA. Approximately 600 active-duty USMC Officers and Enlisted personnel from Logistics, Air, and Infantry bases were enrolled to ensure variability of operational/combat stress exposure and generalizability of the data. The acquired data can be used to compare subsequent assessments to provide direction for the modification and development of COSC programs and to monitor COSC program effectiveness.
Steven A. Murray, Ph.D, Space and Naval WarfareSystemsCenter (SPAWAR)
Although stress and fatigue typically co-occur in military operations, they are often separable constructs and may have differential effects on cognitive performance (and, therefore, on mission effectiveness). This presentation offers an introduction to a current research program intended to determine the nature of such differences in a laboratory setting. A unique feature of this work is the use of a prominent military training tool – Virtual Battlespace 2 (VBS2) – to induce stress in an operationally relevant way. Comparison of results using both VBS2 and conventional stress tasks will serve to more directly tie a body of research results to current military missions. Expanded uses for VBS2 as an applied research tool will be discussed.
1500 – 1600: Session 3
Andrea Lucie, Semper Fit Mobile Unit-Group Exercise Coordinator, MCB CampLejeune and 1stLt Lee Stuckey, USMC
This presentation will educate the audience about the benefits of non-traditional therapy such as Mixed Martial Arts, Yoga, and Meditation. These ancient techniques will aid in the reconditioning process of a traumatized mind and brain. Through diverse forms of physical movements, these techniques will facilitate the traumatized body into self awareness and self regulation, and changes in the perceptual system of the traumatized brain. The service members will regain, among other benefits, self regulation, self attendance, and self reflection; in a nut shell, a reforming or re-wiring of the brain.
1600 – 1700: Session 4
William Boxx, Director, Marine and Family Services and David Nieman, Clinical Director, Marine and Family Services
In 2007, the Warrior Strengthening Program (WSP), located at MCLB, Barstow, and CA. was brief at the 1st Annual Combat Operational Stress Control Conference. This brief covered the five major components of this program, including the trauma resolution component, Complex Trauma Resolution Training (CTRT). In this workshop, the focus will be on that model, a quick intervention and resolution for complex combat stress. This brief will cover the training methodology as well as statistical information on training results. Conference participants will take away a basic understanding of this method and the knowledge that in less that 9 days, Marines who and proven to be treatment resistant in other programs can be helped.