Definition of COSC:

  • Programs developed and actions taken by military leadership to prevent, identify and manage adverse COSRs in units. Combat stress includes all the physiological and emotional stresses encountered as a direct and indirect result of the dangers and mission demands of combat and other military operations (ATP 4-02.8, 2016, Section 4-1, p.69-70).

Definition of COSR:

  • The physical, emotional, cognitive or behavioral reactions, adverse consequences or psychological injuries of soldiers who have been exposed to stressful or traumatic events in combat or military operations.

  • COSRs vary in severity as a function of operational conditions, such as intensity, duration, frequency of combat exposure, rules of engagement, leadership, effective communications, unit morale, unit cohesion and perceived importance of the mission. COSRs do not represent mental health disorders or medically diagnosable conditions and concerns – though they may become such. Posttraumatic stress disorder (PTSD) is not equivalent to or another name for combat and operational stress reaction. Nevertheless, COSRs can result in acute stress disorders and/or PTSD (ATP 4-02.8, 2016, Section 4-4, p. 70).

Purpose of the COSC program:

  • The purpose of combat and operational stress control (COSC) is to promote soldier and unit readiness by:

    • Enhancing adaptive stress reactions

    • Preventing maladaptive stress reactions

    • Assisting soldiers with controlling COSRs and managing behavioral disorders

    • Teaching warrior resiliency skills

Policy: (from Army Brief to DoD COSC WG)


  • This program seeks to optimize mission performance; conserve the fighting strength; and prevent or minimizes adverse effects of COSRs on soldiers and their physical, psychological, intellectual and social health. Its goal is to maintain soldiers on duty, or to return them to duty expeditiously (ATP 4-02.8, 2016, section 4-1, p. 69). COSC activities include routine screening of individuals when recruited; continued surveillance throughout military service, especially before, during and after deployment; continual assessment and consultation with medical and other personnel from garrison to the battlefield; early identification of mild traumatic brain injury; prevention activities to promote resiliency and hardiness; and far-forward, brief interventions to keep soldiers with COSRs on duty or to rapidly return them to duty (ATP 4-02.8, 2016, section 4-1, p. 69).



  • Embedded COSC trained assets include:

    • Leaders

    • Organic & augmenting medical personnel

    • Chaplain personnel

    • Organic & augmenting behavioral health personnel

Relevant Links:

Comprehensive Soldier and Family Fitness

  • Comprehensive Soldier and Family Fitness (CSF2) is designed to build resilience and enhance performance of the Army family — soldiers, their families, and Army civilians. CSF2 does this by providing training and self-development tools so that members of the Army family are better able to cope with adversity, perform better in stressful situations and thrive in life.

Army Public Health Center (Provisional) Combat and Operational Stress Control

  • Our mission is to enhance Army readiness by identifying and assessing current and emerging health threats, developing and communicating public health solutions, and assuring the quality and effectiveness of the Army's public health enterprise.