The purpose of this practical exercise is to gain experience in the practical application of implementing measures to reduce combat stress in a squad/section.

Scenario
You are a squad leader with the "Sapper" platoon, Special Troop Battalion, 3d Brigade, 10th Mountain Division. Your unit is deploying to Iraq to conduct operations in support of Operation Iraqi Freedom. One of the critical tasks in preparation for your deployment includes training your squad in the identification and reporting of possible combat stress related behaviors to their leaders. This task is crucial to the conduct of combat operations as leaders will identify and implement appropriate actions that offset COSR risk factors and control combat stress.

Case Study
During the Gulf War, the Special Troop Battalion (STB) of the U.S. Army armored brigade moved into Kuwait, not far behind the armored battalions. Battles and skirmishes with Iraqi armor and infantry were in progress. Several kilometers away, U.S. air power attacked Iraqi forces entrenched around a mosque. In the aftermath, Soldiers discovered that Kuwaiti civilians took refuge in that mosque. Sadly, some died or received wounds as a byproduct of "collateral damage."

Alpha Company of the STB, along with its Light Infantry support unit was forward as a casualty response team. Accompanying those elements were the brigade's Army psychiatrist, the STB chaplain, and the chaplain's assistant. The fighting grew more ferocious and friendly casualties were mounting as the troops got closer to the mosque and the built-up area. The psychiatrist and several Soldiers can vividly recall the image of the chaplain's assistant coming out of the wreckage carrying two very young girls, one already dead and the other seriously injured. As they got closer to the objective, they became aware that they were in the middle of a "kill zone." An Infantry Soldier who stumbled across a wounded insurgent decided to end the insurgent's physical anguish. When asked why he did it, he called it a "mercy killing," and he stated that he didn't see anything wrong with it.

Over the next several hours, the surviving casualties received transport to the servicing medical company, and all received the necessary emergency care. There was not adequate time to conduct an immediate debrief of the Soldiers. Some of the Soldiers were refusing to follow orders, some were shaking and trembling, some were even argumentative and acting recklessly. The chaplain's assistant became silent and preoccupied, he withdrew from the group, barely able to communicate, and finally, he began to shake uncontrollably. The psychiatrist wanted to treat him on site, but he couldn't. Armored battles continued to rage nearby and the possibility of another mass casualty or emergency move still loomed. He could neither devote full attention to this individual casualty nor trust that casualty to respond appropriately and safely in an emergency.

The Soldiers and the chaplain's assistant departed with the other casualties on a truck going back to the U.S. Army surgical support company and combat stress center in Saudi Arabia. A few days later, they found themselves back on duty in the special troop battalion. By this time, the ground campaign was over. Unfortunately however, the unit was still completing the dangerous and often gruesome process of securing the battlefield. The team went on to participate in the unit's new missions.

Critical Thinking Exercise

1. What stress-related behaviors did you recognize within the scenario?

2. Which COSR risk factors did you recognize?

3. Based on the scenario, what leader actions would you implement? Why?

4. Describe insight or value that you acquired from this practical exercise.