7 Rs The British Army treated Operational<unk><unk>  according to the 7 R's: *Recognition - identify that the individual is suffering from an Operational<unk><unk>  *Respite - provide a short period of relief from the front line *Rest - allow rest and recovery *Recall - give the individual the chance to recall and discuss the experiences that have led to the<unk>  *Reassurance - inform the sufferer that their<unk>  is normal and they will recover *Rehabilitation - improve the physical and mental health of the patient until they no longer show symptoms *Return - allow the soldier to return to their unit BICEPS Modern front-line<unk><unk>  treatment techniques are designed to mimic the historically used PIE techniques with some modification. BICEPS is the current treatment route employed by the U.S. military and<unk> es differential treatment by the severity of<unk>  symptoms present in the service member. BICEPS is employed as a means to treat<unk>  symptoms and return soldiers quickly to<unk> . The following BICEPS program is taken from the USMC<unk><unk>  handbook: Brevity Critical Event Debriefing should take 2 to 3 hours. Initial rest and replenishment at medical CSC<unk><unk>  Control) facilities should last no more than 3 or 4 days. Those requiring further treatment are moved to the next level of care. Since many require no further treatment, military commanders expect their service members to return to duty rapidly. Immediacy CSC should be done as soon as possible when operations permit. Intervention is provided as soon as symptoms appear. Centrality/Contact Service members requiring observation or care beyond the unit level are evacuated to facilities in close proximity to, but separate from the medical or surgical patients at the BAS, surgical support company in a central location (Marines) or forward support/division support or area support medical companies (Army) nearest the service members' unit. It is best to send Service members who cannot continue their mission and require more extensive respite to a central facility other than a hospital, unless no other alternative is possible. The Service member must be encouraged to continue to think of himself as a war fighter, rather than a patient or a sick person. The chain of command remains directly involved in the Service member's recovery and return to duty. The CSC team coordinates with the unit's leaders to learn whether the over-stressed individual was a good performer prior to the<unk> , or whether he was always a marginal or problem performer whom the team would rather see replaced than returned. Whenever possible, representatives of the unit, or messages from the unit, tell the casualty that he is needed and wanted back. The CSC team coordinates with the unit leaders, through unit medical personnel or chaplains, any special advice on how to assure quick reintegration when the Service member returns to his unit. Expectancy The individual is explicitly told that he is<unk> g normally to extreme<unk>  and is expected to recover and return to full duty in a few hours or days. A military leader is extremely effective in this area of treatment. Of all the things said to a Service member suffering from<unk><unk> , the words of his small-unit leader have the greatest impact due to the positive bonding process that occurs during<unk> . Simple statements from the small-unit leader to the Service member that he is<unk> g normally to<unk><unk>  and is expected back soon have positive impact. Small-unit leaders should tell Service members that their comrades need and expect them to return. When they do return, the unit treats them as every other Service member and expects them to perform well. Service members suffering and recovering from<unk><unk>  disorder are no more likely to become overloaded again than are those who have not yet been overloaded. In fact, they are less likely to become overloaded than inexperienced replacements. Proximity In mobile war requiring rapid and frequent movement, treatment of many<unk><unk>  cases takes place at various battalion or regimental headquarters or logistical units, on light duty, rather than in medical units, whenever possible. This is a key factor and another area where the small-unit leader helps in the treatment. CSC and follow-up care for<unk><unk>  casualties are held as close as possible to and maintain close association with the member's unit, and are an integral part of the entire healing process. A visit from a member of the individual's unit during restoration is very effective in keeping a bond with the organization. A Service member suffering from<unk>  is having a crisis, and there are two basic elements to that crisis working in opposite directions. On the one hand, the Service member is driven by a strong desire to seek safety and to get out of an intolerable environment. On the other hand, the Service member does not want to let his comrades down. He wants to return to his unit. If a Service member starts to lose contact with his unit when he enters treatment, the impulse to get out of the war and return to safety takes over. He feels that he has failed his comrades and they have already rejected him as unworthy. The potential is for the Service member to become more and more emotionally invested in keeping his symptoms so he can stay in a safe environment. Much of this is done outside the Service member's conscious awareness, but the result is the same. The more out of touch the Service member is with his unit, the less likely he will recover. He is more likely to develop a chronic psychiatric illness and get evacuated from the war. This is one of the essential principles of CSC. Simplicity Treatment is kept very simple. CSC is not therapy. Psychotherapy is not done. The goal is to rapidly restore the Service member's coping skills so that he functions and returns to duty again. Sleep, food, water, hygiene, encouragement, work details, and confidence-restoring talk are often all that is needed to restore a Service member to full operational readiness. This can be done in units in reserve positions, logistical units or at medical companies. Every effort is made to reinforce Service members' identity. They are required to wear their uniforms and to keep their helmets, equipment, chemical protective gear, and flak jackets with them. When possible, they are allowed to keep their weapons after the weapons have been cleared. They may serve on guard duty or as members of a standby quick<unk>  force. Predeployment preparation Screening Historically, screening programs that have attempted to preclude soldiers exhibiting personality traits thought to predispose them to<unk>  have been a total failure. Part of this failure stems from the inability to base<unk>  morbidity on one or two personality traits. Full psychological work-ups are expensive and inconclusive, while pen and paper tests are ineffective and easily faked. In addition, studies conducted following WWII screening programs showed that psychological disorders present during military training did not accurately predict<unk>  disorders during<unk> . Cohesion While it is difficult to measure the effectiveness of such a subjective term, soldiers who reported in a WWII study that they had a "higher than average" sense of camaraderie and pride in their unit were more likely to report themselves ready for<unk>  and less likely to fall victim to<unk>  or other<unk>  disorders. Soldiers with a "lower than average" sense of cohesion with their unit were more susceptible to<unk>  illness. Training<unk>  exposure training or SET is a common component of most modern military training. There are three steps to an effective<unk>  exposure program. *Providing knowledge of the<unk>  environment Soldiers with a knowledge of both the emotional and physical signs and symptoms of<unk>  are much less likely to have a critical event that reduces them below fighting capability. Instrumental information, such as breathing exercises that can reduce<unk>  and suggestions not to look at the faces of enemy dead, is also effective at reducing the chance of a breakdown. *Skills acquisition Cognitive control strategies can be taught to soldiers to help them recognize<unk> ful and situationally detrimental thoughts and repress those thoughts in<unk>  situations. Such skills have been shown to reduce anxiety and improve task performance. *Confidence building through application and practice Soldiers who feel confident in their own abilities and those of their squad are far less likely to suffer from<unk> . Training in<unk> ful conditions that mimic those of an actual<unk>  situation builds confidence in the abilities of themselves and the squad. As this training can actually induce some of the<unk>  symptoms it seeks to prevent,<unk>  levels should be increased incrementally as to allow the soldiers time to adapt.
Combat stress reaction
Self-harm
Body substance isolation
Stranger anxiety
Listener fatigue
Automatism 
Derealization
Semantic satiation