Air Force COSC


Definition and Description of COSC:

  • Program developed to prevent, identify and manage adverse COSRs in individuals/units; enhance mission performance; increase individual and unit resilience; conserve fighting strength; prevent or minimize adverse effects of combat stress on members’ physical, psychological, behavioral and social health; and to return the unit or service member to duty (AFI 44-153, 2014, p.15). The Air Force COSC program borrows upon the standardized DoD (Army) COSC materials.

Definition of COSR:

  • The physical, emotional, cognitive, or behavioral reactions, adverse consequences, or psychological injuries of service members 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 communication, unit morale, unit cohesion, and perceived importance of the mission, etc. COSRs do not represent mental health disorders or medically diagnosable conditions and concerns. Posttraumatic stress disorder is not equivalent to or another name for COSR (AFI 44-153, 2014, p.15).

Purpose of COSC:

  • COSC seeks to prevent and manage stress reactions through increasing psychological resilience and skill building both prior to and after exposure in a wartime environment (p.10). The Air Force’s proactive strategies to respond to stress and minimize the likelihood of longstanding or debilitating stress are encompassed in both their COSC program as well as their Disaster Mental Health (DMH) response program. Individuals directly involved in combat and operational stress are provided the opportunity to access DHM services, which can include pre-exposure preparation (PEP), education, screening and referrals (p.7). There is also the Personnel Reliability Program (PRP) through DMH in which status members exposed to potentially traumatic experiences in battle are entitled to DMH services for psycho-education (p.8). Thus, where PEP and DMH seek to prevent or minimize responses to stressors prior to any type of potentially traumatic exposure, COSC seeks to prevent and manage stress reactions both prior to and after combat exposure.



  • COSC, in concert with other prevention efforts, seeks to mitigate the risk of potential longer-term physical and psychological consequences of combat and other military operations (p.10).


Mental health professionals assisted by:

  • Non-mental health medical personnel
  • Religious support teams (RSTs)
  • Leadership
  • Line personnel

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