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The COSC interventions are organized into functional areas that cover the full spectrum of care, from prevention to clinical intervention. 2 The COSR casualties are SMs experiencing a stress reaction in combat or operational environment. 2 A stress reaction can be either adaptive for survival and mission accomplishment or maladaptive and potentially lead to misconduct and disciplinary action leading to the SM's removal from duty, and possible incarceration. 1, 2Ĭombat Occupational Stress Reactions (COSR) are the expected, predictable, intellectual, physical, emotional, and/or behavioral reactions of service members (SMs) who have been exposed to stressful events in combat or military operations other than war. 1, 3 COSC is geared to prevent, identify, and manage adverse combat and operational stress reactions. Combat stress is the emotional and physiological stress experienced as a result of exposure to the inherent dangers and demands of serving in a combat environment. In a deployed environment, the Army's Behavioral Health (BH) focus is on Combat and Operational Stress Control (COSC). Occupational therapists play a vital role within the COSC unit as they add the unique perspective of assessing the service member's functional performance in daily living occupations. Deployed assignments included positions as Officers in Charge of restoration centers, and of prevention centers to include animal-assisted therapy, and disaster response. This article describes the deployed operational roles of three OTs, two deployed during OIF and one in OEF during 2008–2010. Although the theoretical deployment role of OTs in Combat and Operational Stress Control (COSC) operations has been described, the literature provides minimal experiential application of OTs in the COSC role. Army OTs have been involved in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) providing BH treatment to service members, serving in Brigade Combat Teams, and Combat Stress Control Units, however, the impact of the OT BH mission has been scarcely documented. Army Occupational Therapists (OTs) during combat operations is the Behavioral Health (BH) mission.