Integrative model of psychological support for military personnel in large-scale combat operations

Context and relevance stem from the realities of modern Large-Scale Combat Operations (LSCO): high intensity, massive casualties, delayed evacuation, and chronic stress. Conventional verbal crisis intervention protocols (CISM, PIES) are considered by many researchers to have significant limitations under such conditions — they presuppose a psychologist's presence, often overlook cortical shutdown during sympathetic storm or dorsal vagal immobilisation, and offer no built-in safeguards against secondary traumatisation of the helper. Objective: to propose and substantiate the integrative “3C+4P” model (three contours, four principles, five protocols) that merges neurobiological frameworks (polyvagal theory, bottom-up regulation, neuroplasticity) with advanced international and Russian practices in military psychology. Hypothesis: shifting the focus of first aid from verbal to behavioural-somatic, complemented by a mandatory psychologist resilience loop, can enhance LSCO support effectiveness and lower secondary trauma risks. Methods: systematic literature review (1995—2026), synthesis and modelling. Results: we propose a three-tier architecture (field, rehabilitation, and psychologist resilience contours), four cross-cutting principles (trauma-informed care, stigma reduction, somatic grounding, systemic approach), and five behavioural protocols with measurable endpoints (HR, RR, reaction time). Neurobiological rationales are provided for each protocol. Conclusions: the “3C+4P” model offers a novel conceptual approach for LSCO settings; its protocols can potentially be mastered not only by psychologists but also by medics, commanders, and peers; the third contour addresses the professional longevity of the practitioner. The model is proposed for discussion and further theoretical and practical development.

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