Counterinsurgency (COIN) operations have served as the fundamental component of the nation's military strategy. Without the established boundaries of conventional operations, switching between diplomatic and combative roles can expose Soldiers to unique stressors when conducting COIN operations. An exploratory study of descriptive data obtained from a retrospective records review of 140 service members deployed to Operation Enduring Freedom identified and described problems in psychosocial functioning. Behavioral health records for the first 7 months of the deployment and throughout the first year of redeployment were reviewed. The most common problems reported by Soldiers were operational stress characterized by anxiety, fear, irritability, frustration, and isolation. Additionally, most of the Soldiers engaged services for psychosocial challenges within the first year of returning from deployment. Establishing reliable access to behavioral healthcare has emerged as an essential component of total force protection in COIN deployments.