Since 2001, more than 2.5 million service members have deployed to wars in Afghanistan and Iraq — and almost half are parents. As tough as mom and dad need to be in combat, kids must weather their own challenges — from frequent moves to long deployments to adjusting when parents return home with battle scars visible and invisible, like post-traumatic stress disorder. While troop levels have declined of late, the longest war in the country’s history has prompted many clinicians and researchers to take a closer look at the psychological strain military service can put on families and children.
“On the whole, military families are really resilient,” says Julie Cederbaum, an assistant professor of social work specializing in children and families at the University of Southern California in Los Angeles. “The majority of these families are going to do just fine. But among those who aren’t doing OK, we’re seeing outcomes that are concerning: so higher levels of depression, higher levels of suicidal ideation.” Children in military families are likely to experience increased anxiety as a result of a parent’s deployment, and researchers say, sometimes related concern, anger and frustration can lead to acting out and behavioral problems as well.
Rather than simply reacting to issues as they arise, many experts are now focusing on ways to improve kids’ resilience and prevent or address mental health challenges in the early-going. And in a military culture that prizes all-for-one toughness, a family-centered, strength-based approach that emphasizes education and skills building is proving to be an effective prevention strategy, according to research published last month in the Journal of the American Academy of Child and Adolescent Psychiatry on the so-called FOCUS program — or Families OverComing Under Stress preventive intervention.
“The program was developed to apply evidence-based interventions that we’d done and shown to be effective in civilian settings, and really do that for the military,” says Dr. Patricia Lester, study lead author and a professor of psychiatry at the University of California–Los Angeles; Lester directs the UCLA Nathanson Family Resilience Center, which provides services to families facing challenging situations. The FOCUS program was implemented in response to increasing data showing kids and parents alike were exhibiting signs of stress as family members were being deployed to Iraq and Afghanistan, Lester says. “The military really wanted to … get in front of that and apply what we knew about helping families during times of stress and to really strengthen their resilience.”
Led by the U.S. Navy’s Bureau of Medicine and Surgery, the FOCUS program has been implemented at 15 military installations in the U.S. and Japan. The study analyzed data collected between July 2008 and December 2013 for 2,615 families, including 3,499 parents and 3,810 children ages 3 to 18.
The program includes elements such as using a “family resilience check-in” Web-based tool to assess kids’ and parents’ psychological health; providing information on topics including strengthening parenting and the impact of military-related stressors on children, parents and families, such as deployments, post-traumatic stress and traumatic brain injury ; and resilience skills building, ranging from communication and problem-solving to emotional regulation and how to handle reminders of separation, trauma and loss. “At the heart of the FOCUS program is really a family narrative,” Lester says. Parents and kids tell their story, reflecting on ups and downs they’ve gone through using a narrative timeline or graphic time map, depending on the child’s age. “Very often when people go through a stressful experience, they kind of keep things to themselves — they want to be strong, they want to protect each other from their concerns, and kids do that, too — they protect their parents,” Lester says. But when people aren’t talking, they aren’t able to really address misunderstandings that may happen along the way, she says: That really can interfere with family life and well-being.”
Around 70 percent of families who participated in preventive intervention completed the six- to eight-session program, Lester says. Parents who had elevated symptoms of depression and anxiety saw those reduced at the time they left the program — and the positive changes persisted over time. “In kids, we saw decreased anxiety,” she says, along with mood symptoms, and declines in disruptive behavior.
For the many military families and reservists who don’t live on a base, some FOCUS resources are offered online, including the FOCUS on the Go! mobile educational app.
In addition, experts say, there are steps military families can take to be proactive in bolstering kids’ resilience and preventing mental health issues:
Talk. “It’s really all about communication,” says Dr. Elspeth Cameron Ritchie, a psychiatrist at the Washington DC VA Medical Center. Keep lines open with children, family and community members who provide support. Talk through changes, like an upcoming deployment, and encourage all family members to share how they feel.
Model resilience, not stoicism. “Children really take their cues from their parent,” Ritchie says. That means demonstrating strength while also acknowledging challenges, say mental health professionals with military experience, and showing kids how to cope — including through improved communication and emotionally connecting.
Get to know your child’s teachers. In addition to children who attend schools on military bases, “There are 1 million to 1.3 million kids enrolled in public schools whose parents are active-duty military, reserve or veterans,” says Ingrid Herrera-Yee, the National Alliance on Mental Illness’s manager for Military and Veterans Policy and Support. Most principals and teachers in these schools aren’t aware if children come from military families, experts says, and likely wouldn’t know how a deployment or recent move might be affecting a child. “This is something parents can help educate the educators on,” Herrera-Yee says.
Consider age. Many deployed parents have pre-school age or younger kids, and some service members are single parents. Work closely with loved ones to anticipate and address a child’s unique age-specific struggles — whether regression, for example, in potty-training, due to the stress of a parent’s absence, or talking through concerns of adolescents who are acutely aware of the dangers, including the risk of death parents face in combat.
Leave a piece of mom or dad behind. Pictures, a necklace and other mementos can be of comfort. “Young kids want to have a reminder,” Ritchie says.
Take advantage of technology to stay in touch. “The Internet, social media and smartphones have made it possible for military parents and their children to connect with each other,” says Dr. Kelly Blasko, a psychologist leading the mobile Web program for the National Center for Telehealth and Technology. The Military Kids Connect program provides children and adolescents ages 6 to 17 from military families across the country the opportunity to engage through an online community, where they can watch videos of military kids telling their own stories, play games to reduce stress, explore interactive world maps, create personal virtual scrapbooks and get peer-to-peer support through a Web-based message board and social media channels.
Take time to adjust to war wounds. When mom or dad suffers from traumatic brain injury or PTSD, it can change the family dynamic, experts say. Encourage wounded warriors and other family members to talk openly about difficulties adjusting. Follow through with rehab, including therapy as needed, and be open to a “new normal,” while striving to be closer to loved ones.
Access resources. There’s no shortage, including apps developed by Sesame Street, to help young children in military families explore their feelings and cope with changes. Military One Source offers free, confidential counseling for military families; “you talk to a live person and you can get the other resources and support there as well,” Herrera-Yee says. In addition to prevention, experts emphasize not to wait to seek professional help if a child or parent is struggling with anxiety, depression or any other mental health issues.
More from U.S. News
11 Simple, Proven Ways to Optimize Your Mental Health
Apps to Mind Your Mental Health
How to Find the Best Mental Health Professional for You
Reducing Mental Health Risk for Kids in Military Families originally appeared on usnews.com
