Military Families and Children During Operation Iraqi Freedom

Department of Psychiatry, Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307-5001, USA.
Psychiatric Quarterly (Impact Factor: 1.26). 02/2005; 76(4):371-8. DOI: 10.1007/s11126-005-4973-y
Source: PubMed


The general public has become increasingly interested in the health and well being of the children and families of military service members as the war in Iraq continues. Observers recognize the potential stresses or traumas that this population might undergo as a result of the military deployment or the possible injury or death of military family members. While such concern is welcomed, it is sometimes misplaced. Not infrequently, conclusions that are drawn are fraught with misunderstanding and bias based upon lack of understanding of the military community or a preconceived notion of the vulnerabilities of the population. This problem is compounded by the paucity of scientific study. In this article the authors review the strengths of military families as well as the unique challenges that they face. The authors also highlight parental deployment, parental injury and parental death as unique stresses to military children and families. Available and pertinent scientific information is reviewed. Clinical observations of children and families during the ongoing war in Iraq are presented.

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    • "Starting with the initial shock of injury notification to longerterm injury adjustment problems, children and families face difficult emotional and practical challenges (Cozza and Guimond 2011). Anecdotal reports (Cozza et al. 2005, 2010; Cohen et al. 2006) describe combat-injured families that are stressed by the injury itself, as well as the tasks inherent in providing both physical care and emotional support to their injured service member. The degree of reported stress likely depends upon time from the original injury, injury type, injury severity, and functional impact on the injured parent; the developmental status of the children; family composition; and preexisting parent, child, or family characteristics. "
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    ABSTRACT: The US military community includes a population of mostly young families that reside in every state and the District of Columbia. Many reside on or near military installations, while other National Guard, Reserve, and Veteran families live in civilian communities and receive care from clinicians with limited experience in the treatment of military families. Though all military families may have vulnerabilities based upon their exposure to deployment-related experiences, those affected by combat injury have unique additional risks that must be understood and effectively managed by military, Veterans Affairs, and civilian practitioners. Combat injury can weaken interpersonal relationships, disrupt day-to-day schedules and activities, undermine the parental and interpersonal functions that support children's health and well-being, and disconnect families from military resources. Treatment of combat-injured service members must therefore include a family-centered strategy that lessens risk by promoting positive family adaptation to ongoing stressors. This article reviews the nature and epidemiology of combat injury, the known impact of injury and illness on military and civilian families, and effective strategies for maintaining family health while dealing with illness and injury.
    Clinical Child and Family Psychology Review 06/2013; 16(3). DOI:10.1007/s10567-013-0141-3 · 4.75 Impact Factor
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    • "Moreover, families in crisis can develop collaborative skills including the ability to anticipate difficulties, problem solve as a family, or use interpersonal cues to monitor and regulate emotion (Saltzman et al. in press). For example, families can obtain and appropriately share important medical, diagnostic, or psychological information about changes in a family member's behavior or functioning following physical or psychological injury (Cozza et al. 2005). Such adjustments can decrease distorted interpretations or self-blame that may arise from a parent's irritability or withdrawal secondary to post-traumatic stress or depression, as well as clarify the expected course of recovery and ways in which family members can provide assistance (Beardslee 2002; Beardslee and Knitzer 2003). "
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    ABSTRACT: We draw upon family resilience and narrative theory to describe an evidence-based method for intervening with military families who are impacted by multiple wartime deployments and psychological, stress-related, or physical parental injuries. Conceptual models of familial resilience provide a guide for understanding the mechanics of how families respond and recover from exposure to extreme events, and underscore the role of specific family processes and interaction patterns in promoting resilient capabilities. Leading family theorists propose that the family's ability to make meaning of stressful and traumatic events and nurture protective beliefs are critical aspects of resilient adaptation. We first review general theoretical and empirical research contributions to understanding family resilience, giving special attention to the circumstances, challenges, needs, and strengths of American military families. Therapeutic narrative studies illustrate the processes through which family members acquire meaning-making capacities, and point to the essential role of parents' in facilitating discussions of stressful experiences and co-constructing coherent and meaningful narratives. This helps children to make sense of these experiences and develop capacities for emotion regulation and coping. Family-based narrative approaches provide a structured opportunity to elicit parents' and children's individual narratives, assemble divergent storylines into a shared family narrative, and thereby enhance members' capacity to make meaning of stressful experiences and adopt beliefs that support adaptation and growth. We discuss how family narratives can help to bridge intra-familial estrangements and re-engage communication and support processes that have been undermined by stress, trauma, or loss. We conclude by describing a family-based narrative intervention currently in use with thousands of military children and families across the USA.
    Clinical Child and Family Psychology Review 06/2013; DOI:10.1007/s10567-013-0142-2 · 4.75 Impact Factor
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    • "This strategy is often counterproductive , in that it communicates that ''it's not OK'' to talk about one's worries and concerns—an implicit message that may foster greater anxiety, rumination, and a sense of isolation. Often, children's fantasies regarding the parent's risk of death are disproportionately much greater than the level of risk (Cozza et al. 2005). Consequently, anxious military children may benefit from parental reassurance and factual information regarding the small likelihood of death or serious injury to the deployed parent, including as compared to other more ''common'' yet risky professions (e.g., firefighters). "
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    ABSTRACT: To date, the US military has made major strides in acknowledging and therapeutically addressing trauma and post-traumatic stress disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (multidimensional grief theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death-especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD.
    Clinical Child and Family Psychology Review 06/2013; 16(3). DOI:10.1007/s10567-013-0143-1 · 4.75 Impact Factor
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