A Theory of Risk and Resilience Factors in Military Families

This article discusses risk and resilience factors that may affect military families, with a focus on frequent relocation, deployment, exposure to combat and PTSD, and postdeployment reunion as possible risk factors influencing child psychosocial and academic outcome. Research findings are presented as supporting a theoretical pathway that suggests that the effects of military life on child outcome may follow an indirect pathway involving parental stress and psychopathology, rather than military life directly affecting children of military parents. The proposed pathway also serves to highlight the need for further research on understudied resilience factors and provides suggestions for interventions that may benefit military families.     

Mechanisms of Risk and Resilience in Military Families: Theoretical and Empirical Basis of a Family-Focused Resilience Enhancement Program

Recent studies have confirmed that repeated wartime deployment of a parent exacts a toll on military children and families and that the quality and functionality of familial relations is linked to force preservation and readiness. As a result, family-centered care has increasingly become a priority across the military health system. FOCUS (Families OverComing Under Stress), a family-centered, resilience-enhancing program developed by a team at UCLA and Harvard Schools of Medicine, is a primary initiative in this movement. In a large-scale implementation project initiated by the Bureau of Navy Medicine, FOCUS has been delivered to thousands of Navy, Marine, Navy Special Warfare, Army, and Air Force families since 2008. This article describes the theoretical and empirical foundation and rationale for FOCUS, which is rooted in a broad conception of family resilience. We review the literature on family resilience, noting that an important next step in building a clinically useful theory of family resilience is to move beyond developing broad “shopping lists” of risk indicators by proposing specific mechanisms of risk and resilience. Based on the literature, we propose five primary risk mechanisms for military families and common negative “chain reaction” pathways through which they undermine the resilience of families contending with wartime deployments and parental injury. In addition, we propose specific mechanisms that mobilize and enhance resilience in military families and that comprise central features of the FOCUS Program. We describe these resilience-enhancing mechanisms in detail, followed by a discussion of the ways in which evaluation data from the program’s first 2 years of operation supports the proposed model and the specified mechanisms of action.     

Vulnerability and Resilience within Military Families: Deployment Experiences,Reintegration, and Family Functioning

This study examined how family factors that diminish feelings of loss (frequent communication) and reflect system-level adaptation (effective household management) during deployment were associated with enhanced resilience and fewer vulnerabilities during reintegration and, ultimately, the promotion of family functioning following deployment. Multiple reporters from active duty (AD) military families (N?=?214 families; 642 individuals) were examined, including AD members, civilian spouses, and their adolescent offspring. Most service members were men and enlisted personnel (95.3% male; 87.9% enlisted). Most AD and civilian spouses were between the ages of 31 and 40 (68.2% and 72.4%, respectively). Adolescent gender was relatively equal between boys (46.3%) and girls (53.7%), and their average age was 13.58. A SEM assessed the influence of communication frequency (reported by both AD and civilian spouses) and household management during deployment (reported by civilian spouses) on subsequent family functioning (reported by AD spouse, civilian spouse, and adolescent). The mediating role of positive and negative aspects of post-deployment family reintegration (reported by AD spouse, civilian spouse, and adolescent) was also assessed, as indicators of family resilience and vulnerability. Communication during deployment and civilian spouses’ household management during deployment were associated with multiple family members’ reintegration experiences. In turn, reintegration experiences were linked to self-perceptions of subsequent family functioning and, in some cases, other family members’ perceptions of family functioning. Similarities and differences among family members are discussed. While deployment and reintegration create systemic family changes and challenges, results indicated opportunity for growth that can reinforce connections between family members.     

Infants and Young Children in Military Families: A Conceptual Model for Intervention

Infants and young children of parents in the military deserve special attention because the first years of life are pivotal in establishing trusting attachment relationships, which are based on the developmental expectation that parents will be reliably available and protective both physically and emotionally. For young children in military families, the stresses of extended absences of mothers and/or fathers as the result of deployment abroad, recurrent separations and reunions resulting from repeated deployments, or parents struggling with the emotional sequelae of their war experiences, and the traumatic impact of parental injury and death can strain and derail the normative expectation of parental availability and protectiveness. This article describes the key features of mental health in infancy and early childhood, the developmentally expectable early anxieties that all children experience in the first years of life across cultures and circumstances, and the ways in which these normative anxieties are exacerbated by the specific circumstances of military families. The article also describes interventions that may be helpful in supporting military families and their children with the specific challenges they face.     

Conceptualizing and Re-Evaluating Resilience Across Levels of Risk, Time, and Domains of Competence

This article examines potential theoretical constraints on resilience across levels of risk, time, and domain of outcome. Studies of resilience are reviewed as they relate to the prevalence of resilience across levels of risk (e.g., single life events vs. cumulative risk), time, and domains of adjustment. Based on a thorough review of pertinent literature, we conclude that resilience, as a global construct, appears to be rare at the highest levels of risk, and that resilience may benefit from a narrower conceptualization focusing on specific outcomes at specific timepoints in development. The implication of this conclusion for future research and intervention efforts is then discussed.     

Resilience in Remarried Families

The present study aims to identify those resilience factors that enable remarried families to withstand and rebound from the disruptive challenges they face. A parent and a child from 38 families independently completed seven questionnaires and answered an open-ended question. The following resilience-associated factors were identified: (1) supportive family relationships, (2) affirming and supportive communication, (3) a sense of control over outcomes in life, (4) activities and routines that help the family to spend time together, (5) a strong marriage relationship, (6) support from family and friends, (7) redefining stressful events and acquiring social support, and (8) spirituality and religion within the family.     

Risk and Resilience Factors in Families Under Ongoing Terror Along the Life Cycle

Families of unarmed civilians who live in warzones at political conflict areas are at risk of exposure to traumatic ongoing terrorism (OGT). This paper focuses on families living at the political conflict area by the border of the Gaza Strip at southwestern Israel, who have experienced OGT of missile fire for a decade and a half. Case examples illustrate the nuances and details of traumatic events, such as massive bombing, life threatening situations, evacuation, threat to and loss of life of family members and close friends, and their implications on the family system along life span. Members of these families are at risk of posttraumatic reactions and maladaptive system functioning in relation to the traumatic context of their specific life cycle stage. However, some families have shown potential for developing resilience, related to three main dimensions: belief system, organizational patterns, and communication channels. The objective of the present paper is to shed light, by evidence of families exposed to OGT, on risk and resilience factors affecting a family’s ability to overcome trauma throughout the lifecycle.     

Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active‐Duty Military Parents

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active‐duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active‐duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross‐influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.     

Understanding and Supporting the Resilience of a New Generation of Combat-Exposed Military Families and Their Children

Taking our nation to war has exposed a generation of military families and children to combat and its consequences. Every dollar spent on bullets, trucks, fuel, and food carried a future ‘tax’ in the form of consequences for psychological and physical health and family relationships. In this commentary, I focus on several themes that emerge from the special collection or articles. For example, I consider how best to define the ecological niche(s) occupied by military-connected children and families. Not surprisingly given significant gaps in our knowledge, evidence regarding the well-being of military-connected children is mixed. I also consider the multi-layered environments within which individuals and families function, recognizing both the challenges and opportunities they provide. The need to respond rapidly to the evolving needs of military families has highlighted the value of both prevention science and implementation science. Public health models emphasizing a full continuum of care that emphasizes not only treatment but also universal, selective, and indicated prevention also are appealing given the uneven density, uncertain locations, and unknown identities of military families in civilian communities (Beardslee 2013; Murphy and Fairbank 2013). Finally, it is important to recognize that we are at the beginning, not the end, of the post-war lifetimes for the new generation of veterans and their families.     

Accumulation of Risk and Promotive Factors Among Young Children in US Military Families

In the families of the new cohort of war veterans now entering the civilian population in the United States are over two million young children (Cozza, Haskins & Lerner, 2013; Institute of Medicine, 2013). Several noteworthy studies have shown that children exposed to separation from a parent due to combat‐related deployment are at elevated risk for a variety of negative consequences (Lester & Flake, 2013). Cozza et al. (2013) argue that existing studies of military children focus too much on the stresses or deficits they experience, failing to give sufficient attention to their strengths, the strengths of their families, or the supports around them. In the current study we focus on risk and promotive factors in the lives of children aged 0–10 in military families. We examine the likelihood of negative outcomes as functions of additive, cumulative, and interactive relationships between risk and promotive factors and children's outcomes. Risk factors, particularly parental depression, community poverty, and cumulative risk, were more strongly associated with children's outcomes than promotive factors. There was, however, a significant risk‐protective relationship between accumulations of risk and promotive factors, consistent with promotive conditions operating in a protective fashion under conditions of elevated risk.     

Cultivating Resilience in Families Who Foster: Understanding How Families Cope and Adapt Over Time

Families who foster offer essential care for children and youth when their own parents are unable to provide for their safety and well‐being. Foster caregivers face many challenges including increased workload, emotional distress, and the difficulties associated with health and mental health problems that are more common in children in foster care. Despite these stressors, many families are able to sustain fostering while maintaining or enhancing functioning of their unit. This qualitative study applied an adaptational process model of family resilience that emerged in previous studies to examine narratives of persistent, long‐term, and multiple fostering experiences. Data corroborated previous research in two ways. Family resilience was again described as a transactional process of coping and adaptation that evolves over time. This process was cultivated through the activation of 10 family strengths that are important in different ways, during varied phases.     

Resilience in Families Adapting to Autism Spectrum Disorder

This study explored adjustment and adaptation in families living with Autism Spectrum Disorder (ASD). Data on family resilience were collected from 19 biological mothers of children with ADS. The data were analysed qualitatively and quantitatively to yield information on factors that enable these families to bounce back from the diagnosis and accompanying challenges with regard to ADS. The findings from the qualitative analysis indicate that social support, the spousal relationship, and family time, togetherness and routines are the most important resilience-promoting factors with ASD. Family hardiness, family problem-solving communication, and family time and routines were significant resilience resources.     

Resilience in Families that have Experienced Heart-Related Trauma

The aim of this study was to identify resilience qualities in families in the wake of heart-related trauma of one of their members. The theoretical framework of this study was the Resiliency Model of Family Stress, Adjustment and Adaptation, which represents a paradigmatic shift from a pathological to a strength-based view of a family. Self-report questionnaires and an open-ended question were used to collect data from 22 family members who experienced the heart-related trauma. The results indicate that family time and routines, parent–child togetherness, family chores and affirming communication are key qualities for mediating family adaptation, while inflammatory communication was found to be negatively associated with family adaptation. Other relevant qualities were social support, family hardiness and a coping style where problem situations are reformulated. The identification of these qualities can serve as the focus for intervention and prevention, enhancing the quality of life for families with a cardiovascular patient.     

Resilience in Families in Which a Parent has Died

Using a cross-sectional survey research design, the present study aimed to explore and explicate those resiliency factors that enable families to adjust and adapt successfully after the loss of a parent. Thirty-nine families completed questionnaires, including an open-ended question in which they were asked to report the most important factors or strengths that they felt helped their family through the stressful period. Results indicate that intrafamilial support, such as emotional and practical support amongst family members, and family hardiness characteristics, such as the internal strengths and durability of the family unit, contribute to resilience within the family. Individual characteristics, for example positive personality characteristics such as optimism, are equally important. Support from extended family and friends, as well as support obtained from religious and spiritual beliefs and activities, were reported as facilitating successful adjustment to the loss.     

Building Resilience in Families,Communities, and Organizations: A Training Program in Global Mental Health and Psychosocial Support

This article describes the Summer Institute in Global Mental Health and Psychosocial Support, a brief immersion training program for mental health, health, and allied professionals who work with populations that have endured severe adversities and trauma, such as domestic and political violence, extreme poverty, armed conflict, epidemics, and natural disasters. The course taught participants to apply collaborative and contextually sensitive approaches to enhance social connectedness and resilience in families, communities, and organizations. This article presents core training principles and vignettes which illustrate how those engaging in such interventions must: (1) work in the context of a strong and supportive organization; (2) appreciate the complexity of the systems with which they are engaging; and (3) be open to the possibilities for healing and transformation. The program utilized a combination of didactic presentations, hands‐on interactive exercises, case studies, and experiential approaches to organizational team building and staff stress management.     

Culture, Communication, and Competence: A Commentary on Variables Affecting Social and Academic Behavior

The editors of this special issue have recruited six papers focused on the ways that language and communication interact with culture to influence student behavior. Two themes that emerge from these papers are the fundamental role of communication in learning and living, and the impact of culture on the functions of communication. The present commentary is offered in admiration for the work of the authors, and with the goal of emphasizing common messages that may guide both future research and practice.     

Very Young Child Well-being in Military Families: A Snapshot

Since the September 11th attacks on the U.S., more than 2 million children have experienced parental deployment during their early years, with potentially lasting impact. When a parent is deployed, a number of factors may affect the well-being of the service member and his/her family. One parental factor—posttraumatic stress disorder or distress—might be particularly powerful in its effect on young children and the family system. We analyzed baseline data from an intervention development project which focused on supporting military families with very young children during post-deployment. The purpose of this research is to understand the relationships between parental mental health status, parenting stress, couple functioning, and young child well-being. The effects of mental health status of home-front and service member parents and the role of couple functioning on parent–child interactions and behavioral problems of young children were examined in a sample of military families during the post-deployment period. Findings suggest that service member posttraumatic stress symptoms are associated with higher parental report of child behavior problems. Higher quality of the couple relationship appears to lessen the impact of parental posttraumatic stress but is not related to parent perceptions of child behavior concerns. Implications for future research with military families are discussed.