Category Archives: Military

Evidence for Supporting Military Families

Following our discussion of the evidence-based movement, I would like to highlight the recent work of Future of Children contributor Col. Stephen Cozza (U.S. Army, retired) and the National Military Family Bereavement Study. In a recent interview, Cozza, who is a professor of psychiatry and associate director of the Center for the Study of Traumatic Stress at the Uniformed Services University of the Health Sciences, explained that the study aims to guide policy by creating a greater base of empirical data on how immediate family members are affected when a service member passes away.

In the interview, Cozza argued that basing policy on research is important for these families, whose needs vary based on relationship to the deceased, the type of death, geographic location, and other factors. By gathering data on these scenarios, Cozza hopes to better advise policy makers on how to help these families.

Even before the study began, Cozza established the importance of this research in his Future of Children article with Allison Holmes and Paula Rauch. A parent’s death in combat not only brings immediate grief, it can also mean that survivors lose their identity within the military community, especially if they have been living on base and need to leave. Additionally, sudden, violent deaths—such as suicides, accidents, and combat-related deaths—are more common among service members than in the general population, and such deaths have been shown to bring a greater risk of PTSD and other emotional issues for surviving loved ones.

Another Future of Children article suggested building communities of care for military families and pointed to a need for further research on how to best do so. In the article, communities of care are defined as complex systems that work across individual, parent/child, family, community, military, and national levels of organization to promote the health and development of military children and families. The authors highlighted the tensions that exist in creating these interdisciplinary care communities. When we attempt to create collaborative communities of care and run into conflicts between the training of clinicians and public health professionals, research evidence could create an objective common ground on which to base programs and policy. Cozza’s National Military Family Bereavement Study is an example of the evidence-based movement in action.

For more Future of Children articles on military families, see our Fall 2013 issue, Military Children and Families. For more on the evidence-based movement, check out this interview with Future of Children senior editor Ron Haskins.

Panels on Military Families

Since the release of the newest issue of the Future of Children, Military Children and Families, the Brookings Institution and the Woodrow Wilson School at Princeton University have each held panel discussions of the issue’s findings and implications.

A chief focus for Brookings was the issue’s accompanying policy brief, which examines the efficacy of prevention programs designed to help families with a service member who has served in a war zone, and offers recommendations on how these programs might be tested and improved. A panel of experts responded to the these recommendations and offered their own thoughts on how to help these families. Full audio and a transcript are available.

Princeton heard from Richard M. Lerner, who summarized the issue and gave recommendations on improving research and practice, and Kristina Callina, who talked about some of her own experiences growing up in a military family. These panelists’ remarks are featured in a video. Additionally, not featured in the video, a panel of military couples discussed the challenges and opportunities their families face in areas such as deployment and frequent moves. Interestingly, confirming the findings of FOC authors Patricia Lester and Lieutenant Colonel E. Flake, the couples said that a particularly difficult time for them is when a deployment ends, because of the sudden change in routine and having an additional parent back in the household. Some of them find that a useful strategy is to immediately take a vacation in a neutral place to get back into the swing of things before returning to home life.

To learn more, see the Future of Children issue on Military Children and Families.

What We Can Learn From Military Families

Future of Children author Ann S Masten writes that the lessons we can learn from military families can potentially help many families inside and outside the military. Military families face unique challenges, but they also share many challenges in common with other Americans, such as finding adequate child care, making ends meet, and educating and disciplining children. With these similarities, military families are uniquely positioned to participate in research that will contribute to basic knowledge about stress, competence, resilience, and child development. Specifically, longitudinal research (that is, research that follows people over time) and intervention research, such as randomized controlled trials, can help us understand how to promote positive adaptation in the context of moves, loss, separation, injury, disability, and other hardships Americans might face.

Furthermore, Anita Chandra and Andrew S. London note that future studies should begin following people before, during, and after military service, and include people who have not served at all. At the very least, military status should be flagged in studies to help researchers better account for military or veteran subpopulations.

What we learn from military families will benefit non-military families, and vice versa. It will be a win-win endeavor. To learn more, see the Future of Children issue on Military Children and Families.

An Invisible Division

One of the largest subcultures in America is also one of the least visible. Military children and families are everywhere–not just on or near installations. To illustrate, only a handful of counties across the continental United States had not sent Guard and Reserve members to Iraq or Afghanistan by 2011. Even though these families are everywhere, they often do not stand out. Military children do not wear uniforms. We need to develop a community-based model, to increase resilience and minimize health risks among military children.

In the Future of Children, Harold Kudler and Colonel Rebecca I. Porter (U.S. Army) explain that communities of care “extend the responsibility for developing [an] environment of respect and positive expectations from the clinic to the community.” With a shortage of mental health professionals, especially in rural areas, it is imperative to intervene at the community level. In order to make communities of care happen, the first step is identification–every clinical program should routinely ask everyone who enters its system, “Have you or has someone close to you served in the military?”, and all clinical staff should be taught about military culture and deployment mental health. A next step is to flag military family status in education, employment, and medical records so that it is not overlooked and tailored support can be offered across time. Also, health-care programs and insurance companies could offer incentives to providers to take military history as a way to improve health outcomes and perhaps reduce costs through better treatment. Additionally, clinical programs competent in working with military families should register their names and basic information in the National Resource Directory to help increase accessibility to community resources.

As Kudler and Porter note, perhaps “the secret of creating communities of care for military children is creating communities that care about military children.” To learn more see the Future of Children issue on Military Children and Families.

Evidence-Based Programs for Military Children

Given the sacrifices that military personnel make, children of military families deserve to have policies and support programs designed to fit their needs. Notable examples include subsidized childcare, deployment assistance, moving assistance, child development programs, and community awareness initiatives that train and support communities in their efforts to improve the lives of military infants and toddlers. Unfortunately, many current programs for military children were implemented quickly, at a time of pressing need; thus, few are based on scientific evidence of what works, and even fewer have been evaluated for their effectiveness.

In the newly released Military Children and Families issue of the Future of Children, an overarching theme is the need for better research about military families and the programs intended to help them. Despite the overall lack of evidence-based programs, there are important directions we can take to implement the principles of best practice to improve programming.

For example, Molly Clever and David R. Segal show that military families are diverse by factors such as age, race, ethnicity, and cultural background. Rather than compelling these families to fit into a fixed and rigidly structured set of programs, we should make support programs accessible to families of all backgrounds and at all stages of life. This is challenging, but programs designed for diverse non-military families have been well researched and evaluated, and this research should help in developing flexible and adaptive programs and policies.

We can also learn from the strengths of programs that appear to be working. Major Latosha Floyd and Deborah A. Phillips recount how the military’s child-care program went from a system in distress to a model for the nation, directly serving or subsidizing care for 200,000 children every day. They tell how the success of this program rests on four pillars–military certification, national accreditation, minimum standards in hiring, and a pay scale that reduces staff turnover.

As we learn from the strengths of good programs, and as we rigorously evaluate as many programs as we can, we will be able to better support military children and families by implementing the best services possible. For more information, see the Future of Children issue on Military Children and Families.

Resilience in Military Children

It’s been over a decade since the tragic events of 9/11. Among those who continue to experience the effects of 9/11 are service members and their families. Recently, a teenager named Sophie Roth-Douquet reminded us in a USA Today opinion article that more than two million military kids have sent parents off to war in the past 12 years; while major deployments are coming to an end, the effects remain with them. For instance, 900,000 of these military children have seen a parent deployed multiple times, and 10,200 have experienced the death of an immediate family member. These children should also be remembered for their sacrifice.

While military families might face hardships such as frequent moves, deployments, posttraumatic stress disorder, or the loss of a parent, most children exhibit extraordinary resilience. In the newly published issue of the Future of Children, Military Children and Families, authors M. Ann Easterbrooks, Kenneth Ginsburg and Richard M. Lerner observe that most military children turn out just fine. Although research on the topic is surprisingly limited, military life can offer unique opportunities for children. For example, children whose parents are deployed may build their self-confidence by taking on new responsibilities in the family, and moving provides opportunities for adventure and personal growth.

One thing is certain, though: military children are children first. And “they must establish positive friendships and peer relationships, make their way through school, build on their talents, develop their own ‘moral compass’ and participate in their families and communities.” When they encounter adversity, they need social support from adults such as parents, committed mentors, and teachers or coaches. While there is much that needs to be done in research and program development to understand and increase resilience among military youth, first and foremost, we should reach out to the military families around us. We owe them an incalculable debt. For more information on resilience among military youth, see the Future of Children issue on Military Children and Families.