The Impact of War on Military Families LTC Harvey D. Leighnor The view expressed in this abstract/manuscript are those of the author and do not reflect.

The Impact of War on The Impact of War on Military FamiliesMilitary Families

LTC Harvey D. LeighnorLTC Harvey D. Leighnor

The view expressed in this abstract/manuscript are those of the The view expressed in this abstract/manuscript are those of the author and do not reflect the official policy or position of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Department of the Army, Department of Defense, or the U.S.

Government.Government.

ReferencesReferences

► The Psychological Needs of U.S. Military The Psychological Needs of U.S. Military Service Members and Their Families: A Service Members and Their Families: A Preliminary Report, American Psychological Preliminary Report, American Psychological Association Presidential Task Force on Association Presidential Task Force on Military Deployment Services for Youth, Military Deployment Services for Youth, Families, and Service Members, February Families, and Service Members, February 20072007

►Dr. Thomas Hardaway, Department of Dr. Thomas Hardaway, Department of Behavioral Medicine, Brooke Army Medical Behavioral Medicine, Brooke Army Medical CenterCenter

Demographics of Military Demographics of Military CommunityCommunity

►Since September 11, 2001Since September 11, 2001 Approx 1.5 million American troops Approx 1.5 million American troops

deployed to combat zonesdeployed to combat zones

1/3 served at least 2 tours in combat1/3 served at least 2 tours in combat

70,000 deployed 3 times70,000 deployed 3 times

20,000 deployed at least 5 times20,000 deployed at least 5 times

FamiliesFamilies

►700,000 children in America have at 700,000 children in America have at least 1 parent deployedleast 1 parent deployed

►Deployed primary caretaker is most Deployed primary caretaker is most stressful event for childrenstressful event for children

►Strain on parent left behindStrain on parent left behind

ExposureExposure►Over 3,240 killed in combat to dateOver 3,240 killed in combat to date

►Over 23,000 returned with wounds up to Over 23,000 returned with wounds up to permanent disabilitiespermanent disabilities

► As many as 1/4As many as 1/4thth returning are struggling with returning are struggling with visible psychological injuriesvisible psychological injuries

►Majority report exposure to life-changing Majority report exposure to life-changing stressors challenging ability to reintegrate on stressors challenging ability to reintegrate on returnreturn

►Disruptive to civilian lifeDisruptive to civilian life

► Family functioning is affected by combat Family functioning is affected by combat exposureexposure

Twenty-First Century MilitaryTwenty-First Century Military

► Changed since last prolonged warChanged since last prolonged war► TodayToday

Approximately 3 million serving in uniformApproximately 3 million serving in uniform Army, Navy, Air Force, Marines, Coast Guard, Army, Navy, Air Force, Marines, Coast Guard,

Reserves, and National GuardReserves, and National Guard Over ¼ are members of ethnic minorityOver ¼ are members of ethnic minority 1/41/4thth million preparing to deploy or are deployed million preparing to deploy or are deployed 3 out of 5 of deployed have 3 out of 5 of deployed have familyfamily responsibilities responsibilities Women are 16% of militaryWomen are 16% of military Women assigned to 90% of job categoriesWomen assigned to 90% of job categories

General Family InformationGeneral Family Information

►Resilience plays major factor in Resilience plays major factor in deploymentdeployment

►Most families “rise to the occasion”Most families “rise to the occasion”

►Family readiness is considered key factor Family readiness is considered key factor in resiliencein resilience

►Family preparedness is a protective Family preparedness is a protective factor when deployments are announcedfactor when deployments are announced

Spouse Active Coping StylesSpouse Active Coping Styles

►Make meaning of the situationMake meaning of the situation

►Receive community and social supportReceive community and social support

►Accept military life styleAccept military life style

►Are optimistic and self reliantAre optimistic and self reliant

►Adopt to flexible gender rolesAdopt to flexible gender roles

Factors That Risk Difficult Factors That Risk Difficult TransitionTransition

►History of rigid coping stylesHistory of rigid coping styles

► Family dysfunctionFamily dysfunction

► Young families (especially first military Young families (especially first military separation)separation)

► Families recently moved to new duty stationFamilies recently moved to new duty station

► Foreign born spouseForeign born spouse

► Families with young childrenFamilies with young children

► Families without unit affiliationFamilies without unit affiliation

► PregnancyPregnancy

►Dual career/single parentsDual career/single parents

Stages of DeploymentStages of Deployment

►Pre-deployment (varies)Pre-deployment (varies)

►Deployment and SustainmentDeployment and Sustainment

►Re-deployment/Reunion (last month)Re-deployment/Reunion (last month)

►Post-deployment (3-6 months after Post-deployment (3-6 months after deployment)deployment)

Pre-deployment Pre-deployment Service Service MemberMember

Normal duties plusNormal duties plus►Necessary military training (12 to 16 hr days)Necessary military training (12 to 16 hr days)►Complete wills and power of attorneyComplete wills and power of attorney►Updating all immunizationsUpdating all immunizations►Completing numerous screenings/evaluationsCompleting numerous screenings/evaluations

Family needsFamily needs►Prepare family for separation and increased Prepare family for separation and increased

independenceindependence►Noted service member becomes “mission Noted service member becomes “mission

focus” and emotional withdrawalfocus” and emotional withdrawal►Wants to educate spouse on financial matters Wants to educate spouse on financial matters

and spend more time with childrenand spend more time with children

Pre-deployment Pre-deployment Spouse and Spouse and ChildrenChildren

Pending deployment initiates significant Pending deployment initiates significant stressstress

Separation and loss anticipatedSeparation and loss anticipated Possible periods of anger and protest Possible periods of anger and protest

followed by emotional detachmentfollowed by emotional detachment National Guard and Reserve families face National Guard and Reserve families face

unique stressorsunique stressors►Short periods of preparationShort periods of preparation►Need information on pay and resourcesNeed information on pay and resources►Military pay may not match civilian payMilitary pay may not match civilian pay►Service members job may not be there on returnService members job may not be there on return

Deployment Deployment Service MemberService Member

Difficult events may produce intense feelingsDifficult events may produce intense feelings►FearFear►HorrorHorror►Helplessness Helplessness ► (required for diagnosis of PTSD)(required for diagnosis of PTSD)

Traumatic events magnified byTraumatic events magnified by►Harsh living conditionsHarsh living conditions►130 degree temperatures130 degree temperatures►Unrelenting noiseUnrelenting noise►Lack of privacyLack of privacy►Constant threat of attackConstant threat of attack

Multiple deployments increases likelihood of Multiple deployments increases likelihood of mental health problemsmental health problems

Deployment Deployment Spouse and Spouse and ChildrenChildren

Periods of emotional destabilization and Periods of emotional destabilization and disorganizationdisorganization

Reports of Reports of ►SadnessSadness DepressionDepression AnxietyAnxiety►LonelinessLoneliness AngerAnger Feeling OverwhelmedFeeling Overwhelmed►NumbnessNumbness ReliefRelief

Physical reactionsPhysical reactions►Sleep disturbancesSleep disturbances►Health complaintsHealth complaints

Added family responsibilitiesAdded family responsibilities

As Deployment Progresses As Deployment Progresses FamilyFamily

►Period of recovery and stabilizationPeriod of recovery and stabilization Reconfiguration of the family (reassigning Reconfiguration of the family (reassigning

authority and duties)authority and duties) Develop new routinesDevelop new routines Increase sense of independence and self Increase sense of independence and self

confidenceconfidence Develop new support systemsDevelop new support systems

►New friendsNew friends►Family Readiness Groups (FRG)Family Readiness Groups (FRG)

CommunicationCommunication During During DeploymentDeployment

► Critical Importance Critical Importance

► Technological advancesTechnological advances PhonePhone Cell phoneCell phone Video callsVideo calls FaxFax EmailsEmails

► Positive and negativePositive and negative Keep service member psychologically presentKeep service member psychologically present Family matters/crisis at home may distract from focus on Family matters/crisis at home may distract from focus on

missionmission

► Family members need open communication with Family members need open communication with Command, FRGs, and other families/spousesCommand, FRGs, and other families/spouses

ReunionReunion

►Deployment endsDeployment ends►HomecomingHomecoming►Excitement and apprehension Excitement and apprehension

increasesincreases Role redefinedRole redefined New family systems developedNew family systems developed All family members have inevitably All family members have inevitably

changedchanged

Post Deployment Post Deployment Service Service MembersMembers

►Documented psychological problems within Documented psychological problems within weeks of returning homeweeks of returning home

► Symptoms increased between homecoming and Symptoms increased between homecoming and 3 to 4 months3 to 4 months

►Okie (2005) reported Traumatic Brain Injury Okie (2005) reported Traumatic Brain Injury (TBI) in 22% wounded(TBI) in 22% wounded

►Cyclical depressionCyclical depression Hearing loss Hearing loss►Coordination problems Memory problemsCoordination problems Memory problems►Affective instabilityAffective instability Decreased ability to concentrate Decreased ability to concentrate

►May have problems disengaging from May have problems disengaging from combat life stylecombat life style

Post Deployment Post Deployment Spouse Spouse and Childrenand Children

► Homecoming exciting and joyful eventHomecoming exciting and joyful event

► Not uncommon for both spouses to have unrealistic Not uncommon for both spouses to have unrealistic expectationsexpectations

► Family roles and routines must be renegotiatedFamily roles and routines must be renegotiated

► Reintegration into a family that changedReintegration into a family that changed

► May resent loss of independenceMay resent loss of independence

► Family members less supportive when hurtFamily members less supportive when hurt

Deployment Stages and Children’s ResponsesDeployment Stages and Children’s Responses(Amen et al., 1988; Murray, 2002; Pincus et al., 2001; Stafford & (Amen et al., 1988; Murray, 2002; Pincus et al., 2001; Stafford &

Grady,2003)Grady,2003)

Pre-DeploymentPre-DeploymentInfantsInfants Fussy, changes in eating habitsFussy, changes in eating habitsPreschoolersPreschoolers Confused, saddenedConfused, saddenedSchool-AgedSchool-Aged Saddened, angry or anxiousSaddened, angry or anxiousAdolescentsAdolescents Withdrawn, deny feelings about pending separationWithdrawn, deny feelings about pending separation

DeploymentDeploymentInfantsInfants No researchNo researchPreschoolersPreschoolers Sadness, tantrums, changes in eating/elimination habits,Sadness, tantrums, changes in eating/elimination habits,

symptoms of separation anxiety may appearsymptoms of separation anxiety may appearSchool-AgedSchool-Aged Increased somatic complaints, mood changes, decline inIncreased somatic complaints, mood changes, decline in

school performanceschool performanceAdolescentsAdolescents Angry, aloof, apathetic, acting out behaviors may increase,Angry, aloof, apathetic, acting out behaviors may increase,

loss of interest in normal activities, decline in school loss of interest in normal activities, decline in school performanceperformance

Post-DeploymentPost-DeploymentInfantsInfants May not recognize returning service member and be fearfulMay not recognize returning service member and be fearfulPreschoolersPreschoolers Happy and excited, but also experience anger at separationHappy and excited, but also experience anger at separationSchool-AgedSchool-Aged Happy and angry, often leading to acting out behaviorsHappy and angry, often leading to acting out behaviorsAdolescentsAdolescents Defiant, disappointed if their contributions at home are not Defiant, disappointed if their contributions at home are not

acknowledgedacknowledged

Supporting the Child Whose Military Supporting the Child Whose Military Parent is Deploying: Tips for ParentsParent is Deploying: Tips for Parents

1.1. Talk as a family before deployment.Talk as a family before deployment.2.2. Bestow, rather than “dump”, Bestow, rather than “dump”,

responsibilities on remaining family responsibilities on remaining family members.members.

3.3. Make plans for the family to continue to Make plans for the family to continue to progress together, and include the progress together, and include the deployed parent in ongoing projects.deployed parent in ongoing projects.

4.4. Continue family traditions and develop Continue family traditions and develop new ones.new ones.

5.5. Help children understand the finite Help children understand the finite nature of a deployment by devising nature of a deployment by devising developmental time-lines.developmental time-lines.

Tips ContinuedTips Continued

6.6. To children, no news is worse than bad To children, no news is worse than bad news.news.

7.7. Listen to a child’s worries about the Listen to a child’s worries about the deployed parent and answer questions as deployed parent and answer questions as truthfully as possible.truthfully as possible.

8.8. Maintain firm routine and discipline in the Maintain firm routine and discipline in the home.home.

9.9. Initiate and maintain a close relationship Initiate and maintain a close relationship with the school and the child’s teacher.with the school and the child’s teacher.

10.10. AS THE REMAINING PARENT, MAKE SURE AS THE REMAINING PARENT, MAKE SURE YOU TAKE CARE OF YOURSELF.YOU TAKE CARE OF YOURSELF.

ReferencesReferences

► The Psychological Needs of U.S. Military The Psychological Needs of U.S. Military Service Members and Their Families: A Service Members and Their Families: A Preliminary Report, American Psychological Preliminary Report, American Psychological Association Presidential Task Force on Association Presidential Task Force on Military Deployment Services for Youth, Military Deployment Services for Youth, Families, and Service Members, February Families, and Service Members, February 20072007

►Dr. Thomas Hardaway, Department of Dr. Thomas Hardaway, Department of Behavioral Medicine, Brooke Army Medical Behavioral Medicine, Brooke Army Medical CenterCenter

LTC Harvey D. LeighnorLTC Harvey D. Leighnor

Tripler Army Medical CenterTripler Army Medical Center

Dept of Social WorkDept of Social Work

Honolulu, Hawaii 96859-5000Honolulu, Hawaii 96859-5000

Phone: 808 433-6606Phone: 808 433-6606

Email: [email protected]: [email protected]

Programs for Military Programs for Military PersonnelPersonnel

►Battlemind TrainingBattlemind Training

►SWAPP (Soldier Wellness assessment SWAPP (Soldier Wellness assessment Pilot Program)Pilot Program)

►SAFAC (Soldier and Family assistance SAFAC (Soldier and Family assistance CenterCenter

► Information HandoutsInformation Handouts

Programs for Children and Programs for Children and FamiliesFamilies

►ResiliencyResiliency

►Multimedia ResourcesMultimedia Resources

►Community Efforts and OutreachCommunity Efforts and Outreach