The Impact of War on Military Families LTC Harvey D. Leighnor

1. The Impact of War on Military FamiliesLTC Harvey D. Leighnor The view expressed in this abstract/manuscript are those 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. Government.

2. References • The Psychological Needs of U.S. Military Service Members and Their Families: A Preliminary Report, American Psychological Association Presidential Task Force on Military Deployment Services for Youth, Families, and Service Members, February 2007 • Dr. Thomas Hardaway, Department of Behavioral Medicine, Brooke Army Medical Center

3. Demographics of Military Community • Since September 11, 2001 • Approx 1.5 million American troops deployed to combat zones • 1/3 served at least 2 tours in combat • 70,000 deployed 3 times • 20,000 deployed at least 5 times

4. Families • 700,000 children in America have at least 1 parent deployed • Deployed primary caretaker is most stressful event for children • Strain on parent left behind

5. Exposure • Over 3,240 killed in combat to date • Over 23,000 returned with wounds up to permanent disabilities • As many as 1/4th returning are struggling with visible psychological injuries • Majority report exposure to life-changing stressors challenging ability to reintegrate on return • Disruptive to civilian life • Family functioning is affected by combat exposure

6. Twenty-First Century Military • Changed since last prolonged war • Today • Approximately 3 million serving in uniform • Army, Navy, Air Force, Marines, Coast Guard, Reserves, and National Guard • Over ¼ are members of ethnic minority • 1/4th million preparing to deploy or are deployed • 3 out of 5 of deployed have family responsibilities • Women are 16% of military • Women assigned to 90% of job categories

7. General Family Information • Resilience plays major factor in deployment • Most families “rise to the occasion” • Family readiness is considered key factor in resilience • Family preparedness is a protective factor when deployments are announced

8. Spouse Active Coping Styles • Make meaning of the situation • Receive community and social support • Accept military life style • Are optimistic and self reliant • Adopt to flexible gender roles

9. Factors That Risk Difficult Transition • History of rigid coping styles • Family dysfunction • Young families (especially first military separation) • Families recently moved to new duty station • Foreign born spouse • Families with young children • Families without unit affiliation • Pregnancy • Dual career/single parents

10. Stages of Deployment • Pre-deployment (varies) • Deployment and Sustainment • Re-deployment/Reunion (last month) • Post-deployment (3-6 months after deployment)

11. Pre-deployment Service Member • Normal duties plus • Necessary military training (12 to 16 hr days) • Complete wills and power of attorney • Updating all immunizations • Completing numerous screenings/evaluations • Family needs • Prepare family for separation and increased independence • Noted service member becomes “mission focus” and emotional withdrawal • Wants to educate spouse on financial matters and spend more time with children

12. Pre-deployment Spouse and Children • Pending deployment initiates significant stress • Separation and loss anticipated • Possible periods of anger and protest followed by emotional detachment • National Guard and Reserve families face unique stressors • Short periods of preparation • Need information on pay and resources • Military pay may not match civilian pay • Service members job may not be there on return

13. Deployment Service Member • Difficult events may produce intense feelings • Fear • Horror • Helplessness • (required for diagnosis of PTSD) • Traumatic events magnified by • Harsh living conditions • 130 degree temperatures • Unrelenting noise • Lack of privacy • Constant threat of attack • Multiple deployments increases likelihood of mental health problems

14. Deployment Spouse and Children • Periods of emotional destabilization and disorganization • Reports of • Sadness Depression Anxiety • Loneliness Anger Feeling Overwhelmed • Numbness Relief • Physical reactions • Sleep disturbances • Health complaints • Added family responsibilities

15. As Deployment Progresses Family • Period of recovery and stabilization • Reconfiguration of the family (reassigning authority and duties) • Develop new routines • Increase sense of independence and self confidence • Develop new support systems • New friends • Family Readiness Groups (FRG)

16. Communication During Deployment • Critical Importance • Technological advances • Phone Cell phone • Video calls Fax • Emails • Positive and negative • Keep service member psychologically present • Family matters/crisis at home may distract from focus on mission • Family members need open communication with Command, FRGs, and other families/spouses

17. Reunion • Deployment ends • Homecoming • Excitement and apprehension increases • Role redefined • New family systems developed • All family members have inevitably changed

18. Post Deployment Service Members • Documented psychological problems within weeks of returning home • Symptoms increased between homecoming and 3 to 4 months • Okie (2005) reported Traumatic Brain Injury (TBI) in 22% wounded • Cyclical depression Hearing loss • Coordination problems Memory problems • Affective instability Decreased ability to concentrate • May have problems disengaging from combat life style

19. Post Deployment Spouse and Children • Homecoming exciting and joyful event • Not uncommon for both spouses to have unrealistic expectations • Family roles and routines must be renegotiated • Reintegration into a family that changed • May resent loss of independence • Family members less supportive when hurt

20. Deployment Stages and Children’s Responses(Amen et al., 1988; Murray, 2002; Pincus et al., 2001; Stafford & Grady,2003) Pre-Deployment Infants Fussy, changes in eating habits Preschoolers Confused, saddened School-Aged Saddened, angry or anxious Adolescents Withdrawn, deny feelings about pending separation Deployment Infants No research Preschoolers Sadness, tantrums, changes in eating/elimination habits, symptoms of separation anxiety may appear School-Aged Increased somatic complaints, mood changes, decline in school performance Adolescents Angry, aloof, apathetic, acting out behaviors may increase, loss of interest in normal activities, decline in school performance Post-Deployment Infants May not recognize returning service member and be fearful Preschoolers Happy and excited, but also experience anger at separation School-Aged Happy and angry, often leading to acting out behaviors Adolescents Defiant, disappointed if their contributions at home are not acknowledged

21. Supporting the Child Whose Military Parent is Deploying: Tips for Parents • Talk as a family before deployment. • Bestow, rather than “dump”, responsibilities on remaining family members. • Make plans for the family to continue to progress together, and include the deployed parent in ongoing projects. • Continue family traditions and develop new ones. • Help children understand the finite nature of a deployment by devising developmental time-lines.

22. Tips Continued • To children, no news is worse than bad news. • Listen to a child’s worries about the deployed parent and answer questions as truthfully as possible. • Maintain firm routine and discipline in the home. • Initiate and maintain a close relationship with the school and the child’s teacher. • AS THE REMAINING PARENT, MAKE SURE YOU TAKE CARE OF YOURSELF.

23. References • The Psychological Needs of U.S. Military Service Members and Their Families: A Preliminary Report, American Psychological Association Presidential Task Force on Military Deployment Services for Youth, Families, and Service Members, February 2007 • Dr. Thomas Hardaway, Department of Behavioral Medicine, Brooke Army Medical Center

24. LTC Harvey D. Leighnor Tripler Army Medical Center Dept of Social Work Honolulu, Hawaii 96859-5000 Phone: 808 433-6606 Email: harvey.leighnor@us.army.mil

25. Programs for Military Personnel • Battlemind Training • SWAPP (Soldier Wellness assessment Pilot Program) • SAFAC (Soldier and Family assistance Center • Information Handouts

26. Programs for Children and Families • Resiliency • Multimedia Resources • Community Efforts and Outreach