millitary families.pdf

7/30/2019 millitary families.pdf

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O R I G I N A L P A P E R

Community Family Therapy with Military Families

Experiencing Deployment

W. Glenn Hollingsworth

Published online: 12 March 2011 Springer Science+Business Media, LLC 2011

Abstract The length and frequency of deployments in the current wars in Iraq and

Afghanistan are associated with increased vulnerability for both part- and full-time military

families who stand to benefit from systems-oriented practice by marriage and family

therapists. Community Family Therapy (CFT) is a modality designed to promote resilience

both within and beyond the four walls of the therapy room, facilitate family connections in

the community, and empower them for local leadership. The effects of deployment on

families are summarized and CFT principles are adapted as a framework for interventionwith this population.

Keywords Community engagement Deployment Family therapy Military families

In over 9 years of the Global War on Terror (GWOT), including Operation Iraqi Freedom

(OIF) and Operation Enduring Freedom (OEF), more than 1.8 million United States service

men and women have been deployed overseas (RAND Corporation 2009), leaving behind

a staggering number of loved ones, including parents, spouses, partners, and children. In

the last few years, research on the effects of a previously unforeseeable number of

deployments and increased operations tempo on military families has expanded rapidly.

There are still numerous gaps, such as program evaluation (Griffith 2010), clarification of

risk versus resilience (Ternus 2010), variations of deployment effects based on gender, and

developmental differences of children (Chandra et al. 2010; Chartrand et al. 2008; Lester

et al. 2010).

One significant and practical gap concerns how civilian counselors and therapists can

more effectively intervene with military families in this situation. In this article I address

the unique role that marriage and family therapists (MFTs) can play in promoting

W. G. Hollingsworth (&)

Family & Community Research Lab (0493), 1880 Pratt Drive, Blacksburg,

VA 24060, USA

e-mail: [email protected]

W. G. Hollingsworth

Virginia Tech, Blacksburg, VA, USA

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DOI 10.1007/s10591-011-9144-8


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resilience in military families. I propose the Community Family Therapy model (CFT)

(Rojano 2004) as a framework for MFT intervention, and argue that therapists can promote

health by moving beyond the four walls of the therapy room and creating broader con-

nections among themselves, military families, and others in the community. Thus, I

respond to the lack of a guiding framework in the literature for the therapist wishing toengage more broadly with this population.

Introduction

While there are various deployment destinations and assignments, I focus here on the

effects of deployment in combat-related situations, namely OIF and OEF. As opposed to

deployments for peace-keeping or routine training missions, combat-related deployments

are more likely to occur with less preparation, more variability (e.g., when the deployment

is scheduled to end), and significantly increased stress for family members back home. A

great portion of the stress incurred by these families consists of worrying about the safety

of their deployed loved one (Flake et al. 2009; Lapp et al. 2010) given the inherent dangers

regardless of the service members proximity to the battlefield. This is particularly salient

given the prevalence of Improvised Explosive Devices in the current conflicts.

In addition, the unique role of National Guard and Reserve service members requires

emphasis. These individuals represent an under-studied group in the literature (Houston

et al. 2009; Mansfield 2009) and are in a unique position as citizen soldiers. They face

challenges that full-time service members do not, such as navigating civilian employment

(Griffith 2010), potentially significant drops in financial income when mobilized (Hosh-mand and Hoshmand 2007), isolation and a separation from unit affiliation (Wiens and

Boss 2006), and limited access to formal support resources provided by the military (Lapp

et al. 2010). Thus, National Guard and Reserve personnel and their families are more

vulnerable than other military professionals (Kline et al. 2010). This population stands to

benefit more directly from a therapist with a community-oriented perspective and ability to

facilitate connections across diverse systems.

My discussion of community engagement and social support networks is generally

informed by social organization theory (Mancini et al. 2005). According to this theory,

networks, social capital, and community capacity are vehicles for change in communities.

Formal networks are those typically indicated by some sort of obligation, and often involveagencies or organizations. Military examples would include unit leadership and various

human service delivery systems involving, for example, relocation or child care (Bowen

et al. 2000) as well as Family Readiness Groups (FRGs) (Huebner et al. 2009). Informal

networks are characterized by voluntary associations, such as naturally occurring groups

among nuclear and extended family members, friends, and work colleagues. Bowen et al.

(2000) argue that a primary function of formal networks is providing support to informal

networks. A larger-systems model of therapeutic practice can operate at the intersection of

these two entities and figure prominently in the promotion of resilience in military families

experiencing deployment.Ramon Rojano, William Doherty, and others recently have brought civic engagement,

collaboration, and turning consumers of family services into producers of change to the

forefront in the MFT field (e.g., Doherty and Beaton 2000; Doherty et al. 2009; Rojano

2004). While Imber-Black (1988) was one of the first family therapy professionals to offer

an assessment and guide for treating families within larger systems, Rojano (2004) has

provided a model of community-focused engagement aimed at low-income, urban families

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that specifically includes helping families earn above the poverty line and other goals not

typically considered within the purview of MFT. I adapt principles from Rojanos model to

military families experiencing deployment and provide ideas for family therapists as to

how they can engage families not only with a community perspective, but also at and

within the level of community. After a review of the literature regarding the effects ofdeployment on families, I situate a variety of therapeutic interventions, many of which are

in the extant literature, within the models three levels of engagement (individual and

family therapy, wrap around networking, and leadership and civic engagement) (Rojano

2004). I also argue that family involvement in the final level is underrepresented in the

military family literature; thus the idea of turning consumers of services into promoters of

change is highly relevant and likely to be beneficial to many in this community.

It is indeed a failure of systems that makes such a broad therapeutic approach necessary.

The helping professions are quite specialized, creating somewhat rigid distinctions among

counselors, family therapists, social workers, community psychologists, and others. As a

result, military families, especially those of the Guard and Reserve, may not benefit from

all relevant services and sources of support due to a lack of communication among these

professionals. Hoshmand and Hoshmand (2007), representing community psychologists,

bring attention to the need for community-minded intervention with military families that

also could bridge this gap. MFTs have simultaneous regard for the individual, family, and

larger systems in treatment, and as a result are in a unique position to provide robust

services to this population.

Such intervention and outreach is crucial given the length of the current wars in Iraq and

Afghanistan and the nature of contemporary, all-voluntary military service. A number of

factors can influence someones choice to remain in the military, and officials are recog-nizing the link between family factors, retention, and readiness for deployment (e.g., Doyle

and Peterson 2005; Karney and Crown 2007). A sample of Army Guard and Reserve

members and their families who reported coping well with deployment were more likely to

express intention of extending their service (Castaneda et al. 2009). Similarly, among a

sample of Army soldiers stationed in Europe, positive beliefs about the military providing a

familyfriendly work environment were also linked to retention (Huffman et al. 2008).

Finally, Amen et al. (1988) even suggested a spouses satisfaction with the military ulti-

mately is associated with better adjustment to deployment. Thus, strategic family support

can promote healthier coping, pro-military attitudes, and, in turn, readiness and retention.

While there are many positives associated with military life, like quality healthcare andopportunity for advancement, and even with deployment itself, such as increased pay and

enhanced sense of family closeness (Castaneda et al. 2009), social factors make inter-

vention by professionals such as MFTs quite valuable. Multiple researchers have written

about the possibility of adverse effects of being a military family, such as the impact of

frequent relocations (Ternus 2010) and a more rigid organizational culture that may

conflict with a broad range of cultural dynamics associated with diverse personnel (Wiens

and Boss 2006). Adolescents have noted that military culture prompted their learning to not

talk about their feelings (Huebner and Mancini 2010). Indeed, the military is experiencing

an increasing number of officers who belong to a generation marked by a relativeunwillingness to sacrifice family and marriage for the demands of an Army career

(Caliber Associates 2007, p. 4); it remains to be seen what kind of long-term effects these

generational changes might promote.

Given current literature on the effects of deployment on families, spouses or partners,

and children, we can address how the MFT can intervene at various levels of community

engagement. Compared to traditional therapeutic encounters bound within the four walls of

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an office, it is my belief that a community approach will have a higher likelihood of

ameliorating certain persistent effects of deployment stress and maladjustment as well as

simultaneously strengthening the communities in which full- and part-time military fam-

ilies live.

Effects of Deployment

In narrative terms, there are dominant and marginalized discourses on the effects of

deployment. It appears that the negative effects of deployment belong to the former. After

all, common sense would suggest that separating loved ones for anywhere from 4 to

15 months under the best of circumstances would be quite stressful, but especially so with

one being in harms way every day and the other experiencing a dramatic shift in roles and

responsibilities as well as conflicts in and outside of the home. However, some families

come out of the deployment experience stronger, with new skills, independence, and self-

reliance (Caliber Associates 2007). A survey by the Kaiser Family Foundation (2004)

found that 58% of Army spouses thought deployment strengthened their marriage com-

pared with 31% who thought it had no effect and 10% who thought their marriage

weakened as a result. There are also those who stress the fact that not everyone or every

family will experience deployment in the same way, leading some to downplay effects like

the relatively mild degree of childrens symptom severity (Mabe 2009, p. 352) and with

others producing more alarming reports (Salamon 2010). Effects also can differ according

to the phase of the deployment cycle (MacDermid Wadsworth 2010).

Regarding the marital relationship, Karney and Crown (2007) found that deploymentactually can strengthen marriages and was associated with greater stability that even

increased with the length of deployment. While the focus here is on effects during the

sustainment phase of deployment (i.e., when the service member is actually in theater),

Allen et al. (2010), on the other hand, found that an Army soldiers deployment status in

the last year was not related to differences in relationship satisfaction between deployed

and non-deployed active duty personnel.

Individually, at-home spouses or partners appear to face a general increase in stress,

with 42% of respondents in one study indicating clinically significant stress levels during

deployment (Flake et al. 2009). Grandparents as well have reported elevations in stress

while raising grandchildren who had a deployed parent (Bunch et al. 2007). Spouses alsomay face increased depressive symptoms (Warner et al. 2009), and loneliness is a common

struggle that may lead to other difficulties in coping (Caliber Associates 2007). Mansfield

et al. (2010) found that, regardless of the length of deployment, Army wives with deployed

husbands also experienced significantly more depressive disorders, as well as sleep dis-

orders, acute stress reactions, and adjustment disorders than wives whose husbands were

not deployed. In addition, stress in the family has been shown to increase along with the

cumulative length of deployment (Lester et al. 2010), and elsewhere a sample of Army

families made more frequent mental health care-related visits to professionals as deploy-

ments drew on (Mansfield 2009).Children face a variety of stressors during deployment, and while many children are

resilient (Jensen et al. 1996; Lester et al. 2010), this can lessen with the length of

deployment (Chandra et al. 2010). Despite the variability of responses to deployment, there

appears to be significant agreement that children may experience increased anxiety and

uncertainty (Chandra et al. 2010), vulnerability for general relationship conflict (Huebner

et al. 2007), higher frequency of depressive symptoms (Jensen et al. 1996; Huebner et al.

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2007), and a higher resting heart rate indicative of increased stress (Barnes et al. 2007).

One of the most significant predictors of how well a child will cope with deployment is the

mental health and coping of the primary caregiver (Flake et al. 2009; Jensen et al. 1996;

Palmer 2008; Chandra et al. 2010). However, some authors (e.g., Mmari et al. 2009)

acknowledge this but de-emphasize it in order to keep searching for other salient factorsaffecting childrens adaptation such as their social milieu (e.g., the presence of anti-war

sentiment in the school or community).

School difficulties can occur as anxiety and uncertainty related to deployment lead to

sadness and anger, causing disruptions (Chandra et al. 2010) as well as overall declines in

academic performance (Huebner et al. 2007). While Flake et al. (2009) found that 32% of

school-aged kids facing the deployment of a parent were at increased risk for psychosocial

morbidity, associated school related declines were not evident. Flake et al. also found more

internalizing symptoms (e.g., worry, anxiety, crying) among children than externalizing or

inattention problems, a finding that is contrary to that of others who suggest that older

children and boys face more school problems, likely due to a tendency to act out anger and

aggression (Chandra et al. 2010).

Gender and developmental differences in deployments effects are also evident. It

would be too simplistic to generalize that boys externalize while girls internalize, though

this is not without some support. Chandra et al. (2010) found that girls internalize more

than boys as measured by anxiety or depression indicators. These authors also note that

girls may struggle in more dangerous ways as a portion of girls in their sample also

engaged in risk-taking behavior such as self-mutilation. Lester et al. (2010), on the other

hand, suggest that girls may externalize more than boys during deployment, with boys

struggling more upon return and reintegration in adjusting to reduced autonomy andincreased structure (p. 318). Manos (2010) takes the aforementioned evidence into

consideration when noting that girls may indeed struggle more with behavioral problems

overall than boys. Still, others have found that girls may struggle more with reintegration

(RAND Corporation 2009), a phase that may be more difficult than sustainment (Huebner

et al. 2007). Developmentally, Chartrand et al. (2008) found that 35 year olds had more

externalizing problems, and that these were independent of caregiver stress, while children

between 1.5 and 3 years of age showed no changes in behavior during deployment.

Overall, younger school-aged children may struggle more than older children (Jensen et al.

1996; Lincoln et al. 2008).

Families of National Guard and Reserve service members face additional challengesleading to greater stress (Lapp et al. 2010; Griffith 2010), heightened vulnerability to

the adverse effects of deployment (Kline et al. 2010), and more reports of mental

health concerns upon return (Milliken et al. 2007). These are also families that could

be alone and without unit affiliation, placing them at higher risk for maladaptation

(Wiens and Boss 2006). Such families also may have less access to the formal and

informal networks of support provided by the military (Lapp et al. 2010). Children in

these families may experience less social support while attending schools that are

unaware of the dynamics of military life (Chandra et al. 2010). A sample of Guard and

Reserve spouses indicated five stressors that summarized their experience: worrying,waiting, going it alone, pulling double duty, and loneliness (Lapp et al. 2010).

Moreover, they also acknowledged believing that others could not understand their

experiences unless they too had faced the deployment of a loved one. These aspects of

disconnection are particularly salient to the discussion of how MFTs can intervene at

community and network levels.

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Risk Factors

According to McCubbins Double ABCX model of family stress and adaptation, risk

factors would impact a familys existing resources (B) and perceptions of the stressor

(C) (McCubbin and Patterson 1983). These would be the various disparate elements thateither increase or decrease the chance of a familys bonadaptation (effective, optimal

coping and adjustment) or maladaptation to a stressor, in this case, deployment, and

occur on individual, familial, and contextual levels.

Individual stressors of at-home caregivers include facing barriers to mental health care,

such as getting time away from family and off from work, as well as a concern that seeking

mental health treatment would be detrimental to a spouses career (Warner et al. 2009).

Wiens and Boss (2006) utilize Bosss (2002) Contextual Family Stress Framework in

identifying internal and external contexts that affect an individuals response to stress.

Internal contexts refer to ones philosophy, perceptions, appraisals of the individual

regarding his or her view of the stressor, and use of support resources. External contexts

include past history, culture, economy, and development. Pile-ups of stressors overall can

make the family more vulnerable to dysfunction, such as lower socioeconomic status,

young and inexperienced families, being without unit affiliation, and first time deploy-

ments (Stafford and Grady 2003; Wiens and Boss 2006; MacDermid Wadsworth 2010).

Additionally, children appear more vulnerable based on the at-home parents mental

health (e.g., Chandra et al. 2010) and the extent to which family routines are disrupted

(McFarlane 2009). Increased responsibilities at home can take a toll, as can multiple and or

extended deployments (Chandra et al. 2010), and fear of death of the deployed parent

(Houston et al. 2009). Exposure to media coverage refers to an external context that canadversely affect children (Cozza et al. 2005), as can challenges at school regarding per-

ceptions of war held by others in the community (Houston et al. 2009). Thus, children may

have difficulty confiding in friends and suppress their feelings as a result (Huebner and

Mancini 2010), and overall may face deficits in the availability of social support, especially

if the family leaves what it considers home to live with or be closer to extended family

(Cozza et al. 2005).

On the contextual level, risk factors include the type of deployment (Wiens and Boss

2006; Lincoln et al. 2008), as well as military culture as it relates to the suppression of

emotion, for example, or the potential for conflict given contrasts with a diversity of family

structures and dynamics (Wiens and Boss 2006). In addition, there may be barriers relatedto mental health care provided by the military, such as the need to go off-base for mental

health services as well as awareness of resources, finances, and child care responsibilities

more generally (Eaton et al. 2008).

Protective Factors

Maladjustment to deployment is not inevitable, and there are a variety of protective factors

and positive coping activities to consider. A brief review of the literature reveals thatemployment and higher level of parental education (Flake et al. 2009), parental adjustment

and mental health (Lester et al. 2010; Manos 2010; Chandra et al. 2010), parental value of

a childs education (Chandra et al. 2010), parental support for children (Morris and Age

2009), appropriate communication around deployment (Huebner and Mancini 2010),

clarity around issues of control (i.e., what can and cannot be changed; Huebner et al. 2007)

and the meaning attributed to deployment (Antonovsky and Sourani 1988; Wiens and Boss

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2006; Mabe 2009; Lapp et al. 2010) are all important variables in determining how a

family responds to the pile-up of stressors associated with deployment. Wiens and Boss

(2006) also suggest that family preparedness for deployment, flexible gender roles, and

active coping strategies can increase a familys resilience during deployment.

Protective factors that center on social support and relationships that family membershave with others outside of the family are prominent in the literature as well as being a

focus of this article. Living on a military base is associated with less vulnerability to

negative effects (Chandra et al. 2010), as is feeling supported by the military community, a

religious organization in which a family is involved, and/or the community in general

(Wiens and Boss 2006; Flake et al. 2009). It is important for these families to have ongoing

relationships with other families as well (Castaneda et al. 2009). For children, appropriate

and adequate supervision in the home and community is beneficial (Chandra et al. 2010).

Huebner and Mancini (2008) argue for more explicit attention to be paid to teenagers and

their social networks in this regard, since youth appear to socially construct meanings

about deployment in their interactions with others (Huebner et al. 2007). Adolescents also

can benefit from giving advice to other deployed kids (Huebner and Mancini 2010),

especially as these young people may tend to feel understood only by others who have

experienced similar circumstances. Children can benefit when there is sufficient social and

emotional support provided at their school by staff as well as peers (Chandra et al. 2010).

A variety of social connections are vital. In a survey completed by the National Military

Family Association (2006), only 47% of respondents indicated sustained support

throughout deployment, and 17% of respondents indicated that no support programs were

available to them. In addition to emotional support, these informal network connections

also can provide important information regarding benefits and resources in the form ofother formal supports and programming (Huebner and Mancini 2008; Faber et al. 2008;

Houston et al. 2009), such as Operation Purple Camp (McFarlane 2009), a summer camp

for youth with a deployed parent. Ongoing family support groups (Huebner et al. 2007;

Faber et al. 2008) and initiatives such as Operation: Military Kids can be healthy avenues

for families to get emotional as well as instrumental needs met, and more formal ones can

be used for teaching coping skills, promoting neighborhood outreach to target at-risk

families, and promoting a sense of community (Lombard and Lombard 1997; Bowen et al.

2003). Other groups that families can engage in include those provided by the military

itself, such as Family Readiness Groups (Doyle and Peterson 2005; Di Nola 2008;

Mansfield 2009). Social support and connection figure prominently in the literature, pro-viding an avenue of opportunity for community-minded MFTs.

The Unique Role of the Family Therapist

Families do not exist in vacuums, but are embedded within a variety of larger systems

(Bronfenbrenner et al. 1986). Just as it is important that a sibling subsystem maintain

healthy boundaries and responsive communication with a parental subsystem, so, too, is it

necessary for families and their individual members to remain in healthy relationships withothers outside and beyond the familys borders. Darwin (2009) notes that isolation creates

a fertile ground for trauma (p. 437). Moreover, a sense of community is a significant

variable in how well a family adapts to military life (Bowen et al. 2003). Numerous risk

and protective factors point to the importance of social support and connection with others

via informal (such as religious organizations or support groups) and formal networks (such

as ones work or even a Family Readiness Group). In addition to the simple fact of human

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connection and emotional or instrumental support, such robust relationships can aid in the

transfer of support or resource-related information, thus reducing barriers to intervention

(Eaton et al. 2008) and enhancing the effectiveness of programs already in place. Thus, the

systemically focused MFT who places a premium on relationships is in a unique position to

help address the needs of individual family members by facilitating their connection toother sources of support and engagement in the community.

While there are resources available for therapists working with these families, many

institutions and organizations fail to consider adequately the familys involvement in other

relational systems. For instance, Darwin (2009) cites an example of a child being sus-

pended from school for acting out behaviors, yet the school was unaware that the child had

a parent who was deployed. The schools response likely exacerbated the childs mal-

adaptive coping, whereas had the staff been aware of the effects of deployment and this

students particular circumstances, a different plan of intervention could have been

implemented and likely increased the resilience of the family overall. The blind spots in the

literature regarding the familys relationship with and to other systems leave the family

therapist with the lack of a guiding framework for such intervention. The therapist who is

content to simply see an adolescent or a parentchild dyad once a week to address coping

in the face of deployment likely will see suboptimal results, given the emphasis in the

literature on social supports and systems beyond the family. To be sure, within the family

therapy field there are those who have offered models of intervention with families and

larger systems (e.g., Imber-Black 1988), yet only recently has there been a burgeoning

movement within the field to expand the influence of MFT into the community proper and

even reshape the actual practice of therapists.

What distinguishes Rojanos model of Community Family Therapy from other sys-temically-oriented interventions is best summed up by Doherty when he writes that the

CFT therapist is a vigorous collaborator with multiple systems, including families, citi-

zens groups, professional groups, and community-based services (Doherty and Beaton

2000, p. 154). Whereas in other theoretical orientations the therapist may talk about

community or network issues (e.g., the relational selves of narrative approaches), in CFT

the therapists and clients involvement in community issues becomes part of the treatment

plan itself. Other responsibilities of the therapist include increasing availability and

access to necessary community resources and developing leadership skills and capacity

for civic engagement (Rojano 2004, p. 63). Similarly, there are three broad treatment

goals for clients that include (a) constructing an autobiography that focuses on strengthsand a life plan that invites positive action and self development, (b) developing a functional

and effective community network of personal and supportive resources, and (c) providing

for leadership development and civic engagement (p. 67). These three goals then cor-

respond to Rojanos levels of engagement mentioned earlier: individual and family ther-

apy, wrap around networking, and leadership and civic engagement.

The first level of engagement consists of interventions aimed at what typically are

identified in the literature as the stressors faced by military families. It is in individual or

family sessions where discussions of role responsibilities and realignments, boundaries,

hierarchy, and the like can be held. Therapists can work at this point with clients onidentifying strengths as well as internal and external resources, and developing positive,

active coping strategies. Issues of control (Huebner et al. 2007; Morris and Age 2009),

helplessness, and hopelessness can be addressed here as well. Strategies to promote self-

care are essential given the increased responsibilities undertaken by family members that

may lead to fatigue and difficulty functioning at work or school (Chandra et al. 2010). And

since the meaning or interpretation given to deployment has received attention in the

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literature (Huebner and Mancini 2010), narrative work also can occur at this level. In

particular, dominant discourses around the military family syndrome (Bradshaw et al.

2010) and the inevitable harm associated with deployment can be deconstructed in favor

of alternative narratives of resilience, adaptation, and strength.

Community Family Therapy principles become more salient for our purposes at thesecond level of engagement. Rojano (2004) writes, This level seeks to help clients

connect or re-connect with the community of resources that can offer sources of support

and opportunities to meet basic and developmental needs (p. 69). In the same article, he

notes a need to help clients construct a nuclear network of family members and close

friends the personalized community (p. 69). Therapists can have explicit discussions

about sources of social support available to the family and how to improve access,

including addressing any individual issues that may be a barrier to outreach, such as ones

attachment issues (Huebner 2009) or trauma history.

Perhaps more importantly, there is an opportunity for therapists to begin moving beyond

the four walls of the therapy room by actually facilitating the connection of these families

with a variety of supports (i.e., formal or informal networks) in the community. First,

therapists must be aware of what is actually available. For instance, it would be helpful to

know that Family Readiness Groups (FRGs) are essentially Army-sponsored support

groups for families. FRGs also disseminate military-related information (e.g., on a soldiers

deployment status, military benefits) and provide general support for families (Di Nola

2008; Mansfield 2009). Other service branches also provide similar resources, such as

those associated with the Navys Fleet and Family Support Programs. MFTs could

establish relationships with military chaplains or others who would be a rich source of

information regarding other prevention services (e.g., parenting programs, financialcounseling). Therapists also must educate themselves (and possibly clients) on other

aspects of military culture, such as how to go about receiving mental health benefits and

even the vast array of acronyms the various branches employ, an ignorance of which can

quite clearly identify one as an outsider. This is especially significant since families of the

deployed, unlike the service men themselves, must seek mental health care away from the

post (Eaton et al. 2008). A well-educated therapist can be a rich source of information to a

multi-stressed caregiver, as well as a catalyst in working with a family to get something

like a support group started if it does not exist (Faber et al. 2008). Therapists can facilitate

other groups in collaboration with clients, such as support groups for the teaching of coping

skills (Lombard and Lombard 1997) or providing stress management workshops (Faberet al. 2008).

Di Nola (2008) notes the role of independence and financial responsibility in adapting to

deployment. In Community Family Therapy in general there is a goal of increasing median

family income, and this principle applies as well to military families with respect to

deployment. Since many National Guard or Reserve service members families may

experience significant reductions in income due to departures from regular employment,

therapists could assist the at-home parent in a coaching fashion to perhaps find alternative

sources of income or ways to enhance his or her vocational skills. The therapist can make

the client aware of job-training programs based in the community if needed. Thus, therapytakes on a more robust focus in enhancing resilience to include such contextual economic

factors.

Another way a therapist could engage at this level is in advocacy for a family or child

with the local school system. In the previous example, a child was punished at school for

acting out. If the school had been aware of the context of the misbehavior, an alternative

and more beneficial intervention could have ensued. Incidents like this can be reduced

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significantly if there are improvements in the flow of information between schools and the

military (Chandra et al. 2010). Therapists can help facilitate this communication directly as

advocates and by working with caregivers to become more proactive in making a school

aware of a parents deployment, anticipated return, or any other event associated with the

military that may put the child under increased stress, thus heightening vulnerability formisbehavior at school. In all of these interventions, the therapist is becoming more

involved in the systems affecting a family for the clients sake; it is at the next level of

engagement that the families themselves take up the mantle of leadership and advocacy

related to community concerns.

In the book Bowling Alone, Robert Putnam (2000) notes the single most common

finding from a half-century of research on the correlation of life satisfaction, not only in the

United States but around the world, is that happiness is best predicted by the breadth and

depth of ones social connections (p. 332). As suggested by the Community Family

Therapy model, connecting families to larger communities in leadership capacities not

only empowers families, bringing them out of a one-down or marginalized position, but it

also has the capacity to set in motion various changes, such as increases in community

resilience, that can affect a much larger number of people than the therapist seeing only

one family at a time during his or her weekly practice. Furthermore, this is an overlooked

area in the research on military families and deployment. While there are programs such as

Operation: Military Kids Speak Out for Military Kids youth presentation (Operation:

Military Kids, n.d.) teams that consist of non-military youth raising awareness of military

issues with their peers, there is little in the literature regarding how members of military

families can be promoters of change themselves and not simply consumers of services.

Altruism, Rojano (2004) writes, is a major curative factor (p. 66), and Huebner andMancini (2010) allude to the altruistic effects of adolescents giving advice to peers also

facing deployment. Beyond that recognition, (to my knowledge) there appears to be little

else said about how military families can become more resilient by proactively addressing

the needs of others in their community.

The third level is about leadership and civic engagement and ideally would obviate the

need for a therapist. The goal is to facilitate both family empowerment and their com-

munity connections toward the enhancement of community capacity, which refers to a

sense of shared responsibility and collective competence among members of a

community, leading to heightened community resilience (Mancini and Bowen 2009). Thus,

the client becomes more actively engaged in the community, perhaps by advocating for theneeds of other military families at city council meetings or arranging food drives for

families with fewer financial resources. Individuals could petition local organizations (e.g.,

the Y) to reduce fees for children with deployed parents or coordinate a fund-raising

effort to this end. These strategies would be especially applicable to those families who

have experienced multiple deployments and who have grown considerably as a result of

their experiences. Such families could be models for others who are new to the deployment

process and all its inherent challenges, especially since some families believe that only

those who also have experienced deployment will understand what they are going through

(Lapp et al. 2010). Another option would be for the spouse of a deployed service memberto facilitate some sort of adopt a family program. Military families during deployment

have a number of instrumental needs that usually cannot be addressed directly by a

therapist, such as childcare, grocery shopping, and house cleaning. A community-minded

at-home parent could raise awareness of deployment issues and help create a network of

other local families who sign up to adopt a military family, perhaps providing them with

transportation to appointments, purchasing of groceries, or cooking a meal, and the like.

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An adolescent with a deployed parent could even recruit a cadre of babysitters from among

his or her social networks to offer free services to multi-stressed caregivers who need time

for self-care. There are obviously numerous options at this level and I cannot list all that

could be born out of a spirit of collaboration and empowerment.

Conclusion

A variety of factors affect resilience, making definitive statements about how a family will

experience the deployment of a loved one useless as well as impossible. What we do know

is that relationships and connections matter, inside the family and out. The flexibility of the

Community Family Therapy model enables its application to military families facing

deployment. Of course, this does not answer all questions about how a family therapist can

best intervene, but it does provide a general framework that better takes into account the

role of larger systems as contexts for growth. Future research could certainly test such a

framework and gain clarity regarding the influence of the social context on adjustment.

There is also a need to evaluate programs for military families and how well these pro-

grams are incorporating social factors. The myriad experiences of service members and

their families in the current wars in Iraq and Afghanistan have taught us much about what

promotes resilience and what does not. Researchers, clinicians, and others are fortunate to

have access to their triumphs and struggles and with such continued collaboration, optimal

outcomes for more families likely will result.

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