Strong Families Strong Forces: Building a Community Driven Home-Based Intervention for Military Families with Young Children

Background and Purpose: Approximately 2 million children have been affected by parental deployment to the wars in Afghanistan and Iraq (OEF/OIF), 40% of them younger than five years old (DOD, 2008). While US military families have shown remarkable resilience throughout these conflicts (Elder & Clipp, 2006), very young children are particularly vulnerable to deployment separation given the developmental processes occurring during these years (Cozza & Lieberman, 2007). Yet, little research and evidence-based programming are available for these families. This presentation reports on the first two years of a 4-year Community-Based Participatory Research program to develop and test a home-based intervention designed to mitigate the impact of deployment experiences on military families with young children. Specifically, we will (a) present findings from our initial exploratory phase, and (b) describe how we have used our findings to inform the development of an evidence-based reintegration program.

Methods: During the first phase of this mixed-method project, standardized measures assessing PTSD (PCL), parenting stress (PSI), and psychological distress (BSI) were administered to OEF/OIF service-member parents (N= 39) and spouses (N= 31) of very young children Additionally, audio-taped semi-structured interviews focused on parents' experiences of the deployment cycle, specifically reintegration, parent-child relationships, parenting, and resources/supports. Quantitative data were entered into SPSS for analysis and interviews were transcribed verbatim and analyzed using grounded theory techniques (Charmaz, 2006).

Findings: Both quantitative and qualitative findings illustrated that overall most families were coping well with deployment and reintegration. Yet, 14% of service members met criteria for PTSD, 22% reported clinically significant parenting stress, and 54% were struggling with depression or anxiety. Spouses were functioning better with only one meeting criteria for PTSD, 12% struggling with clinically significant parenting stress, and 48% exhibiting some depression or anxiety. Interview themes addressed parents' mental health, the perceived legacy of war-related experiences, and recognizing and responding to young children's reactions to deployment separation. More specifically, participants discussed the following issues: (1) mixed experience of contact while deployed; (2) strains of parenting in the post-deployment period; (3) tensions associated with re-negotiating family/couple roles and relationships; (4) challenges of mental health concerns as impediments to optimal parenting; and (5) questions regarding helping children during deployment and reintegration. Consistent with a CBPR approach, findings, together with available evidence from the intervention literature, were used to inform the development of an 8 module home-based therapeutic program. Each module was constructed to address a specific constellation of concerns identified by our sample, including the emotional cycle of deployment and reintegration, parenting concerns, coming back together as a family, and re-establishing the service-member's relationships with the child.

Conclusions: Our collaborative approach to program-building is intended to maximize participant input regarding deployment-related experiences and family perceptions of need related to reintegration and parenting of very young children. This approach to intervention development ensures that the resulting program will have strong ecological validity and practical relevance for military families. Implications of building a community driven and evidence-informed family program for returning OIF/OEF service members with young children will be discussed.