Clinical Child and Family Psychology Review

, Volume 14, Issue 3, pp 213-230

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Mechanisms of Risk and Resilience in Military Families: Theoretical and Empirical Basis of a Family-Focused Resilience Enhancement Program

  • William R. SaltzmanAffiliated withUCLA Semel Institute for Neuroscience and Human Behavior and California State University Email author 
  • , Patricia LesterAffiliated withUCLA Semel Institute for Neuroscience and Human Behavior
  • , William R. BeardsleeAffiliated withChildren’s Hospital Boston, Harvard Medical School
  • , Christopher M. LayneAffiliated withUCLA/Duke National Center for Child Traumatic Stress
  • , Kirsten WoodwardAffiliated withUnited States Bureau of Navy Medicine and Surgery
  • , William P. NashAffiliated withDefense Centers of Excellence for Psychological Health and TBI


Recent studies have confirmed that repeated wartime deployment of a parent exacts a toll on military children and families and that the quality and functionality of familial relations is linked to force preservation and readiness. As a result, family-centered care has increasingly become a priority across the military health system. FOCUS (Families OverComing Under Stress), a family-centered, resilience-enhancing program developed by a team at UCLA and Harvard Schools of Medicine, is a primary initiative in this movement. In a large-scale implementation project initiated by the Bureau of Navy Medicine, FOCUS has been delivered to thousands of Navy, Marine, Navy Special Warfare, Army, and Air Force families since 2008. This article describes the theoretical and empirical foundation and rationale for FOCUS, which is rooted in a broad conception of family resilience. We review the literature on family resilience, noting that an important next step in building a clinically useful theory of family resilience is to move beyond developing broad “shopping lists” of risk indicators by proposing specific mechanisms of risk and resilience. Based on the literature, we propose five primary risk mechanisms for military families and common negative “chain reaction” pathways through which they undermine the resilience of families contending with wartime deployments and parental injury. In addition, we propose specific mechanisms that mobilize and enhance resilience in military families and that comprise central features of the FOCUS Program. We describe these resilience-enhancing mechanisms in detail, followed by a discussion of the ways in which evaluation data from the program’s first 2 years of operation supports the proposed model and the specified mechanisms of action.


Resilience Family resilience Military family FOCUS FOCUS project Risk and resilience Resilience enhancement program Trauma treatment program Combat stress program Wartime deployment Family stress Military family treatment Military child and family Military family prevention