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Dissemination of Family-Centered Prevention for Military and Veteran Families: Adaptations and Adoption within Community and Military Systems of Care

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Abstract

In response to the needs of military families confronting the challenges of prolonged war, we developed Families OverComing Under Stress (FOCUS), a multi-session intervention for families facing multiple deployments and combat stress injuries adapted from existing evidence-based family prevention interventions (Lester et al. in Mil Med 176(1): 19–25, 2011). In an implementation of this intervention contracted by the US Navy Bureau of Medicine and Surgery (BUMED), FOCUS teams were deployed to military bases in the United States and the Pacific Rim to deliver a suite of family-centered preventive services based on the FOCUS model (Beardslee et al. in Prev Sci 12(4): 339–348, 2011). Given the number of families affected by wartime service and the changing circumstances they faced in active duty and veteran settings, it rapidly became evident that adaptations of this approach for families in other contexts were needed. We identified the core elements of FOCUS that are essential across all adaptations: (1) Family Psychological Health Check-in; (2) family-specific psychoeducation; (3) family narrative timeline; and (4) family-level resilience skills (e.g., problem solving). In this report, we describe the iterative process of adapting the intervention for different groups of families: wounded, ill, and injured warriors, families with young children, couples, and parents. We also describe the process of adopting this intervention for use in different ecological contexts to serve National Guard, Reserve and veterans, and utilization of technology-enhanced platforms to reach geographically dispersed families. We highlight the lessons learned when faced with the need to rapidly deploy interventions, adapt them to the changing, growing needs of families under real-world circumstances, and conduct rigorous evaluation procedures when long-term, randomized trial designs are not feasible to meet an emergent public health need.

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Acknowledgments

The authors acknowledge their profound appreciation to US service members and their families who teach us each day what it means to serve our national community and to the partnership of the Navy Bureau of Medicine and Surgery for their vision and commitment to public mental health prevention. Project FOCUS (Families OverComing Under Stress) for military families provides services to military families though a contract to the University of California—Los Angeles from the Navy Bureau of Medicine and Surgery. Dr. Lester receives research grant support from the Department of Defense, McCormick Foundation and Major League Baseball, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, R01 HD072324-01A1.

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Authors and Affiliations

  1. Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    William R. Beardslee

  2. UCLA Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA

    Lee E. Klosinski, William Saltzman, Catherine Mogil & Patricia Lester

  3. California National Guard Behavioral Health, Sacramento, CA, USA

    Susan Pangelinan

  4. Los Angeles County Department of Mental Health, Los Angeles, CA, USA

    Carl P. McKnight

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  1. William R. Beardslee
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  2. Lee E. Klosinski
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  3. William Saltzman
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  4. Catherine Mogil
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  5. Susan Pangelinan
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  6. Carl P. McKnight
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  7. Patricia Lester
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Correspondence to William R. Beardslee.

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Beardslee, W.R., Klosinski, L.E., Saltzman, W. et al. Dissemination of Family-Centered Prevention for Military and Veteran Families: Adaptations and Adoption within Community and Military Systems of Care. Clin Child Fam Psychol Rev 16, 394–409 (2013). https://doi.org/10.1007/s10567-013-0154-y

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