Abstract
Military children and families possess many strengths and generally enjoy health, wellness, and a capacity for resilience. However, they have also faced unprecedented war-related challenges since 2001, including combat-related parental injury, illness, and death. This chapter describes the distress faced by military children and families due to these experiences and the unique parenting challenges that result. The contribution of parenting to child outcomes is well-established in the literature, although less is known about the potential effects of parenting on child outcomes in such highly stressful or traumatic settings. While several parenting and family programs have been developed to support civilian and military children, none has been designed to specifically address the difficulties faced by these highly impacted families. The author recommends applying positive parenting strategies derived from evidence-based principles to at-risk families, while connecting them to communities capable of supporting their many needs over time. Six evidence-based parenting and family intervention strategies are discussed: (1) maintaining a physically safe and structured environment, (2) engaging required community resources, (3) developing and sharing knowledge within and outside of the family that builds shared understanding, (4) building a positive emotionally safe and warm family environment, (5) mastering and modeling important interpersonal skills, including problem solving and conflict resolution, and (6) maintaining a vision of hope and future optimism for the family. The chapter concludes by highlighting the need for future research to develop and study strategies to meet the needs of these highly impacted families.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Brent, D., Melhem, N., Donohoe, M., & Walker, M. (2009). The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident or sudden natural death. The American Journal of Psychiatry, 166, 786–794.
Butera-Prinzi, F., & Perlesz, A. (2004). Through children’s eyes: Children’s experience of living with a parent with an acquired brain injury. Brain Injury, 18(1), 83–101.
Calhoun, P., Beckham, J., & Bosworth, H. (2002). Caregiver burden and psychological distress in partners of veterans with chronic posttraumatic stress disorder. Journal of Traumatic Stress, 15(3), 2015–2212.
Cerel, J., Firstad, M., Verducci, J., Weller, R., & Weller, E. (2006). Childhood bereavement: Psychopathology in the 2 years postparental death. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 681–690.
Cerel, J., Fristad, M., Weller, E., & Weller, R. (2000). Suicide-bereaved children and adolescents: II. Parental and family functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 437–444.
Chandra, A., Lara-Cinisomo, S., Jaycox, L., Tanielian, T., Burns, R., Ruder, T., & Han, B. (2010). Children on the homefront: The experience of children from military families. Pediatrics, 125(1), 16–25.
Charles, N., Butera-Prinzi, F., & Perlesz, A. (2007). Families living with acquired brain injury: A multiple family group experience. NeuroRehabilitation, 22(1), 61–76.
Chemtob, C., Nomura, Y., Rajendran, K., Yehuda, R., Schwarz, D., & Abramovitz, R. (2010). Impact of maternal posttraumatic stress disorder and depression following exposure to the September 11 attacks on preschool children’s behavior. Child Development, 81, 1129–1141.
Chesnut, R., Carney, N., Maynard, H., Patterson, P., Mann, N., & Helfand, M. (1999). Rehabilitation for traumatic brain injury. Rockville, MD: Agency for Health Care Policy and Research.
Cohen, J., & Mannarino, A. (2002). Childhood traumatic grief: Concepts and controversies. Trauma, Violence and Abuse, 3, 307–327.
Cohen, J., & Mannarino, A. (2004). Treatment of childhood traumatic grief. Journal of Clinical Child and Adolescent Psychology, 33(4), 819–831.
Cozza, S., Chun, R., & Miller, C. (2011). The children and families of combat-injured service members. In E. Ritchie (Ed.), Combat and operational behavioral health (pp. 503–534). Falls Church, VA: Office of the Surgeon General, United States Army.
Cozza, S., Chun, R., & Polo, J. (2005). Military families and children during operation Iraqi freedom. Psychiatric Quarterly, 76(4), 371–378.
Cozza, S., & Feerick, M. (2011). The impact of parental combat injury on young military children. In J. Osofsky (Ed.), Clinical work with traumatized young children (pp. 139–154). New York, NY: Guilford Press.
Cozza, S., Fisher, J., La Flair, L., Zhou, J., LaMorie, J., Grein, K., … Ursano, R. (manuscript in review). Bereaved military dependent spouses and children: Those left behind in a decade of war (2001–2011).
Cozza, S., & Guimond, J. (2011). Working with combat-injured families through the recovery trajectory. In S. MacDermid Wadsworth & D. Riggs (Eds.), Risk and resilience in U.S. military families (pp. 259–277). New York, NY: Springer.
Cozza, S., Guimond, J., McKibben, J., Chun, R., Arata-Maiers, T., & Schneider, B. (2010). Combat-injured service members and their families: The relationship of child distress and spouse-perceived family distress and disruption. Journal of Traumatic Stress, 23(1), 112–115.
Dausch, B., & Saliman, S. (2009). Use of family focused therapy in rehabilitation for veterans with traumatic brain injury. Rehabilitation Psychology, 54(3), 279–287.
Dowdney, L. (2000). Annotation: Childhood bereavement following parental death. Journal of Child Psychology and Psychiatry, 41(7), 819–830.
Easterbrooks, M., Ginsburg, K., & Lerner, R. (2013). Resilience among military youth. The Future of Children, 23(2), 99–120.
Flake, E., Davis, B., Johnson, P., & Middleton, L. (2009). The psychosocial effects of deployment on military children. Journal of Developmental and Behavioral Pediatrics, 30(4), 271–278.
Galovski, T., & Lyons, J. (2004). Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran’s family and possible interventions. Aggression and Violent Behavior, 9, 477–501.
Gawande, A. (2004). Casualties of war-military care for the wounded from Iraq and Afghanistan. New England Journal of Medicine, 351, 2471–2475.
Gewirtz, A., Forgatch, M., & Wieling, E. (2008). Parenting practices as potential mechanisms for child adjustment following mass trauma. Journal of Marital and Family Therapy, 34(2), 177–192.
Gewirtz, A., Pinna, K., Hanson, S., & Brockberg, D. (2014). Promoting parenting to support reintegrating military families: After deployment, adaptive parenting tools. Psychological Services, 11(1), 31–40.
Gewirtz, A., Polusny, M., DeGarmo, D., Khaylis, A., & Erbes, C. (2010). Posttraumatic stress symptoms among National Guard soldiers deployed to Iraq: Associations with parenting behaviors and couple adjustment. Journal of Consulting and Clinical Psychology, 78(5), 599–610.
Gibbs, D., Martin, S., Kupper, L., & Johnson, R. (2007). Child maltreatment in enlisted soldiers’ families during combat-related deployments. Journal of the American Medical Association, 298(5), 528–535.
Gilreath, T., Wrabel, S., Sullivan, K., Capp, G., Roziner, I., Benbenishty, R., & Astor, R. (2016). Suicidality among military-connected adolescents in California schools. European Child and Adolescent Psychiatry, 25(1), 61–66.
Goldberg, M. (2007). Statement of Matthew S. Goldberg, Deputy Assistant Director for National Security: Projecting the costs to care for veterans of U.S. military operations in Iraq and Afghanistan. Washington, DC: Congressional Budget Office Testimony.
Green, B., Krupnick, J., Stockton, P., Goodman, L., Corcoran, C., & Petty, R. (2001). Psychological outcomes associated with traumatic loss in a sample of young women. American Behavioral Scientist, 44(5), 817–837.
Grieger, T., Cozza, S., Ursano, R., Hoge, C., Martinez, P., Engel, C., & Wain, H. (2006). Posttraumatic stress disorder and depression in battle-injured soldiers. The American Journal of Psychiatry, 163, 1777–1783.
Hagan, M., Tein, J., Sandler, I., Wolchik, S., Ayers, T., & Luecken, L. (2012). Strengthening effective parenting practices over the long term: Effects of a preventive intervention for parentally bereaved families. Journal of Clinical Child and Adolescent Psychology, 41(2), 177–188.
Halcomb, E., & Davidson, P. (2005). Using the illness trajectory framework to describe recovery from traumatic injury. Contemporary Nurse, 19, 232–241.
Harrington-Lamorie, J., Cohen, J., & Cozza, S. (2014). Caring for bereaved military family members. In S. Cozza, M. Goldenberg, & R. Ursano (Eds.), Care of military service members, veterans and their families (pp. 257–276). Washington, DC: American Psychiatric Publishing.
Herzog, J., Everson, R., & Whitworth, J. (2011). Do secondary trauma symptoms in spouses of combat-exposed national guard soldiers mediate impacts of soldiers’ trauma exposure on their children? Child and Adolescent Social Work Journal, 28(6), 459–473.
Hidalgo, R., & Davidson, J. (2000). Posttraumatic stress disorder: Epidemiology and health-related considerations. Journal of Clinical Psychiatry, 61(Suppl. 7), 5–13.
Hisle-Gorman, E., Harrington, D., Nylund, C., Tercyak, K., Anthony, B., & Gorman, G. (2015). Impact of parents’ wartime military deployment and injury on young children’s safety and mental health. Journal of the American Academy of Child Adolescent Psychiatry, 54(4), 294–301.
Hoge, C., Auchterlonie, J., & Milliken, C. (2006). Mental health problems, use of mental health service, and attrition from military service after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295(9), 1023–1032.
Hoge, C., Castro, C., Messer, S., McGurk, D., Cotting, D., & Koffman, R. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.
Holmes, A., Cozza, S., Anderson, A., Sullivan, J., Fullerton, C., & Ursano, R. (2013). Child functioning in combat-injured military families: The moderating effects of injured service member parenting and PTSD symptoms. Seattle, WA: Society for Research in Child Development.
Holmes, A., Rauch, P., & Cozza, S. (2013). When a parent is injured or killed in combat. The Future of Children, 23(2), 143–162.
Kaltman, S., & Bonanno, G. (2003). Trauma and bereavement: Examining the impact of sudden and violent deaths. Journal of Anxiety Disorders, 17(2), 131–147.
Kelley, S., & Sikka, A. (1997). A review of research on parental disability: Implications for research and counseling practice. Rehabilitation Counseling Bulletin, 41, 105–121.
Kessler, R. (2000). Posttraumatic stress disorder: The burden to the individual and to society. Journal of Clinical Psychiatry, 61(Suppl. 5), 4–12.
Kreutzer, J., Stejskal, T., Godwin, E., Powell, V., & Arango-Lasprilla, J. (2010). A mixed methods evaluation of the Brain Injury Family Intervention. NeuroRehabilitation, 27, 19–29.
Kreutzer, J., Stejskal, T., Ketchum, J., Marwitz, J., Taylor, L., & Menzel, J. (2009). A preliminary investigation of the brain injury family intervention: Impact on family members. Brain Injury, 23(6), 535–547.
Kwok, O., Haine, R., Sandler, I., Ayers, T., Wolchik, S., & Tein, J. (2005). Positive parenting as a mediator of the relations between parental psychological distress and mental health problems of parentally bereaved children. Journal of Clinical Child and Adolescent Psychology, 34, 260–271.
LeClere, F., & Kowalewski, B. (1994). Disability in the family: The effects on children’s wellbeing. Journal of Marriage and Family, 56, 457–468.
Lester, P., Peterson, K., Reeves, J., Knauss, L., Glover, D., & Mogil, C. (2010). The long war and parental combat deployment: Effects on military children and at-home spouses. Journal of the American Academy of Child and Adolescent Psychiatry, 49(4), 310–320.
Lester, P., Stein, J., Saltzman, W., Woodward, K., MacDermid, S., & Milburn, N. (2013). Psychological health of military children: Longitudinal evaluation of a family-centered prevention program to enhance family resilience. Military Medicine, 178(8), 838–845.
Lin, K., Sandler, I., Ayers, T., Wolchik, S., & Luecken, L. (2004). Resilience in parentally bereaved children and adolescents seeking preventive services. Journal of Clinical Child and Adolescent Psychology, 33, 673–683.
Manguno-Mire, G., Sautter, F., Lyons, J., Myers, L., Perry, D., & Sherman, M. (2007). Psychological distress and burden among female partners of combat veterans with PTSD. Journal of Nervous and Mental Disease, 195(2), 144–151.
Mansfield, A., Kaufman, J., Engel, C., & Gaynes, B. (2011). Deployment and mental health diagnoses among children of US Army personnel. Archives of Pediatric and Adolescent Medicine, 165(11), 999–1005.
Mansfield, A., Kaufman, J., Marshall, S., Gaynes, B., Morrissey, J., & Engel, C. (2010). Deployment and the use of mental health services among US Army wives. New England Journal of Medicine, 362(2), 101–109.
McCarroll, J., Fan, Z., Newby, J., & Ursano, R. (2008). Trends in US Army child maltreatment reports: 1990–2004. Child Abuse Review, 17, 108–118.
Melhem, N., Porta, G., Shamseddeen, W., Payne, M., & Brent, D. A. (2011). Grief in children and adolescents bereaved by sudden death. Archives of General Psychiatry, 68(9), 911–919.
Miklowitz, D., & Goldstein, M. (1997). Bipolar disorder: A family focused approach. New York, NY: Guildford Press.
Milliken, C., Auchterlonie, J., & Hoge, C. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. Journal of the American Medical Association, 298(18), 2141–2148.
Owens, B., Kragh, J., Wenkos, J., Macaitis, J., Wade, C., & Holcomb, J. (2008). Combat wounds in operation Iraqi freedom and operation enduring freedom. Journal of Trauma-Injury Infection and Critical Care, 64, 295–299.
Pessar, L., Coad, M., Linn, R., & Willer, B. (1993). The effects of parental traumatic brain injury on the behaviour of parents and children. Brain Injury, 7(3), 231–240.
President’s Commission on Care for America's Returning Wounded Warriors. (2007). Serve, support, simplify: Report of the President's Commission on Care for America's Returning Wounded Warriors. Washington, DC.
RAND Center for Military Health Policy Research. (2008). Invisible wounds: Mental health and cognitive needs of America’s returning veterans. Arlington, VA: RAND.
Reiber, G., McFarland, L., Hubbard, S., Maynard, C., Blough, D., Gambel, J., & Smith, D. (2010). Service members and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: Survey methods, participants, and summary findings. Journal of Rehabilitation Research and Development, 47(4), 275–298.
Rentz, E., Marshall, S., Loomis, D., Casteel, C., Martin, S., & Gibbs, D. (2007). Effect of deployment on the occurrence of child maltreatment in military and nonmilitary families. American Journal of Epidemiology, 165(10), 1199–1206.
Resnik, L., & Allen, S. (2007). Using international classification of functioning, disability and health to understand challenges in community reintegration of injured veterans. Journal of Rehabilitation and Research Development, 44(7), 991–1006.
Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in children of Vietnam veterans. Hospital and Community Psychiatry, 36, 538–539.
Saltzman, W., Lester, P., Beardslee, W., Layne, C., Woodward, K., & Nash, W. (2011). Mechanisms of risk and resilience in military families: Theoretical and empirical basis of a family-focused resilience enhancement program. Clinical Child and Family Psychological Review, 14, 213–230.
Sandler, I., Ayers, T., Wolchik, S., Tein, J., Kwok, O., & Haine, R. (2003). The Family Bereavement Program: Efficacy evaluation of a theory-based prevention program for parentally bereaved children and adolescent. Journal of Consulting and Clinical Psychology, 71(3), 587–600.
Sanders, M., Kirby, J., Tellegen, C., & Day, J. (2014). The triple P-positive parenting program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34, 337–357.
Tanielian, T., & Jaycox, L. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Arlington, VA: RAND Corporation.
Urbach, J., & Culbert, J. (1991). Head-injured parents and their children: Psychosocial consequences of a traumatic syndrome. Psychosomatics, 32, 24–33.
Verhaeghe, S., Defloor, T., & Grypdonck, M. (2005). Stress and coping among families of patients with traumatic brain injury: A review of the literature. Journal of Clinical Nursing, 14(8), 1004–1012.
Wain, H., & Gabriel, G. (2007). Psychodynamic concepts inherent in a biopsychosocial model of care of traumatic injuries. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 35(4), 555–573.
Walsh, F. (2006). Strengthening family resilience (2nd ed.). New York, NY: Guilford Press.
Weaver, F., Burns, S., Evans, E., Rapacki, L., Goldstein, B., & Hammond, M. (2009). Provider perspectives on soldiers with new spinal cord injuries from Iraq and Afghanistan. Archives of Physical Medicine and Rehabilitation, 90, 517–521.
Weinstein, E., Salazar, A., & Franklin, D. (1995). Behavioral consequences of traumatic brain injury. In F. Jones, L. Sparacino, V. Wilcox, J. Rothberg, & J. Stokes (Eds.), War psychiatry (pp. 319–351). Falls Church, VA: Office of the Surgeon General, United States Army.
Wickrama, K., & Kaspar, V. (2008). Family context of mental health risk in tsunami-exposed adolescents: Findings from a pilot study in Sri Lanka. Social Science & Medicine, 64, 713–723.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Cozza, S.J. (2016). Parenting in Military Families Faced with Combat-Related Injury, Illness, or Death. In: Gewirtz, A., Youssef, A. (eds) Parenting and Children's Resilience in Military Families. Risk and Resilience in Military and Veteran Families. Springer, Cham. https://doi.org/10.1007/978-3-319-12556-5_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-12556-5_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-12555-8
Online ISBN: 978-3-319-12556-5
eBook Packages: Social SciencesSocial Sciences (R0)