Long-term Effectiveness of Family-level Intervention for U.S. Military Children and Families Affected by Wartime Deployments
Family-level preventive intervention can lead to improved behavioral health outcomes for military families affected by wartime deployment, a new study published in the January 2016 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) reports. Results highlight significant reductions in anxiety and depression symptoms among deployed parent, home-based parent and their children after intervention.
The wars in Iraq and Afghanistan have resulted in the deployment of more than 2.5 million service members since 2001, with the majority of those service members experiencing one or more deployments. Approximately 45% of those deployed have dependent children. The intervention approach FOCUS (Families Overcoming Under Stress) uses a family-centered methodology to address the impact that traumatic and stressful situations, like parental deployment, have on each member of a family unit. Implemented in eight provider-led sessions, FOCUS is a strength-based preventive intervention designed to bridge gaps in the continuum of behavioral health care for military families and has been implemented with over 600,000 individuals in the US.
Using data from a sample of 2,615 active duty military families, living at designated military installations with a child ages 3-17, a group of researchers led by Dr. Patricia Lester, of the University of California, Los Angeles (UCLA) Semel Institute for Neuroscience and Human Behavior, examined the impact of FOCUS on behavioral health outcomes, including depression, anxiety, and child pro-social behavior over two follow up assessments. In previous studies, FOCUS was found to be feasible, acceptable, and able to demonstrate preliminary effectiveness in improving family adjustment and reducing parent and child psychological health risk symptoms. For this present study, researchers examined the sustained impact of FOCUS for each family member over time.
Overall, there was an improvement in outcomes for both the military and civilian parent with significant reductions in clinically meaningful anxiety and depression symptoms (23% at intake to 11% at follow up) these results remained relatively consistent at both follow up assessments after completion of the FOCUS intervention. Children who participated in FOCUS also saw a reduction in self-reported anxiety symptoms (from 14.5% at intake to 11.8%). Children also displayed positive prosocial behavior that continued to improve between assessments.
Based on these findings, the authors concluded that the underlying ecological framework and attention to the reverberating impact of challenges, like military service, on each member of a family system allows FOCUS to address stress at the family level. The findings of improvement for both children and parents alike provide further support for this framework, underscoring the importance and potential of family-level prevention and intervention when it comes to enhancing the well-being of military children and families.
The article “Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes” by Patricia Lester, MD, Li-Jung Liang, PhD, Norweeta Milburn, PhD, Catherine Mogil, PsyD, Kirsten Woodward, LCSW, William Nash, MD, Hilary Aralis, MS, Maegan Sinclair, MPH, Alan Semaan, BA, Lee Klosinski, PhD, William Beardslee, MD, William Saltzman, PhD (http://dx.doi.org/10.1016/j.jaac.2015.10.009) appears in the Journal of the American Academy of Child and Adolescent Psychiatry, Volume 55, Issue 1 (January 2016), published by Elsevier.
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Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families. www.jaacap.com
The journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.
the UCLA Nathanson Family Resilience Center
The UCLA Nathanson Family Resilience Center (NFRC) bridges the gap between research and practice to help families become stronger in the face of challenges. Working with communities and systems of care, they develop and evaluate high-quality, preventive services that support family relationships and child development. The UCLA NFRC also provides training to bring evidence-based, family-centered programs to agencies and community providers. Their programs and services support military and Veteran Families, new parents, at-risk adolescents, and families impacted by stress, trauma, or grief. FOCUS (Families OverComing Under Stress) is a resilience-building program of the UCLA NFRC. http://nfrc.ucla.edu/
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