Family-Centered Preventive Intervention for Military Families: Implications for Implementation Science

In this paper, we report on the development and dissemination of a preventive intervention, Families OverComing Under Stress (FOCUS), an eight-session family-centered intervention for families facing the impact of wartime deployments. Specific attention is given to the challenges of rapidly deploying a prevention program across diverse sites, as well as to key elements of implementation success. FOCUS, developed by a UCLA-Harvard team, was disseminated through a large-scale demonstration project funded by the United States Bureau of Navy Medicine and Surgery (BUMED) beginning in 2008 at 7 installations and expanding to 14 installations by 2010. Data are presented to describe the range of services offered, as well as initial intervention outcomes. It proved possible to develop the intervention rapidly and to deploy it consistently and effectively.

[1]  William R. Saltzman,et al.  Families overcoming under stress: implementing family-centered prevention for military families facing wartime deployments and combat operational stress. , 2011, Military medicine.

[2]  E. Rice,et al.  Family-Based Processes Associated with Adolescent Distress, Substance Use and Risky Sexual Behavior in Families Affected by Maternal HIV , 2010, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[3]  J. Ford,et al.  Ecological resilience: working with child-related psychosocial resources in war-affected communities , 2009 .

[4]  William R. Saltzman,et al.  Evaluation of a family-centered prevention intervention for military children and families facing wartime deployments. , 2012, American journal of public health.

[5]  R. Liberman,et al.  Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research , 1998 .

[6]  E. J. Wright,et al.  A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change. , 2003, Pediatrics.

[7]  P. Lester,et al.  Developmental Predictors of Somatic Symptoms in Adolescents of Parents with HIV: A 12-Month Follow-Up , 2003, Journal of developmental and behavioral pediatrics : JDBP.

[8]  Mary Jane Rotheram-Borus,et al.  Six-year intervention outcomes for adolescent children of parents with the human immunodeficiency virus. , 2004, Archives of pediatrics & adolescent medicine.

[9]  Cale D. Palmer,et al.  A Theory of Risk and Resilience Factors in Military Families , 2008 .

[10]  W. Beardslee,et al.  Prevention of childhood depression: recent findings and future prospects , 2001, Biological Psychiatry.

[11]  Rachel M. Burns,et al.  Children on the Homefront: The Experience of Children From Military Families , 2010, Pediatrics.

[12]  S. Cozza,et al.  Military Families and Children During Operation Iraqi Freedom , 2005, Psychiatric Quarterly.

[13]  B. Leadbeater,et al.  Investing in Children, Youth, Families, and Communities: Strengths-Based Research and Policy , 2003 .

[14]  P. Jensen,et al.  Children's response to parental separation during operation desert storm. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[15]  R. DiClemente,et al.  Enhancing adoption of evidence-based HIV interventions: promotion of a suite of HIV prevention interventions for African American women. , 2006, AIDS education and prevention : official publication of the International Society for AIDS Education.

[16]  Patricia Lester,et al.  Wartime Deployment and Military Children: Applying Prevention Science to Enhance Family Resilience , 2011 .

[17]  H. Meltzer,et al.  Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. , 2000, The British journal of psychiatry : the journal of mental science.

[18]  William R. Saltzman,et al.  Trauma/grief-focused group psychotherapy: School-based postwar intervention with traumatized Bosnian adolescents , 2001 .

[19]  M. Rotheram-Borus,et al.  An intervention for parents with AIDS and their adolescent children. , 2001, American journal of public health.

[20]  T. Boat,et al.  Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities , 2009 .

[21]  G. Keitner,et al.  Evaluating and Treating Families: The McMaster Approach , 2005 .

[22]  L. Sroufe,et al.  Attachment and development: A prospective, longitudinal study from birth to adulthood , 2005, Attachment & human development.

[23]  Marni L. Kan,et al.  Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent-child relations. , 2008, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[24]  W. Beardslee,et al.  Adaptation of the preventive intervention program for depression for use with predominantly low-income Latino families. , 2009, Family process.

[25]  Laura F. White,et al.  Effect of parents' wartime deployment on the behavior of young children in military families. , 2008, Archives of pediatrics & adolescent medicine.

[26]  Mady Wechsler Segal,et al.  The Military And the Family As Greedy Institutions , 1986 .

[27]  E. J. Wright,et al.  Long-term effects from a randomized trial of two public health preventive interventions for parental depression. , 2007, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[28]  Tim S. Ayers,et al.  Long-term effects of the family bereavement program on multiple indicators of grief in parentally bereaved children and adolescents. , 2010, Journal of consulting and clinical psychology.

[29]  M. Rutter,et al.  Resilience in the Face of Adversity , 1985, British Journal of Psychiatry.

[30]  E. Werner.  Risk, resilience, and recovery: Perspectives from the Kauai Longitudinal Study , 1993, Development and Psychopathology.

[31]  W. Junek.  The Development of the Person: The Minnesota Study of Risk and Adaptation from Birth to Adulthood , 2007 .

[32]  R. Spoth,et al.  Family-Centered Preventive Intervention Science: Toward Benefits to Larger Populations of Children, Youth, and Families , 2002, Prevention Science.

[33]  W. Beardslee,et al.  Mental health services: A family systems approach. , 2004 .

[34]  R. Parritz,et al.  Behavioral inhibition and stress reactivity: the moderating role of attachment security. , 1996, Child development.

[35]  L. Beckwith,et al.  Intergenerational benefits of family-based HIV interventions. , 2006, Journal of consulting and clinical psychology.

[36]  C. Fullerton,et al.  Deployment and the probability of spousal aggression by U.S. Army soldiers. , 2010, Military medicine.

[37]  L. Jaycox,et al.  Children on the Homefront , 2010 .

[38]  M. Coye,et al.  NATIONAL RESEARCH COUNCIL AND INSTITUTE OF MEDICINE , 1998 .

[39]  Eric M. Flake,et al.  The Psychosocial Effects of Deployment on Military Children , 2009, Journal of developmental and behavioral pediatrics : JDBP.

[40]  A. Masten.  Regulatory Processes, Risk, and Resilience in Adolescent Development , 2004, Annals of the New York Academy of Sciences.

[41]  M. Rutter,et al.  Parental psychiatric disorder: effects on children , 1984, Psychological Medicine.

[42]  Patricia Lester,et al.  The long war and parental combat deployment: effects on military children and at-home spouses. , 2010, Journal of the American Academy of Child and Adolescent Psychiatry.

[43]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[44]  A. Spirito,et al.  Development of a brief coping checklist for use with pediatric populations. , 1988, Journal of pediatric psychology.