Families and Deployment Hero Stories

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Families and DeploymentHero Stories Horror
Stories

• LTC (Ret) Mark Chapin, Ph.D., LISW, BCD
• Department of Social Work
• Walter Reed Army Medical Center

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The Deployment Cycle

• Deployment is a developmental crisis
• Familys experience parallels soldiers
  experience
• Source of both stress and growth
• Resiliency Model of Family Stress, Adjustment,
  and Adaptation
• Hamilton McCubbin, 1996
• Components tied to measures
• Based on ABCX Model of Reuben Hill (1949)

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Resiliency Model
Family Meaning And Schema
Stressor Events
Situational Appraisal
Family Adaptation
Family Type
Family Problem- Solving and Coping Skills
Family Resources
Pile-up of Demands
Social Support
Source McCubbin McCubbin, 1996
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Deployment Cycle
Slide courtesy of Dr. David Riggs,Center for
Deployment Psychology
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Slide courtesy of Dr. David Riggs,Center for
Deployment Psychology
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Pre-Deployment
Notification
Stressor Events
Perception of mission purpose
Family Meaning And Schema
Rumors
Open-ended deployment timing
Lack of information
Expected length of upcoming deployment
Situational Appraisal
Deployment Date
Short prep time
Family Type
Anticipated threat to soldier
Unit preparation
Family Resources
Changes in Family Dynamics
Pile-up of Demands
Social Support
Family preparation
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Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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Deployment
Change job or move
Family Meaning And Schema
Stressor Events
Child Maltreatment
Situational Appraisal
Kids reactions to war events
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Family Adaptation
Family Type
Family Problem- Solving and Coping Skills
Communication
Family Resources
Length of Deployment
Pile-up of Demands
Social Support
Loneliness
FRGs in military community vs going home to Mom
Single Parenting
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Stressors
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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Childrens Coping
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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Deployment and Spouse Satisfaction
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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Child Neglect (1-2 year olds)
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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Post Deployment
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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Post-Deployment
Changed Roles Responsibilities
Family Meaning And Schema
Stressor Events
Resilience Return to Normal
Situational Appraisal
Reunion
Family Adaptation
Family Type
Family Problem- Solving and Coping Skills
Glad for help or resentful
Single to mutual decision-making
Family Resources
Divorce or Family Distress
Pile-up of Demands
Social Support
Shift back to pre-deployment structure
Just wait til your father gets home!
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A One-Year Deployment
Changed Roles Responsibilities
Perception of mission purpose
Change job or move
Notification
Family Meaning And Schema
Expected length of upcoming deployment
Stressor Events
Deployment Date
Resilience Return to Normal
Kids reactions to war events
Open-ended deployment timing
Rumors
Situational Appraisal
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Child Maltreatment
Lack of information
Reunion
Family Adaptation
Length of Deployment
Short prep time
Family Type
Family Problem- Solving and Coping Skills
Anticipated threat to soldier
Glad for help or resentful
Communication
Single to mutual decision-making
Family Resources
Unit preparation
Family preparation
Changes in Family Dynamics
Divorce or Family Distress
Pile-up of Demands
Loneliness
Social Support
FRGs in military community vs going home to Mom
Single Parenting
Shift back to pre-deployment structure
Just wait til your father gets home!
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Deployment and PTSD

• 18 of soldiers return with diagnosable Mental
  Disorder
• All are affected by deployment
• Soldiers typically minimize symptoms on PDHA
• Symptom levels increase over next 6 months
• PTSD affects couples on multiple levels

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PTSD Effects on Intimate Relationships

• Changes roles spouse becomes caregiver r
• Changes intimacy (avoidance cluster)
• Intrusive memories and vivid re-experiencing
  symptoms can be frightening
• Arousal Cluster symptoms create irritability
• Violent outbursts precipitate dynamics of
  intimate partner violence

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PTSD Impact on Relational Problems




Riggs et al., 1998
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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PTSD and Relationship Quality
Riggs et al., 1998
Jordan et al., 1992




Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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PTSD and Partner Distress





Calhoun et al., 2002
Slide courtesy of Dr. David Riggs, Center for
Deployment Psychology
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PTSD Impacts Resilience
PTSD Behaviors
Important work or Why are we there?
Family Meaning And Schema
Stressor Events
Back to Normal or Not Quite Right
Situational Appraisal
Family Adaptation
Family Type
Family Problem- Solving and Coping Skills
Impaired
Family Resources
Parenting impacted
Pile-up of Demands
Level of Disability
Social Support
Spouse acts as social buffer
Withdrawal from Intimacy
Caregiver Burden
One-sided
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Injured Soldiers

• Crisis of whether soldier will survive, level of
  recovery/disability
• Crisis of meaning Can I still be a soldier?
• Disruption and dislocation during recovery
• Spouse torn between duty to soldier and duty to
  children
• Rapidly shifting caregiver responsibilities
• Balance between nurturing and pushing for maximum
  rehabilitation
• Re-defining family identity after disability
• Restoration of marital intimacy after disability

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Injury Impacts Resilience
Notification of Injury
Family Meaning And Schema
Are we still a Military Family?
Stressor Events
Unplanned travel
Fight to stay in or take medical retirement?
Situational Appraisal
Conflicts with extended family about care
decisions
Family Adaptation
Family Type
Family Problem- Solving and Coping Skills
Impact of TBI on cognitive skills
Family Resources
Delays in processing medical boards
Pile-up of Demands
Availability of extended family
Social Support
Cabin Fever
Needs of injured soldier vs needs of children
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Soldiers Killed in Action

• Families lose not only their soldier, but also
  undergo changes that usually take them away from
  their military connections
• Intensive initial support from military
• Casualty Assistance Officer
• Death Benefits and SGLI
• Military Funeral
• Bereavement complicated by move out of military
  housing or away from military base
• Usually return to extended family home

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Soldier Death Impact on Resiliency
Unexpected Loss
How do we go on?
Family Meaning And Schema
Stressor Events
Meaning and context of soldiers death
Situational Appraisal
Notification Trauma
Family Adaptation
Family Type
Family Problem- Solving and Coping Skills
Bereavement Process
Extended Family
Family Resources
Pile-up of Demands
400K SGLI
T.A.P.S. and other support organizations
Social Support
Military Funeral
Move household
Casualty Assistance Officer
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Resources for Families

• Military Resources
• DVBIC (Defense Veterans Brain Injury Center)
• DHCC (Deployment Health Clinical Center)
• Military One Source
• Veterans Administration
• VA Med Centers--inpatient treatment centers,
  Polytrauma centers
• RCS community based counseling service centers
• Private Organizations (just a few examples)
• SOFAR (Strategic Outreach to Families of All
  Reservists)
• DSUSA (Disabled Sports USA)
• TAPS (Tragedy Assistance Program for Survivors
• Canine Companions for Independence
• Give an Hour Foundation
• Disabled American Veterans
• Partnerships
• Intrepid Fallen Heroes Fund (Center of Excellence
  for TBI PTSD)
• VA Seamless Transition workers placed in DoD
  Medical facilities
• National Demonstration Program for
  Citizen-Soldier Support (UNC)

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QUESTIONS DISCUSSION