Transcript Slide 1
Debra Klemann, MS, LCPC
Cameo Borntrager, Ph.D
Amy Foster-Wolferman, MA
Psychosocial
adjustments
Family Structure Changes
Indicators of Struggles
Strategies for Schools to Help
More
than 2,000,000 children have had a
parent deployed since 2001
At least 19,000 children have had a parent
wounded in action
Over 2,000 children have lost a parent in Iraq
or Afghanistan
AGE
Active Duty Parents
National Guard and
Reserve Parents
Ages 0-5
43% (481,103)
28% (174,401)
Ages 6 to 11
32% (368,850)
52% (327,342)
Ages 12 to 18
25% (279,319)
20%(126,284)
National Center for Children in Poverty
Fear,
uncertainty, worry for the loved one’s
safety
May be exasperated by media coverage
Lengthy
deployments
Possibility of multiple deployments and short
turn around time between deployment
Children
are resilient
Expect some “normative” stress in response
to the absence of a parent
Secure attachment to a parent= foundation
for a healthy development
Threat of separation = stress
Stress can manifest into psychosocial
disturbances and a possible decrease in
functioning
Infants: Reactions in response to the
caregiver distress
Increased irritability
Sleep disruption
Eating problems
Increased periods of crying
Toddlers
More clingy to the at home parent
More resistance to daily activities
Preschoolers
Regression of previously acquired milestones
More aggressive, crying, clingy
School-Aged
Children
Aware of the threats of war and danger
Difficulty regulating emotions
Worry
Sleep difficulties
Poor attention spans
Adolescents:
Angry
Indifferent
Loss of interest in usual activities
Take on extra responsibility in the household
Feelings of being overwhelmed
Decrease in school performance, lack of
exercise, poor diet during the mother’s
deployment (Turnas 2010)
Older
children may have to take care of
younger children
Children may have increased responsibilities
Children feel an increasing need to fulfill the
role of emotional support for the parent at
home
Evidence
to suggest that parental
deployment is associated with lower test
scores (Engel et al. 2009)
May
affect levels of concentration
Increased family responsibility at home
may increase days tardy, absences, and
late homework
Some
children coping well
Interfering with children’s school functioning
and ability to learn
Student uncertainty about deployment
Perceived mental health issue of at-home parent
Increased responsibility and stress at home
Study by Chandra et al. (2009)
A
difficult time for families is reintegration
Children may want and expect attention, parent
may need space
Return may feel confusing
Described
school as a safe haven for
children, arrive early and stay late
Children are more “emotionally needy” at
school
Difficulties in accessing mental health
services
Study by Chandra et al. (2009)
Infants/Toddlers
(1-3): May not know or
remember the solider and may be slow to
warm up.
Preschoolers (3-6): May still feel guilty or
scared over separation
School-age (6-12): May want a lot of
attention
Teenagers: May act ambivalent
The Emotional Cycle of Deployment: A Military Perspective
Poor
mental health of the at-home parent
The most significant predictor of child
psychosocial functioning during wartime
deployment = parenting stress (Flake, et al. 2009)
Family
dysfunction
Lack of family supports
Child maltreatment & domestic violence
Increases during deployment and reunification
Recent
relocation
Lower SES
First separation
Existing internalizing or externalizing
disorders
Returned solider with PTSD, TBI, or
depression
Anxiety
Depression
Childhood
Traumatic Stress
Parent/Child dysfunction
Disruptive behavior
“An
exceptional experience in which
powerful and dangerous events overwhelm a
person’s capacity to cope.” (Fitzgerald & Groves)
Not an event, but a response to a stressful
experience, where one’s ability to cope and
adapt is overwhelmed and feelings of
helplessness and terror are generated
Automobile Accidents
Life-Threatening illness
Witnessing or experiencing community violence (shootings, stabbings,
robbery, fighting at home, in the neighborhood, or at school)
Natural Disasters
Terrorism
Physical or sexual abuse
Abandonment
Witnessing Domestic Violence
Death or loss of a loved one
Bullying
Neglect
Living in a chronically chaotic environment
Military deployment
Hyperarousal
Feeling scared for no reason
Feeling “crazy” or out of control
Being on guard; feeling like something bad is
going to happen
Jumping when there is a loud noise
Re-experiencing
•
Nightmares or trouble sleeping
Thinking about the trauma all the time
Flashbacks
Intrusive thoughts
Sense of Foreshortened future
o
o
Withdraw from family/friends
Decrease in interests/activities
•
Changes in affect
Feeling
o Feeling
o Feeling
o Feeling
o
anger, sometimes for no reason
shame
guilty
sadness/grief/loss
Avoidance and Numbing
Wanting to NOT think or talk about the trauma
Avoiding places, people, or things that are connecting
with the event
Not being able to remember parts of what happened
Having physical health problems and complaints
Parent-Child
Interactive Therapy (PCIT)
Trauma Focused Cognitive Behavioral
Therapy (TF-CBT)
Loss/Traumatic Grief
Childhood Traumatic Stress
Cognitive
Behavioral Intervention for Trauma
in Schools (CBITS)
Cognitive behavioral therapy or Behavioral
therapy for specific problem areas (i.e.,
anxiety, depression, disruptive behavior)
COGNITION
BEHAVIOR
EMOTION
Family
involvement
Toolbox analogy
Phase-based treatment
Treatment generalization
Support
Support
Support
Ask
kids if their family member has been
deployed
Be sensitive to timing issues
Reach out to the at-home parent see what he
or she sees as needed for their child in the
school
Be sensitive to how current events are taught
~Professor Robert Blum, as cited in AASA Toolkit: Supporting
the Military Child
Guidance/health
curriculum on increasing
coping skills
(STAR)Students, Trauma, and Resiliency:
classroom curriculum designed for increasing
coping for traumatic stress
Mentoring: matching students with a selfidentified trusted staff member who can
check in with the student throughout the
school year
1.
2.
3.
List supports: Positive people,
places, and things
Identify when and how often
to engage in these supports
Remind you student to utilize
their support plan
My
Family
Friends
Teachers
Other adults in the
community
Places
I go to relax
Places I go to socialize
Places I go in the
community
Remember
my qualities
Use positive thoughts
Talk to people when I feel
bad
See a counselor
Religious
practices and
events
Cultural practices and
events
Exercise
Healthy
Eating
Staying away from drugs
and alcohol
Going to the doctor when
sick
Use
the lists of support activities
Identify actives that can be done:
Daily
Weekly
Monthly
Remind the child to do this plan
Share plan with family, if okay
with child
Identify
cohorts of children
Initiate peer mentoring
Increase support
Education about common reactions to the
stress of deployment
Relaxation training
Progressive relaxation
Mindfulness
Feelings
identification and sharing
Cognitive therapy to challenge anxiety
provoking or negative thoughts
Social and Family Problem Solving
Address issues of loss: identify activities to
keep connection to deployed loved ones
Possibly
soldiers and their families do not
maintain the same level of recognition as
towards the start of the conflicts
Host school wide activities that show support
for veterans, soldiers, and their families
Build
positive, trusting
relationships with
students and families
Create safe, nurturing
environments
Provide consistent,
predictable routines
Create clear behavioral
expectations
Provide specific,
positive feedback often
Use
reinforcement
systems
Teach social skills
Provide pre-corrects
(reminders) and
actively supervise
Use consistent
consequences that
teach
Model
appropriate
behavior
Create behavior
support teams
Consult with
mental health
professionals
Establish and
practice emergency
procedures
Psycho-education
Students’ Trauma and
Resilience (STAR)
Self-care training and
support teams for staff
Data collection –
why is the behavior
occurring?
Are these
interventions working?
Provide
choices (build
sense of control)
Provide warnings before
changes
Intensive social skills
instruction (relaxation
techniques, coping,
anger management,
etc.)
Check-in/Check-Out
program
Mentorship
program
Behavior Support Team
Peer network
Cognitive Behavioral
Interventions for
Trauma in Schools
(CBITS) groups
Individualized
strategies to address individual
symptoms (aggression, impulsivity, short attention
span, social isolation, etc.) – Functional Behavioral
Analysis (understanding triggers and antecedents
which may be trauma based)
Trauma focused individualized counseling or therapy
Behavior support team connects student to counselor
or therapist, works with family
American Association of School Administrators. AASA toolkit: Supporting the Military
Child. (2009). Retrieved from, http://www.aasa.org/MilitaryChild.aspx
Chandra, A., Martin, L. T., Hawkins, S. A., Richardson, A., The impact of parental
deployment on child social and emotional functioning: Perspectives of school
staff. 2010 Journal of Adolescent Health. 46(2010) 218-223.
Engel R.C., Gallagher, L.B., Lyle, D.S., Military deployment and children’s academic
achievement: Evidence from Department of Defense Education Activity Schools.
Economics of Education Review 2009.
Flake, E., Davis, B.E., Johnson, P. L., The psychosocial effects of deployment on
military children. Journal of Developmental Behavior Pediatric 2009; 30: 271-8.
Jensen P., Maritn D,. Watanabe H. Children’s response to parental seperation during
Operation Desert Storm. Journal of American Academy Child Adolescent
Psychiatry 1996; 35: 433-41.
Lincoln, Alan; Swift, Erika.; Shorteno-Fraser, Mia. 2008 Psychological Adjustment
and Treatment of Children and Families with Parents Deployed in Military
Combat. Journal of Clinical Psychology 64 (8), 984-992.
Lincoln, Alan; Swift, Erika.; Shorteno-Fraser, Mia. 2008 Psychological
Adjustment and Treatment of Children and Families with Parents
Deployed in Military Combat. Journal of Clinical Psychology 64 (8), 984992.
Pincus, S.H., House, R., Christenson, Jl, Adler, L., E.The emotional cycle of
deployment a military family perspective. In Operation: Military Kids,
Ready, Set, Go! A training manual.6th Edition, Chapter 5 Us Army Med
Dep J. 2001.
Sogomonyan, F., Cooper, J. L. (2010) Trauma faced by children of military
families: What every policymaker should know. Retrieved from: Columbia
University, National Center for Children in Poverty website:
http://www.nccp.org/publications/pub_938.html.
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military deployment. Journal of Adolescent Health 46 (2010) 203-206.