Understanding and Supporting the Resilience of aNew Generation of Combat-Exposed Military Familiesand Their Children

Shelley MacDermid Wadsworth

Published online: 1 October 2013

� Springer Science+Business Media New York 2013

Abstract Taking our nation to war has exposed a gen-

eration of military families and children to combat and its

consequences. Every dollar spent on bullets, trucks, fuel,

and food carried a future ‘tax’ in the form of consequences

for psychological and physical health and family relation-

ships. In this commentary, I focus on several themes that

emerge from the special collection or articles. For example,

I consider how best to define the ecological niche(s) occu-

pied by military-connected children and families. Not

surprisingly given significant gaps in our knowledge, evi-

dence regarding the well-being of military-connected

children is mixed. I also consider the multi-layered envi-

ronments within which individuals and families function,

recognizing both the challenges and opportunities they

provide. The need to respond rapidly to the evolving needs

of military families has highlighted the value of both pre-

vention science and implementation science. Public health

models emphasizing a full continuum of care that empha-

sizes not only treatment but also universal, selective, and

indicated prevention also are appealing given the uneven

density, uncertain locations, and unknown identities of

military families in civilian communities (Beardslee 2013;

Murphy and Fairbank 2013). Finally, it is important to

recognize that we are at the beginning, not the end, of the

post-war lifetimes for the new generation of veterans and

their families.

Keywords Military families � Deployment �Resilience � Development � Context

Who are military-connected children and families? Are

they beleaguered and depleted, made vulnerable by more

than a decade of high operational tempo, repeated separa-

tions, exposure to trauma, and the injuries and deaths of

loved ones and friends? Or are they resilient, committed,

and energetic patriots who constantly innovate to proac-

tively meet each new challenge and opportunity presented

by their family’s military service? Of course they are all of

these things, which is perhaps one of the most important

things to remember about them. I am very pleased to see

the publication of this special double issue collection of

articles focusing on military-connected children and fam-

ilies, and commend the journal editors for devoting so

much space to this important topic. There are many

important insights into the collection that will inform the

work of both researchers and practitioners. I focus my

commentary on several themes that emerge from the col-

lection with the goal of distilling key ‘take-away’ points.

How Best to Define the Ecological Niche(s) Occupied

by Military-Connected Children and Families?

The articles in this special collection identify a wide

variety of possible impediments to the healthy growth and

development of children exposed to war through their

parents’ military service (Paley et al. 2013). In addition to

high mobility (Astor et al. 2013; Milburn and Lightfoot

2013) and maternal underemployment (Hosek and Mac-

Dermid Wadsworth 2013), common among active com-

ponent families, and separations normally experienced by

both active and reserve component families (Paley et al.

2013), war brings longer and more worrying separations,

parental exposures to trauma, and very high levels of work

demands regardless of deployment status. Military culture

S. M. Wadsworth (&)

Military Family Research Institute at Purdue University, West

Lafayette, IN, USA

e-mail: shelley@purdue.edu

123

Clin Child Fam Psychol Rev (2013) 16:415–420

DOI 10.1007/s10567-013-0155-x

is hierarchical and often intrusive, imposing strict rules

regarding the behavior of service members and sometimes

family members as well (MacDermid Wadsworth and

Southwell 2011). Alcohol misuse (Schumm and Chard

2012), military sexual trauma (Arthur et al. 2007), and

intimate partner violence (MacDermid Wadsworth 2010)

occur at problematic levels in the military. Reserve com-

ponent families live dual lives as ‘citizen soldiers,’ with

children sometimes experiencing marginalization and even

victimization at the hands of civilian children who typically

greatly outnumber them at school (Astor et al. 2013). Most

military families, even in the active component, live, work,

attend school, and receive health care in civilian commu-

nities, subjecting them to not only the same problems with

access as experienced by civilian families but also the

problems of lack of sensitivity to or preparation for dealing

with military-connected difficulties (Paley et al. 2013.

Understanding the risks confronting military-connected

children and families also requires a thorough under-

standing of their resources (Lieberman and Van Horn 2013;

Masten 2013; Milburn and Lightfoot 2013). For example,

military service is selective, screening out candidates who

lack sufficient education, have prohibitive physical or

psychological problems, or who have committed certain

crimes. Thus, children born to young military parents in the

active component have at least one parent who is educated,

employed, and relatively healthy (Institute of Medicine

2013). Because of random drug-testing, these children have

at least one parent who is unlikely to be regularly using

illicit drugs (DrugFacts: Substance Abuse in the Military

2013).

Active component military children receive health care

at low or no cost, youth programs and prevention services,

and subsidies for access to high-quality child care, relo-

cation expenses, and housing (Hosek and MacDermid

Wadsworth 2013). Because most military members in the

active component enter service in their late teens or early

twenties, their children enter military culture at birth rather

than later and thus have ready access to peers with similar

experiences (Milburn and Lightfoot 2013). In the reserve

component, children live somewhat more complex lives

(Murphy and Fairbank 2013). On the one hand, they are

insulated from some of the demands of military life, such

as the intrusive scrutiny that can arise when living on

installations. But they also are separated from military

culture and may have difficulty accessing some of the

programs and services available to active component

families, even when they are on active status (Milburn and

Lightfoot 2013; Murphy and Fairbank 2013).

Despite the research completed in the past decade and

earlier, we do not yet thoroughly understand the ecological

niches occupied by military-connected children, and in

what ways and under what conditions, their experiences

differ systematically from those of civilian children

(Institute of Medicine 2013). Military-connected children

are exposed to an unusual combination of stressors, espe-

cially during periods when combat deployments are fre-

quent, long, and dangerous, but they also have access to an

unusual array of resources, in many cases much more

extensive than those available to civilian children who

experience frequent separations from their parents, or

whose parents do dangerous jobs (Institute of Medicine

2013). On balance, it is not yet clear what we should expect

as baseline levels of child outcomes among military-con-

nected children, nor how those track overtime in relation to

civilian children.

We not only lack information about the population of

military-connected children as a whole, but we lack

information about the specific niches occupied by children

exposed to different military circumstances. For example,

much of what is known about military families comes from

studies of male Army soldiers in the active component and

their families. Families of female service members are

often excluded from data collection or analysis because

they are such a low-density population (Institute of Medi-

cine 2013). In addition, while the service branches share

many commonalities, their missions, policies, and pro-

grams can be distinct. Children of Navy sailors have his-

torically experienced separation much more regularly than

children of Army soldiers because of the rhythms of sea

duty, but children in the latter group are much more likely

to have been exposed to a parent’s deployment to ground

combat. Children whose parents work in special operations

experience very frequent deployments with little or no

advance notice.

Not surprisingly given the gaps in our knowledge, evi-

dence regarding the well-being of military-connected

children is mixed. In this collection, Milburn and Lightfoot

(2013) summarize findings showing lower levels of risk

behaviors and similarities in levels of disorder between

military-connected children and community samples, as

well as evidence showing that military-connected children

cope well with relocation. These findings contrast with

results showing that children with military parents report

elevated levels of alcohol use, thoughts of suicide,

depressed mood, substance use, and experiences of bully-

ing, violence, victimization or gang affiliation, sometimes

linked to parents’ deployment history, and sometimes

simply to military service (Astor et al. 2013; Milburn and

Lightfoot 2013). In addition, a variety of negative sequelae

of deployment have been found, including increased levels

of anxiety, sleep disturbances and use of mental health

services among spouses and children (Murphy and Fair-

bank 2013; Paley et al. 2013), and reduced relationship

quality between spouses (Murphy and Fairbank 2013).

Given that more than two million children have

416 Clin Child Fam Psychol Rev (2013) 16:415–420

123

experienced the deployment of a parent, more than 90

percent of whom attend school in civilian communities

throughout the country, developing a more precise under-

standing of their circumstances is very important (Astor

et al. 2013).

Pushing Ahead to the Next Wave of Research

This collection exemplifies a ‘third wave’ of scholarship

about military families conducted during the war. The first

wave, early in the conflict, comprised ‘think pieces’ and

primarily descriptive studies aimed at beginning to assess

the degree to which children and their parents were expe-

riencing difficulties as a function of deployment experi-

ences. Thought-provoking contributions from this wave

include articles by (Cozza et al. 2005), Bowling and

Sherman (2008). In the second wave, samples became

larger, designs became more rigorous, and the breadth of

description widened, sometimes with an epidemiological

focus. Examples of studies during this wave included

Chandra et al. (2010) examination of children applying to

Operation Purple Camps and (Mansfield et al. 2011) ana-

lysis of population data regarding health care claims. The

third wave, now well underway, comprises studies focused

less on description and more on explanation, presenting

new theoretical insights, lessons learned from attempts to

intervene, and identification of within-group diversity.

With at least two large longitudinal studies of families

underway, the fourth wave of research is on the horizon.

I applaud the efforts by Nash and Litz (2013) (Kaplow

et al. 2013) to develop new constructs and apply familiar

ones to the military population for the first time, and

exemplars of the third wave of research described above.

Nash and Litz contribute to the vigorous discussion about

the existence and nature of secondary traumatization,

proposing that not only just fear, but also shame and guilt

that cause ‘moral injuries’ by pushing moral cognition past

the breaking point can propel traumatic distress throughout

families. Kaplow et al. (2013) expand our understanding of

grief, proposing taxonomy for both normative and non-

normative grief, and cataloging several types of accom-

panying distress. They make the important point that grief

can emerge not only just in the aftermath of death, but also

during the anticipation of an upcoming separation or in

relation to other deployment-related events.

The authors contributing to this collection use a variety

of theoretical perspectives to organize their work, but

several clear themes emerge. One is that the developmental

timing of events likely matters: Younger and older children

have different capabilities; relocations during the summer

may have different consequences than relocations during

the school year; parental separations that occur while

internal working models of attachment are being con-

structed may be more consequential than those at other

times (Lieberman and Van Horn 2013; Masten 2013). This

presents significant challenges for researchers and policy

makers, as rates of development vary both across and

within children (e.g., physical and cognitive development

are not always well synchronized). Second, children are

embedded within multiple systems that affect their devel-

opment and well-being (Murphy and Fairbank 2013; Paley

et al. 2013; Saltzman et al. 2013). Within families, both

parent–child and marital relationships are consequential.

Beyond families, education, health care, and government

institutions, all influence children’s access to resources and

support and may or may not do so in ways that fit chil-

dren’s needs well (Astor et al. 2013; Cozza et al. 2013).

Organizing and coordinating these systems is a formidable

challenge. Finally, these multiple systems are interdepen-

dent, influencing each other overtime (Link and Palinkas

2013; Paley Lester and Mogil 2013). Both resources and

risks can accumulate and multiply overtime, forming

positive or negative cascades (Masten 2013), and may

originate from within or beyond families.

Families as Systems

A key unifying theme of this collection is the recognition

that families operate as systems. While this may seem

obvious, the early application of general systems theory to

families and other social groups was transformational,

providing a framework and language for the dynamics

therapists had long observed as families repeatedly

maneuvered to maintain their equilibrium despite external

forces pressing for change. Today, rhetoric in military and

veteran circles often emphasizes the importance of fami-

lies, but programs, policies, and practices sometimes lag

behind, as Glynn (2013) observes in her commentary.

When families are studied, they are often examined as

potential sites for and sources of ‘collateral damage’ as a

function of military service or deployment, but the articles

in this collection emphasize that families can also be

wellsprings of resources and support.

In the civilian world, decades of research have made it

clear that children’s well-being is tightly tied to that of

their parents (Paley Lester and Mogil 2013; Lieberman and

Van Horn 2013). In military families too, deployments or

other demands of military life are not experienced just by

the service member, or even FIRST by the service member.

Instead, deployment ‘happens’ to each member of the

family (Paley Lester and Mogil 2013). Paley et al. (2013)

also emphasize the interdependencies among marital, par-

ent–child, and co-parenting relationships, whereby

dynamics within one relationship can affect dynamics in

Clin Child Fam Psychol Rev (2013) 16:415–420 417

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the others. Masten (2013) and Beardslee (2013) remind us

that this spillover across relationships can create cascades

that spread the currents of both positive and negative

influences throughout families overtime (Masten 2013).

For a variety of reasons, including well-intentioned

eagerness to draw attention to the sacrifices of military

families, there may be an inclination to focus on their

vulnerabilities and to view them as passive recipients of

excessive and burdensome military demands, at the

expense of recognizing their considerable resiliency and

internal resources. While there is considerable evidence

that deployment can be corrosive for families, Saltzman

et al. (2013) challenge this view by identifying powerful

ways in which families are, or can be resourceful actors,

not just passive ‘victims’ of military demands. For exam-

ple, parents who can competently manage their own

emotional expressions engage their children in develop-

mentally appropriate discussion of children’s emotions,

and mobilize support processes can do a great deal to

buffer the potential negative impacts of parental separation

or other challenges.

Another obvious theme running through the collection is

the importance of meaning making. The most destructive

events humans face are those that fracture their belief in a

positive future (Kaplow et al. 2013; Nash and Litz 2013). In

order to recover from traumatic experiences, individuals

must find ways to construct meaning that restores their

confidence (Beardslee 2013). Families who exhibit resil-

ience must construct shared meaning of their challenging

experiences. Saltzman et al. (2013) illustrate this point by

describing a specific set of activities within the FOCUS

program, where individual family members are invited to

explain their individual perspectives about events experi-

enced during a recent deployment and then to collabora-

tively construct a ‘picture’ of their experiences, thus creating

shared meaning. Nash and Litz (2013) argue that moral

injuries occur when individuals’ worldviews are destroyed,

and that only with forgiveness (of self or others) can a sense

of meaning be restored. Finally, Kaplow et al. (2013) invoke

the importance of meaning making in the aftermath of

wounds, injuries, or death, when family members may

struggle to develop shared confidence about a hopeful future.

One challenge for researchers raised by these perspec-

tives and findings is how best to map the boundaries of

‘typical’ or ‘normative’ stressors for military-connected

children and families, as distinct from stressors that cross

into catastrophic territory (Paley et al. 2013). Lieberman

et al. (2013, p. 5) phrase it nicely: ‘What kinds of parental

separations produce ‘‘developmentally expectable, mild-to-

moderate stress,’’ versus ‘‘intense, pervasive, and chronic

stress.’’’

We also must be cautious not to overgeneralize findings

from prior wars regarding consequences for family life of

parental experiences during war. While many studies

document negative legacies of the Holocaust or military

service in Vietnam for children of survivors, findings of

psychological symptoms in later generations are more

likely when samples comprise members of the older gen-

eration who display clinical symptoms (MacDermid

Wadsworth 2010). While there is good evidence that par-

ents whose war-related experiences have already resulted

in psychological symptoms or diagnoses will be more

likely to experience difficulties in their relationships with

their spouses and children, who in turn also may be more

likely to experience symptoms (Institute of Medicine

2013), evidence regarding outcomes for children whose

parents are free of negative sequelae is less consistent

(Milburn and Lightfoot 2013).

Development in Context

Masten (2013) and others argue persuasively that levels

and targets of vulnerability among children to war-related

challenges will vary as a function of their developmental

status. For example, young children might be especially

vulnerable to separation because their internal working

models of attachment are still under construction. Such

patterns would echo those observed by Glen Elder in his

study of two groups of children who encountered the Great

Depression at different developmental periods (Brooks

et al. 1991), with younger children whose identities were

less fully formed exhibiting more serious and persistent

negative consequences than older children, sometimes

lasting well into adulthood.

Adolescents can face particularly challenging binds

(Milburn and Lightfoot 2013; Paley et al. 2013). Their

more advanced developmental status increases the likeli-

hood that they can experience positive consequences of

their parent’s military service, such as playing an important

role in helping the family to cope with daily challenges.

But it also increases the likelihood that they will face

expectations that exceed their resources, ‘adultifying’ them

in stressful ways. They are also cognitively more able than

young children to understand the magnitude of the risks

faced by deployed parents, potentially increasing their

worry, fear, and anxiety (Milburn and Lightfoot 2013).

Masten and others embed their understanding of indi-

vidual development within the larger context of families

and society. For example, Saltzman et al. (2013) nicely

interweave developmental and relational dynamics, illus-

trating how parents can scaffold experiences that foster the

development of children’s socio-emotional skills. Astor

et al. (2013) focus on schools, identifying how they can

become places that encourage children to feel safe, cared

about, and that they belong. Murphy and Fairbank (2013)

418 Clin Child Fam Psychol Rev (2013) 16:415–420

123

consider civilian communities, identifying ways in which

lack of awareness or understanding of key aspects of mil-

itary culture might unintentionally limit the effectiveness

of assistance to military members and their families.

Practical Rigor at the Intersection of Research,

Practice, and Policy

The past decade has intensified the intersection of scientific

understanding, policy, and program development with

regard to military families. Taking our nation to war has

exposed a generation of military families and children to

combat and its consequences. Every dollar spent on bullets,

trucks, fuel, and food carried a future ‘tax’ in the form of

consequences for psychological and physical health and

family relationships. Even in periods of relative peace,

thousands of military families experience separations,

relocations, and work stressors, and unless operational

tempo reverses a 30 year trend, deployments will remain a

prominent feature of military service as the force shrinks in

the coming years.

Researchers, practitioners, and others have exerted

considerable innovation and creativity to respond to the

evolving challenges faced by military families (Murphy

and Fairbank 2013). The pressure of families’ distress,

combined with gaps in programming tailored to military

families’ experiences, has not been easily compatible with

the scientific need for evidence gathered through rigorous

longitudinal randomized trials. Murphy and Fairbank

(2013) and Milburn and Lightfoot (2013) catalog a wide

variety of new innovations, including the development of

new and adapted treatments, new ways of organizing

treatment, policy initiatives, mechanisms for training

helping professionals or parents, the development of peer

networks for adults and children, and technological solu-

tions. Although in several instances, programs were con-

strained from gathering baseline data or incorporating

randomized control groups, and investigators have instead

incorporated extensive intake and outcome data, careful

process evaluation, or made other attempts to distill lessons

from their implementation experience.

Another impetus for innovation has been the growing

recognition that services for military families cannot be

delivered exclusively through military installations. The

accessibility of installation-based facilities has decreased

with base realignment and closures. The dispersion of mil-

itary families into civilian communities far away from units

or installations has increased with the privatization of mili-

tary housing and reorganization of the reserve component.

Many organizations are now grappling with questions about

the role and even the definition of communities as they relate

to military families. Certainly, communities are defined by

geography—the cities, towns, and rural areas where military

families live, work, attend school, or receive services.

Communities are also defined by affiliation, such as the

communities of behavioral health professionals, educators,

and veterans service organizations that have mobilized on

behalf of military and veteran families. The special collec-

tion offers several interesting examples of mobilizing

communities around families, lessening the burden on

families themselves to untangle red tape or navigate

bureaucratic labyrinths. The Breakthrough Collaborative

Series (Murphy and Fairbank 2013) helps transform com-

munity-based agencies providing behavioral health services

to prepare to more effectively help clients with military

experience. The Interstate Compact on Educational Oppor-

tunities for Military Children has engaged almost every state

in the nation in refining administrative rules that blocked

academic progress for children who had to move from state

to state when their military parents were reassigned (Murphy

and Fairbank 2013). Astor et al. (2013) describe their efforts

to help civilian schools to become more supportive envi-

ronments for military-connected children.

The need to respond rapidly to the evolving needs of

military families has highlighted the value of both pre-

vention science and implementation science. Public health

models emphasizing a full continuum of care that empha-

sizes not only treatment but also universal, selective, and

indicated prevention also are appealing given the uneven

density, uncertain locations, and unknown identities of

military families in civilian communities (Beardslee 2013;

Murphy and Fairbank 2013). The demands of large-scale

and widespread community-based implementation have

propelled scientific innovations that would have been

unlikely in more traditional intervention models. Examples

include, but are not limited to, the extensive technological

capabilities across multiple platforms, impressive reporting

structures, and diverse delivery formats built as part of the

implementation of FOCUS around the world (Beardslee

2013). Careful observation and data gathering focused on

the implementation process itself will help to maximize

program effectiveness.

Policy makers are also important parts of the science-

policy-program puzzle, including not only legislators at

multiple levels of government, but also regulators,

employers, and others who interpret, enforce, and imple-

ment policies. Here too, the intersection takes on particular

urgency during war time. How should decision makers

weigh to the allocation of resources among high-quality

care for military children, pay for treatment for combat-

related psychological disorders, or buy better body armor

for service members? In their eagerness to push for pro-

grams that rapidly deliver services, policy makers may be

tempted to overlook the importance of baseline data and

rigorous evaluation designs.

Clin Child Fam Psychol Rev (2013) 16:415–420 419

123

What should readers take away from this thought-pro-

voking collection of articles? I suggest the following: (1)

Don’t assume, oversimplify, or pathologize military fami-

lies—there are many reasons to expect resilience, but also

good reasons to watch for vulnerability; (2) Fully engage

families as systems, aiming to mobilize their resiliency-

enhancing mechanisms as well as minimizing their nega-

tive qualities; (3) Try to think carefully about the full

continuum from individual development to family context,

to community environments—all can be activated to help,

but all can pose barriers as well; and (4) Recognize that we

are at the beginning, not the end, of the post-war lifetimes

for the new generation of veterans and their families. In

addition, every day thousands of military members and

many other workers are separated from their children,

many for jobs that carry substantial risk. These lessons and

others being learned today about military and veteran

families may apply much more broadly, of course, and

have the potential to enhance the lives of many other

families who face demands from difficult jobs, challenging

communities, or personal strife.

Acknowledgments I am very appreciative to Patricia Lester and

Blair Paley for helpful suggestions during the preparation of this

commentary.

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