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Article review

Alan J. Lincoln Ph.D. MSCP & Kathie Sweeten PsyD BCBA (2011) Considerations for the Effects of Military Deployment on Children and Families, Social Work in Health Care, 50:1, 73-84

Dr. Alan J. Lincoln and Dr. Kathie Sweeten both work for CARES – The Center for Autism Research, Evaluation, and Service. Dr. Lincoln is a Director of CARES and a professor of clinical psychology for Alliant International University. He has been keenly involved in the study and treatment of persons with autism and general developmental disorders for the past thirty years. Besides autism, Dr. Lincoln is an expert in the treatment of patients with Asperger syndrome and other severe forms of developmental psychopathology. Dr. Sweeten is a licensed clinical psychologist with a specialization in child and family therapy. She is currently one of the directors of the Center for Autism Research, Evaluation and Service. Dr. Sweeten has been working with discrete trial techniques for over twenty years. Thus, she knows perfectly how to maximize the learning of children with autism. Dr. Sweeten has helped many families to develop multiple skills, including communication, play, cognitive, social and self-help skills.

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Working for years with children who have different developmental disorders, the authors of this article understood the need for preparation of experts in this field. Thus, they decided to write this article in order to draw the attention of professionals to some of the stressors of deployment as experienced by children. Another reason to present this article to the public lays in the need for clinical considerations for those who work with the children and families of the deployed. The article provides information about the potential vulnerability of children of the deployed parent-soldiers to enable professionals to assess the psychological or behavioral problems of children and adolescents objectively. The article explains the regularities of the Cycle of Deployment and a different set of challenges on each stage of this cycle. The given information serves for the purpose of recognizing the family stressors on each level and their potential to increase. Professionals should be aware of the effects of deployment as a source of new psychological and behavioral problems. Each of the military engagement stages has its own unique circumstances, levels of risk, and potential for moderating family burden. The research can be referred to as credible ones for the authors to use valid data from reputable sources. The basis of their article is Logan’s model of the deployment process (known as The Cycle of Deployment), experienced by military families. Lincoln and Sweeten also use the data of multiple statistical researches. To name some, there are statistics by Kelly, Johnson, Flake, Davis, McFarlane, Rentz, Gibbs, Newby, Brett, Katz and others.

The point of the article is that parental stress may escalate the intensification of symptoms in a child. The deployment cycle brings another period – that of the interrelation of parental and child psychic conditions. Since parental stress affects the children, their health worsens and in turn, worrying about the child’s health affects the deployed parent’s ability to participate in the assigned theater. To work properly with children of the deployed parents, professionals should know about the effects of deployment on children, factors that escalate the level of stress, the additional sources for stress and the activities of other support centers for such families. Professionals should be aware of the main center’s principles of work; thus, they are encouraged to borrow the findings of others for their own improvement.

In this article, the authors try to answer important questions related to the military deployment effects. They attempt to explore which are the common effects of military deployment both on children and parents, thus, for the whole family. They wonder and try to identify the key stressors that escalate apprehension and psychological disorders in children. The main question they try to answer is the degree to which deployment and children’s problems depend on each other.

The author’s argumentation comes as following. Dr. Lincoln and Dr. Sweeten argue that there are two types of children’s attitudes towards the deployment of their parents. The first group consists of resilient children, who realize the importance of their parents’ work. They usually honor the responsibility and significance of the mission required of their deployed parent.

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While such children form a majority among 1.2 million children of military families, the number of children vulnerable to the effects of the parents’ deployment is also high. Using Logan’s Cycle of Deployment model, the authors explain its five successive stages: (1) Pre-Deployment (from notification to departure), (2) Deployment (from departure to return), (3) Sustainment, (4) Redeployment, and (5) Post-Deployment. Different children respond differently to the mentioned stages of deployment. It depends on the type of psychological disorder of a particular child, and on the possible irritants for the disorder. For instance, children with a separation anxiety disorder are at greater risk to experience intensification of their symptoms during pre-deployment and deployment periods.

There are three cases presented in the article to visually demonstrate and support the author’s opinion. The first case relates to the marine family and shows the negative effects of the lack of communication. The main character of this case, an active on-duty, mid-ranking marine, who reported that due to the lack of communication his family had fallen apart; thus, he lost his wife and son. The idea is developed further for the lack of communication serves as one of the most common stressors in military families. The authors suppose that the burden to such families and marriages can be mitigated if their deployment implies the potential for communication. In the context of the first case, other effects of deployment on children are mentioned. In particular, the children of a deployed parent are much more likely to reveal symptoms of stress and depression such as emotional reactivity, anxiousness/depression, somatic complaints and withdrawal, attention difficulties, and aggression. Parent’s stress is one more significant cause of childhood psychological problems. The article proves the correlation between parent’s post-traumatic stress disorder (PTSD) and the emotional condition of a child. To cope with the increasing stress disorder, parents often vent their anger on innocent children. It is one more aspect professional should take into account when working with military families, not mentioning the lack of communication, typical for such families. While separations may be frequent and sustained in non-military professions, communication is still possible under most circumstances.

The second case presents one more marine family, where a father lost his wife and son. The difference is that the ex-wife of the marine remarried to another jolly and gave birth to two more children. Thus, her oldest son has received two half-brothers. Nevertheless, even living in a full-grown family did not prevent him from having neurodevelopmental problems leading to impulsivity and increased anxiety. The given case is a vivid example of the results of limited communication, leading to fantasies. It confirms that often children fill the vacuum of specific knowledge with troubling thoughts and worries. The boy was not an exception. He had developed significant fantasy to give a good reason for the absence of his biological father. His anxiety reached its climax when the father forgot to send him a birthday card. To explain this fact somehow, the boy thought up that his father must be in Afghanistan on a dangerous mission.

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However, there are many additional sources of family stress mentioned in the article. They include increased geographical mobility, lower-income, and a higher divorce rate. The authors do not only list particular problems the military families may face, but they also suggest some solutions for that. Especially, they recommend both parents and professionals to cooperate with specialized mental health support called TRIWEST. It offers a “Behavioral Health Portal,” phone and online counseling 24/7, as well as a map that outlines the resources and service providers by state.

The third case is about a military family with two boys. One of them is Andrew, an 8-year-old boy with autism. His example demonstrates evidence of the correlation between the deployment and the worsening of Andrew’s behaviors. It also serves as proof of the TRIWEST’s practical usage. Andrew’s family was assigned to the TRIWEST agency specializing in autism. Here, the authors explain the importance of such agencies. Thus, a possible audience can find out about the work with autistic children. They can learn how to deal with aggression toward others, use profanity, and get the necessary social skills there. The program is also able to address various deficits in children’s self-help skills and provides parent training. A family could learn how to implement the programs designed to target these behaviors with the mentioned training. Children with autism can start a therapeutic relationship with the service providers, and it will help them to heal emotional distress, as it helped Andrew. The results of this approach are highly positive: the frequency of aggressive behaviors decreases and acceptance of change in routine improves. Children develop basic social and play skills. Andrew benefited greatly, and the overall stress in the family was reduced as a result. Thus, one can assume that this revealing example is some sort of advertisement, provided by the authors.

The audience of this article that is social workers, psychologists, clinical psychologists, and those who work with the children and families of the deployed, will find the ending of the article very useful. It consists of a number of clinical considerations for the given issue. After reading the article, readers are assumed to get a general understanding of the stressors of psychological problems typical for military families. The knowledge forms the preconditions for their following treatment and clinical intake assessment. The primary task for medical and mental health professionals is then to know the background information about a particular family. Therefore, a history of mental health problems in the past or during periods of previous deployments matters. The authors suggest professionals asking parents – a list of questions about the circumstances, during which one of the parents is deployed. They should also help families identify sources of social and mental health support. The military is advised to more effectively communicate with civilian professionals about available resources and programs and how such resources can be accessed. Finally, the main idea according to the article, is to prevent mental health problems instead of spending time and money on their solution.

The main conclusions of the article are as follows: parents’ stress and the lack of communication lead to the development of psychological problems in their children. The information is vitally important to the professionals of the field. Thus, military families need additional psychological attention and more time to solve their problems. Medical and mental health professionals have to receive additional training before dealing with the effects of military deployment on children.