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Risk and Resilience in Military and Veteran Families

Abigail H. Gewirtz
Adriana M. Youssef Editors

Parenting and
Children's
Resilience
in Military
Families
Risk and Resilience in Military
and Veteran Families
Series Editor
Shelley MacDermid Wadsworth
Department of Human Development and Family Studies,
Military Family Research Institute,
Purdue University,
West Lafayette, IN, USA

More information about this series at http://www.springer.com/series/11919

Abigail H. Gewirtz • Adriana M. Youssef
Editors

Parenting and Children’s

Resilience in Military Families
Editors
Abigail H. Gewirtz Adriana M. Youssef
Department of Family Social Science Institute for Translational Research in
Institute of Child Development, and Children’s Mental Health
Institute for Translational Research in University of Minnesota
Children’s Mental Health Minneapolis, MN, USA
University of Minnesota
Minneapolis, MN, USA

Risk and Resilience in Military and Veteran Families

ISBN 978-3-319-12555-8 ISBN 978-3-319-12556-5 (eBook)
DOI 10.1007/978-3-319-12556-5

Library of Congress Control Number: 2016935846

© Springer International Publishing Switzerland 2016

This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made.

Printed on acid-free paper

This Springer imprint is published by Springer Nature

The registered company is Springer International Publishing AG Switzerland
Acknowledgments

Many people in addition to authors and editors help to create a book. We thank the
following individuals for their generosity in reviewing the chapters in this book:
W. Andrew Collins, Jodi Dworkin, Christopher Erbes, Eric Flake, Marion Forgatch,
Sarah Friedman, Robin Gurwitch, Ernie Jouriles, Greg Leskin, Shelley MacDermid,
Joseph McQuade, Melissa Polusny, and Michelle Sherman. Our thanks to Diane
Timba and Alyssa Garr, for their editorial support and careful attention to detail.
Finally, we express our gratitude to our own families—husbands and children—for
allowing us to take time away from them in the service of furthering knowledge of
military families.
This book is dedicated to two pioneering family researchers: Marion Forgatch and
Gerald Patterson. Marion’s development, rigorous testing, and widespread imple-
mentation of parent training has improved the lives of many thousands of families
across the globe. Jerry, a World War II veteran awarded the Bronze Star and Purple
Heart for his courage and bravery, has shown us through a lifetime of research how
effective parenting is crucial to children’s well-being.

v
Contents

1 Parenting and Children’s Resilience in Military Families:

A Twenty-First Century Perspective ..................................................... 1
Abigail H. Gewirtz and Adriana M. Youssef
2 The Impact of Military Life on Young Children
and Their Parents.................................................................................... 11
Phillip Stepka and Kristin Callahan
3 Parenting School-Age Children and Adolescents
Through Military Deployments ............................................................. 27
Anita Chandra
4 Placing Fatherhood Back in the Study and Treatment
of Military Fathers .................................................................................. 47
David S. DeGarmo
5 Military Mothers ..................................................................................... 65
Rachel Barnes, Sharon A.M. Stevelink, Christopher Dandeker,
and Nicola T. Fear
6 The Special Case of Civilian Service Members:
Supporting Parents in the National Guard and Reserves ................... 93
Amanda L. Schuh, Michelle Kees, Adrian Blow, and Lisa Gorman
7 Parents’ Childhood Exposures to Traumatic Events
and Current Functioning in Military Families..................................... 109
Allison Flittner O’Grady, Shelley MacDermid Wadsworth,
and Patricia Lester
8 Child Maltreatment and Intimate Partner Violence
in Military Families................................................................................. 131
Amy M. Smith Slep and Richard E. Heyman

vii
viii Contents

9 Parenting in Military Families Faced with Combat-Related

Injury, Illness, or Death .......................................................................... 151
Stephen J. Cozza
10 Parenting and the Military: The Case of Israel ................................... 175
Rachel Dekel, Rivka Tuval-Mashiach, and Yaara Sadeh
11 Interventions to Support and Strengthen Parenting
in Military Families: State of the Evidence .......................................... 195
Jennifer DiNallo, Michelle Kuhl, Lynne M. Borden,
and Daniel Perkins
12 Prevention and Treatment for Parents of Young Children
in Military Families................................................................................. 213
Ellen R. DeVoe, Ruth Paris, and Michelle Acker
13 Evidence-Based Parenting Programs for School-Aged Children ....... 229
Adriana M. Youssef, Alyssa S. Garr, and Abigail H. Gewirtz
14 Parenting Programs and Supports for Teens
in Military Families................................................................................. 251
Michelle D. Sherman and Patti L. Johnson
15 Military Parenting in the Digital Age: Existing Practices,
New Possibilities ...................................................................................... 265
Kelly A. Blasko and Pamela R. Murphy
16 How do Military Family Policies Influence Parenting
Resources Available to Families? ........................................................... 283
Yuko K. Whitestone and Barbara A. Thompson
17 Conclusions and a Research Agenda for Parenting
in Military Families................................................................................. 299
Abigail H. Gewirtz and Adriana M. Youssef

Index ................................................................................................................. 307

Contributors

Michelle Acker, Psy.D. Boston University School of Social Work, Boston, MA,
USA
Rachel Barnes, M.Sc. King’s Centre for Military Health Research, King’s College
London, Weston Education Centre, London, UK
Kelly A. Blasko, Ph.D. National Center for Telehealth and Technology, Joint Base
Lewis-McChord, Tacoma, WA, USA
Adrian Blow, Ph.D. Human Development and Family Studies, Michigan State
University, East Lansing, MI, USA
Lynne M. Borden, Ph.D. University of Minnesota, St. Paul, MN, USA
Kristin Callahan, Ph.D. Department of Psychiatry, Louisiana State University
Health Sciences Center, New Orleans, LA, USA
Anita Chandra, Dr.P.H. RAND Corporation, Arlington, VA, USA
Stephen J. Cozza, M.D. Department of Psychiatry, Uniformed Services University
of the Health Sciences, Bethesda, MD, USA
Christopher Dandeker, Ph.D. King’s Centre for Military Health Research, King’s
College London, Weston Education Centre, London, UK
David S. DeGarmo, Ph.D. Department of Educational Methodology, Policy, and
Leadership, Prevention Science Institute, Center for Assessment, Statistics, and
Evaluation, University of Oregon, Eugene, OR, USA
Rachel Dekel, Ph.D. The Louis and Gabi Weisfeld School of Social Work, Bar
Ilan University, Ramat Gan, Israel
Ellen R. DeVoe, Ph.D., L.I.C.S.W. Boston University School of Social Work,
Boston, MA, USA

ix
x Contributors

Jennifer DiNallo, Ph.D. Clearinghouse for Military Family Readiness, The

Pennsylvania State University, State College, PA, USA
Nicola T. Fear, D.Phil., O.X.O.N. King’s Centre for Military Health Research,
King’s College London, Weston Education Centre, London, UK
Alyssa S. Garr, B.A. Institute for Translational Research in Children’s Mental
Health, University of Minnesota, Minneapolis, MN, USA
Abigail H. Gewirtz, Ph.D., L.P. Department of Family Social Science, Institute of
Child Development, and Institute for Translational Research in Children’s Mental
Health, University of Minnesota, Minneapolis, MN, USA
Lisa Gorman, Ph.D. Michigan Public Health Institute, Okemos, MI, USA
Richard E. Heyman, Ph.D. Family Translational Research Group, Cariology and
Comprehensive Care, New York University, New York, NY, USA
Patti L. Johnson, Ph.D. Child, Adolescent, and Family Behavioral Health Office,
Tacoma, WA, USA
Michelle Kees, Ph.D. Department of Psychiatry, University of Michigan, Ann
Arbor, MI, USA
Michelle Kuhl, Ph.D. University of Minnesota, Minneapolis, MN, USA
Patricia Lester, M.D. Nathanson Family Resilience Center, University of
California Los Angeles, Los Angeles, CA, USA
Shelley MacDermid Wadsworth, Ph.D. Military Family Research Institute,
Purdue University, West Lafayette, IN, USA
Pamela R. Murphy, Psy.D. Private Practitioner, Menard, TX, USA
Allison Flittner O’Grady, Ph.D. Military Family Research Institute, Purdue
University, West Lafayette, IN, USA
Ruth Paris, Ph.D., L.I.C.S.W. Boston University School of Social Work, Boston,
MA, USA
Daniel Perkins, Ph.D. University of Minnesota, St. Paul, MN, USA
Yaara Sadeh, M.S.W. The Louis and Gabi Weisfeld School of Social Work, Bar
Ilan University, Ramat Gan, Israel
Amanda L. Schuh, M.S., R.N. School of Nursing, University of Michigan, Ann
Arbor, MI, USA
Michelle D. Sherman, Ph.D. Broadway Family Medicine, University of
Minnesota, Minneapolis, MN, USA
Amy M. Smith Slep, Ph.D. Family Translational Research Group, Department of
Cariology and Comprehensive Care, New York University, New York, NY, USA
Contributors xi

Phillip Stepka, Psy.D. Department of Psychiatry, Louisiana State University

Health Sciences Center, New Orleans, LA, USA
Sharon A.M. Stevelink, Ph.D. King’s Centre for Military Health Research, King’s
College London, Weston Education Centre, London, UK
Barbara A. Thompson Department of Defense, Office of Family Readiness
Policy, Office of Deputy Assistant Secretary of Defense for Military Community
and Family Policy, Alexandria, VA, USA
Rivka Tuval-Mashiach, Ph.D. Department of Psychology, Bar Ilan University,
Ramat Gan, Israel
Yuko K. Whitestone, Ph.D. Department of Defense, Office of Family Readiness
Policy, Office of Deputy Assistant Secretary of Defense for Military Community
and Family Policy, Alexandria, VA, USA
Adriana M. Youssef, Ph.D. Institute for Translational Research in Children’s
Mental Health, University of Minnesota, Minneapolis, MN, USA
Chapter 1
Parenting and Children’s Resilience
in Military Families: A Twenty-First Century
Perspective

Abigail H. Gewirtz and Adriana M. Youssef

Introduction

This book aims to provide a twenty-first century perspective on families in the mili-
tary, one that views parenting as the engine of the military family. This new perspec-
tive reflects a shift away from an emphasis on individual differences toward
understanding individuals within their social context. Such a shift provides a crucial
opportunity to understand children and parents as nested within families, and fami-
lies as nested within a larger military context. The theoretical stream that attempts
to understand the development and adjustment of individuals within their social
context includes developmental–ecological models (e.g. Bronfenbrenner, 1986),
risk and resilience perspectives (e.g. Garmezy, 1991), and transactional models of
development (e.g. Sameroff, 2009). All these theoretical models consider the effects
of both proximal (e.g. family) and distal (e.g. society) contexts on the individual—
and the individual’s influence on his/her contexts (i.e. bidirectional or transactional
effects).
Military families are nested within a broader military context whose pervasive
influence affects many aspects of family life. For example, when a parent is
deployed, the military controls many aspects of that person’s daily life, including
the ability to communicate with family at home. Once the Service member has

A.H. Gewirtz, Ph.D., L.P. (*)

Department of Family Social Science, Institute of Child Development, and Institute
for Translational Research in Children’s Mental Health, University of Minnesota,
Minneapolis, MN, USA
e-mail: agewirtz@umn.edu
A.M. Youssef, Ph.D.
Institute for Translational Research in Children’s Mental Health, University of Minnesota,
Minneapolis, MN, USA
e-mail: herre064@umn.edu

© Springer International Publishing Switzerland 2016 1

A.H. Gewirtz, A.M. Youssef (eds.), Parenting and Children’s Resilience in
Military Families, Risk and Resilience in Military and Veteran Families,
DOI 10.1007/978-3-319-12556-5_1
2 A.H. Gewirtz and A.M. Youssef

returned home, however, s/he must take leadership, once again, within the family.
The shift in context is stark, and often abrupt, and little research has examined the
impact on parenting. However, a considerable body of research has demonstrated
that parents are powerful drivers of their children’s development and adjustment
(Collins, Maccoby, Steinberg, Hetherington, & Bornstein, 2000). Effective parent-
ing is a strong predictor of children’s resilience and is particularly important in
times of stress (Masten, 2001).
Since the Global War on Terror (GWOT) began after the terrorist events of 9/11,
more than 2.7 million US Service members have been deployed to war in
Afghanistan, and, subsequently, Iraq. Nearly half of these Service members are
partnered, and 1.3 million are parents (Defense Manpower Data Center, 2015).
Approximately 1.98 million children have been affected by the deployment of a
parent to Iraq or Afghanistan (Department of Defense, 2009). In the wake of these
recent conflicts, the past decade has seen a proliferation of military family research.
It is surprising that far less research has focused on parenting, per se.
Twenty-first century wars have differed from prior conflicts in ways that increase
the need for attention to parenting in military families. These differences include (a)
the unprecedented reliance on the Reserve Component (i.e., National Guard and
Reserves, NGR; Institute of Medicine (US), 2010), (b) the higher proportion of
female Service members than in prior conflicts, and (c) the changing nature of inju-
ries in these conflicts. NGR personnel, sometimes known as weekend warriors, tend
to be older than active duty personnel and hence are more likely to be partnered and
parenting. Few NGR personnel prior to 9/11 considered the possibility of deploy-
ment to war, let alone the multiple, often lengthy deployments that many subse-
quently experienced. Indeed, the longest single deployment in the recent conflicts
was the 22-month long deployment of the Minnesota Army National Guard’s first
Brigade Combat Team in 2007 (H.CON.RES.185).
The increase in female Service members has meant that for the first time, the US
Military has deployed mothers to war in significant numbers, an issue rarely dis-
cussed in the military family literature (see, e.g. Gewirtz, McMorris, Hanson, &
Davis, 2014). In fact, this is arguably the military family arena in which research
most lags behind practice and policy. Kelley’s research on deployed Navy mothers
during the Gulf War was the only empirical work published on deployed mothers
from the 1990s until the end of the first decade of the recent wars (see, e.g., Kelley,
Hock, Jarvis, Smith, Gaffney, & Bonney, 2001). Despite the lack of research, recent
policy and practice changes have been significant giving permission for women to
serve in combat positions, and paying attention to the high rates of sexual assault in
the military and its treatment of sexual harassment and assault crimes (National
Defense Research Institute, 2014). We continue to have very little knowledge
regarding the impact of military service and deployment, in particular, on mother-
hood. Furthermore, empirical knowledge regarding children’s adjustment in rela-
tion to maternal separation due to deployment is, as yet, lacking.
A third factor that distinguishes recent and prior conflicts is the far higher sur-
vival rates of injured Service members. The nature of these conflicts, fought by
insurgents with improvised explosive devices, resulted in large numbers of what has
1 Parenting and Children’s Resilience in Military Families: A Twenty-First… 3

been termed the signature injury of the conflicts: traumatic brain injury (Polusny
et al., 2011). Other injuries, such as loss of limbs, facial injuries, and posttraumatic
stress disorder, were also evidenced at higher rates than in prior wars (Polusny et al.,
2011). Moreover, thanks to remarkable advances in military medicine, battlefield
survival is higher than ever before. Service members who would not have survived
their injuries in previous conflicts are now returning home and require care for their
injuries and their altered state of physical and psychological functioning.
Understanding how to support these Service members in their roles as parents is a
crucial aspect of the new normal.
The length of the conflicts in Iraq and Afghanistan, together with the three dis-
tinguishing factors mentioned above, has significantly changed the landscape of life
for military families. The impact on NGR families of lengthy, multiple parental
deployments, and the return of many Service members with traumatic brain injury,
other physical injuries, and PTSD, has fundamentally changed the lives of many of
our nation’s military children and youth, by their impact on the functioning of their
parents. These themes are infused throughout our book, but specifically in chapters
focused on unique issues for deployed mothers, families in the National Guard, and
parenting in the context of death or injury.
What do we know about the experience of parenting in military families? As a
system, the military family is a powerful promoter of the values inherent to the mili-
tary: service, loyalty, discipline, and commitment. When a parent chooses to serve
his or her country (whether that choice was made before or after the individual
became a parent—and typically it is before) the whole family serves. Children and
spouses serve—voluntarily or otherwise—by accommodating to the nature and
rhythm of military life, including multiple family moves for many active duty fami-
lies and absences due to deployments for all Service member families. They serve
by ensuring that family life continues while the Service member is gone, by dealing
with the worries and anxiety associated with a parent or partner being in harm’s
way, and by preparing for and accommodating the Service member’s return, some-
times as a changed person. And of course, when a Service member is killed in the
service of the country, this ultimate sacrifice reverberates permanently throughout
the family.
For many of the 1.98 million children affected by the deployment of parents,
their formative years have been spent experiencing one or both parents preparing to
deploy, deploying, or reintegrating after deployment. The literature on the psycho-
social effects of deployment on children is now burgeoning. Much of that literature
highlights how children’s adjustment is connected to the mental health of their par-
ents, although numerous studies have found strong associations between parents’
mental health and their parenting practices (e.g., Bailey et al., 2013). Far less
research connects children’s adjustment to their caregivers’ parenting. Yet, the
broader developmental and family psychology literature has established an irrefut-
able link between parenting and children’s adjustment and resilience (e.g. Collins
et al., 2000).
Parenting refers to “the process of taking care of children until they are old
enough to take care of themselves” (Merriam-Webster dictionary). Parents are their
4 A.H. Gewirtz and A.M. Youssef

children’s primary and first socialization agents. Although parenting may be consid-
ered just one element of the family system (the path from parent to child), research
has demonstrated the mutual influences of parenting not simply for children, but
also for the individual adjustment of parents, for the adjustment of the couple, sib-
lings, and for the family as a whole. For example, a parent-training intervention
targeting stepfamilies demonstrated that improved parenting led not simply to
improvements in children’s adjustment, but also improved observed and reported
couple adjustment (Bullard et al., 2010). A similar study aimed at single mothers
demonstrated that improvements in parenting led to reductions in maternal depres-
sion and substance use as well as later improvements in maternal income, educa-
tion, and occupation (Patterson, Forgatch, & DeGarmo, 2010).
An overarching framework for this book is that parenting mediates the impact of
stressful events on children. Explicitly or otherwise, several of the chapters in this
book utilize a family stress model (e.g. Conger et al., 2002). These models propose
that contextual events (e.g., deployment, marital transitions, socioeconomic stress-
ors) cause parents to feel stressed; this stress in turn impairs parenting and disrupts
children’s adjustment. While family stress models provide the contours of how
external stressors might impair family functioning and child adjustment, the details
of the moment-by-moment interactions between parents and their children that
result in disruptions in child adjustment are offered by Gerald Patterson’s social
interaction learning (SIL) model. Patterson and colleagues’ extensive research has
shown how stressed parents interact in a more coercive manner with their children
(i.e., using more negative reinforcement, negative reciprocity, and aversive behav-
iors), reinforcing children’s experience that conflict bouts are won using negative
tactics, leading to children’s use of coercion in settings outside the home, and dis-
rupting children’s development and adjustment (Patterson et al., 2010). Coercion is
a powerful shaper of behavior but—fortunately—so is positive parenting (Patterson
et al., 2010). Prevention research has demonstrated that improving parenting is
effective and leads to cascading positive changes throughout the family system (see,
e.g., Patterson, Forgatch, & DeGarmo, 2010; Sandler, Schoenfelder, Wolchik, &
MacKinnon, 2011).
Understanding parenting, and parent–child relationships, and using that knowl-
edge for prevention and intervention, is crucial for supporting the current generation
of military children, as they are twice as likely than their civilian counterparts to
become the next generation of Service members (Kudler & Porter, 2013). Specific
empirical questions might include the following: How does deployment influence
parenting? How is parenting of the at-home caregiver affected by the absence of the
deployed parent? How might effective parenting at different child developmental
stages mitigate children’s worries and fears about their deployed parent and pro-
mote healthy adjustment? How might the experience of motherhood be changed by
military service in general and deployment in particular? How are deployed fathers
influential for their children’s development and adjustment, and how can they be
supported in these efforts? And, how might military parents transmit military cul-
tural values, such as service, to their children?
1 Parenting and Children’s Resilience in Military Families: A Twenty-First… 5

This book addresses some of the above questions, providing a preliminary over-
view of the research on parenting and children’s adjustment in military families
early in the twenty-first century. Three key themes provide the structure for the
individual chapters: (i) a focus on mothers, fathers, and children at different devel-
opmental stages; (ii) parenting in diverse and challenging contexts (reserve compo-
nent families, military families in Israel, family violence, and injury or loss); and
(iii) what is known about programs, resources, and policies to support and strengthen
parenting in military families. While the majority of this book (and the research on
military families) is focused in the USA, we have included two chapters on military
families outside the USA: in the U.K. (Chap. 4) and Israel (Chap. 10). The UK
Military has contributed significantly to the Global War on Terror—since 2007,
there have been more than 160,000 UK personnel deployed to Iraq and Afghanistan
(Defence Statistics, Tri Service, 2015)—and the authors review various aspects of
the intersection of motherhood and military service, including a historical perspec-
tive on women in the UK Military. Chapter 10 focuses specifically on the military
in Israel, which unfortunately has provided a unique laboratory for understanding
the impact of PTSD and battle stressors (e.g., captivity, terrorism) on parenting and
family relationships.
The first few chapters of this book focus on parenting in different family con-
texts: children of different developmental stages; female Service members as moth-
ers; fathering in military families; and families with parents in the NGR. Chapters 2
and 3 highlight the impact of military service and deployment on key developmental
tasks in early and middle childhood (e.g. attachment in early childhood; social and
school functioning in middle childhood) and describe what is known about how
military parents transmit values and behavioral expectations in raising their children
and adolescents. Chandra (Chap. 3) reports data from a multi-informant study of
deployment and family communication, highlighting the shifting family roles when
a parent is deployed—increased responsibilities for children, for example, that must
be renegotiated during reintegration. In Chap. 4, DeGarmo reveals the striking
dearth of information about military fathers and argues for a shift away from the
historic emphasis on father absence models, toward newer paradigms such as online
fathering (Schachman, 2010). Military mothers are an underrepresented population
in military family research; Chap. 5 discusses how the UK Military has engaged
women, how women’s roles in the military have shifted over the past few decades,
and how this “new military” is experienced by mothers.
In the following chapters, the book’s focus broadens to parenting in military
families living in diverse and stressful contexts. Reserve component families are the
focus of Chap. 6; NGR Service members have been deployed in unprecedented
numbers in the recent conflicts. These civilian–soldier families live in civilian com-
munities with few of the supports and structures of the military installation. Chapters
7, 8, and 9 discuss parenting in families dealing with adverse experiences. In Chap.
7, O’Grady and colleagues report data on the associations of early traumatic life
experiences with parenting in civilian spouses of deployed Service members.
Slep and Heyman (Chap. 8) critically review the literature on maltreatment and
intimate partner violence in military families, concluding that prevalence of child
6 A.H. Gewirtz and A.M. Youssef

maltreatment appears to be less in military than in civilian families, and reporting

data from a dissemination trial of a model practice designed to streamline proce-
dures related to child maltreatment. Findings indicate significant reductions in child
maltreatment recidivism in the Air Force. In Chap. 9, Steve Cozza provides a com-
prehensive overview of what is known about parenting in the context of parental
injury, psychopathology, and death as a result of military service. He highlights the
cascading stressors and challenges to parenting following the injury, illness, or
death of a military parent. Cozza describes how children’s developmental stage and
their understanding of injury should drive parents’ communication about the injury,
expectations of parents for children’s increased responsibilities, and so on.
These chapters also emphasize the role of the broader context; the fact that par-
enting occurs not simply within a family context, but against a broader backdrop of
culture, community, and society. Chapter 10 focuses on parenting in Israel; its
unique military situation is a function of the near constant state of war it has expe-
rienced since its founding in 1948. That state of war has required mandatory mili-
tary service from almost the entire population and this situation allows for an
interesting discussion on the parenting of young adult Service members. Almost no
empirical data have been gathered on how adult parenting is associated with well-
being in their emerging adult (18–21 year olds) soldiers (Polusny et al., 2011).
Chapter 10 highlights the fact that military families reside within a larger mili-
tary and national context, with corresponding structures and supports. In Israel, for
example, the universality of the military experience among Jewish and Druze
Israelis (due to mandatory service) results in strong support for Service members,
almost all of whom are young adults. Far more research is needed to understand
how contexts both proximal (i.e. family) and distal (the installation, broader national
community) may buffer military families. The chapter also highlights the parallel
but often conflicting roles that parents who are Service members face: being both a
parent (and typically a coparent) at home, and being a commanding commissioned
or noncommissioned officer in charge of soldiers who are often young. In Israel, it
appears that “in the competition for loyalties, the military father overpowers the
family father” (see Chap. 10, p. 181).
Chapters 11 through 15 review programs and practices to support parenting in
military families. Interventions to buffer parenting in stressful civilian contexts have
proven successful. Multiple national and international databases now review, screen,
and track the evidence-base for prevention and treatment interventions to address
multiple child and family outcomes. However, as the chapters in this section recount,
the evidence-base for prevention and treatment interventions targeting parenting in
military families is limited. In 2015, there is not one military parenting program
with data from more than a single randomized controlled trial. Work is well under-
way, however, and the chapters describe some of that work. Chapter 11 reviews the
history of parenting programs in the US Military and describes Penn State’s
Clearinghouse for military family programs. Chapters 12, 13, and 14 highlight pro-
grams to promote effective parenting of very young children (infants, toddlers, and
preschoolers), school-aged children, and adolescents. Technology is increasingly
used as a vehicle to disseminate parenting resources for military families, and
1 Parenting and Children’s Resilience in Military Families: A Twenty-First… 7

Chap. 15 discusses innovative web-based approaches to support parents and mili-

tary families.
The final two chapters aim to provide a brief overview of policy and research
agendas for parenting in military families. There is tremendous opportunity for the
Office of the Undersecretary of Defense to influence military family policy. Chapter
16 provides an overview of the history and current efforts of that office in guiding
resources available to military families. Finally, in Chap. 17, we offer some conclu-
sions from the book and a current and future research agenda for military families.
Crosscutting themes beyond those constituting the individual sections of the
book will be evident throughout. For example, attention to parenting in the context
of military deployment necessitates understanding coparenting processes (see, e.g.,
chapters by Cozza and DeGarmo), as well as the influence of parental absence or
parent–child separations. In both these instances, it may be that other literatures—
such as divorce (in the case of coparenting) or incarceration or migration (in the
case of parental absence) can inform military family research (see, e.g., Rodriguez
& Margolin, 2015).
While the key thrust of this book is parenting and children’s resilience, other
aspects of the family system are relevant here. Marital or couple adjustment, for
example, has strong associations, both concurrently and over time, with both par-
enting and child adjustment—as highlighted in Chaps. 4, 6, and 9.
A final theme that merits note here is that change begets change. For example,
the transition associated with deployment often results in other transitions—changes
in children’s routines, parents’ work habits, families’ schedules, or sometimes big-
ger changes—moving to be close to extended family, moving in with grandparents,
or changing school, and so on. This is similar to what resilience researchers have
termed the pileup of stressors or accumulation of risks (see, e.g., Masten, 2001).
What begins as a single process (deployment) becomes a cascade of multiple change
events that can pile up and disrupt child and family life.
Fortunately, effective parenting programs targeting military families have the
potential to interrupt negative pathways, enhancing or buffering parenting, and pro-
moting children’s adjustment even against a backdrop of adversity (see, e.g., Chap.
13). This book aims to provide the reader a broad understanding of both the possi-
bilities and the pitfalls associated with parenting in military families, and the prom-
ise of effective programs, policies, and resources to support the families who serve
and sacrifice.

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Chapter 2
The Impact of Military Life on Young
Children and Their Parents

Phillip Stepka and Kristin Callahan

Introduction

Children in the birth to preschool age range account for approximately 40 % of all
military children, the single largest group found in military families (U.S. Department
of Defense, 2012). In addition, these children are overrepresented in families where
the service member parent is exposed to multiple deployments in high combat areas
(Cozza & Feerick, 2011). It has been posited that early experiences lay the founda-
tion for later development. Thus, it becomes critical to explore early childhood
experiences within the military context and their impact on the developing child.
Regarding military families with young children, two major factors must be con-
sidered. First, since the establishment of the all-volunteer military and changes in
deployment policies since the conflicts following 9/11, the demands of military life
on families have changed considerably. Over the last decade, deployments and duty
assignments have grown longer, become less predictable in onset and duration,
more frequently involved combat exposure, and have shortened times between
deployments (U.S. Department of Defense, 2010, 2012). Second, very few studies
have examined the impact of military culture on the youngest children in military
families or their caregivers (Osofsky & Chartrand, 2013; Paris, Devoe, Ross, &
Acker, 2008).
This chapter explores the impact of military service on families with young chil-
dren as well the unique needs of these families. We begin with a brief review of
socio-emotional development throughout the 0–5-year age range and a description
of experiences that can facilitate or challenge healthy development. Using a devel-
opmental framework, we then review what is currently known in the research field

P. Stepka, Psy.D. (*) • K. Callahan, Ph.D.

Department of Psychiatry, Louisiana State University Health Sciences Center,
1542 Tulane Ave., New Orleans, LA 70112, USA
e-mail: pstepk@lsuhsc.edu; kcall1@lsuhsc.edu

© Springer International Publishing Switzerland 2016 11

A.H. Gewirtz, A.M. Youssef (eds.), Parenting and Children’s Resilience in
Military Families, Risk and Resilience in Military and Veteran Families,
DOI 10.1007/978-3-319-12556-5_2
12 P. Stepka and K. Callahan

regarding the impact of military life on young children and their caregivers. Taking
the information gleaned from these two areas, we conclude with recommendations
for future research, as well as points to guide clinicians and parents as they support
children through this period.

Socio-Emotional Development Within the Context of Early

Relationships

What a child experiences and learns during infancy and early childhood establishes
a cognitive template for future events and sets into motion a trajectory of capacities
and expectations about how things and people will interact, which affects how the
young child will select and process new experiences (Shonkoff & Phillips, 2000).
The social-emotional aspect of development relates to the intra- and interpersonal
capacities and experiences of the child that facilitate their ability to adapt to various
stressors, regulate their affective and behavioral reactions, and develop and main-
tain meaningful relationships. We use the model of attachment theory (Bowlby,
1969, 1988) to help explain developmental processes in the social and emotional
domains. This theory proposes that early interactions with caregivers both promote
survival and form the foundation for later, more complex representations of caregiv-
ers as available and responsive. While an in-depth review of infancy and early child-
hood is outside the scope of this chapter, it is necessary to explore some of the key
socio-emotional developmental tasks that are relevant to understanding the potential
impact of military life on young children.
Within the first months of life, the infant is not quite able to self-regulate sleep,
feeding, distress, and arousal. He relies heavily on his primary caregiver(s) to read
his “signals” and meet his emotional and physical needs, thus keeping the infant’s
distress and discomfort within reasonable limits. Infants cannot self-regulate but do
have some capacity for “co-regulation” (Fogel, 1993), which requires the support of
a sensitive and responsive caregiver (Ainsworth & Bell, 1974; Sroufe, 2000).
Between 0 and 2 months, the infant’s signals are more reflexive and it is entirely up
to the caregiver to maintain smooth regulation. However, from about 2–3 months,
the infant is able to sustain longer periods of attention and display social smiles and
vocalizations, setting the stage for reciprocal exchanges between caregiver and
infant in which a semblance of back and forth communication and shared emotions
can take place (Fogel, 1993). During this period, the caregiver is responsible for
adjusting his/her behavior to attune to the infant’s cues (e.g., widening eyes and
smiling when the infant smiles). Between 3 and 6 months, caregiver–infant interac-
tions become increasingly reciprocal because the infant is able to respond to social
bids. From 6 to 9 months, the infant is actively participating in the regulation pro-
cess. The infant develops more goal-directed, purposeful behavior with the intent of
eliciting a particular response from the caregiver (e.g., calling a caregiver when
scared); if the caregiver misreads the signal, the infant may adjust his behavior to
2 The Impact of Military Life on Young Children and Their Parents 13

get the response he desires. These early reciprocal interactions typically occur
within the context of the parent–infant relationship and within close family relation-
ships, and promote the development of the infant–parent attachment relationship
discussed next. Thus, there is a critical need to support stateside caregivers during
this time so that they can be emotionally and physically available for their infants.
Between 7 and 18 months, the infant is able to discriminate between familiar and
less familiar people and a special relationship between the infant and his primary
caregiver forms based on the history of parent–infant interactions occurring up until
this point. The infant will begin to show a specific preferential relationship with one
caregiver or a small number of caregivers. In the presence of these caregivers, the
infant shares positive emotions and experiences with them, and feels comfortable
exploring his environment. When the infant is distressed, he seeks contact from
these caregivers, and draws comfort and reassurance from them. In what is termed
a “secure attachment,” the caregiver has a history of being consistently responsive
to the young child, meeting both the child’s physical and emotional needs (Ainsworth
& Bell, 1974). Likewise, the securely attached child is confident that when he sig-
nals a need, the need is met. Because of this responsive caregiving, the child learns
that he is effective in his own regulation; this is important in developing a sense of
self-confidence and self-worth and lays the foundation for later emerging self-
regulation of emotion and arousal (Bretherton & Munholland, 1999; Schuder &
Lyons-Ruth, 2004).
During the establishment of “focused attachment” (Emde & Buchsbaum, 1989),
other key milestones occur. Between 7 and 18 months, the child develops anxiety
around strangers and distress when physically separated from primary caregivers.
He also begins to keep a person in mind, even when he or she is not present. This
knowledge of “people permanence” and of the continuity of primary relationships
in general continues to develop through 36 months. Between 7 and 9 months,
advances in memory and cognition allow the infant to anticipate or expect certain
social routines. Between 9 and 12 months, he also displays a beginning awareness
for others’ point of view and can use others’ facial expressions to understand new
situations. Thus, for military-related transitions, the child may begin to look toward
the caregiver’s emotions in order to understand how to respond to change.
Between 18 and 36 months, the toddler has a stronger sense of his own auton-
omy; his goals and intentions may differ from those of his parents, contributing to
increased tantrums. The toddler can tolerate a moderate amount of frustration, but
he is still easily overwhelmed and requires a sensitive and responsive caregiver to
help him practice self-regulation within a secure attachment relationship. Through
“guided self-regulation” (Sroufe, 1996), the caregiver allows the toddler to master
skills within his capacity but also anticipates circumstances beyond the child’s level
and helps the toddler when he gets overwhelmed. Thus, for military toddlers coping
with significant transition, caregivers play a large role in protecting them from stress
while allowing them to master successes within their developmental capacity. As
the toddler becomes more effective in regulating emotions and behavior, the care-
giver’s role shifts to that of providing optimal contexts for mastery, setting limits for
appropriate behavior, and monitoring the child’s regulation efforts. As will be
14 P. Stepka and K. Callahan

discussed in the next section, deployed parents may struggle with how to set appro-
priate limits and monitor their young children from afar.
The toddler has a growing capacity for theory of mind, or the ability to under-
stand that the internal states of others may be different from his own (Wellman,
Cross, & Watson, 2001). As theory of mind develops, the toddler has an increased
ability to negotiate and coordinate his behavior in terms of the goals of another
person. He may show more empathic responding to the distress of others (Spinrad
& Stifter, 2006), particularly when he has had past experiences of empathic caregiv-
ers who have responded to his own distress. During this time, the emergence of
self-awareness occurs, and with this awareness comes a range of “self-conscious
emotions” such as pride, shame, empathy, and guilt (Lewis, 2008). Because of lim-
ited theory of mind abilities, coupled with the emergence of self-conscious emo-
tions, it is possible that military children may feel at fault for situations that are
unrelated to them (e.g., parental absence or injury) and this may lead to feelings of
guilt or shame (Cozza & Feerick, 2011). Additionally, they may have difficulty
showing empathy for—or understanding the perspective of—a caregiver who is in
distress due to a military-related stressor.
Toddlerhood is also a period when the child’s social abilities are facilitated by his
growing capacity for symbolic functioning, such as language. However, it is still
difficult for the child to fully understand and verbally express his emotions, which
becomes relevant when military-related situations necessitate difficult conversa-
tions about transition. Rather than using language to express their needs, young
children may exhibit difficulties in other areas of functioning, such as disturbances
in eating, sleeping, and coping with transitions in daily routines, particularly during
times of stress (Pincus, House, Christensen, & Adler, 2005).
With increases in symbolic thought and memory, the toddler can remember past
events and sequences. Repeating these sequences facilitates the formation of men-
tal representations. These representations guide the toddler’s later behavior in new
situations. Thus, it is possible for a toddler to remember activities done with a mili-
tary parent, particularly when those activities are done repeatedly and consistently.
The child’s emerging social competence with adults, siblings, and peers is largely
influenced by his early interactions with caregivers and attachment security. Between
18 and 36 months, the toddler shows an increasing interest in other children and
begins to play alongside peers (i.e., parallel play) rather than alone. With increasing
social and emotional capacities, the toddler is able to have meaningful interactions
with siblings and peers in various settings. Throughout the preschool period and
beyond, the long-term effects of a secure attachment relationship are apparent as the
child navigates new relationships with adults and peers. The securely attached child
can initiate new peer relationships and sustain interactions, even in the face of peer
conflict. He tends to respond with positive emotion to peer initiations and have overall
good social skills such as empathy (Hartup, 1992). The young child’s emerging self-
regulatory skills and the ability to use play to initiate and maintain interactions enhance
the preschooler’s ability to interact in socially competent ways (Denham et al., 2003;
Eisenberg & Fabes, 1998). These children tend to be rewarded with popularity and
acceptance while aggressive and disruptive children are at risk for peer rejection
2 The Impact of Military Life on Young Children and Their Parents 15

(Hartup, 1992). For securely attached children, this can reinforce their belief that rela-
tionships are rewarding, a source of pleasure, and a resource for meeting one’s physi-
cal and emotional needs. However, in order to obtain optimal social–emotional
trajectories, children must be afforded consistent, sensitive, and responsive caregivers
who can meet their rapidly changing developmental needs.
This section highlights key social and emotional developmental tasks throughout a
typical child’s first five years with implications for supporting children within the
military context. Notably, young children develop within a caregiving relationship
that is transactional in nature: both partners in the dyad continuously shape each oth-
er’s social and emotional experience in a dynamic, continuous way (Sameroff, 1993).
Not discussed but still important is that there are individual differences, not only in the
developmental timing of these tasks but also in the quality of these capacities.
Individual factors such as temperament and genes (and interactions within and among
various factors) play a large role in the development of social and emotional skills.
Additionally, environmental factors impact development such as parenting behavior
and parents’ own attachment history. In the next section, we discuss the limited
research on young children within the post-9/11 military context.

Research on the Impact of Deployment on Children’s

Adjustment

There has been a significant increase in OPTEMPO (rate of military operations)

since the beginning of the current OIF and OEF conflicts. This change in OPTEMPO,
exposure to more combat operations, and decreased predictability in changes
imposed upon military families by the services have created conditions that are
more challenging when compared to prior conflicts (U.S. Department of Defense,
2010, 2012). Recent research suggests that post-9/11 deployments may have a nega-
tive impact on young children’s adjustment. This is a critical issue, not only for the
well-being of families but also for the retention of service members who may hesi-
tate to re-enlist if their young children are having behavioral problems (Barker &
Berry, 2009). While many factors may contribute to young children’s adjustment
problems, we focus on the areas where qualitative and quantitative research has
been conducted: parent’s service-seeking behaviors, child’s age, deployment char-
acteristics, and parental stress, coping, and mental health.

Health Care Utilization

During deployments, many stateside caregivers seek more mental health services
for their children. For example, comparing children with and without a deployed
caregiver, Gorman, Eide, and Hisle-Gorman (2010) found that preschool children
had an 11 % increased utilization of mental and behavioral health visits when a
16 P. Stepka and K. Callahan

parent was deployed. Notably, service utilization for all other healthcare visits
decreased significantly during times of deployment. This same group of researchers
later examined utilization of healthcare services for children with preexisting diag-
noses of Attention Deficit/Hyperactivity Disorder (ADHD; Hisle-Gorman, Eide,
Coll, & Gorman, 2014). They found that the youngest children showed increased
ADHD symptoms, higher utilization of mental health services, and increased utili-
zation of medications during the deployment period. This data highlights the impor-
tance for community mental health resources to be informed in how to best meet the
needs of military families.
Less is known regarding what factors influence parent’s service-seeking behav-
iors such as perceived versus actual increases in child behavior problems, access to
support services, or parental stress. However, emerging evidence suggests that
healthcare utilization rates may be influenced by family composition and the gender
of the deployed parent. Hisle-Gorman et al. (2014) found that when the deployed
service member was a married male, children were shown to have significantly
more mental health visits than comparisons from single-parent homes or when the
deployed service member was a married woman. Conversely, there were found to be
reductions in medication utilization when mothers deployed versus fathers. These
findings highlight the need to further examine the factors that may impact parent’s
service-seeking behaviors when it comes to their children’s mental health (e.g.,
Levai, Ackerman, Kaplan, & Hammock, 1995).

Child Adjustment as a Function of Age

Some studies find that preschool-aged children are more vulnerable to the negative
effects of deployment than infants. For example, Chartrand, Frank, White, and
Shope (2008) found that compared to nondeployed peers, children aged 3–5 years
of deployed parents showed more behavioral problems across home and school set-
tings, even when parental stress and depression were controlled for, whereas chil-
dren under 3 years of age functioned similarly to age-matched controls. Similarly,
Barker and Berry (2009) found that for young children with a deployed parent,
behavior problems tended to increase with age. More research is needed examining
those factors which may buffer children at different developmental periods—from
developing problems in the context of a parent’s deployment.

Child Adjustment Across the Deployment Cycle

The behavior problems of young children may manifest at different periods of the
deployment cycle (e.g., predeployment, deployment, and reintegration). Barker and
Berry (2009) found that children ranging in age between birth and 47-months-old
with a deployed parent displayed increased behavior problems (e.g., tantrums,
2 The Impact of Military Life on Young Children and Their Parents 17

attention seeking, problems with sleeping and eating) from deployment to the rein-
tegration phase compared to children without a recently deployed parent. Because
this data relied on two time points, a more detailed description of how these behav-
ior problems developed over time is unknown (e.g., gradually or more abruptly
when the parent deployed). However, qualitative data of military parents with young
children has helped researchers better understand how behavior problems may
develop over time.
In their focus groups of military parents of preschool-aged children, Waliski,
Bokony, and Kirchner (2012) were able to gain insights into the experiences of
these parents throughout the deployment cycle. They found that predeployment was
considered by the majority of families to be most difficult and overwhelming. These
parents noted that knowing how to discuss and prepare their young children was
especially challenging considering their children’s cognitive capacity and the fact
that these were often the first deployments for the family. Families also noted a dif-
ficult but seemingly essential need for the deploying parent to withdraw emotionally
from the family as deployment approached. Similar to Barker and Berry’s (2009)
findings, stateside parents reported increased emotional and/or behavioral chal-
lenges in their children during the deployment phase compared to predeployment.
Taken together, these data suggest that behavior and emotional problems in young
children appear to increase across the deployment cycle. The deployed parent may
be inclined to withdraw emotionally during this critical time, which may have
implications for how the child’s emerging social and emotional skills develop.
Furthermore, we know little about how these child problems manifest and continue
throughout the reintegration period and beyond. As will be discussed below, the
well-being of the stateside caregiver plays a large role in supporting the young child
throughout the deployment cycle.

Parental Mental Health

Much less studied, but equally relevant to the experience of young military children,
is the role of the parents’ mental health in child adjustment. In particular, parental
depression, PTSD, and substance use problems have been associated with older
military children’s behavioral and emotional problems (e.g., Beardslee, Bemporad,
Keller, & Klerman, 1983; Glenn et al., 2002). Stigma and other barriers may inhibit
military service members’ utilization of services to help with the identification and
treatment of mental health problems; their mental health problems may go unde-
tected for long periods (Hoge et al., 2004). Unfortunately, studies assessing the
direct impact of service members’ mental health on young children are extremely
sparse and an area in need of future research (Cozza & Feerick, 2011; Osofsky &
Chartrand, 2013). However, studies on civilian populations suggest that mental
health problems can have deleterious effects on young children in multiple domains
of development. For example, in the research on civilian children in infancy through
preschool years, parental depression is consistently associated with increased
18 P. Stepka and K. Callahan

problems in behavior, social skills, emotional development, and cognitive capacity

(Caplan et al., 1989; Carro, 1993; Cummings & Davies, 1994; Dave, Sherr, Senior,
& Nazareth, 2008; Jacob & Johnson, 1997; Kurstjens & Wolke, 2001; Ramchandani
et al., 2008; Wiffen & Gotlib, 1989). Future research is needed in examining the
impact of service members’ mental health on young children and those factors that
may mediate or moderate this association.
Relatively more research has been conducted on stateside caregivers’ mental
health and child adjustment. During times of deployment, young children in mili-
tary families rely heavily on their stateside caregivers for emotional and behav-
ioral regulation. It has been posited that children may be buffered from
experiencing the stress of a parent’s deployment when they have a secure attach-
ment relationship with a stateside caregiver who copes effectively (e.g., copes
with stress and maintains good psychological adjustment) and maintains effective
and stable positive parenting practices (Miller, Miller, & Bjorklund, 2010; Paris
et al., 2008; Riggs & Riggs, 2011; Rosen, Teitelbaum, & Westhuis, 1993). Thus,
stateside caregivers often carry the large responsibility of providing for their
young children’s emotional and behavioral needs, maintaining stable daily rou-
tines, and protecting their children from stress, all while negotiating their own
deployment-related stress.
Qualitative data suggest that many stateside caregivers are aware of the connec-
tion between their mental health and their children’s adjustment. Waliski et al.
(2012) found that stateside mothers of preschoolers reported heightened levels of
anxiety and depression during deployment, and felt that symptoms were most likely
due to stressors they experienced such as isolation, loneliness, and the challenges of
caring for young children who require much more attention than older age groups.
Along these lines, home front parents were sensitive to the impact of their own dis-
tress on the family. Not only did stateside parents frequently report increased emo-
tional and/or behavioral challenges in their children, they often attributed these
changes to the child’s reaction to their own distress rather than the loss of the service
member parent. Barker and Berry (2009) also found a positive association between
parental stress and young children’s behavior problems.
An indication of the mental health problems and stress home front parents expe-
rience is child maltreatment rates, which have increased during recent deployments.
In their analysis of civilian and Army abuse rates between 1990 and 2004, McCarroll,
Fan, Newby, and Ursano (2008) discovered a substantial increase in child neglect
rates during the combat deployments of the Gulf Wars. Cases of neglect particularly
rose for children under 8 years, with most cases involving children 2 years or
younger. Other researchers generally confirm these findings with wartime deploy-
ments post-9/11 (Gibbs, Martin, Kupper, & Johnson, 2007; Rentz et al., 2007). For
example, Gibbs et al. (2007) found that the rate of neglect was nearly three times
higher during deployments and that civilian mothers were the large majority of
offenders during deployment. When examining healthcare utilization records of
military dependents, one study found that young military children had higher all-
cause hospital admissions, drowning/near drowning, and intracranial injury com-
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