Program helps military parents, children

When Eliana Duffy, 3, asks her mother where her father is, Sarita Duffy, a student at the Franciscan University of Steubenville, Ohio, tells her that he’s "far away, fighting bad guys."

As far as her daughter is concerned, "Daddy goes bye-bye," Duffy said of her husband, who was deployed to Afghanistan in February.

“The stress is being apart. It’s hard to keep communication going,” Duffy said.

It’s here, in the stress that accompanies the deployment of a family member, where UCLA, in collaboration with the U.S. Navy’s Bureau of Medicine and Surgery and a team from Harvard University Medical School, saw a need for a preventative service to help families avoid problems during wartime.

Project FOCUS ““ Families OverComing Under Stress ““ aims to help build and develop family resiliency at nine sites around the country and one in Japan, according to Dr. Patricia Lester, UCLA assistant professor of child and adolescent psychiatry and director of the FOCUS program.

"There is increasing awareness that military families, especially the children, can be significantly affected when a parent is deployed, and it is the repeated deployments that add cumulative stress," Lester said.

Lester said project FOCUS was conceptualized between 2004 and 2005, after the start of the war in Iraq and Afghanistan. It was then further developed last year after mental health reports concerning military families suggested a need for a preventative service for those facing deployment.

She said project FOCUS, after a start-up phase beginning in March 2008, is now fully staffed and ready to start seeing families.

Gregory Leskin, professor of clinical psychology and Military Family Liaison for the UCLA FOCUS Program and National Center for Child Traumatic Stress, said the program was based on implementing a core set of family communication skills.

“We need to understand what their experiences are in order to develop a program that is a good fit,” he said.

Lester said the program is based on family resiliency, aiming to teach children and parents emotional regulation and awareness. The families meet with counselors, sometimes with parents present, sometimes without.

“The heart of intervention is family communication … dealing with and understanding the child’s reaction to the separation,” Lester said.

Project FOCUS is different from other services provided for military families in its preventative nature, said Captain Robert Koffman, director of Psychological Health and Traumatic Brain Injury for Navy Medicine. He said that project FOCUS is concerned with prevention, intervention and education of families rather than mental health or PTSD treatment, said Leskin.

“Even though Navy medicine is connected with this, this is really outside of the usual referral-based network,” Koffman said.

Leskin said Project FOCUS will try to intercede before there is a problem, offering group communication skills before a family member gets deployed.

One of the core skill sets underlined in project FOCUS is understanding emotional state and expression; something Leskin said was referred to as "taking your emotional temperature" – a skill that helps family members determine when they can most effectively communicate with one another.

“These are metaphors anyone – children or parents – can appreciate,” he said.

Asuka Tsukuda, a fourth-year International Development Studies student at UCLA whose husband was deployed shortly after Sept. 11 and has since returned, said deployment is “definitely not a positive thing,” but that living in an academic setting helps her stay objective and informed. Tsukuda said her former residences included a military base.

“It’s not like when you live on a military base, and you only associate with military people. Here, I’m more open, and I can talk to a lot of different people. I have more of an opportunity to tell people what it’s like to have a husband leaving for a year,” she said.

Tsukuda said many people have a hard time talking about what happened during deployment upon reentry.

"There’s this pressure that you can’t be weak about it, that you’re not supposed to have a problem. … If you have a problem, it’s like, “˜What’s wrong with you?’"

Kirsten Woodward, project manager for FOCUS, said families can access the program through family services at each installation, and internal newsletters, medical providers and community officials will link families to the project.

Lester noted that military families often deal with deployment well, but said things get more difficult when dealing with the idea of a family member being in danger, especially when explaining things to children.

“Deployment is hardest on her. … She understands as much as she can what he’s doing, but she doesn’t fully grasp it,” Duffy said about her young daughter.

Each age group is presented with different challenges with regard to family separation, and Project FOCUS employs different strategies as appropriate, Koffman said.

For example, he said the program will try to help younger children visualize their parent’s deployment time with a paper chain with the number of days the deployed parent is expected to be gone. The child can then snip off a link every day, helping develop his or her understanding of the parent’s absence.

“Family roles get shifted suddenly when a parent leaves; routines are interrupted, the children may not understand where their mom or dad has gone,” Lester said.

“It is important to understand how to deal with a child’s reaction to the separation and the types of worrying they may be experiencing.”

The data regarding the long term effects of PTSD or multiple deployments on a child’s adjustment and mental health is still limited, Lester said. Studies suggest families can be strained by deployment, Leskin said.

“We’re really just at the beginning to understand the challenges that a military family faces,” said Leskin.