NEW YORK – A novel, family-centered, resiliency-training program involving U.S. military families produced substantial improvements in psychological measures among both children and their parents during the first 2 years of the program involving nearly 1,700 children and their families.
"Child psychological health assessment indicates significant reduction of emotional distress and behavioral problems, and increase in prosocial behaviors" after participation in the intervention program, Dr. Patricia E. Lester said at the annual meeting of the American Academy of Child & Adolescent Psychiatry. "Children also reported significantly increased positive coping skills."
Their parents derived benefits as well. "Parental psychological health measures and functional adjustment for active duty and nonactive duty indicate significant improvement following intervention. Family adjustment assessment indicated a greater prevalence of families with healthy functioning following intervention," said Dr. Lester, medical director of the child and family trauma psychiatry service at the University of California, Los Angeles.
Photo credit: Courtesy Anne Allhoff Photo credit: Courtesy Anne Allhoff
Photo credit: Courtesy Anne Allhoff Dr. Patricia E. Lester says military families can benefit from resiliency-training programs which have resulted in significant reductions in emotional distress and behaviorial problems in children.
The FOCUS (Families Overcoming Under Stress) program that was developed by Dr. Lester and her associates also has an initial assessment component, which found that both active duty and nonactive duty parents had baseline psychological symptom levels that were increased, relative to community norms, and that nearly half of their children had significant baseline emotional/behavioral symptoms.
The FOCUS program adapted evidence-based interventions for military families who are affected by wartime stress, and it combines both assessment and education about resiliency skills. Specific aims include teaching parents to appreciate the children’s experiences, to normalize distress, to promote perspective taking, to increase positive interactions within the family, and to encourage family-level problem solving and goal setting through family plans.
The program includes eight sessions, starting with two sessions for parents only, then two with the children only, a third session only for parents, and finally three sessions that include the entire family.
Implementation of FOCUS began at seven U.S. military sites for the Navy and Marine Corps in March 2008. In June 2009, the program expanded to an additional seven sites within these two services, and then in September 2009, it expanded to four sites for the Army and Air Force. The program included 1,680 children aged 3-18 years from July 2008 to July 2010.
Data collected so far show that both active duty and nonactive duty parents had significant reductions from baseline to postintervention follow-up in three measures that were made using the Brief Symptom Inventory (global severity index, anxiety, and depression). For example, among active duty parents, global severity dropped by an average of 4.42 points, anxiety fell by an average of 1.39 points, and average depression scores were reduced by 2.39 points. Similar statistically significant drops in all three scores also occurred among nonactive duty parents.
The prevalence of clinically significant anxiety and depression also fell significantly in both types of parents. Among those on active duty, clinically significant depression was reduced from 30% at baseline to 7% at follow-up after the FOCUS intervention, and clinically significant anxiety dropped from 22% to 6%. Again, similar significant cuts in prevalence rates also occurred in nonactive duty parents.
To assess children, Dr. Lester and her associates used the SDQ (Strengths and Difficulties Questionnaire). They saw significant declines in the children’s total difficulties scores among both girls and boys and in all age subgroups that were assessed (3-7 years, 8-10, and 11 and older). The prevalence of conduct problems, emotional symptoms, and total difficulties all dropped significantly from baseline to follow-up after participation in FOCUS. (See box.)
Dr. Lester said she had no disclosures.
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