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      Mechanisms of Risk and Resilience in Military Families: Theoretical and Empirical Basis of a Family-Focused Resilience Enhancement Program

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          Abstract

          Recent studies have confirmed that repeated wartime deployment of a parent exacts a toll on military children and families and that the quality and functionality of familial relations is linked to force preservation and readiness. As a result, family-centered care has increasingly become a priority across the military health system. FOCUS (Families OverComing Under Stress), a family-centered, resilience-enhancing program developed by a team at UCLA and Harvard Schools of Medicine, is a primary initiative in this movement. In a large-scale implementation project initiated by the Bureau of Navy Medicine, FOCUS has been delivered to thousands of Navy, Marine, Navy Special Warfare, Army, and Air Force families since 2008. This article describes the theoretical and empirical foundation and rationale for FOCUS, which is rooted in a broad conception of family resilience. We review the literature on family resilience, noting that an important next step in building a clinically useful theory of family resilience is to move beyond developing broad “shopping lists” of risk indicators by proposing specific mechanisms of risk and resilience. Based on the literature, we propose five primary risk mechanisms for military families and common negative “chain reaction” pathways through which they undermine the resilience of families contending with wartime deployments and parental injury. In addition, we propose specific mechanisms that mobilize and enhance resilience in military families and that comprise central features of the FOCUS Program. We describe these resilience-enhancing mechanisms in detail, followed by a discussion of the ways in which evaluation data from the program’s first 2 years of operation supports the proposed model and the specified mechanisms of action.

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          Most cited references39

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          Ordinary magic. Resilience processes in development.

          The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. The most surprising conclusion emerging from studies of these children is the ordinariness of resilience. An examination of converging findings from variable-focused and person-focused investigations of these phenomena suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems. The conclusion that resilience is made of ordinary rather than extraordinary processes offers a more positive outlook on human development and adaptation, as well as direction for policy and practice aimed at enhancing the development of children at risk for problems and psychopathology.
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                Author and article information

                Contributors
                wrsaltzman@mednet.ucla.edu
                Journal
                Clin Child Fam Psychol Rev
                Clinical Child and Family Psychology Review
                Springer US (Boston )
                1096-4037
                1573-2827
                8 June 2011
                8 June 2011
                September 2011
                : 14
                : 3
                : 213-230
                Affiliations
                [1 ]UCLA Semel Institute for Neuroscience and Human Behavior and California State University, Long Beach, CA USA
                [2 ]UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA USA
                [3 ]Children’s Hospital Boston, Harvard Medical School, Boston, MA USA
                [4 ]UCLA/Duke National Center for Child Traumatic Stress, Los Angeles, CA USA
                [5 ]United States Bureau of Navy Medicine and Surgery, Washington, DC USA
                [6 ]Defense Centers of Excellence for Psychological Health and TBI, Silver Spring, MD USA
                Article
                96
                10.1007/s10567-011-0096-1
                3162635
                21655938
                b4a5073d-249a-4e8b-a391-fc863b6dda72
                © The Author(s) 2011
                History
                Categories
                Article
                Custom metadata
                © Springer Science+Business Media, LLC 2011

                Clinical Psychology & Psychiatry
                military family,combat stress program,family stress,military family treatment,military child and family,resilience,wartime deployment,focus project,risk and resilience,resilience enhancement program,military family prevention,family resilience,focus,trauma treatment program

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