Grief among Children of Military Families

Arriaza & Cornelissen

Grief among Children of Military Families

Grief among Children of Military Families Pablo Arriaza, PhD, MSW, LCSW Kerri Cornelissen, MSW

of military parents do not have the opportunity to process and work through an initial griefrelated event (i.e., the first deployment of a parent), because that same parent may soon be deploying again. At present, more than 2 million children are affected by the war (Flake, Davis, Johnson, & Middleton, 2009). It is essential to note that the word affected can only be dealt with on a conceptual level, because as a society we have just begun to understand the full extent of the effects of the current war on children. Because research has primarily focused on deployed military personnel, spouses, and the family as a unit, few studies and narratives have focused exclusively on children. Children of military families are usually mentioned in the literature only within the context of the family as a whole. Although the psychosocial ramifications of the current war on military families—and specifically on children of military parents— are far from being fully understood, a dialogue must be established to identify appropriate contemporary interventions. Such interventions may stabilize and strengthen children’s psychosocial functioning, as they continue to experience ongoing, frequent, and at times unresolved grief. This paper explores the imperative and critical need to focus attention on the psychosocial needs of children of military families. Specifically, the aim is to contextualize a broader understanding of grief in relation to the different cycles of deployment that children of military families regularly experience. The information presented in this paper has been collected by reviewing the literature; conference papers presented at national and international conferences; and the direct clinical practice experience of the first author, who has worked with military families for the past 16 years, both overseas and in the United States, and the second author’s research related to military families and psychosocial issues.

Abstract Children of military parents experience grief reactions as they go through the different cycles of deployment. With more than 2 million children currently being affected by the war, a need exists to understand the meaning of grief and identify contemporary interventions to help these children, and their families, cope with ongoing and frequent deployments. The aim of this paper is to discuss the grief reactions of children of military families in the context of these cycles. Contemporary interventions are discussed and recommendations are made to stabilize and enhance the psychosocial functioning of children of military families. Introduction In the past nine years, many children of military parents have endured ongoing grief. Their grief and bereavement responses have been widely misunderstood and often medicalized and pathologized. Such grief can be acute, chronic, frequent, ongoing, unresolved, and even disenfranchised. Grief reactions are not always associated with the death of a loved one. Although the death of a parent certainly can elicit grief responses, children of military parents most often experience grief as a result of the different deployment stages that they and their families go through. It can be argued that the effects of the current war on these children’s developmental functioning and psychosocial response are unprecedented events. It seems appropriate to use the word unprecedented to describe what military families are currently experiencing: namely, that many military families have to go through multiple deployment cycles in relatively short periods of time. This frequency has challenged military families’ ability to maintain a sense of equilibrium and connection. The anticipation of welcoming home a deployed parent (or parents) is often, and quickly, replaced with the expectation that they will soon be deploying again. In a sense, children ILLINOIS CHILD WELFARE

1

2011-2012 Volume 6 Number 1



characterized by ecological support systems mobilizing to support and help the older child. In military systems, for example, these support elements include schools, family support centers, command units, family readiness groups, classmates, friends, and family. To understand grief among children, it may be prudent to consider grief expression within different contexts. For example, language provides face value for grief expression. When children say, “I am sad because Daddy is gone” or “I wish Mom was here watching me play soccer,” they are using verbal language to express their grief. In contrast, some children may not have the emotional resources, language, cognitive functioning, or self-regulating internal resources to verbally express their feelings. Instead, these children will express their grief behaviorally (i.e., crying, withdrawal) and emotionally. Therefore, to understand grief reactions among children of military families, it is necessary to understand their bio-psychosocial functioning. In other words, we must consider their biological, emotional, psychological, social, and spiritual functioning and collectively use this information to holistically and constructively shape their meaning of grief. Grief is a socially and culturally mediated process. The military is a culture nested within different cultures. In relation to grief, each cultural layer (or nest) further challenges the operationalization of grief. The expression of grief is not uniform and thus the meaning of grief belongs to the individual—in this case, the child. Much has been written about the meaning and processes of grief (KüblerRoss, 1997), yet we continue to struggle as a society to have a clear understanding of this somewhat elusive concept. Therefore, when working with children of military parents who are at risk for experiencing grief reactions, it is imperative to have a flexible and multidirectional understanding of the meaning of grief.

Grief Simply stated, grief is the reaction to a meaningful loss. Children can experience grief when someone dies, when they move to a new home, when they change schools, when roles and responsibilities change, and when they transition from one developmental stage to another. Specific to military families, children experience grief related to deployment cycles (predeployment, the deployment itself, and postdeployment). Grief is always a normal reaction, both affective and physical, to an overwhelming loss (Ringdal, Jordhoy, Ringdal, & Kaasa, 2001). It is important to consider that grief may vary in intensity and that there is no standard method of grieving. This is true for people at every stage of development. Defining grief can be challenging because operational definitions of grief are difficult to conceptualize. The lack of uniformity in grief responses and in theoretical perspectives (Ringdal et al., 2001) has led various researchers to consider several stage-like perspectives and models of grief in efforts to provide a basis for understanding the reactions to a meaningful loss (Kübler-Ross, 1997). Specific to children, some argue that specific stages of grief resemble the stages of grief in adults, from denial to anger and perhaps eventually acceptance, and hope. However, it is important to first and foremost consider the developmental functioning of the child prior to labeling or ignoring any symptoms. Younger children will respond differently to grief—behaviorally, emotionally, and cognitively—than older children. It is important to consider that habituation, or a decrease in grief response, may arise much earlier than for older children. Furthermore, with recurrent and frequent separations, as is the case with military families frequently experiencing deployment cycles, younger children may experience additional challenges with recurrent and unresolved grief. For older children, the outward expression of grief may serve as an effective coping mechanism to reintroduce a sense of equilibrium. This balance may be 2011-2012 Volume 6 Number 1

Grief Reactions

Common and frequently observed grief reactions of children include sadness, 2

ILLINOIS CHILD WELFARE



depression, anger, guilt, anxiety, fear, regression, physical distress, and inability to self-regulate. Children of military families might also express grief by being clingy, abusing substances, cutting, making suicide attempts, engaging in attention-seeking behaviors, withdrawal, behaving with defiance, and bullying. The medicalization of unresolved grief has led many professionals to pseudonormalize the grief reactions of children of military families. This can happen when friends, family, and even community support systems apply normalizing labels to their grief. When internalized, the labels may cause disenfranchisement, both to the children and to the grieving process. Two such labels are “resilient” and “well adjusted.” These terms are confusing and invalid. In fact, the word resilient has unfortunately become a thoughtless label for children of military families. Despite the documented efforts by researchers (Flake, Davis, Johnson, & Middleton, 2009) suggesting that up to onethird of children of military families are at a higher risk of morbidity due to psychosocial stressors, practice, research, and policy gaps continue to exist in the literature. These labels may be deceiving at best; at worst, they disempower children from acknowledging their grief. In other words, labeling children as “resilient” may lead to suppression of feelings and delay of grief responses. From a developmental perspective, frequent deployment events affect children’s sense of grief and their understanding of separation, as well as their attachment to significant others. On the one hand, we have a general understanding of the effects of manmade and nature-related traumatic events on children. Critical incident response teams often deploy to areas of devastation after hurricanes, earthquakes, bombings, and shootings and often respond with “curative” approaches (Kalksma-Van Lith, 2007). Although such responses can be quite meaningful and helpful, they are reactionary in that they occur after the trauma or loss. On the other hand, we know very little about the experiences of children of military families ILLINOIS CHILD WELFARE

and their grief-related responses to cycles of deployment. An opportunity exists to explore the phenomenon of grief among children of military families as it intersects with the cycles of deployment. In addition, we have a responsibility to understand these children, not so much on a contextual familial level, but on an individual level in relation to social, psychological, and emotional factors. Cycles of Deployment Military families experience unique psychosocial challenges that do not arise for other (civilian) families. These challenges can be perceived from cultural and/or contextual perspectives and have a direct impact on children. Military families have, historically, been well known for “taking care of their own” and for being “resilient.” However, these attributes, along with resources, are constantly being redefined—and depleted. Ten years ago, Department of Defense Schools had comparatively few students with deployed parents; today the reverse is true. The effects of family separation have been normalized and the specific effects of deployment on children have been misunderstood and often ignored. Why do we need to perceive children of military families and their grief reactions differently than children of civilian parents? Children of military families experience ongoing and frequent spiral events related to deployments/trainings every 6 to 12 months. An example of the stress and spiral process these children experience is depicted in the following case scenario. Though fictitious, it is a true representation of the current experiences of children of military parents: Mary is currently 9 years old. Her mother’s first military deployment occurred when Mary was 12 months old; she returned when Mary was 2 years of age. Her mother deployed a second time when Mary was 30 months (2.5 years) old, and returned when she was 42 months (3.5 years) old. At that time, the family moved from Colorado to Alabama. The fourth deployment occurred when Mary was 5, and her mother returned when she was 7. Mary’s mother deployed a fifth time when Mary was 9. Her mother is expected to return in 15 months. (Mary has thus been serially separated from her mother for more than half of her life.)

3




The cyclical experience of military families, which has traditionally been termed the “Emotional Cycle of Deployment,” includes anywhere from five to seven stages (Logan, 1987). The cycle provides a detailed explanation of the emotions and experiences of the family members left behind when their loved one is serving away from home. Children’s responses to the deployment of their parents vary across developmental stages. It is common for children to regress to behaviors that they displayed at earlier developmental stages in response to the anxiety caused by separation. Younger children may revert to behaviors such as thumb-sucking and bed-wetting (Fitzsimons & Krause-Parello, 2009). Older children report that they take on as many additional responsibilities as possible while their parents are deployed; in the process, many appear to have been parentified (Ellis, 2008). Considering the Emotional Cycle of Deployment can be helpful in examining the challenges that military children encounter, the coping strategies that these children often utilize, and the ways in which professionals can help them throughout their experiences.

However, this does not ensure that the parents or the children will cope successfully. A 2009 study found that “the best predictors of children’s overall ability to cope with deployment were the parent’s adaptation and coping success” (Huebner, Mancini, Bowen, & Orthner, 2009, p. 218). Open communication in relationships with caring adults can enable military children to cope. A consistent relationship with a pet can also help military children to learn to attach to others and form trusting relationships during a time of uncertainty (Fitzsimons & KrauseParello, 2009). Interventions

During the stage of predeployment, clinicians can be helpful to military families by assisting them in the process of open and honest communication. Children should each be encouraged to explore and discuss their own feelings about the deployment (Black, 1993). Art and play therapy are two techniques that can be used in the predeployment phase because they help families to express the multitude of emotions they are experiencing (Echterling, Stewart, & Budash, 2010). These authors suggest that families create a “deployment crest” depicting the family’s strengths, roots, and potential for growth; feelings about the deployment; and hopes for the future. A creative tool of this nature can be used to help families come together prior to deployment and to remind them of their internal resources that will help them through the coming challenges.

Predeployment

Challenges of Military Families

The first stage of the Emotional Cycle of Deployment is predeployment, when military families learn about their loved one’s upcoming deployment. Predeployment is largely categorized by anticipation and fear of the unknown (Pincus, House, Christenson, & Adler, 2007). During this phase, family members alternate between moving closer to the service member and pulling away. Common emotions experienced during predeployment are denial, fear, anger, resentment, and hurt. As the date of the deployment approaches, feelings may include confusion, ambivalence, and anger (Rotter & Boveja, 1999).

Deployment

Challenges of Military Families

Children of military families live with daily and ongoing stress of impending deployments of one or both parents, in addition to uncertainties regarding their return. Military spouses report that deployments are the most stressful military experience (Dimiceli, Steinhardt, & Smith, 2010). In the Emotional Cycle of Deployment, this phase has been separated into three distinct categories: deployment, sustainment, and redeployment (Pincus et al., 2007). The initial phase of deployment is a time of

Coping with Predeployment

Throughout predeployment, many services are available to the military family from both military and civilian organizations. 2011-2012 Volume 6 Number 1

4




uncertainty until the family receives the first phone call indicating that the service member has arrived safely. Common emotions that may emerge for children and family members during this time include a sense of abandonment, loss, emptiness, pain, and disorganization (Rotter & Boveja, 1999). This is usually the time when families receive the most support from friends, families, and community resources. Conversely, it is also the time when children are reminded that they are “resilient,” “strong,” “responsible,” and “grown-up,” thereby reinforcing suppression of feelings. The sustainment phase is markedly different, because the family system is structurally altered so that it can function without the deployed family member (Pincus et al., 2007). Sustainment is the time when families feel the most adjusted, so they might experience feelings of hope, confidence, and calmness, although loneliness is prevalent throughout the deployment (Rotter & Boveja, 1999). During this phase, it is especially important to be aware of the children’s emotional state and functioning and to remember that children and adolescents’ experience of deployment is largely a function of the military spouse’s ability to cope and adapt (Mmari, Roche, Sudhinaraset, & Blum, 2009). The last portion of deployment is redeployment, which is the short period of time just before the service member returns home (Pincus et al., 2007). Although this time involves significant excitement, emotions are likely to be mixed and include apprehension, high expectations, and worries (Rotter & Boveja, 1999). Younger children may not understand the concept and meaning of time, while older children may experience a range of emotions from happiness to anger and disbelief. It is important to mention that children living off military installations may be at increased risk for psychosocial issues. This becomes further complicated when comparing children living outside the United States (OCONUS) with children living in the United States (CONUS). Children living in OCONUS and off a military base may have ILLINOIS CHILD WELFARE

limited support from friends and experience a higher sense of disconnection from general military resources. Their sense of self, selfesteem, and self-concept may be at risk. Coping with Deployments

Military families have different methods of coping with deployments. Although these methods may fall on a continuum from rituals to moving closer to other family members, military families will either increase visibility within military systems or will detach and withdraw physically from these systems. Both of these coping styles can affect the manner in which children of military families exhibit grief responses and the support they will or will not receive. For instance, when military families move to nonmilitary towns/ systems, children experience the additional loss of the familiar and expected. Interventions

When families have extra support and engage in military-laden activities, it is natural to expect that such support will also transfer to any existing children. However, parents, teachers, caregivers, and counselors may react and prescribe interventions without considering the child’s unique needs. Children are often perceived twodimensionally rather than as functioning within a complex and intricate flexible system composed of biological, psychological, spiritual, and social systems. We often neglect to observe children for long periods of time and frequently before labeling their situation. During the deployment, children benefit from maintaining routines (Black, 1993), but (conversely) they also benefit from special considerations at school (Mmari et al., 2009). Mental health providers need to consider that building trust with adolescents takes time; rushing the process may be detrimental to the relationship, rapport, and trustbuilding required for effective therapy. Although adolescents are developmentally in different stages than young children, the initial steps of assessment and intervention remain the same. For example, it is imperative that mental health professionals stop, listen, observe, and be present for 5




longer periods of time before prescribing activities (even medication) to enhance children’s psychosocial functioning. Many contemporary interventions incorporate writing and expressive techniques, which allow children to express their emotions. Service members can encourage the use of expressive techniques by communicating, when able, with each child individually so that each child has the opportunity to respond (Black, 1993). Alternately, the child can keep a journal of his or her emotions throughout the experience (Echterling et al., 2010) and share them with the service member during appropriate times.

the deployment. Upon the return of the deployed parent, the child must readjust to the shared parenting style. In particular, adolescents might have a difficult time during this phase because they have taken on many extra responsibilities while the parent was deployed, and now they are expected to return to the role of “child” (Mmari et al., 2009). Open communication among family members can be especially helpful for military children as they readjust to the new normal of their family life. When family systems remain closed to communication during this time, children’s confusion can increase and make the transition more difficult (Faber, Willerton, Clymer, MacDermid, & Weiss, 2008). Additionally, children and adolescents who live on or near a military base often turn to their peers who have experienced similar situations to find support (Mmari et al., 2009).

Reunion Stress

The process of reunification is generally expected to be a happy time, but it can be a stressful experience for both service members and their families. Some sources divide reunification into two distinct stages: honeymoon and readjustment (Rotter & Boveja, 1999; Pincus et al., 2007). This distinction acknowledges that the process of homecoming does not end until long after the initial excitement has faded. During the months following homecoming, military families must work to establish a “new normal” for themselves (Bowling & Sherman, 2008). Although children will likely be eager to spend time with the returning parent, this transition entails another change in routine, which can be stressful for children (Fitzsimons & KrauseParello, 2009; Pincus et al., 2007). Additionally, children have inevitably grown in the 6 to 18 months since their parent’s deployment began, so they might be in a new developmental phase. This shift makes it necessary for the returning parent and the child to establish an altered relationship, which incorporates each of their personal experiences during their time apart (Pincus et al., 2007). This phase is categorized by discomfort and role confusion, which hopefully results in satisfaction once the family has reintegrated (Rotter & Boveja, 1999).

Interventions This phase appears to be an enjoyable time for families, but the process of reunification can involve unanticipated challenges, so this is a time when military families might turn to outside help. In July of 2008, a Department of Defense Directive-Type Memorandum (DTM) established the Yellow Ribbon Reintegration Program, which was created to help military families successfully navigate the process of reunification (Department of Defense, 2008). This program provides support to military families throughout all of the phases of deployment, but the majority of its activities and resources are geared specifically toward reunification. Clinicians who engage in work with military families must recognize that in this phase, family members need to work through practical details; however, this must be balanced with the work of managing emotions, opening lines of communication, re-creating intimacy in their relationships, and creating shared meaning (Bowling & Sherman, 2008). Clinicians can use games with children and their family members to help them to get to know one another again (Echterling et al., 2010), as well as offer strategies to help with communication and problem solving (Bowling & Sherman, 2008). Because each member of the family experienced the deployment time differently, it can be helpful to create a narrative or

Coping during Reunion Reunion can be especially difficult for children who have adapted to the particular parenting style of the parent (or guardian) who has been at home throughout 2011-2012 Volume 6 Number 1

6




scrapbook incorporating the perspectives of all family members (Bowling & Sherman, 2008). The resulting product will help family members to create shared meaning from the experience, and it will also represent to the family’s resiliency and ability to overcome obstacles.

of life that in military systems, children’s functioning is often fragmented and not understood or considered in relation to other systems. Starting with a macro perspective and arriving at the individual level (micro) can be helpful. The goal is to empower the system within while minimizing the labeling and pathologizing of children. Parents, caregivers, and mental health professionals may consider addressing griefrelated concerns of children of military parents within a systemic perspective. Being mindful of the reciprocal and continuous exchange between children and their environment is key to helping them secure a new equilibrium during and after a grief-related event. The focus must be on the children, their environment, and their interactions. To guide parents and professionals in this process, it may be helpful to consider the intersection of these ecological systems in terms of applicable interventions. Parents, caregivers, and mental health providers may find the INCLINE (Include; Nurture Child; Communicate; Listen; Intensity; Nurture Self; and External Resources) perspective (Arriaza, 2010) useful when helping children of military parents cope with grief. Table 1 provides detailed information on the INCLINE perspective.

Family Interventions Helping children of military families cope with the frequent and ongoing separation from significant role models, caregivers, and parents requires a multisystemic model of intervention. Common sense and temporal awareness are perhaps the most crucial aspects to keep in mind when interacting with children of military parents. Systemically, it is important to target interventions at micro and macro levels. Children interact with their environment and arrive at conclusions about their functioning, the stability of their support systems, and love from their daily experiences. The model of working from the “outside in” makes the most sense. In other words, at times the focus of interventions/changes should be on other systems (child day care centers, schools) that intersect the child’s daily activities. It is a fact

Table 1 Responding to Children’s Grief: The INCLINE Perspective (Arriaza, 2010) Intervention

Explanation/Considerations for parents and support systems of children of military parents experiencing grief

Include

•

Include children in decision making, especially in maintaining control over disclosure of loss. Children can be great story tellers and allowing them to tell their stories verbally/expressively can be meaningful and therapeutic for them.

Nurture Children

•

Include children in societal rituals/practices when indicated.

•

Include children in family’s decision to find meaning.

•

Include children’s support systems during significant life transitions.

•

Nurture children physically, emotionally, spiritually, and socially by making their favorite foods, giving them hugs, helping them find meaning in the loss, and supporting their decisions to engage in social activities (friends, clubs, sports).


7



Communicate


•

Acknowledge that communication can be verbal or nonverbal.

•

Establish routines to increase communication (eating meals together, having family meetings, playing games, family night).

•

Keep conversations short, simple, and general.

•

With older children, parents may consider sending them an electronic mail message and/or texting them to increase communication.

Listen

•

Listen to children’s concerns by paraphrasing their stories and writing them and/or drawing them to exhibit genuine concern.

•

Validate children’s feelings by using their language and words

•

Use drawings of faces to elicit emotional responses (J K L).

•

Communicate at eye-to-eye level.

•

Establish routines (family meetings, family night) to practice listening, expressing emotions, validating feelings, and family cohesiveness.

Intensity

•

When children’s grief symptoms increase in intensity, consider seeking external support.

•

Pay attention to children’s mood and activities (increased anger, withdrawal, frequently talking about death, hopelessness, isolating from support systems, appetite and/or sleep disturbance, extreme clinginess, fearfulness, regressions).

Nurture Self

•

Establish a routine for self-care.

(Parents/Caregivers)

•

Reduce stress.

•

Take a time-out when communication with children/others is unproductive.

•

Seek emotional, social, physical, spiritual, and/or psychological support when needed/indicated.

External Resources

•

Seek external resources if expressions of grief become maladaptive.

•

Communicate with children’s support systems to stabilize and access community resources (support groups).


8




Conclusion The unprecedented prosecution of the war on terror has affected the family system of military families in ways that, as a society, we have yet to fully understand. The effects of grief on children of military parents are unique and ongoing. To target these effects, it is essential to understand the cycle of deployment and its impact on military families and to recognize and understand the different ways in which it can affect children embedded in these systems. Although such grief can be chronic and ongoing, parents, caregivers, and professionals can counteract the pressure of grief on children by using a systemic and ecological perspective. By doing so, the children’s psychosocial functioning can be stabilized and redefined.

Faber, A. J., Willerton, E., Clymer, S. R., MacDermid, S. M., and Weiss, H. M. (2008). Ambiguous absence, ambiguous presence: A qualitative study of military reserve families in wartime. Journal of Family Psychology, 22(2), 222–230. doi:10.1037/0893-3200.22.2.222. Fitzsimons, V., and Krause-Parello, C. (2009). Military children: When parents are deployed overseas. Journal of School Nursing (Sage Publications Inc.), 25(1), 40–47. Flake, E.M., Davis, B. E., Johnson, P. L., and Middleton, L.S. (2009). The psychosocial effects of deployment on military children. Journal of Developmental & Behavioral Pediatrics, 30(4), 271–278. Huebner, A. J., Mancini, J. A., Bowen, G. L., and Orthner, D. K. (2009). Shadowed by war: Building community capacity to support military families. Family Relations, 58(2), 216– 228. Kalksma-Van Lith, B. (2007). Psychosocial interventions for children in war-affected areas: The state of the art. Intervention, 5(1), 3–17. Kübler-Ross, E. (1997). On death and dying. New York, NY: Touchstone. Logan, K. V. (1987). The emotional cycle of deployment. Proceedings, 113(2), 43–47. Mmari, K., Roche, K. M., Sudhinaraset, M., and Blum, R. (2009). When a parent goes off to war: Exploring the issues faced by adolescents and their families. Youth & Society, 40(4), 455–475. Pincus, S. H., House, R., Christenson, J., & Adler, L. E. (2007). The emotional cycle of deployment: A military family perspective. Washington, DC: U.S. Army Center for Health Promotion and Preventive Medicine, the Army National Guard, and the Office of the Chief, Army Reserve. Retrieved November 1, 2010, from http://www.hooah4health.com/deployment /familymatters/emotionalcycle2.htm Ringdal, G. I., Jordhoy, M. S., Ringdal, K., and Kaasa, S. (2001). The first year of grief and bereavement in close family members to individuals who have died of cancer. Palliative Medicine, 15(2), 91–105. Rotter, J. C., and Boveja, M. E. (1999). Counseling military families. Family Journal, 7(4), 379– 382.

References Arriaza, P. (2010, October). The grief, bereavement, and mourning experiences of children of military parents. Unpublished paper presented at the Latino Social Work Organization Social Work Summit, Chicago, IL. Black, W. G. (1993). Military-induced family separations: A stress reduction intervention. Social Work, 38(3), 273–280. Bowling, U. B., and Sherman, M. D. (2008). Welcoming them home: Supporting service members and their families in navigating the tasks of reintegration. Professional Psychology: Research and Practice, 39(4), 451–458. Department of Defense. (2008). Implementation of the Yellow Ribbon Reintegration Program. Department of Defense Directive-Type Memorandum 08-029. Dimiceli, E. E., Steinhardt, M. A., and Smith, S. E. (2010). Stressful experiences, coping strategies, and predictors of health-related outcomes among wives of deployed military servicemen. Armed Forces & Society, 36(2), 351–373. Echterling, L., Stewart, A., and Budash, D. (2010). Suddenly military: Play-based interventions for deployed National Guard and Reserve families. Retrieved from http://counselingoutfitters. com/vistas/vistas10/Article_19.pdf Ellis, D. (2008). Off to war: Voices of soldiers’ children. Toronto: Groundwood Books. ILLINOIS CHILD WELFARE

9




Pablo Arriaza, PhD, MSW, LCSW, is an Assistant Professor of Social Work at the University of New Hampshire. Dr. Arriaza has practiced social work for the past 19 years with the last 16 years providing direct services to military families both in the U.S. and abroad. Dr. Arriaza is independently licensed as a clinical social worker in Florida and in Alabama. His research focuses on the intersection of death and dying with cultural and professional factors. He can be reached at [email protected]. Kerri Cornelissen, MSW is currently employed in the private sector. Her research has focused on issues concerning military families and psychosocial factors. She can be reached at [email protected].


10
