Unique Program Treats Military Families With Mental Health Issues

Soldiers returning home from deployment face many challenges, as do their families. How do they adjust to the separations and reunions? Three years ago, I became the Project Director for Military Families Are Resilient (MFAR), a program created at Didi Hirsch Mental Health Services in the Los Angeles area to help military families cope with the stresses associated with military life.

I had unique qualifications for the job. I had been employed at Didi Hirsch for a few years as a family therapist. I was also a military spouse and mother; my husband, Captain Perez, served four of the last five years with the US Army in Iraq, Kuwait, and Afghanistan. Our first daughter was four days old when he was deployed and our baby was four months old when he was deployed yet again.

When we met him at the airport on a home visit, our baby demonstrated some stranger anxiety symptoms and did not greet him right away. Our family had wrestled with anxiety, issues around reintegration, and feelings of loss, and I had had also experienced being overwhelmed as a single parent. It felt natural to bring my passion and intimate knowledge of being part of a military family to my work. 

One of the main goals of MFAR’s mission is to educate community-based services about the mental health needs of military families. Military children commonly experience feelings of anxiety, depression, abandonment, and anger, and the feelings I experienced as a spouse are typical. Military families often do not seek help for these issues because of the stigma associated with mental health challenges. Approximately 1.4 million military-connected children are enrolled in schools where they receive little or no support for their special challenges and needs.

Without this knowledge, we are missing an important piece of the puzzle. For instance, we received a referral for a child with defiant behaviors and attention-deficit/hyperactivity disorder (ADHD)-like symptoms. When we learned that the child’s older brother, a father-figure, had enrolled in the military and this child was feeling abandoned, we were able to provide more effective therapy.

To make it easier to identify military-connected students, we lobbied for revisions to school enrollment forms. So far, the Los Angeles Unified School District, which is the second largest school district in the nation, and three other Los Angeles County school districts have revised their forms to make it easier to identify students experiencing stress or trauma as a result of a family member’s military service. When these children are identified, school staff can make sure their families get connected to resources. 

At Didi Hirsch, we have treated 133 military-connected children over the past three years and have trained approximately 50 therapists throughout the agency in military culture. We also train therapists who want to work with military families in Families OverComing Under Stress (FOCUS), an evidence-based practice developed at UCLA.  The treatment helps families with resilience building, parenting, coping skills, and communication. The eight-week program involves families mapping their life stressors separately and together.

Children learn how to associate their feelings with their experiences, such as what it was like to have a holiday or birthday without the parent present. Parents are assigned homework that includes communication exercises. One of our veterans who participated in FOCUS described feeling like a stranger when he came home and feeling frustrated that his children didn’t respect his authority. Through FOCUS he learned how to communicate more effectively and now feels more integrated into his family.

MFAR is also involved in teaching parenting workshops at local veteran centers. In a parenting group, a veteran reported, “I cannot tolerate when my child says ‘no’ to me because it feels like disrespecting a command.” We then educated the veteran about his child, explaining that it is appropriate for a two year old to say ‘no’ because that is how a child learns he or she has choices. We also educate children about their parents. For instance, we may help a child understand that “Dad is struggling with his health and loud noises are hard right now.”

On a personal note, I was honored to win the National Council for Behavioral Health’s 2015 “Rising Star” Award for my work with MFAR and plan to donate my $10,000 grant to Didi Hirsch, where I hope to continue to make a difference in the life of military families. Didi Hirsch Mental Health Services provides quality mental health, substance abuse, and suicide prevention services at 11 locations in Los Angeles and Orange County.  Home to the nationally renowned Suicide Prevention Center, the nonprofit agency is dedicated to communities where poverty or stigma limits access and serves more than 90,000 children and adults each year.

Erica Trejo, LMFT, is a licensed marriage and family therapist and the project director for the Military Families Are Resilient Program at Didi Hirsch Mental Health Services, which operates many centers in the Los Angeles area. She is an advocate for military families and contributes to numerous boards and panels, including the Child Traumatic Stress Network.