Understanding Military Stressors for Civilian Clinicians Part 1-Childhood Trauma

As Reported by the National Child Traumatic Stress Network: The most frequent forms of abuse in military families are neglect, physical abuse, and emotional abuse. Just as in civilian families, sexual abuse is less common than the other forms of abuse. The rate of neglect, or failure to properly meet children’s basic needs, has increased markedly, particularly in families where one parent is deployed and the other parent is at home in charge of the children and household. The rate of physical abuse has also increased in these circumstances. Mothers are three times more likely to engage in child maltreatment when their spouses are away than when they are at home. The implication is that in some families, stress created by deployments and the absence of a parental partner may impair the ability of at-home parent(s) to manage their emotions and behavior and appropriately care for their children. According to the Center for Deployment Psychology: The following findings are from a recent study examining the association between combat-related deployments (OIF and OEF) and rates of child maltreatment in families of enlisted soldiers (Army only) with substantiated reports of child maltreatment (Gibbs et. al., 2007): • Overall, the rate of child maltreatment during soldier deployments was 42% higher than the rate of child maltreatment when soldiers were not deployed. • The rates of child neglect were almost twice as great during deployment vs. non-deployed time periods. • Among female spouses who were civilians (e.g., non-military wives of soldiers), the rates of maltreatment, neglect, and physical abuse during deployment were more than three, four, and two times as great respectively when compared to the non-deployed time period. • Younger children ages 2 – 12 years showed elevated rates of maltreatment during deployment compared with children under 2 years or over 12 years of age. There were no differences found for rate of maltreatment based on gender of the child. When trying to coach other civilian clinicians I like to ask this challenging question to get the "juices" moving...and to get them out of their comfort zone; "What stressors could play into an increased potential for abuse during a deployment cycle?" Although neglect and failure to meet children’s needs increase with the deployment cycle, statistics show that abuse is more often perpetrated by the active duty parent (54% of cases) than the at-home parent (40%). The active-duty perpetrator is more often the father (57% of cases). Younger enlisted members are the most frequent perpetrators of child maltreatment. Civilian clinicians need to understand that child abuse /neglect and domestic violence have different ways of being reported by the military. Child abuse and neglect are to be addressed the same as civilian cases however, if you are a contractor to the military, a GS counselor or work on a military installation, you must also follow your indicated “duty to warn” mandate. That could be reporting to your specified “point of contact” for the military or the military person’s commanding officer and/or military police. In child abuse/neglect cases you will always contact the State CPS. Regardless of your roll inside or outside of the military your role as a mandated reporter is consistent. Keeping this in mind, the responsible clinician should work to be culturally competent and especially mindful of the military culture, when child abuse or neglect may be in question.

Namaste

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