Papers by William Saltzman
Journal of Child & Adolescent Trauma, 2008
... DOI: 10.1080/19361520801934399 Patricia Lester a * , William Saltzman b , Vera Vine c , W. Sc... more ... DOI: 10.1080/19361520801934399 Patricia Lester a * , William Saltzman b , Vera Vine c , W. Scott Comulada d , Rise Goldstein e , Margaret Stuber f & Robert Pynoos g pages 47-61. ... [CrossRef], [PubMed], [Web of Science ®] View all references; Diamond & Josephson, 200514. ...
Clinical Child and Family Psychology Review, 2011
Recent studies have confirmed that repeated wartime deployment of a parent exacts a toll on milit... more 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 familycentered, 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. Keywords Resilience Á Family resilience Á Military family Á FOCUS Á FOCUS project Á Risk and resilience Á Resilience enhancement program Á Trauma treatment program Á Combat stress program Á Wartime deployment Á Family stress Á Military family treatment Á Military child and family Á Military family prevention
Prevention Science, 2000
In this paper, we report on the development and dissemination of a preventive intervention, Famil... more In this paper, we report on the development and dissemination of a preventive intervention, Families Over-Coming Under Stress (FOCUS), an eight-session familycentered intervention for families facing the impact of wartime deployments. Specific attention is given to the challenges of rapidly deploying a prevention program across diverse sites, as well as to key elements of implementation success. FOCUS, developed by a UCLA-Harvard team, was disseminated through a large-scale demonstration project funded by the United States Bureau of Navy Medicine and Surgery (BUMED) beginning in 2008 at 7 installations and expanding to 14 installations by 2010. Data are presented to describe the range of services offered, as well as initial intervention outcomes. It proved possible to develop the intervention rapidly and to deploy it consistently and effectively.
Journal of the American Academy of Child & Adolescent Psychiatry, 2010
Given the growing number of military service members with families and the multiple combat deploy... more Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 through 12) of an active duty Army or Marine Corps parent currently deployed (CD) or recently returned (RR) from Afghanistan or Iraq. Children (N = 272) and their at-home civilian (AHC) (N = 163) and/or recently returned active duty (AD) parent (N = 65) were interviewed. Child adjustment outcomes were examined in relation to parental psychological distress and months of combat deployment (of the AD) using mixed effects linear models. Parental distress (AHC and AD) and cumulative length of parental combat-related deployments during the child's lifetime independently predicted increased child depression and externalizing symptoms. Although behavioral adjustment and depression levels were comparable to community norms, anxiety was significantly elevated in children in both deployment groups. In contrast, AHC parental distress was greater in those with a CD (vs. RR) spouse. Findings indicate that parental combat deployment has a cumulative effect on children that remains even after the deployed parent returns home, and that is predicted by psychological distress of both the AD and AHC parent. Such data may be informative for screening, prevention, and intervention strategies.
Clinical Child and Family Psychology Review, 2013
We draw upon family resilience and narrative theory to describe an evidence-based method for inte... more We draw upon family resilience and narrative theory to describe an evidence-based method for intervening with military families who are impacted by multiple wartime deployments and psychological, stress-related, or physical parental injuries. Conceptual models of familial resilience provide a guide for understanding the mechanics of how families respond and recover from exposure to extreme events, and underscore the role of specific family processes and interaction patterns in promoting resilient capabilities. Leading family theorists propose that the family's ability to make meaning of stressful and traumatic events and nurture protective beliefs are critical aspects of resilient adaptation. We first review general theoretical and empirical research contributions to understanding family resilience, giving special attention to the circumstances, challenges, needs, and strengths of American military families. Therapeutic narrative studies illustrate the processes through which family members acquire meaningmaking capacities, and point to the essential role of parents' in facilitating discussions of stressful experiences and co-constructing coherent and meaningful narratives. This helps children to make sense of these experiences and develop capacities for emotion regulation and coping. Family-based narrative approaches provide a structured opportunity to elicit parents' and children's individual narratives, assemble divergent storylines into a shared family narrative, and thereby enhance members' capacity to make meaning of stressful experiences and adopt beliefs that support adaptation and growth. We discuss how family narratives can help to bridge intra-familial estrangements and re-engage communication and support processes that have been undermined by stress, trauma, or loss. We conclude by describing a family-based narrative intervention currently in use with thousands of military children and families across the USA.
Proceedings of the 2014 Acm International Joint Conference, Sep 13, 2014
American Journal of Public Health, 2012
Risk and Resilience in U.S. Military Families, 2010
... Applying Prevention Science to Enhance Family Resilience Patricia Lester, Gregory Leskin, Kir... more ... Applying Prevention Science to Enhance Family Resilience Patricia Lester, Gregory Leskin, Kirsten Woodward, William Saltzman, William Nash, Catherine Mogil ... for poor adjustment in children (Beardslee, 1984; Lester, Stein, & Bursch, 2003; Rutter, 1966; Rutter & Quinton, 1984 ...
Clinical Child and Family Psychology Review, 2013
In response to the needs of military families confronting the challenges of prolonged war, we dev... more In response to the needs of military families confronting the challenges of prolonged war, we developed Families OverComing Under Stress (FOCUS), a multi-session intervention for families facing multiple deployments and combat stress injuries adapted from existing evidence-based family prevention interventions (Lester et al. in Mil Med 176(1): 19-25, 2011). In an implementation of this intervention contracted by the US Navy Bureau of Medicine and Surgery (BUMED), FOCUS teams were deployed to military bases in the United States and the Pacific Rim to deliver a suite of family-centered preventive services based on the FOCUS model (Beardslee et al. in Prev Sci 12(4): 339-348, 2011)
Military Medicine, 2013
Family-centered preventive interventions have been proposed as relevant to mitigating psychologic... more Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research.
Care of Military Service Members, Veterans, and Their Families, 2014
Risk and Resilience in U.S. Military Families, 2010
... Applying Prevention Science to Enhance Family Resilience Patricia Lester, Gregory Leskin, Kir... more ... Applying Prevention Science to Enhance Family Resilience Patricia Lester, Gregory Leskin, Kirsten Woodward, William Saltzman, William Nash, Catherine Mogil ... for poor adjustment in children (Beardslee, 1984; Lester, Stein, & Bursch, 2003; Rutter, 1966; Rutter & Quinton, 1984 ...
Prevention Science, 2011
In this paper, we report on the development and dissemination of a preventive intervention, Famil... more In this paper, we report on the development and dissemination of a preventive intervention, Families OverComing Under Stress (FOCUS), an eight-session family-centered intervention for families facing the impact of wartime deployments. Specific attention is given to the challenges of rapidly deploying a prevention program across diverse sites, as well as to key elements of implementation success. FOCUS, developed by a UCLA-Harvard team, was disseminated through a large-scale demonstration project funded by the United States Bureau of Navy Medicine and Surgery (BUMED) beginning in 2008 at 7 installations and expanding to 14 installations by 2010. Data are presented to describe the range of services offered, as well as initial intervention outcomes. It proved possible to develop the intervention rapidly and to deploy it consistently and effectively.
Journal of Interpersonal Violence, 2007
This study examines the psychological and behavioral effects of exposure to community violence of... more This study examines the psychological and behavioral effects of exposure to community violence of 47 Latino mothers and their young adolescent children. Using data gathered from multiple sources, this study tests the associations between lifetime exposure to community violence, maternal depression, and child behavior problems. More than 80% of the youngsters ranging from age 11 to 14 years and 68% of the mothers reported being exposed to at least one act of community violence either as a victim or as a witness. Analyses reveal that maternal depression is a mediator of child behavior problems, reducing the direct effect of community violence exposure by more than 50%. Findings suggest that maternal depression is a factor more important than child's community violence exposure in contributing to young adolescents' behavioral problems.
Journal of Child & Adolescent Trauma, 2008
Page 1. 63 Journal of Child & Adolescent Trauma, 1:6374, 2008 Copyright © 2008 b... more Page 1. 63 Journal of Child & Adolescent Trauma, 1:6374, 2008 Copyright © 2008 by The Haworth Press. All rights reserved. ISSN: 1936-1521 print / 1536-153X online DOI: 10.1080/19361520801934423 WCAT1936-1521 ...
Journal of Child & Adolescent Trauma, 2008
... DOI: 10.1080/19361520801934399 Patricia Lester a * , William Saltzman b , Vera Vine c , W. Sc... more ... DOI: 10.1080/19361520801934399 Patricia Lester a * , William Saltzman b , Vera Vine c , W. Scott Comulada d , Rise Goldstein e , Margaret Stuber f & Robert Pynoos g pages 47-61. ... [CrossRef], [PubMed], [Web of Science ®] View all references; Diamond & Josephson, 200514. ...
Journal of the American Academy of Child and Adolescent Psychiatry, 2008
To evaluate the comparative effectiveness of a classroom-based psychoeducation and skills interve... more To evaluate the comparative effectiveness of a classroom-based psychoeducation and skills intervention (tier 1) and a school-based trauma- and grief-focused group treatment (tier 2) of a three-tiered mental health program for adolescents exposed to severe war-related trauma, traumatic bereavement, and postwar adversity.
Group Dynamics: Theory, Research, and Practice, 2001
Recent studies document high levels of community violence exposure among adolescents and link vio... more Recent studies document high levels of community violence exposure among adolescents and link violence exposure to psychological distress and impaired academic achievement. This study assessed the prevalence of trauma exposure among middle school students and evaluated the effectiveness of a school-based, trauma/grief-focused group psychotherapy protocol in treating a sub-group of students with severe exposure, posttraumatic stress disorder (PTSD) and functional impairment. Using a stratified screening procedure, 812 students completed a screening survey, 58 students (7.1% of those surveyed) met criteria for group treatment, and 26 students participated in the group. Group participation was associated with improvements in posttraumatic stress and complicated grief symptoms, and in academic performance. Results suggest that students who are exposed to severe levels of community violence may not be typically identified or treated. The findings also suggest that severe PTSD in adolescence may be associated with impaired school functioning, and that a reduction in PTSD symptoms may be related to academic remediation.
Group Dynamics: Theory, Research, and Practice, 2001
Uploads
Papers by William Saltzman