Expert Interview Working With Children and Families Lee Combrinck-Graham, MD

How Clinicians Can Support Military Families

If you don’t live near a military base, you may not think that developing skills for helping military families is a concern for your practice. But here are the facts: As of February of 2019, there were almost 1.4 servicemembers in active duty with another almost 800,000 in reserves. Those 1.3 million active-duty service members have 1.6 million immediate family members. In addition, there are 18.2 million veterans in the United States. Extended families of soldiers and veterans live anywhere and everywhere. Sometimes they need our help.

Every branch of the armed services has counseling and support services for both the service member and their family. But some people think that seeing a private clinician guarantees more confidentiality than someone associated with a base. Some simply live too far from a VA facility or a base.

Here are some examples: (Identifying information in case examples has been changed to protect client privacy).

Joanie came into my office looking shaken and pale. As soon as she sat down, she said, so quietly I almost didn’t hear: “We’re at war.” This was in 2001, when the U.S. declared war on Afghanistan. Until we talked that day, I didn’t know she had a son in the military who would likely be deployed.

Many years later, Carlota came in, brimming with excitement. She had just returned from her older son’s graduation from Basic Training. Her son had changed, she told me, from a rebellious kid to a confident soldier. She was proud. She was impressed.

Then her face crumbled. “Oh God. Oh God. He’s just a kid”, she sobbed. “He’s so proud to be a solider. He’s in infantry. All I can think about is where he’ll be going and if he’ll be back.”

I’d been treating Al for depression for months. He seemed distracted, even though his mood had been improving. After some prodding, he told me that he had a cousin in harm’s way in the Middle East.

Al said he thought of him when he went to sleep and when he woke up. He often woke in the middle of the night with worry. Why hadn’t he talked about it? “Because,” he said, “I didn’t think it had anything to do with depression, especially since we’re only cousins.”

And then there was Georgia, a mother of three children under age seven. While her husband was deployed, she and the kids moved in with her in-laws. Unlike some who find the close kinship of families on base helpful, she felt she had no privacy.

So here she was, hundreds of miles away from her own family and from the base where she had been living. She found she had traded in the lack of privacy on the base for the lack of privacy at her in-laws. Her mother-in-law was trying to be helpful but had different ideas about parenting than she did.

Implications for Mental Health Counselors

Even if your private practice is far from a military installation, you may have clients who are connected to the military. Since this topic is huge, I’m going to confine this discussion to family members of those in active service or the reserves, not on the individual service member or veterans and their families.

Here are some reminders for you to consider:

Intake should always include inquiry about whether anyone in the family is in the military Although some extended family members and friends are acutely aware that their distress is at least partly because of their worries about their loved one, others aren’t or are in denial about it.

Educate yourself about the military culture: Make it your business to learn all you can about the culture of the branch of service to which the family member belongs. An internet search will give you an overview.

Learn about the common stressors: Yes, military families are like everyone else. But there are also stressors that are unique. The typical military family, for example, moves every two to three years.

Studies have shown that spouses of deployed soldiers often report loneliness, depression, anticipatory fear or grief, and worries about how they will react to their spouse when she or he returns.

Parents left behind frequently report stress around parenting issues. The absence of a parent, their own worries for the deployed parent’s safety, and the kids’ response to the remaining parent’s distress can all have a negative effect on children.

Military parents facing deployment often experience additional stress as they deal with their pending absence from their children.

If both parents are deployed at the same time, there is even more stress on the couple as they look for adequate care for their children.

In most cases, the kids move in with grandparents or another close relative – who are then stressed by their worry about the parents, by the changes necessitated by the addition of the children to their lives, and by the children’s stress.

Extended family members sometimes feel they don’t have a “right” to be upset. They don’t want to worry their deployed son or daughter. They feel they should be supports for the spouse and children and don’t want to add to the family’s stress. They are sometimes confused about when and how to express their own feelings.

Find out about available supports: When family members support the mission of the soldier and are helpful to the family left behind, the spouse and children do better. But don’t assume that support. Some kinds of “help” are not helpful. Extended family who is critical of military service or who have different ideas about what the spouse ought to be feeling or doing only add to the stress.

On the other hand, grandparents can significantly reduce the stress on parents – provided they and the parent are in agreement about child rearing practices.

Consider family sessions: It’s often helpful when treating a spouse of a deployed soldier to include some sessions with family members who live nearby. It can be a relief for the family to have a safe place to talk about their mutual concerns and how best to be supportive of each other as well as the deployed person.

Educate yourself about military resources for families: Every branch of the military now has a program for families:




How Clinicians Can Support Military Families

Marie Hartwell-Walker, EdD

Marie Hartwell-Walker, Ed.D. is an author, licensed psychologist, and a marriage and family therapist who has been in practice for more than 35 years. She is a regular contributor to Psych Central and one of the therapists who answer questions at Ask the Therapist.


APA Reference
Hartwell-Walker, M. (2019). How Clinicians Can Support Military Families. Psych Central. Retrieved on August 13, 2020, from


Scientifically Reviewed
Last updated: 24 Dec 2019
Last reviewed: By John M. Grohol, Psy.D. on 24 Dec 2019
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