Family Resilience in the Military

Abstract

Military life presents a variety of challenges to military families, including frequent separations and relocations as well as the risks that service members face during deployment; however, many families successfully navigate these challenges. Despite a recent emphasis on family resilience, the U.S. Department of Defense (DoD) does not have a standard and universally accepted definition of family resilience. A standard definition is a necessary for DoD to more effectively assess its efforts to sustain and improve family resilience. RAND authors reviewed the literature on family resilience and, in this study, recommend a definition that could be used DoD-wide. The authors also reviewed DoD policies related to family resilience, reviewed models that describe family resilience and identified key family resilience factors, and developed several recommendations for how family-resilience programs and policies could be managed across DoD.

Key Findings

• Definitions of family resilience vary among the services; there is no officially recognized DoD-wide definition.

• As of early 2015, DoD had 26 policies related to family resilience.

• To facilitate a comprehensive view of family resilience programming across DoD, a well-defined, well-articulated definition of a family-resilience program is necessary.

• The most common family resilience factors—that is, the resources that families use to cope with stress—can be grouped into five domains: family belief system, family organization patterns, family support system, family communication/problem-sharing, and the physical and psychological health of individual family members

The military conflicts of the past decade have increased stress and strain on service members and their families. Frequent deployments, separations, and relocations are hallmarks of military life and can greatly affect military families. The past decade has also seen increased rates of traumatic brain injury, depression, posttraumatic stress disorder, and suicide among service members.

Many families have been able to cope with and overcome these difficulties, but others have needed additional support to recover from the stresses associated with military life. For example, studies on the effects of deployment on military spouses have reported that wives of the deployed have higher rates of depression, anxiety disorders, sleep disorders, acute stress reaction, and adjustment disorders than those of non deployed service members (de Burgh et al., 2011). Deployment and military stressors also affect children: Children of deployed parents are more likely to exhibit anxiety, depression, aggression, attention deficits, and behavioral problems than others, and they are more likely to suffer neglect or maltreatment (Aranda et al., 2011; Chartrand et al., 2008; Lester et al., 2010; Lincoln and Sweeten, 2011; Chandra et al., 2010; Chandra et al., 2011; Gibbs et al., 2008).

Despite its recent emphasis on family resilience and the demand for deployment of soldiers, the U.S. Department of Defense (DoD) does not have a standard and universally accepted definition of family resilience. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) therefore requested that the RAND Corporation review studies on family resilience, summarize the literature, and develop a definition that could be used DoD-wide. RAND also reviewed DoD policies and programs related to family resilience, reviewed models that describe family resilience, and developed several recommendations for how family-resilience programs and policies could be managed across DoD.

Defining Family Resilience

To identify current definitions of resilience, we reviewed current DoD definitions across the services, gray literature from the Defense Technical Information Center's online database of technical reports and policies, and nearly 4,000 citations in the PubMed, PsycINFO, and Social Science Abstracts databases from the past 25 years. We focused on literature that debated the resilience of individuals in the context of their families and, more generally, the resilience of families as a whole. We found that the majority of research has focused on individual resilience versus family; however, many of its themes and definitions have influenced those of family resilience.

Individual Resilience

Individual resilience is generally defined as the ability to “bounce back” after experiencing stress (Wald et al., 2006; Meredith et al., 2011). Such definitions assume that stress negatively affects the well-being of individuals, and that individuals counteract or withstand stress through coping. Coping includes the use of such resources as individual attributes, characteristics, qualities, and the individual's environment to overcome anxious feelings that are attached to stress.

Research on resilience uses several related terms. Hardiness generally refers to personality characteristics that effectively assist individuals in handling anxiety and strain to prevent negative outcomes (Kobasa, 1979; Kobasa and Maddi, 1977; Bartone et al., 1989). Sense of coherence focuses on how individuals perceive and respond to certain events in their lives and is defined by comprehensibility (how individuals interpret these events), manageability (the degree to which individuals believe they can address these events), and meaningfulness (how individuals attach meaning or importance to these events) (Antonovsky, 1993; Antonovsky and Sagy, 1986). Flourishing, also interchangeable with thriving (Carver, 1998; O'Leary and Ickovics, 1995) or posttraumatic growth (Tedeschi and Calhoun, 2004), refers to individuals functioning at higher levels and experiencing greater well-being (Keyes, 2002), though this is typically in the context of trauma rather than stress.

Another often-used term in the military is readiness. Department of Defense Instruction 1342.22 (2012) defines personal and family readiness as “the state of being prepared to effectively navigate the challenges of daily living experienced in the unique context of military service.” Ready families are knowledgeable about the challenges they will face with deployment, equipped with the skills to function in the face of such challenges, and aware of the resources available to them—although DoD does not specify which skills and/or resources support family readiness.

While readiness and resilience are seldom incorporated or even interchangeable, we do not view the two as synonymous. Readiness is a state and/or condition that focuses on the resources individuals have before experiencing stress, whereas resilience is a process that focuses on the outcome of experiencing stress.

DCoE (2011) and the Institute of Medicine (2013), adopting a definition put forth by the Joint Chiefs of Staff (Chairman of the Joint Chiefs of Staff Instruction 3405.01, 2011), have defined resilience as “the ability to withstand, recover, and grow in the face of stressors and changing demands.” This framing of resilience as an ability suggests that resilience is not a stable, unchangeable quantity. By emphasizing an ability to withstand stress, this definition incorporates elements of hardiness within resilience, while also noting that resilience enables growth. Finally, this definition includes changing demands, suggesting that resilience is a process that occurs over time.

The Air Force has adopted the DCoE and IOM definition of individual resilience, but the other services have their own (Table 1). The Army definition contains elements of the above definition but includes different types of stress. The Navy's and the Marine Corps' definition emphasizes some concepts used in the Army definition, including different types of stressors, but also includes a focus on preparing for stressors, suggesting that readiness is a part of resilience.

Table 1.

Department of Defense and Institute of Medicine Definitions of Resilience

Service	Definition of Resilience	Source
Air Force	Resilience is the ability to withstand, recover, and/or grow in the face of stressors and changing demands.*	Draft Air Force Pamphlet
	Family Resilience: A sense of community among families along with an awareness of community resources, feeling prepared/supported during all stages of deployment, and an increased sense of unit, family, and child/youth support.	Jones, 2011
	Spouse Resilience: The extent to which spouses experience a meaningful connection to the Air Force, know and use their individual and community resources, and meet the challenges of military life.	Air Force Family Resiliency Working Group, July 26, 2010
Army	Resilience is a key factor in the mental, emotional, and behavioral ability to cope with and recover from the experience, achieve positive outcomes, adapt to change, and grow from the experience.*	Department of the Army, 2010
Navy and Marine Corps**	The process of preparing for, recovering from, and adjusting to life in the face of stress, adversity, trauma, or tragedy.*	Marine Corps Reference Publication (MCRP) 6–11C/Navy Tactics, Techniques, and Procedures (NTTP) 1–15M, 2010
Office of the Secretary of Defense (Military Community and Family Policy)	There is no DoD-recognized official operational definition of family resilience.	Not applicable
DCoE	Resilience is the ability to withstand, recover, and/or grow in the face of stressors and changing demands.*	Chairman of the Joint Chiefs of Staff Instruction (CJCSI) 3405.01
Institute of Medicine***	The ability to withstand, recover, and grow in the face of stressors and changing demands.	IOM (2013); CJCSI 3405.01

NOTE: Definitions accurate as of February 3, 2015.

^*Applies to both active and reserve components.

^**A second, similar definition of resilience also appears earlier in the document (pp. 1–2): “The ability to withstand adversity without becoming significantly affected, as well as the ability to recover quickly and fully from whatever stress-induced distress or impairment has occurred.”

^***Report produced for the Department of Homeland Security.

Family Resilience

The definitions of individual resilience have a number of themes. These include a process, successfully overcoming adversity or obstacles, being strengthened by an experience, and having resources and utilizing these resources effectively. Discussions of family resilience also emphasize the collectivity of the family. While individuals may have the resources for resilience, the whole family must benefit from the use of those resources for the family, as a whole, to be resilient.

To classify a definition of family resilience, we searched several academic databases, identifying 3,994 citations discussing topics such as “resilience,” “mental health,” and “family.” After excluding tangentially related works (e.g., those focusing on physical rather than psychological resilience), the research team reviewed 172 peer-reviewed journals, articles, and books for definitions of family resilience. Of these, 29 presented at least one definition with original content (i.e., a new definition or one building on a prior definition).

Though there is a plethora of existing definitions of family resilience, we recommend adopting one that covers the key themes above. We believe that Simon, Murphy, and Smith (2005) best define family resilience when they write: “Family resilience can be defined as the ability of a family to respond positively to an adverse situation and emerge from the situation feeling strengthened, more resourceful, and more confident than its prior state.”

This definition focuses on the family as a unit gaining either resources (i.e., acquiring new resources) or competencies (i.e., successfully using existing resources) to “bounce back” from stressors. This bounce may mean that the family functions even better after the stress than before, although this is not a prerequisite for resilience to have occurred. For example, a family that loses its home may develop more coping skills to effectively find new housing (i.e., acquire new resources) or may hone present skills to find a new place to live (e.g., using existing resources). This can make evaluation of program effectiveness especially difficult as it means that more traditional formulations of how to measure “resilience” (e.g., outcome-based functioning) may not actually capture post-event growth as it pertains to an improved ability to use coping resources or resourcefulness. Growth in this definition thus refers to a family's successful use of new or preexisting family-resilience skills. This definition also considers adverse situations or stressors as either episodic (i.e., a bounded event) or chronic. For example, a family member's deployment could be considered an adverse situation that is both a single stressful event and an enduring state of strain.

Family Resilience Policies

The rapid emergence of resilience as an area of policy relevance for DoD has led to two groups of policies: (1) policies about programs that originally had different purposes, such as youth programs, which are then modified to address resilience or family readiness, and (2) new policies that establish or address programs that specifically target family resilience.

Altogether, we found about two dozen DoD policies related to family resilience, distributed across the department and the services (Table 2). Eight of the 26 policies were at the DoD or Joint Chief of Staff level, three were Army, five were Air Force, six were Navy, two were shared by the Navy and Marine Corps, one was Marine Corps and one was National Guard. The origin of the documents varied, with 18 from service and support agencies (such as family, youth, and community services), five from medical portions of the military, one from special management, one from training, and one from operations. Of these, only one, the Chairman's Total Force Fitness Framework (CJCSI 13405.01), seeks to unify how different key agencies (e.g., chaplains, medical services, and community agencies) influence resilience, but this policy is not binding or regulatory. We are aware of several policies currently being developed, including the “Comprehensive Soldier and Family Fitness” for the Army and “Comprehensive Airmen Fitness” for the Air Force (release dates are not known).

Table 2.

Department of Defense Policies Related to Family Resilience

Policy Document Number	Policy Document Title	Date
Department of Defense
DoD Instruction (DoDI) 1342.22	Military Family Readiness	July 3, 2012
DoDI 6400.05	New Parent Support Program	June 13, 2012
DoDI 6490.09	DoD Directors of Psychological Health	February 27, 2012
CJCSI 3405.01	Charman's Total Force Fitness Framework	September 1, 2011
DoDI 1342.28	DoD Yellow Ribbon Reintegration Program	March 30, 2011
DoDI 6490.06	Counseling Services for DoD Military, Guard and Reserve, Certain Affiliated Personnel, and Their Family Members	April 21, 2009 (revised July 21, 2011)
DoDI 6060.4	DoD Youth Programs	August 23, 2004
DoD Directive 6400.1	Family Advocacy Program	August 23, 2004
Air Force
Air Force Instruction (AFI) 90-505	Suicide Prevention Program	August 10, 2012
AFI 44–172	Mental Health	March 14, 2011
AFI 40–101	Health Promotion	December 17, 2009
AFI 36–3009	Airmen and Family Readiness Centers	January 18, 2008
Army and National Guard
Army Regulation (AR) 608-18	Family Advocacy Program	October 30, 2007
AR 608-48	Army Family Team Building	March 28, 2005
Department of the Army Pamphlet 350-21	Family Fitness Handbook	November 1, 1984
National Guard Regulation 600-63	Army National Guard Health Promotion Program	July 1, 1997
Navy and Marine Corps
Marine Corps Order 1754.9A	Unit, Personal and Family Readiness Program	February 9, 2012
Chief of Naval Operations Instruction (OPNAVINST) 1738.1	Chaplains Religious Enrichment Development Operation	December 19, 2011
OPNAVINST 1750.1G	Navy Family Ombudsman Program	September 21, 2011
NTTP 1–15M and MCRP 6–11C	Combat and Operational Stress Control	December 20, 2010
OPNAVINST 1754.7	Returning Warrior Workshop Program	June 19, 2009
OPNAVINST 1754.1B	Fleet and Family Support Program	November 5, 2007
Secretary of the Navy Instruction 1754.1B	Department of the Navy Family Support Programs	September 27, 2005

In general, existing policies do not define resilience or factors that may contribute to or sustain it. Nor do they define desired outcomes of resilience beyond vague and unmeasurable terms. When more specific language is used, it does not link or relate to other policies, meaning that policies act in isolation, rather than being complementary. Family resilience policies often incorporate other related constructs, such as readiness. In addition, some family resilience policies focus on related subject areas, such as mental health.

DoD policies seeking to foster resilience have evolved over time, albeit at various rates across the services. Programs and interventions developed as a result of these polices have had varying degrees of evaluation for effectiveness. Altogether, the military's efforts to promote resilience are still developing, with little formalization, standardization, or evaluation. There is a notable lack of detailed and rigorous methods to implement, validate, and assess resilience programs and policies.

Models of Family Resilience

Given that military efforts to address family resilience have not yet fully developed, what models might DoD pursue to assess and promote resilience? What outcomes might DoD expect from its efforts? To answer these questions, we identified the most prominent models of family resilience in the academic literature, all of which have been applied to civilian populations, and some of which have been applied to military families as well. We also identified common elements of these models, called family-resilience factors, including characteristics, qualities, and abilities that such programs are likely to target.

Two frameworks inform family-resilience models. First, the ABCX Formula (Hill, 1958) emphasizes that stressors (A) and families' resources (B) intersect with the meaning (C) that families apply to stressors to produce a crisis (X). Families may define stressors as positive or negative depending on the reactions and/or outcomes of the stressor. Family organization is crisis-proof if the family resources for dealing with stress are adequate, but is considered crisis-prone if the family's resources are inadequate.

The second framework, the Double ABCX (McCubbin and Patterson, 1983), seeks to answer criticisms of the ABCX framework for only describing pre-crisis variables, which are both linear and deterministic. The Double ABCX framework extends the ABCX framework by recognizing that a family's response to a crisis is also affected by post-crisis factors; these include a pileup of stressors on top of the initial stressor (aA); existing and new resources (bB); perception of the initial stressor, pileup, and existing and new resources (cC); and coping and adaptation post-crisis (xX). Critiques of this model suggest that coping is not recognized until a family has actually used its resources (Burr, 1989).

The three most prominent models of family resilience are (1) the resiliency model of family stress, adjustment, and adaptation, (2) the systems theory of family resilience, and (3) the family adjustment and adaptation response (FAAR) model, each of which is discussed in the following sections. Other models we identified are derived from one or more of these or are not widely cited.

The Resiliency Model of Family Stress, Adjustment, and Adaptation

This prevention-oriented model explains the behavior of families under stress and the role of the family's strengths, resources, and coping mechanisms (McCubbin and McCubbin, 1988; McCubbin et al., 1995).

Practitioners use this model to help families find mechanisms to cope with stressors, i.e., any demand, problem, or loss that may affect the family's functioning or relations (McCubbin and McCubbin, 1993). Families may use protective factors, which can enable them to respond positively when a crisis strikes, or families can incorporate recovery factors to help them cope during and/or after a crisis or trauma. Although the relative importance of specific resources varies over the family life cycle and by culture, family characteristics that can promote proactive or recovery factors include accords, celebrations, communication, financial management, hardiness, health, leisure activities, personality, support network, time and routines, and traditions (McCubbin and McCubbin, 1993). Family resilience is greatest when protective factors are greatest and risk factors fewest (Hawley, 2000).

Previous literature focuses more on protective than recovery factors. Identifying recovery factors has been more challenging, in part because the most influential ones are situation-specific (McCubbin and McCubbin, 2005). For families facing prolonged deployment, key recovery factors are self-reliance (the degree to which family members can act independently in the family's best interest), family advocacy (the extent to which the family is part of collective efforts of other families in the same situation), and family meanings (how families define their demands and capabilities and see themselves in relation to the outside world) (McCubbin and McCubbin, 1988).

Systems Theory of Family Resilience

The systems theory of family resilience “identif[ies] and target[s] key family processes that can reduce stress and vulnerability in high-risk situations, foster healing and growth out of crisis, and empower families to overcome prolonged adversity” (Walsh, 2003, p. 6). It assumes that (1) the individual must be considered within the family and social world where he or she lives and (2) all families have the potential for resilience and can maximize it by identifying and building on resources and coping strategies that already exist and are favored by the family.

Three processes are associated with resilience: belief systems, organizational patterns, and communication/problem-solving (Walsh, 2003). Belief systems include the capacity to make meaning from adversity, a positive outlook, and spirituality. Organizational patterns include the flexibility to adapt and restabilize, connectedness with others, and economic resources. Communication/problem-solving includes clear, consistent information, emotional expressiveness, and collaborative decisionmaking.

This conceptualization of family resilience is incorporated in the concept of military family fitness. Fitness for a military family is its ability to use physical, psychological, social, and spiritual resources to prepare for, adapt to, and grow from the demands of military life (Westphal and Woodward, 2010). The Navy uses a Stress Continuum Model for improving family fitness, based on the conservation of resources theory and Walsh's (2006, as cited in Westphal and Woodward, 2010) model of family resilience. This model cites specific risk mechanisms by which exposure to trauma or a stressful situation experienced by a family member can lead to problems with family functioning. These risk mechanisms are based on the broad family processes of the systems theory of family resilience.

The Stress Continuum Model identifies four stress behavior stages within the family: (1) withstanding adversity without serious distress or loss of function, (2) limiting the severity of distress or impairment when it occurs, (3) recovering quickly and relatively fully from distress or impairment, and (4) coping with residual and persistent distress or changes in functioning. The goal is for unit leadership to engage with caregivers to ensure the best result for service and family members in each stage. The model highlights the expectation of stress responses and seeks to help provide families with the tools they need to work through stress.

Family Adjustment and Adaptation Response (FAAR) Model

The FAAR model is based on family stress and coping theory (McCubbin and Patterson, 1982, 1983; Patterson, 1988, 1999). It defines family adjustment or adaptation as the result of the processes families practice as they balance demands with capabilities as they intersect with meanings (Patterson, 2002). Families interact in a consistent way daily as they juggle demands with capabilities. Yet there are times when demands significantly outweigh a family's capabilities, which can produce a crisis. A crisis often results in a major change in family structure or functioning patterns and can create a discontinuity in the family's functioning.

Common Themes of Family Resilience Models

The three models outlined above differ in some ways. For example, some emphasize family processes and behaviors (Walsh, 2003), or pathways that families follow in response to stressors (De Haan, Hawley, and Deal, 2002). Others emphasize static family characteristics or attributes (e.g., McCubbin and McCubbin, 1988, 1993). Yet in other ways these models are quite similar For example, all three models—the resiliency model, the systems theory, and the FAAR model—are prevention-oriented and focus on identifying key family processes that families can use to cope in high-risk situations and prevent family dysfunction or dissolution.

These models also have several common concepts distinguishing them from other models of individual resilience and family well-being. Earlier models assumed that family resilience is the sum of the resilience of individual family members (Luthar, 1993; Walsh, 2003), while contemporary models consider the resilience of the family as a unit in addition to that of individuals within it.

We found several common family resilience factors—resources that families use to cope with stress—in research on family resilience models. We group these factors in five domains. Programs to boost family resilience may target the characteristics of each.

The domains and their component factors are

• Family Belief System: interpreting adversity with meaning, sense of control, sense of coherence, confidence that the family will survive and flourish, positive outlook, family identity, transcendence and spirituality, and worldview.

• Family Organizational Patterns: flexibility, connectedness and cohesion, family time, shared recreation, routines, rituals and traditions, family member accord and nurturance, effective parenting, social and economic resources, and sound money management.

• Family Support System: family and intimate relational support network and extended social support network.

• Family Communication/Problem-Sharing: clarity of communication, open emotional expression, emotional responsiveness, interest and involvement, and collaborative problem-solving.

• Physical and Psychological Health of Individual Family Members: emotional health, behavioral health, physical health, mastery, and hardiness.

The family resilience factors above have helped civilian families cope with financial distress, divorce, chronic physical and psychiatric illness, drug addiction or abuse, and exposure to trauma and natural disasters. Military families face all these problems and more, such as deployment and frequent relocation. Although the types (and, possibly, amount) of stress that military families face may differ from those which civilians face, the resources needed to combat them do not.

Assessing Family Resilience

Assessing family-resilience initiatives can be difficult. Many studies seeking to evaluate family resilience identify outcomes that are nearly the same as the family-resilience factors listed previously. Family-resilience factors, in turn, may vary by situation or stressor. For example, support from other military families to buffer the stress of deployment would be a family-resilience factor, while this support (or the lack of support) for a family experiencing a financial crisis would be a family-resilience outcome.

In other words, family-resilience factors represent the stock of resources a family has before stress, while outcomes indicate change in that stock. This change can be challenging to measure. For example, while one study (Arditti, 1999) suggests that young adults reporting greater closeness with their mothers following divorce show evidence of resilience, we suggest that this measure is incomplete because it ignores the contribution of the resilience of other family members and the family as a whole. A better measure would capture changes in other family relationships as well.

Another approach to measuring resilience would be to ask families how they view themselves following a challenging event. A limitation of this approach is that it is not always clear whether the family was strong or struggling prior to the event. Asking families how they are doing before the event could result in retrospective biases (Mezulis et al., 2004). The strongest approach to measuring family-resilience outcomes would be to measure family functioning before, during, and after the crisis (De Haan, Hawley, and Deal, 2002), although there is no agreement on the optimal pre- and post-crisis measurement times.

By broadening the definition of psychological health to include well-being, we can also include outcomes such as financial problems, family communication and cohesion, and domestic violence. This broader approach has three advantages. First, as noted, many family-resilience factors can also be considered outcomes of family resilience. Second, more-proximate determinants of resilience, such as family functioning and marital accord, are also important outcomes of the family-resilience process. Third, this broader focus can detect maladaptive responses, such as spouse or child abuse, to stress, that may be missed if the focus remains on traditional psychological health outcomes.

Defining a Family-Resilience Program

One of the most important aspects of attempting to assess the state of family resilience across DoD is knowing which programs should be evaluated for effectiveness. Thus, it is integral to have a standard definition of what a family-resilience program is (and clear criteria for what is not), much like it is integral to have a standard definition of family resilience. To develop a definition of a family-resilience program, we draw on previous findings from RAND's Innovative Practices for Psychological Health and Traumatic Brain Injury project (see Weinick et al., 2011). Based on this literature, we suggest that family resilience programs are distinct from routine clinical care, such as family counseling and nonsupport services provided in chaplaincy and family-support departments. They are also distinct from one-way, passive transmission of information resources, such as a hotline.

Programs to improve family resilience rely on growing research for identifying new treatments and best practices. However, the degree to which family-resilience programs use existing research varies. Existing delivery systems of care rely on well-established, validated empirical support and target clinical problems. Programs, while having less empirical support, are more focused on prevention, resilience, and other subclinical problems.

As an example, in Table 3 we outline one possible definition of what constitutes a family-resilience program and what does not. We note, however, that the example in Table 3 is simply that—an illustrative example. Other criteria could be used for the definition. The larger point is that in order to facilitate a comprehensive view of family resilience programming across DoD, a well-defined, well-articulated definition of a family-resilience program is necessary. Such a definition will allow all of the key stakeholders to speak a similar language and start to develop the infrastructure necessary to evaluate the family-resilience programs that meet the agreed-upon definition.

Table 3.

Example of Family Resilience Program Inclusion and Exclusion Criteria

Inclusion Criteria	Exclusion Criteria
Provides active services or other interactive efforts in support of family resilience	Involves routine care, such as that provided at a military treatment facility
Focuses on at least one family factor hypothesized to help families address a challenging situation or chronic issue	Involves passive transfer of information, such as via hotlines
Aims to improve psychological health and well-being (broadly defined)	Not aimed at improving psychological health and well-being (broadly defined)
Targets active component National Guard or Reserve component service members and/or their family members	Screening tools not associated with a program that meets the criteria
Sponsored by DoD	Consists only of laws, policies, memorandums, advisory teams, working groups, task forces, committees, or conferences
Operational during some defined period

Recommendations

Based on our findings on efforts to define family resilience as well as models and programs for it, we make six recommendations. These recommendations are designed to help DoD move toward a culture of evaluation of family-resilience programs and to help DoD craft and implement policies that create, sustain, and improve family resilience.

First, DoD should designate a governing or oversight body to manage the overall family-resilience enterprise, including definitions, metrics, policies, and programs. Currently, no overarching office, group, or organization has been officially charged with this. DoD should designate a governing or oversight body to do so. It should ensure that this enterprise organization has the authority to hold other organizations and programs responsible for outcomes through a clear chain of command. The chain of command should ensure that DoD-wide family-resilience policies are properly created, vetted, and followed and that these policies match current research.

Second, the family-resilience enterprise organization should adopt an official DoD definition and model of family resilience. The organization should define family resilience for programs and specify components or outcomes to target in order to better understand how programs help service members and their families. Definitions, models, frameworks, and outcomes should be explicitly defined in written policy.

Third, the family-resilience enterprise organization should have a “road map” that follows established programs, policies, and definitions, ensuring that all stakeholders know their role and how they contribute to the success of the overall family-resilience enterprise. Different stakeholders in the military (e.g., medical, youth coordinators, chaplains, and family advocates) make different contributions to resilience, but there is no mechanism to unify them and their efforts. Family resilience must have a clear definition and set of outcomes or goals. Agencies must have a clear understanding of how they contribute to the whole, as well as to organizational structure, command, and authority.

Fourth, the family-resilience enterprise organization should encourage a culture of continuous quality improvement (CQI) across DoD and within family-resilience programs. CQI, which requires learning about and incorporating best practices, can optimize services by focusing on the use of data to measure and improve efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality program processes.

Fifth, DoD should develop a system of coordination between programs to avoid redundancy and to encourage CQI. Coordination among programs can avoid redundancy and allow programs interested in similar initiatives to share lessons learned.

Sixth, the broader research community should identify what aspects of family resilience matter most for best practices in military family-resilience programs. Knowing where to focus the resources and programmatic efforts is necessary to efficiently and effectively build resilience among military families.

Conclusion

By defining the concept of family resilience, DoD can better develop programs to support it and help military families best adapt to the challenges of military life. Many military families already exhibit remarkable strength through their beliefs, organization, communication, support, and health. Developing models that recognize this and help families improve where they can will help military families become more resilient by improving their psychological and physical health as well as their ability to respond to potential stressors.

While we believe this work can help the military best support its families, we note that our research has some limitations. First, despite our best effort to identify all relevant elements of family-resilience programs, we may have overlooked some. Second, subsequent evaluation of family-resilience programs should explore the tools needed to implement programs. Third, social desirability may always affect research such as this, leading to caution in sharing information about relevant elements and programs.