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Parenting and Problem Solving Group for Veterans & Their Families
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The journey “home” for Veterans can be overwhelming, especially when confronted with unplanned stressors such as; physical/emotional health concerns, relationship/family problems, financial issues and/or employment concerns . These events can become difficult to manage, creating a perfect storm to an already naturally stressful process of reintegration.
VA Medical Centers, clinics and Vet Centers often provide quality clinical care, but there is no program that offers a parenting and problem solving class to Veterans, their partner/spouse and children. This program addresses deployment and reintegration challenges for service members and their families. This program recognizes that parenting challenges are dynamic and change over time and provides resources for the Veteran and their families to reconnecting and re-establishing their roles within the family. The Parenting and Problem Solving Program that Providence VA developed and Boston VA Healthcare System replicated, offers a whole health approach to working Veterans and their Families. The Parenting and Problem Solving Program for Veterans & Their Families is unique and dynamic and focuses on supporting the Veteran and the family unit through multi-system collaboration at the local, state and federal level.
Origin:
October 2016, Providence VA Medical Center
Adoptions:
1 successful, 1 in-progress
Awards and Recognition:
Providence got VISN 1 Culture of Improvemnet innovation Grant and Boston Health Care System (Brocton VA0 received Spark Seed Spread Innovation Grant
Partners:
Diffusion of Excellence, VHA Innovators Network
Recent Updates
Overview
Problem
Newly returning Veterans and their families are impacted by their experiences in war. Veterans often face many challenges including readjustment, facing the demands, stressors and conflicts of returning home and reintegrating back into society and their home lives. The VA offers a variety of services for these veterans from MH, Physical health, case manag
...
Newly returning Veterans and their families are impacted by their experiences in war. Veterans often face many challenges including readjustment, facing the demands, stressors and conflicts of returning home and reintegrating back into society and their home lives. The VA offers a variety of services for these veterans from MH, Physical health, case management, job assistance etc. The one thing that is presently not addressed for Veterans is their reintegration into families and parenting. Many of these Veterans have young children, are newly married and the above has great impact on them. Family members need to be educated on these challenges and learn to cope with their “New” Veteran. This in integral to the successful reintegration of the Veteran.
• Combat deployment and reintegration are challenging for service members and their families.
• Parenting challenges are dynamic and change over time.
• Reconnecting and re-establishing your role within the family can be a challenge
Implications of Veteran’s struggling with anger on their families:
Adverse consequences include:
• Increased risk for divorce
• Domestic violence
• Job loss and financial instability
• serious impairments in family, social, and occupational functioning
Impact on Children:
• Child distress, depression and anxiety are associated with parent combat deployment
• Greater distress associated with longer deployment
• Deployment related to more transitions in children lives See more
• Combat deployment and reintegration are challenging for service members and their families.
• Parenting challenges are dynamic and change over time.
• Reconnecting and re-establishing your role within the family can be a challenge
Implications of Veteran’s struggling with anger on their families:
Adverse consequences include:
• Increased risk for divorce
• Domestic violence
• Job loss and financial instability
• serious impairments in family, social, and occupational functioning
Impact on Children:
• Child distress, depression and anxiety are associated with parent combat deployment
• Greater distress associated with longer deployment
• Deployment related to more transitions in children lives See more
- Overview of how Parenting Group was developed Parenting Group from Idea to Innovation
Files
Solution
Run a Problem solving skills training/parenting class for both the Veteran and their significant other Classes run on Monday evenings (1 ½ hours)
• 10 Weeks
• A children's group is running during this time and offers pizza, juice, a snack and meaningful activities
•
Objective of Project is to teach Veteran and significant others skills in
- Basic edu ... Run a Problem solving skills training/parenting class for both the Veteran and their significant other Classes run on Monday evenings (1 ½ hours)
• 10 Weeks
• A children's group is running during this time and offers pizza, juice, a snack and meaningful activities
•
Objective of Project is to teach Veteran and significant others skills in
- Basic education on child development
- Age Appropriate discipline
- Affective engagement/ Good communication skills
- Increase problem solving skills
- Educate veteran and significant other on managing symptoms and family relationship and how their experience impacts their children.
- How to disciple child appropriately while gone and in wake of veterans own mental health and physical issues.
Children’s Group:
- Provide children with vocabulary of feelings words
- Explore feelings and emotions and learn how to identify feelings and put words to feelings. We are able to do this by watching movies (Inside Out) and engaging in fun play and activities. See more
• 10 Weeks
• A children's group is running during this time and offers pizza, juice, a snack and meaningful activities
•
Objective of Project is to teach Veteran and significant others skills in
- Basic edu ... Run a Problem solving skills training/parenting class for both the Veteran and their significant other Classes run on Monday evenings (1 ½ hours)
• 10 Weeks
• A children's group is running during this time and offers pizza, juice, a snack and meaningful activities
•
Objective of Project is to teach Veteran and significant others skills in
- Basic education on child development
- Age Appropriate discipline
- Affective engagement/ Good communication skills
- Increase problem solving skills
- Educate veteran and significant other on managing symptoms and family relationship and how their experience impacts their children.
- How to disciple child appropriately while gone and in wake of veterans own mental health and physical issues.
Children’s Group:
- Provide children with vocabulary of feelings words
- Explore feelings and emotions and learn how to identify feelings and put words to feelings. We are able to do this by watching movies (Inside Out) and engaging in fun play and activities. See more
Results
Lessons Learned from the first 2 cohorts offered:
• Kids are motivating factor in parents returning to class
• Each session asked for the group to run longer
• Each session inquired about follow up groups
• Evaluation on quality of workshop has received scores of 4 out of 5 (1=poor, 3=average, 5=excellent)
• Too many evaluation forms
Request to in ... Lessons Learned from the first 2 cohorts offered:
• Kids are motivating factor in parents returning to class
• Each session asked for the group to run longer
• Each session inquired about follow up groups
• Evaluation on quality of workshop has received scores of 4 out of 5 (1=poor, 3=average, 5=excellent)
• Too many evaluation forms
Request to incorporate more role playing
Post Class Survey Responses—Evidence From Participants:
• I have learned from surveys that this Program has been instrumental in helping Veterans and families improve communication and problem solving skills. Which have also decreased stress, DV, and family issues. Veteran and Spouse have communicated a need for additional parenting classes to address and have support for other issues as their families grow. They have spoken about the resources provided in the classes and stating they will occasionally refer back to them when encountering issues in their homes.
• One couple informed the interviewer in the post-class survey that they had participated in parenting classes as a court ordered requirement while going through a divorce and stated that the class really helped them in using age appropriate tasks/punishments and gave them further understanding of how PTS/Depression can negatively affect their parenting. Veteran and Spouse stated that by having a better understanding of how their mental health affects their communication skills and therefore their parenting skills they are more aware of self and how they talk to their children and how to assign appropriate task/punishments.
• Veteran and spouse have informed interviewer that they communicate more now when deciding on tasks/punishments with their children allowing them to be on the same page and feeling like they have each other for support.
Letter received from Veteran:
Veteran called and wanted to share his thanks for the impact your parenting group had on him, his wife and their two children. He said that he was only able to attend about 75% because of medical issues, but his wife kept going because she liked it so much. They found the insight and solutions that were offered to be very helpful, and they continue to use them today. The class was ‘highly beneficial’ both because of the materials you used and the atmosphere you created. Even his two children still pull out a book they made as part of the group they attended while the parents were in class 3 or 5 times a week. He and his wife also found it comforting to know they were not the only family struggling.
Sean has had what he describes as his ups and downs at the VA, but that the parenting group was definitely ‘one of the good parts’. See more
• Kids are motivating factor in parents returning to class
• Each session asked for the group to run longer
• Each session inquired about follow up groups
• Evaluation on quality of workshop has received scores of 4 out of 5 (1=poor, 3=average, 5=excellent)
• Too many evaluation forms
Request to in ... Lessons Learned from the first 2 cohorts offered:
• Kids are motivating factor in parents returning to class
• Each session asked for the group to run longer
• Each session inquired about follow up groups
• Evaluation on quality of workshop has received scores of 4 out of 5 (1=poor, 3=average, 5=excellent)
• Too many evaluation forms
Request to incorporate more role playing
Post Class Survey Responses—Evidence From Participants:
• I have learned from surveys that this Program has been instrumental in helping Veterans and families improve communication and problem solving skills. Which have also decreased stress, DV, and family issues. Veteran and Spouse have communicated a need for additional parenting classes to address and have support for other issues as their families grow. They have spoken about the resources provided in the classes and stating they will occasionally refer back to them when encountering issues in their homes.
• One couple informed the interviewer in the post-class survey that they had participated in parenting classes as a court ordered requirement while going through a divorce and stated that the class really helped them in using age appropriate tasks/punishments and gave them further understanding of how PTS/Depression can negatively affect their parenting. Veteran and Spouse stated that by having a better understanding of how their mental health affects their communication skills and therefore their parenting skills they are more aware of self and how they talk to their children and how to assign appropriate task/punishments.
• Veteran and spouse have informed interviewer that they communicate more now when deciding on tasks/punishments with their children allowing them to be on the same page and feeling like they have each other for support.
Letter received from Veteran:
Veteran called and wanted to share his thanks for the impact your parenting group had on him, his wife and their two children. He said that he was only able to attend about 75% because of medical issues, but his wife kept going because she liked it so much. They found the insight and solutions that were offered to be very helpful, and they continue to use them today. The class was ‘highly beneficial’ both because of the materials you used and the atmosphere you created. Even his two children still pull out a book they made as part of the group they attended while the parents were in class 3 or 5 times a week. He and his wife also found it comforting to know they were not the only family struggling.
Sean has had what he describes as his ups and downs at the VA, but that the parenting group was definitely ‘one of the good parts’. See more
Metrics
- 1st Group 10/2016: 7 Individuals referred all 7 completed group 2nd Group 4/2017: 5 referred to group 1 dropped out 3rd Group 10/2017 6 referred 5 dropped out 4th group 6 referred 3 dropped out, 2 dropped after 1st classes 3rd dropped ½ way through 5th (2019) class 6 attended, 1 dropped after class 3, 5 completed group. 6th group 6/11/2019 – 8 referred, 2 declined 1 dropped, 5 completed 7th group, 2020 - 4 referred and started 1 couple completed on line individual due to covid 2021 - 9 referrals, 8 completed Number of Health care professions to run the program 2 in Providence , 1 in Brocton, 2 in Bedford
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
-
Month 1 and 2
Time Line:1 – 2 months• Obtain permission to run group in your dept.• Reach out and contact public affairs office to ensure there are not any other resources/avenues you need to look into to run group. (IE: Run Children’s group – checked with Lawyers about having children’s group on site).• Recruit co-lead• Complete TMS training (Moving Forward A problem Solving Approach to Achieving Life’s Goals, Instructors Manual/VA 36797)• Figure out recruitment plan (IE: Refers through other departments in hospital/advertise group)• If you want to have a consult pt. Set it up (may want to complete after you run one trial of groups) -
Month 2 - 4
2 – 4 months• Select start date for group• In person/Online : Obtain space to hold in-person group/Make sure you have appropriate tools to run VVC group• Start recruitment (Advertise group)• Get Materials together (PP Presentation, pre -evaluations (Or consult pt) , Handouts ) -
Month 4 - 6
4 – 6 months• Outreach Veterans who are referred, Inquire if interested in attending, complete initial assessments/ If you’re doing Virtual groups ensure Veteran have adequate technology to participate in group if they not do digital divide consult/ Complete pre evaluations for Veteran’s whom will participate• Review PP presentation• Set note titles – what office -
Month 6 -8
Run Group10 Week group 2 hrs.Collect weekly and post evaluations -
Month 8
Final PhaseProgram evaluationMeasure outcomes
Departments
- Voluntary Services
- Mental health care
- Mental health care
- Social work
- Chaplaincy
- Psychiatry
- Billing
- Marketing
- Maternity
- LGBTQ+ Veteran care
- Eligibility
- Housekeeping
- Caregiver support
- Addiction and substance abuse treatment
- Psychology
- Intimate partner violence
- Military sexual trauma
- Primary care
- PTSD treatment
- Returning service member care
- Social services
- Vocational rehabilitation and employment programs
- Whole health
- Women Veteran care
- Homeless Veteran care
Core Resources
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PEOPLE |
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TOOLS |
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Support Resources
| Resource type | Resource description |
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TOOLS |
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Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email VHAPROPARENTINGGROUP@va.gov with questions about this innovation.
About
Origin story
About:
The parenting program became an idea which developed as I worked in TCM (Returning Veteran’s Program) at the Providence VA medical Center. I noted that the VA offered multiple different program to returning Veteran’s though the one missing like was Parenting. Why Parenting?
• Combat deployment and reintegration are challenging for service member
...
About:
The parenting program became an idea which developed as I worked in TCM (Returning Veteran’s Program) at the Providence VA medical Center. I noted that the VA offered multiple different program to returning Veteran’s though the one missing like was Parenting. Why Parenting?
• Combat deployment and reintegration are challenging for service members and their families.
• Parenting challenges are dynamic and change over time.
• Reconnecting and re-establishing your role within the family can be a challenge
While working in this program I received an increased number of calls from the Veteran their significant other and/or VJO worker asking for assistance due to new charges of DCF or Domestic Violence. These Veteran’s and families were having difficulty with reintegration back into their families which was often resulting in legal issues.
• Anger & Aggression issues in a significant proportion of OEF/OIF/OND Veterans
• Out of 117 OEF and OIF combat veterans presenting to a VA Deployment Health Clinic:
• 39% At least one act of aggression (ex: destroying property)
• 15% Threatened physical violence
• 21% Got into physical fights
• Survey of reintegration problems among combat veterans showed that anger was the most commonly reported problem
• 57% reporting increased problems in controlling anger.
(Sayer et al, 2010 & Japukcat et al, 2007)
As we know Parenting challenges are dynamic and change over time. Though we may not of thought of how difficult it would be for these Veterans to reintegrate back into their own homes. The Veteran’s an their spouse/significant other including their children were now faced with a whole new set of challenges. How does the returning Veteran his/her spouse and children reconnect and re-establish their Individual role’s within the family.
As noted in research the implications of Veteran’s struggling with anger on their families resulted in the following:
• Combat deployment and reintegration are challenging for service members and their families.
• Parenting challenges are dynamic and change over time.
• Reconnecting and re-establishing your role within the family can be a challenge
(Kulka et al, 1990).
IT was also noted that Children’s lives were greatly impacted by their parent’s deployment:
• Child distress, depression and anxiety are associated with parent combat deployment
• Greater distress associated with longer deployment
• Deployment related to more transitions in children lives
(Jenson, Martin & Watanabe, 1996 & Pierce, Vinokur, & Buck, 1998)
Readjustment issues such as the following caused allot of heartache and issues for the Veteran and their families:
• Disagreements about the division of responsibilities in your family
• Children not acting warmly toward you or acting afraid of you
• Feeling like a guest or outside in your own home
•
Due to the above, I noted there was a need to assist not only the Veteran but the entire family with reintegration issues. The VA offered a multitude of programs to address medical, mental health, substance abuse, family and couples counseling though the one missing like was a Parenting Program. I thought if the VA could offered an educational group about Parenting and Problem solving skills and include a group for the kids we may be able to help address and alleviate some of the above identified issues. By giving the Veteran and their spouse/significant others a place to learn some new communications and problem solving skills we can help them transition back into their families lives.
The children are able to participate in kids group that taught skills about how to recognize emotions and feeling and learn coping strategies in a fun and safe environment. Through this entire process I noted not only deployed Veteran’s but all Veteran’s who have families could benefit from this program. Thus the Problem Solving and Parenting Program was born.
At this time we offer a Problem Solving Skills Training/Parenting Class, Classes run one evening a week for (1 ½ hours) that runs for 10 weeks. A children’s group also runs during this time and offers pizza, juice, a snack and meaningful activities ( Lessons, movies and fun activities that help the kids learn about their feeling, emotions and helps them identify and put words to them).
When Covid Hit I had to redesign the program to fit online VVC classes, I took the material and put it into a Power Pt. Presentation and we have since ran 2 online Parenting programs with good reviews for the Veteran's and families that have participated in them.
Original team
Laurie Harris
LICSW, Program Developer, Runs Program at Providence VA Healthcare
Wendy McDonald
LICSW, Assisted in applying for initial grant and running group at the Boston VA healthcare systemroup running at the Boston/Brocton VA in applying for grant and has started Group at the Boston VA
Heather Kohl
Systems Redesign
Chivi Kapungu,
Psychologist responsible for getting group running at the Bedford VA
Buffy Gamache
LICSW team member and responsible for assisting Chivi in getting Parenting Program running at the Bedford VA Chivi in getting program running at the
Caitlin Burditt
Psychologist, Co-lead groups at Providence VA
We are in the process of adopting this program. Our peers are thrilled and the members are giving positive feedback!