Staff Perspective: Surviving Military Families: Supporting Parent-Child Relationships
There are military families living quietly among us who carry a weight that most of us can scarcely imagine. They are the spouses whose hearts shattered at the loss of their partner and experienced another shattering as they found words to tell their children that their parent would never come home. They are the children who learned, at ages far too young, to live without their mom or dad. Surviving military families — those who have lost a service member parent or spouse — benefit greatly from a mental health community that understands the unique dimensions of their loss and is equipped to meet their needs.
For the surviving spouse, losing their service member often means losing an identity, a community, and the future they sacrificed everything to build. When a service member is killed while they are serving, it can trigger a cascade of secondary losses — on-base housing, proximity to a supportive military community, the daily rhythms of military family life and can be thrust into civilian communities that do not understand their experiences (Holmes et al., 2013). Veterans’ families face similar experiences in their loss, but may find themselves with even fewer resources to find stability after loss, which often occurs after long and costly battles with mental and/or physical illness. Bereaved spouses navigate grief layered upon grief. Research confirms the magnitude: among military widows, sudden and violent loss has been associated with a two- to five-fold increase in depressive, posttraumatic stress, and adjustment symptoms (Cozza et al., 2020).
A recent needs assessment of surviving military families found that nearly half — 48.5% — met criteria for complicated grief (Burgin et al., 2023). Those experiencing complicated grief were more likely to experience significantly higher anxiety and depressive symptoms compared their non-complicated grieving counterparts (Burgin et al., 2023). Importantly, resilience — so often invoked as the hallmark of military culture — did not differentiate those with complicated grief from those without. These are families who often appear strong, and may even describe themselves that way, but are nonetheless quietly struggling despite their significant efforts to cope.
The surviving parents in this study reported elevated parenting stress — and identified feeling social alienation, guilt, and unsure of how to parent their children amid their grief (Burgin et al., 2023). These are parents who feel isolated, who doubt themselves, and who are trying to raise children through a grief that has no clear roadmap. Further, their children showed elevated ratings for depressed and anxious mood, social withdrawal, and disengagement from achievement (Burgin et al., 2023). These data do not depict a portrait of families falling apart, but of families doing their very best under extraordinary circumstances, quietly asking for something more from the systems meant to support them.
Bereaved military families benefit from both practical and relational support. One of the most valuable contributions a clinician can offer is an understanding that a child’s grief does not resolve; it evolves. As children reach new developmental milestones — starting a new school year, learning to drive, walking across a graduation stage — they may encounter their loss anew, through a lens shaped by who they are now. A bereaved ten-year-old and a bereaved seventeen-year-old are processing the same loss in profoundly different ways, and both deserve care that honors their experience. Holmes et al. (2013) noted that surviving parents often need guidance about how to talk with their children at each stage of development; clinicians who take time to understand the unique features of military grief — including its cultural context, secondary losses, and community disruption — are well positioned to provide this kind of support.
The parent-child relationship is not peripheral to grief care for these families. It is central to it. Research has consistently shown that a surviving parent's functioning and the family's cohesiveness are among the strongest predictors of children's positive adjustment after parental loss (Holmes et al., 2013). Supporting the parent is, in a very real sense, supporting the child.
The providers bereaved families turn to need to be families with the unique contours of military grief. For clinicians working with these families, a few orienting principles can guide effective care. First, take a military-informed history — even when the service member is gone, understanding the family’s military background, branch of service, and community connections can illuminate important sources of meaning, identity, and loss. Second, be attentive to what might be called the “resilience paradox”: because these families have often internalized a culture of strength, they may minimize their distress or delay seeking help. Third, recognize that grief in these families is frequently compounded, layered with the loss of community, financial instability, and role disruption; addressing these practical stressors alongside emotional ones is part of comprehensive care. Finally, treating the parent-child relationship as a direct focus of treatment — not simply a contextual backdrop — supports the whole family system. These are invitations to bring what you already know into a context that rewards informed, curious, and compassionate care.
These families have already given more than most. Clinicians who approach their care with cultural humility, a curiosity about the military experience, and attention to both the emotional and practical dimensions of their loss can make an extraordinary difference. The mental health community has both the tools and the opportunity to meet these families with the depth of care they deserve.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.
Elizabeth Burgin, Ph.D., is a Licensed Professional Counselor serving as a Military Behavioral Health Child Counselor at the Consortium for Defense Psychology (CDP) at the Uniformed Services University for the Health Sciences in Bethesda, Maryland. In this role, she supports the DoD Child Collaboration Study to identify best practices for enhancing and expanding accessibility to care for military-connected children and adolescents.
References
Burgin, E. E., Prosek, E. A., Shin, K., Cunningham, V. L., & Ponder, W. N. (2023). *Needs assessment of surviving military families: Clinical symptoms and the parent-child relationship*. Manuscript submitted for publication.
Cozza, S. J., Hefner, K. R., Fisher, J. E., Zhou, J., Fullerton, C. S., Ursano, R. J., & Shear, M. K. (2020). Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study. *Depression and Anxiety, 37*(1), 45–53. https://doi.org/10.1002/da.22971
Holmes, A. K., Rauch, P. K., & Cozza, S. J. (2013). When a parent is injured or killed in combat. *The Future of Children, 23*(2), 143–162. https://doi.org/10.1353/foc.2013.0017
There are military families living quietly among us who carry a weight that most of us can scarcely imagine. They are the spouses whose hearts shattered at the loss of their partner and experienced another shattering as they found words to tell their children that their parent would never come home. They are the children who learned, at ages far too young, to live without their mom or dad. Surviving military families — those who have lost a service member parent or spouse — benefit greatly from a mental health community that understands the unique dimensions of their loss and is equipped to meet their needs.
For the surviving spouse, losing their service member often means losing an identity, a community, and the future they sacrificed everything to build. When a service member is killed while they are serving, it can trigger a cascade of secondary losses — on-base housing, proximity to a supportive military community, the daily rhythms of military family life and can be thrust into civilian communities that do not understand their experiences (Holmes et al., 2013). Veterans’ families face similar experiences in their loss, but may find themselves with even fewer resources to find stability after loss, which often occurs after long and costly battles with mental and/or physical illness. Bereaved spouses navigate grief layered upon grief. Research confirms the magnitude: among military widows, sudden and violent loss has been associated with a two- to five-fold increase in depressive, posttraumatic stress, and adjustment symptoms (Cozza et al., 2020).
A recent needs assessment of surviving military families found that nearly half — 48.5% — met criteria for complicated grief (Burgin et al., 2023). Those experiencing complicated grief were more likely to experience significantly higher anxiety and depressive symptoms compared their non-complicated grieving counterparts (Burgin et al., 2023). Importantly, resilience — so often invoked as the hallmark of military culture — did not differentiate those with complicated grief from those without. These are families who often appear strong, and may even describe themselves that way, but are nonetheless quietly struggling despite their significant efforts to cope.
The surviving parents in this study reported elevated parenting stress — and identified feeling social alienation, guilt, and unsure of how to parent their children amid their grief (Burgin et al., 2023). These are parents who feel isolated, who doubt themselves, and who are trying to raise children through a grief that has no clear roadmap. Further, their children showed elevated ratings for depressed and anxious mood, social withdrawal, and disengagement from achievement (Burgin et al., 2023). These data do not depict a portrait of families falling apart, but of families doing their very best under extraordinary circumstances, quietly asking for something more from the systems meant to support them.
Bereaved military families benefit from both practical and relational support. One of the most valuable contributions a clinician can offer is an understanding that a child’s grief does not resolve; it evolves. As children reach new developmental milestones — starting a new school year, learning to drive, walking across a graduation stage — they may encounter their loss anew, through a lens shaped by who they are now. A bereaved ten-year-old and a bereaved seventeen-year-old are processing the same loss in profoundly different ways, and both deserve care that honors their experience. Holmes et al. (2013) noted that surviving parents often need guidance about how to talk with their children at each stage of development; clinicians who take time to understand the unique features of military grief — including its cultural context, secondary losses, and community disruption — are well positioned to provide this kind of support.
The parent-child relationship is not peripheral to grief care for these families. It is central to it. Research has consistently shown that a surviving parent's functioning and the family's cohesiveness are among the strongest predictors of children's positive adjustment after parental loss (Holmes et al., 2013). Supporting the parent is, in a very real sense, supporting the child.
The providers bereaved families turn to need to be families with the unique contours of military grief. For clinicians working with these families, a few orienting principles can guide effective care. First, take a military-informed history — even when the service member is gone, understanding the family’s military background, branch of service, and community connections can illuminate important sources of meaning, identity, and loss. Second, be attentive to what might be called the “resilience paradox”: because these families have often internalized a culture of strength, they may minimize their distress or delay seeking help. Third, recognize that grief in these families is frequently compounded, layered with the loss of community, financial instability, and role disruption; addressing these practical stressors alongside emotional ones is part of comprehensive care. Finally, treating the parent-child relationship as a direct focus of treatment — not simply a contextual backdrop — supports the whole family system. These are invitations to bring what you already know into a context that rewards informed, curious, and compassionate care.
These families have already given more than most. Clinicians who approach their care with cultural humility, a curiosity about the military experience, and attention to both the emotional and practical dimensions of their loss can make an extraordinary difference. The mental health community has both the tools and the opportunity to meet these families with the depth of care they deserve.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.
Elizabeth Burgin, Ph.D., is a Licensed Professional Counselor serving as a Military Behavioral Health Child Counselor at the Consortium for Defense Psychology (CDP) at the Uniformed Services University for the Health Sciences in Bethesda, Maryland. In this role, she supports the DoD Child Collaboration Study to identify best practices for enhancing and expanding accessibility to care for military-connected children and adolescents.
References
Burgin, E. E., Prosek, E. A., Shin, K., Cunningham, V. L., & Ponder, W. N. (2023). *Needs assessment of surviving military families: Clinical symptoms and the parent-child relationship*. Manuscript submitted for publication.
Cozza, S. J., Hefner, K. R., Fisher, J. E., Zhou, J., Fullerton, C. S., Ursano, R. J., & Shear, M. K. (2020). Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study. *Depression and Anxiety, 37*(1), 45–53. https://doi.org/10.1002/da.22971
Holmes, A. K., Rauch, P. K., & Cozza, S. J. (2013). When a parent is injured or killed in combat. *The Future of Children, 23*(2), 143–162. https://doi.org/10.1353/foc.2013.0017