By Gloria Montgomery, Carl R. Darnall AMCJuly 11, 2019
FORT HOOD, Texas -- Whether it's a duty station move, a parent's deployment, or leaving friends and familiarity behind, the military lifestyle brings unique challenges to military Families.
Reactions to significant events can manifest into behaviors such as depression, academic problems, acting out, excessive worry, suicide ideations and anxiety. If not caught early, the Family unit is disrupted.
One resource to help counter the emotional obstacles that threaten Family readiness is Carl R. Darnall Army Medical Center's Child and Family Behavior Health Service (CAFBHS). Once separate entities, child psychiatry and marriage and Family programs have evolved into the all-inclusive CAFBHS.
"It's all about keeping the Family together with early intervention," said Michelle Aguayo, CAFBHS's outreach coordinator who helps steer Families toward the right services at CRDAMC. "Family readiness is Soldier readiness. How is that Soldier going to be ready to deploy when he or she has to worry about their spouse and 3-year-old with autism?"
The Child and Family Behavioral Health System is the Army's model to provide behavior health (BH) care for children and families. CAFBHS has been endorsed by senior Army leaders as a key component of the Behavioral Health System of Care (BHSOC) and the preferred method for delivering BH care to Children and Families. CAFBHS model blends best practices in consultation, collaboration with primary care and integration of BH care to meet the needs of the Army child and Family population.
CAFBHS programs include family counseling and therapy, as well as individual counseling for children and adolescents, support groups for children ages 11-13 and 14-17 and psychiatry medication- management services.
"Family counseling could be with the kids or it could be about parenting," she said, adding that sometimes new parents with a young child need help. "Maybe that child has attention deficit disorder (ADD) or other behavior issues. "We work with mom and dad on how to manage behaviors with that child."
Aguayo, who is a licensed counselor, said the clinic has three psychologists, in addition to a psychologist in the pediatric clinic who specializes in autism. There also are school-based behavior services.
The value of the school program is that it "coordinates a continuum of care because the program increases access to care; decreases burden on families to get services; promotes school connectedness, and enhance social/emotional climate in the school, delivers behavior health care in the child's natural environment; improves capability to meet challenges quickly; increases early intervention of behavior health treatment; decreases school absences and provides state of the art prevention, interventions, evaluations and treatment services."
"We have a child and family provider embedded in every school on post. They're our eyes on the ground," she said.
For example, she said, if a child is diagnosed with ADD, the provider might refer them to primary care for medication management or refer them to one of CRDAMC's three child psychologists.
"It really is a premier program because we are starting intervention and prevention early on," she said.
Another part of her job is reaching out in the community to build partnerships, a critical aspect of the job.
"More than 70 percent of our Fort Hood Families live off post," she said, "By working with our community partners, we're able to connect those Families to available community resources."
Inpatient care, she said, is one area where community partnerships are a critical asset.
"We don't have inpatient behavior health for kids, so we need those community partners for referrals," Aguayo said, adding that this also enhances communication. "Good communications is key because it enables a seamless transition from a community inpatient hospital to outpatient care at CRDAMC. This ensures there are no barriers to their care because we will have the information we need instead of having to wait weeks and weeks for their record."
Aguayo said the clinic also works hand in hand with the primary care providers by holding quarterly training for them on the more common behavior health conditions.
In an average month, the clinic will have around 2,000 encounters, an increase Aguayo attributes to more acceptance in seeking help, more available resources and more stress on children.
"All kids now have a certain level of stress that we didn't have before 9/11," she said. "You have mom and dad deploying and the children worrying if their parent will be safe. You have school and cyber bullying. Then every few years, the children are losing their friends and their support system.
It's not easy being a military child, but they grow up to be some of the most resilient individuals because of their experiences. That's why if there is a stumble or a roadblock along the way, we need to be there to support them."
For more information about CAFBHS services, contact the clinic at 254-7079/287-1866. They are open 7:30 a.m.-4:30 p.m.