SOFAR: In the News

SOFAR Focuses on Military Families

Reprinted from Clinical Psychiatry News, Vol. 36, No. 8, August, 2008

BY AUDREY KUBETIN, Editorial Intern

Alone soldier, bandaged up to his elbow, stood amid a crowd of clinicians, parents, and teachers, telling the story of a bad day in Iraq.

His audience had gathered at Boston Medical Center to discuss the impact of war and terrorism on children, Kenneth I. Reich, Ed.D., recalled in an interview. The soldier was citing himself as a testament to how easily the war zone can overlap with the home front.

He remembered returning from a difficult mission to find that it was his turn to talk to his family via videophone. What would he tell them? They would be able to tell by looking at him that something was wrong. He didn’t want them to worry, but he didn’t want to lie about what had happened. Read More>>

SOFAR: Supporting Families, Invisible Casualties of War By Kenneth I. Reich

Reprinted from The American Psychoanalytic Association magazine The American Psychoanalyst, Winter/Spring 2008 Vol. 42, No. 1

We know from reviewing medical records of Civil War soldiers that, by today’s diagnostic criteria, almost 40 percent of soldiers suffered anxiety, depression. or post traumatic stress disorder.  Today, one-third of homeless men in America are Vietnam veterans, with the number of homeless vets easily exceeding that of the soldiers actually killed in Vietnam.  While no one has studied the impact of war on these soldiers’ families, it is not difficult to appreciate that they too suffered the casualties of war. Read more>>

Spouse Calls: Counselors support military families

By Terri Barnes, Special to Stars and Stripes Scene, Sunday, March 23, 2008

Military families in crisis often feel isolated, but their cries are being heard. Compassionate professionals from military and civilian spheres are responding.

A group of psychoanalytic professionals in the Boston area founded the Strategic Outreach For All Reservists. SOFAR offers free and confidential counseling to military families, with an emphasis on reservists and their families, who are often isolated from the larger military community. Read more>>

NPR: Morning Edition. November 12, 2007. By Bob Oakes (Read Original

Richard Moody of Danvers and Shirley Burke of Salem use the services of SOFAR.
BOSTON, Mass. - November 12, 2007 - On Veterans Day, we often pause to think about the sacrifice of soldiers, especially those in combat in Iraq and Afghanistan.

When they return from war, they can face significant mental health challenges. Often, it's more than the soldiers who need help: Families also need psychological support. Army Reserve and National Guard families are in a unique position because they lack the support of a military base community.

Shirley Burke lives in Salem and says she felt scared and lonely while her husband Phillip served two tours of duty in Iraq. "Every night you go to bed and you say am i going to get a phone call tonight," Burke says, "A knock on the door, that's how we live every day."

Burke found help with a free counseling group called " SOFAR," or Strategic Outreach to Families of All Reservists. She says SOFAR's mental health professionals let her talk about her fear of losing her husband, something she didn't think her neighbors could relate to.

Counselors also go to group meetings of Army Reservists and National Guard families. Air Force veteran Richard Moody of Danvers runs a family support group.

He invited SOFAR to speak about the isolation that families feel when a family member is deployed. Moody says, "At any minute we could be killed. And that's a level of stress that you can't explain to people that don't understand it. What happens is that almost everybody that comes back is changed. And when they change, the people back home need to be addressed as to how to cope, how to handle that."

SOFAR's 70 volunteers meet with individuals and family groups in Boston and throughout New England. The organization's Co-Directors Ken Reich and Jaine Darwin join WBUR's Bob Oakes in conversation this morning.

"Forever changed" The Boston Globe 26 August 2006

An article about SOFAR's work with families of deployed reservists and the impact of war on the homefront.

"War's invisible wounds." Monitor on Psychology, the publication of the American Psychological Association, January 2006.

An article on SOFAR including an interesting interview with Mary Anne Meigs about her experience as an army wife during several wars.

"Reservists' families get free mental health care." Richard E. Gill. The National Psychologist, Vol. 14., No. 6; Nov/Dec 2005; Pages 5 and 10.

"Reservists' families get free mental health care"
By Richard E. Gill
Assistant Editor

Boston is a moderate sized city compared to giants like New York, Chicago and Los Angeles, but two "Beantown" professionals, Kenneth Reich, Ed.D., and Jaine Darwin, Psy.D., have designs on the entire country.

Their mission is to provide free mental health services to the families of military personnel assigned to the wars in Iraq and Afghanistan. What they hope is that the pilot program they're creating in Boston will eventually spread across the nation.

"We are hoping to create a useful program in Massachusetts which can be replicated nationally though the local chapters of Division 39 and the American Psychoanalytic Association," said Reich, president of the Psychoanalytic Couple and Family Institute of New England, the umbrella organization that launched the Reservist project called SOFAR (Strategic Outreach to Families of all Reservists), one of six pro bono community outreach projects he oversees.

Reich's projected number of veterans and family members impacted by the war are astonishing. From the beginning of the war until September 2004 about a million troops had been deployed to the war zones. It's expected another 500,000 will be deployed over the next year, Reich said.

Based on the concept of six degrees of separation, Reich loosely estimates that as many as 63 million veterans, family and extended family members - aunts, uncles, cousins, even friends and co-workers - will require some kind of mental health treatment.

Reich said the scope of the large number of people that will be impacted by the war is staggering. The number could even go higher, he predicted. Reich was quick to add, however, "That doesn't mean that everybody in that group will have some kind of mental health problem that needs treatment." Still, the number is stunning.

Reich emphasized that the U.S. Surgeon General estimated several weeks ago that 30 percent of returning veterans would suffer some mental health symptoms, such as anxiety or depression.

Darwin, who joined SOFAR in January and is past president of Division 39, said, "Our main goal actually is to head off a massive amount of trauma because we think these families are terribly vulnerable.

"These families are incredibly dispirited and unlike regular Army family members they're incredibly isolated. They're all over the place."

SOFAR volunteers include, among others, psychologists, psychopharmacologists, psychiatric nurses and social workers.

Darwin explained that treatment begins a couple of months before alert - when a reserve unit is notified it will be activated - continues while the soldier is on active duty and at least four months after the soldier returns home.

Also, SOFAR has assembled a group of experts to put together a pamphlet that will help teachers, parents and pediatricians identify trauma in children. In the near future, the group hopes to set up a model workshop for teachers in dealing with trauma.

"Unlike regular Army children who tend to be in a school with other Army children, the children of Reservists are more isolated and have fewer kids like themselves to talk to and no one focusing on helping them to cope. We will try to make teachers savvy about things to look for with children in stress," Darwin said.

"We're worried about Reservists and their families. When this project started they actually were getting little or no care. They now are getting some veteran's insurance, but they don't have a cohort standing by, they don't have an affiliation group that's readily available. They are really quite isolated," Darwin said.

"They can be the only one in their town. Their kids can be the only ones in their school that have a parent who is activated." Add that to other things like financial stress, separation and worries of infidelity and the problems mount, she said.

Darwin said it's not the purpose of SOFAR to train family members to recognize symptoms of poor mental health, rather to prepare them about what to expect when a loved one returns home.

"They are not going to be the same person they were when they went away. They may be better, they may be worse, but they're not going to be the same. So you can't go back to business as usual. They are going to be stressed and people will have to re-calibrate their roles," she said.

The idea for SOFAR was the result of a post Sept. 11 trip by Reich to New York where he was raised and watched the construction of the World Trade Center.

Reich admitted the trip had a profound affect on him and when he returned home he sought a way to help. In organizing a conference at the Boston Medical Center, entitled War, Terrorism and Children: Supporting Family Strength and Resilience, Reich found his calling.

"It was there I learned that the families of Reservists sent to Iraq and Afghanistan were being offered one mental health session," Reich said. "I looked at that and said, 'my God, that's not right.' That's a community that must be hurting. They weren't getting the support they needed. That's when the program really crystallized."

Reich spent the next two years working feverishly to find a way to break through military red tape and bureaucracy to find a way to contact these people and offer, at absolutely no charge, the services of a group of 20 mental health professionals that had volunteered their assistance. That number has since grown to 70.

During the arduous process of seeking military assistance, the Army made it clear this would not be a partnership because the military had to maintain separateness, but the Army has been enormously helpful as a catalyst. Every step up the ladder everybody believed it was a good idea, Reich said.

"The biggest concern," Reich said, "was that family members in many respects are the invisible causalities of war. Many of them were having varying types of problems, especially with long-term separation. They were being exposed to returning veterans who were having difficulties and the families were developing what is called secondary trauma."

One of his immediate challenges was how to find these families. "You can't look them up in the phone book. They're a pretty heterogeneous group rather than a homogenous population."

After more than a year and a half of due diligence by the Judge Advocate General's Office of the Army Reserve of New England, Reich was introduced to the director of Family Readiness of the New England Reserves. The director oversees close knit groups of family members of military personnel. Because of the work done by the Judge Advocate General's Office, his group was readily accepted.

To continue to grow, Reich hopes that members of this group will recommend SOFAR to other people. Still, they will need referrals, publicity and financial aid if SOFAR is to succeed, he said.

Those wishing to learn more about the project or to make donations can contact Reich's website www.pcfine.org.

Both Reich and Darwin are clinical instructors of psychology in the Department of Psychiatry at Harvard Medical School and serve on the faculty at the Massachusetts Institute For Psychoanalysis. They are both in private practice in Cambridge.

Reprinted with permission from The National Psychologist, 6100 Channingway Blvd., Suite 303, Columbus, Ohio 43232; Phone: 614/ 861-1999; Fax: 614/861-1996; website: www.nationalpsychologist.com. Subscriptions are available for $35 for one year or $60 for two years. This article was originally published in The National Psychologist, Vol. 14., No. 6; Nov/Dec 2005; Pages 5 and 10.

"He'll Provide First Aid On the Home Front." Jonathan Abel.The Boston Globe 26 April 2005:E2.

Kenneth Reich's expertise in families has made watching the Iraq war particularly difficult. While others think of American soldiers as part of a military unit, Reich, a psychoanalyst, sees them in terms of the family unit, and for two years he's been yearning to treat military families.

"Troops returning from deployment are almost all wounded in some way, physically, psychologically or both," Reich said. "Their families are also real, and often invisible, casualties of war."

Separation and anxiety put stress on marriages and often make children resent their far-off parents. The war is one giant family problem, he said.

Reich, 57, cofounded SOFAR: So Good (Strategic Outreach to Families of Army Reservists), a volunteer group of 60 local psychoanalysts dedicated to treating relatives of National Guard and Army Reserve troops who have served in the war. Reich's pilot program was launched this month, after two years of negotiations with the military, and has begun to receive its first referrals from the Boston-based 883d Medical Company of the Army Reserves.

The group is focusing on the families of non-active-duty soldiers, Reich said, because they have had comparatively little access to mental health services.

In talking with soldiers and officers about the need for a program like SOFAR, Reich came to understand that "it wasn't about the war. It wasn't about soldiering," he said. "It was about families."

Too often, Reich said, psychoanalysts forget to look beyond their own couches, failing to think about how therapy affects the families of their patients.

He learned to pay attention to the whole family and their home environment when, as an intern, he was assigned to a family whose members were psychiatrically hospitalized more often than any other in the Massachusetts General Hospital system.

They kept canceling their appointments with flimsy excuses; one day when they called to say they were busy moving in a new refrigerator, Reich offered to come over and help. From then on, he carried out therapy sessions around their kitchen table, treating the entire family.

He had two brushes with terrorism that helped him focus his concerns on the mental health problems caused by war, even on those who are not soldiers. During the first Gulf War, Reich was in Israel, teaching a one-week course on psychoanalysis when Iraqi Scud missiles rained down on the country. "I remember hearing many stories both clinical and personal about what the impact of the incoming Scuds from Iraq was on the population."

A decade later, he was visiting his daughter in New York immediately after the Sept. 11 attacks and was overwhelmed by the event's psychological effects on the city.

When American soldiers started to fight in Afghanistan and Iraq, however, Reich began to think that the real crisis for the country would come not from the fear of terrorist attacks but from the "secondary trauma" brought back by troops who had fought in the war.

"What affects one affects all," Reich said.

Once the program is firmly established, his next goal is to go to Iraq himself. "It's useful to see where 1 million people have gone and come back," he said.

"War Wounds Families, Too", Chris Helms, Cambridge Chronicle, March 24 2005

Sculptor and Vietnam War veteran Peter Haines isn't the only Cantabrigian reflecting on lessons the country should have learned from the conflict in Indochina.

A group of local psychologists has started an innovative free program to help heal the wounds war inflicts on soldiers' families.

"We know that no one returns unchanged," said Dr. Kenneth Reich, a clinical psychologist who teaches at Harvard Medical School. "One factor not to be underestimated is 'secondary trauma'."

That's a term coined by psychologists at Veterans Administration hospitals. The therapists' weekly sessions with combat veterans, Reich says, were unsettling for the therapists despite their considerable training. How much more of an impact, Reich wondered, do family members feel when they are around a combat veteran all day, every day?

It was a question that sparked creation of SOFAR: So Good, which stands for Strategic Outreach to Families of Army Reservists. The pilot program, two years in the making, addresses the needs of family members of Reservists who are deployed to Iraq or Afghanistan or who soon will be. It aims to repair psychological damage, and, perhaps, prevent it.

"Families are also the invisible victims of war," said Reich.

A corps of 60-plus volunteer therapists started working with military family members last week. Reich hopes to expand the program to the families of National Guard members as well. SOFAR provides up to four months of free, confidential treatment and offers referrals to other resources.

Adolescents whose mother or father have been away in Iraq or Afghanistan are particularly vulnerable, Reich said.

"Some families have it harder," he said. "It all filters down to impacting children."

The program is available through the military's Reserve Support Centers and unit chaplains.

If the pilot program proves helpful locally, it could be expanded outside New England, he said. The program would also need additional funding, as the military does not provide any financial support, Reich said.

SOFAR isn't alone. More people and organizations are beginning to focus efforts on military families.

"I think the idea is evolving," Reich said.

"War Wounds Families, Too." Mopsy Strange Kennedy. The Improper Bostonian 1-14 June 2005.

SOFAR (Strategic Outreach to Families of All Reservists) offers free psychotherapy to relatives of troops stationed in Iraq and Afghanistan. Millions of people are at least indirectly affected. Licensed therapists or other volunteers can call 617-266-2611.

Your degrees of separation from someone stationed in Iraq or Afghanistan - a brother, sister, boyfriend - may be but one dot away. And the spider web of psychological turmoil produced by any one person going to war, or coming back, is huge. SOFAR is a pro bono project of the Psychoanalytic Couples and Family Institute of New England. Its Blue State contribution to families of Reservists and National Guard troops comes in the form of free psychotherapy to the loved ones of those who serve, from the time they get the well-named "alert" phone call about a mobilization to four months after a member of the armed forces returns home. (The troops themselves have other resources and aren't included in this project.) It's estimated that at least one out of six veterans will suffer depression, anxiety, and/or post-traumatic stress disorder. So injections of preparedness and resilience, to absorb the bounce that families and friends experience, are in order. Preparation - knowing what to expect and how to supportively relate to this sensitized military person and cushion yourself - is important. Licensed psychotherapists can volunteer, even an hour a week, and fund-raising and development help are needed.

Reprinted with permission of the Improper Bostonian Magazine, 2005