London — As news and media companies develop new ways of preparing and supporting teams working in war zones and covering trauma, research indicates the importance of considering the families of those deployed — and of ensuring that they too are given the right kind of support.

Drs Walter and Angela Busuttil of Britain's respected Ticehurst Priory Hospital have analysed several sets of research going back to World War Two and in a fascinating set of conclusions (click here for a full summary), highlight just how distressed partners and children can become, especially where their loved ones are deployed in harm's way.

They note that repeated cyclical separations, separations enforced under threat of death and longer separations without a clear prospect for reunion and especially when enforced under threat of death, can all affect the psychological health and function of families and their members.

Different members of a family left behind adopt, they say, similar patterns of coping and behaviour. As the level of psychological threat to the partner or parent increases, coping patterns can potentially become more inappropriate and disturbed.

In some circumstances, the Busuttil research recommends what's termed active management of family members. In other circumstances, however, this might make things worse — offering some immediate relief, but possibly damaging longer term-function and stability of the marriage and relationships within the family.

The research — based mostly on observation of families of servicemen — lists a number of recommendations for any organisation whose staff face possibly mortal danger — ranging from the military to oil rig and aid workers, as well as journalists.

1. Help should be available to all family members of the nuclear family. Children of all ages must not be forgotten.
    
2. Practical support that encourages independence is helpful, providing the husband's return is expected and actively talked about.
    
3. Psychological support which allows planning for the husband's return, reunion and re-integration should be part of any group or individual support given to wives and children. It should be recognised that grieving is part of the separation process, but that completion of the grieving process may have detrimental effects for the family in the long term after the partner returns.
    
4. Physical illness may be a manifestation of severe psychological stress, and appropriate medical and psychological support should be made available.
    
5. Psychological and psychiatric symptoms and syndromes are common, and should be screened, assessed and treated, in their own right.
    
6. Alcohol abuse and dependence along with other harmful practices such as smoking require screening, advice and treatment.
    
7. Psychological help delivered during the separation should be linked into what will be provided after return.

The research authors note that organisations whose employees are likely to enter dangerous situations in the context of being separated from their families have a responsibility and even a duty of care towards these
families.

Practical and clinical guidelines to medical professionals should ideally be made available by the organisation's occupational health department. The organisation should also provide families with psychological and practical help during the deployment and separation.

Guidelines might also be made available nationally in times of war, for example, when civilian general practitioners and therapists might be the first to come across distressed families.

The Busuttil research notes that in the case, for example, of a family whose journalist father and husband disappears in a country where a conflict is raging, it is less likely that most professional medical carers will be aware of, and recognise the significance of the issues, dynamics and psychiatric syndromes that can emerge.