What is resilience

And can we affect it’s emergence?
Infant Mental Health Conference Jan 9, 2010 Dallas

Possible Risks for Children Facing Adversity
Academic failure Social maladjustment Health problems Poverty Mental illness Substance abuse Law enforcement involvement

What’s the other side?

What is Resilience?

Resilience
Positive outcome in the face of adversity and disadvantage “Bouncing back” Qualities that cushion a vulnerable child from the worst effects of adversity
Allow coping, survival, possibly thriving

The Kauai Longitudinal Study (KLS)
Three major, "relatively enduring" protective factors have enabled these strong, resilient, well-functioning individuals to withstand the troubles that overwhelmed the others who faced them. These are attributes such as activity level, sociability, and intelligence, which have a strong genetic base ... And environmental factors such as unconditional emotional support from a family member or close friend ... and a school or work atmosphere that rewarded effort and competency.
• Emmy Werner

Resilience—is it common
Many longitudinal studies show that 50-70% children exposed to adversity
mentally ill parent Alcoholic parent, abusive parents criminally involved poverty stricken or homeless Living with war Loss of parent/culture to HIV Special needs/cerebral palsy

Overcome odds to “turn life around”

Research in many fields
Positive psychology Body-mind connection Education
Early literacy Head Start

Youth programs Community development Attachment

Resilience in Adults
PTSD Literature
50-60% exposed to traumatic events 5-10 % develop PTSD

Ways to measure traits
Time for some self measurement of resiliance Rate questions from 1 to 5; 1 very little and 5 very strong

Scoring traits
Count up all your 1s, 2s, 3s, etc Multiply 2 total by 2, 3 total by 3 etc Example: 10 2s, 5 3s, 3 4s
10x2=20 5x3=15 3x4=12

Total products=47

Results
65-80 50-65 40-50 >80

Characteristics
Temperament factors Easy going, good self regulation, attentional controls Problems solving skills High IQ, flexibility Social competence Empathy, caring, sense of humor Autonomy Sense of identity, ability to act independently Sense of purpose and future orientation Goal directed, achievement motivation Sense of meaning (spirituality) Sense of optimism Academic and social success

Personal Factors
Social competence Problem solving Critical consciousness Autonomy Sense of purpose

Social competence qualities
Responsiveness
Elicit positive responses from others

Flexibility
• Move between different cultures

Empathy Communication skills Sense of humor

Problem solving skills
Ability to plan Ability to be resourceful in seeking help Think critically Think creatively
Non academic talents

Think reflectively

Critical consciousness
Reflective awareness of structures of society/culture Creative strategies for overcoming this

Autonomy
Sense of one’s own identity Ability to act independently Exert some control over environment
Task mastery Internal locus of control Self-efficacy

Resistance to negative messages Detachment from dysfunction

Sense of purpose
Belief in a future
Goal direction Educational aspirations Achievement motivation Persistence Hopefulness Optimism Spiritual connectedness

External factors
Family School (childcare) Community

Caring relationships
A way of being that conveys compassion, respect, understanding and interest At least ONE person
Conveys compassion, belief that child is doing the best they can
• Masten and Reed

Often teacher
• Werner and Smith-40 year study • Noddings

Within family protections
Perception of availability of caregivers Provision of structure High expectations Low family discord Organized home environment
Rituals, ceremonies, shared dinner times, shared responsibilities

Secure emotional base Socioeconomic advantages

Protective factors-Schools
School connectedness Participative learning High expectations
Support to be successful

Opportunities for participation
Meaningful involvement through responsibility Encourage critical thinking and dialogue Making learning hands on Involve students in curriculum planning Participatory evaluation Cooperative strategies
Peer helping, cross age mentoring, community service

Protective factors community
High level public safety Good emergency and social services Good public health and health care availability Support from cultural and religious traditions “Connected” community becomes extended family

Fostering Resilience
Remove/decrease risk factors Provide prenatal care Better quality of care in infancy Provide early childhood education
School readiness

Adequate medical care Motivational climate

Fostering Resilience
Increase parents’ involvement in education Improve quality of attachment relationships Good integrative schools Promote competencies, encourage interests Increase sense of belonging to school Peer teaching
Search-institute.org TeachSafeSchools.org Apahelpcenter.org

Social support
Listening Emotional support Emotional challenge Reality confirmation Task appreciation Task challenge Tangible assistance Personal assistance
• Richman, Rosenfield and Hardy (1993)

Model for children
I HAVE I AM I CAN

Promoting Resilience Action model
• Gotberg

I HAVE Trusting and loving relationships with others: parents, siblings, teachers, friends.

I AM Loveable: the child possesses, or is helped to develop, qualities that appeal to others.

I CAN Communicate: the child is able to express feelings and thoughts, and listen to those of others.

Structure at home: clear rules and routines, comprehensible and fair sanctions when breached, praise when followed.

Loving: the child is able to express affection to others, and is sensitive to their distress.

Solve problems: the child can apply themselves to problems, involve others where necessary, and be persistent.

Role models: parents, other adults, peers, siblings, who model good behaviour and morality.

Proud of myself: the child feels they have the capacity for achievement and resists discouragement.

Manage my feelings: the child knows and understands emotions, recognises the feeling of others, and controls impulsive behaviour.

Encouragement to be independent: people who offer praise for growing autonomy.

Responsible: the child accepts and is given responsibilities, and believes that their actions can make a difference.

Understand my temperament: the child has insight into their personality and that of others.

Access to health, education and social care: consistent direct or indirect protection for physical and emotional health.

Hopeful and trustful: the child has faith in institutions and people, is optimistic for the future and is able to express their faith within a moral structure.

Seek out trusting relationships: the child has the ability to find people – peers or adults – in whom they can confide and develop mutual trust.

Promoting resilience-action model Grotberg 1997

I have…..
Trusting and loving relationships Structure at home
Rules and routines; fair consequences; frequent earned praise

Role models Encouragement to be independent
Praise for movements of autonomy

Access to health care, education and social care

I am….
Loving
Express affection, be sensitive to distress

Proud of myself
Capacity for achievement; resistant to discouragement

Responsible
Able to make a difference

Hopeful and trustful Optimistic for the future
Within a moral structure

I can…
Communicate Solve problems
Apply myself, seek out help if needed, be persistent

Manage my feelings Understand my temperament
Insight into personality and that of others

Seek out trusting relationships
Ability to find appropriate adults and peers

“40s” for various age groups
20 external and 20 internal assets External
• • • • • • • • Support Empowerment Boundaries and expectations Constructive use of time Commitment to learning Positive values Social competencies Positive identity
• SEARCH institute

Internal

Increase in information
Numbers of web pages dealing with resilience
Sept 2003 April 2006 394,000 30,000,000

Not as general as first thought
Domain specific
Academic Social Behavioral

Fluid over time
Relatedness of risk and protective factors

Multiple pathways to gain resilience

Genetic factors
Personal factors
Promotor of monamine oxidase gene
• Less degredation of norepinephrine-more anxiety

Promotor of serotonin transporter gene
• Short allele, long allele

Related to stress pathway development Brain areas: amygdala, prefronal cortex, hippocampus

Gender differences
Males
Active problem solving Scholastic competence at 10 predictive of adult success More sensitive to loss and separation in first decade

Females
Strong caring relationships High self-esteem and self efficacy predictive More sensitive to family discord and loss in second decade

Interaction of Risk and Protective Factors
Risk cumulative and subtle Covariance of environment and genetics (epigenetics) • Depression runs in families • Depressed mothers inconsistent, unresponsive, negative, coercive
• People “select” neighborhoods

Increasing number of risks-associated with negative outcome High risk over longer times more negative

Interaction of Risk and Protective Factors
Protective factors appear less frequently at highest risk Harder to express individual protective factors Some factors less protective • Family support less important in high levels of community violence May wash out with cumulative family stressors • High IQ and positive temperament Limits to effects of some protective factors in highest levels of risk

Literature Review
Studies reporting prevalence rates of positive outcomes Studies that examine positive outcomes over time Studies that examine positive outcome across multiple domains
• Ella Vanderbilt-Adriance, Daniel Shaw Pittsburgh 2008

Single risk/Middle class
Range of positive outcomes
30-90% with cluster at 40-60%

One study parental psychopathology
Maternal depression PLUS paternal depression, anxiety or substance abuse Good functioning over 4 assessments encompassing 10 years 41% without a psychiatric diagnosis

Multiple risks and Poverty
Rochester Longitudinal Study
6% positive outcome

Christchurch Health and Development Study 16 years New Zealand
37% positive outcome in high risk Most disadvantaged—5 % positive Least disadvantaged– 80% positive

Multiple risk
Preterm birth
+poverty—12% normal at age 3 No poverty—40% normal at age 3

Maltreatment + poverty
18% positive outcome

Overall 1-40% positive outcome
2 studies >35% positive 9 studies 25% or less

Resilience across domains
10/13 studies
Only one domain

School based competence-resilient
When absence of emotional distress added, 15% of original group remained

Where are we?
Resilience = concept, interactive, changes over time Characteristics can be promoted and supported
Basics of many programs, interventions

Not “magic” Combination of nature/nurture

Starfish story

Useful websites
Resiliency.com Projectresilience.com Freespirit.com WestEd.org/hks Publicallies.org Dosomething.org Kidsconsortium.org

NASP Online Resources for Members
Crisis Response Handout:
Identifying Seriously Traumatized Children: Tips for Parents and Educators. NASP Resources: Crisis Resource: Trauma. Managing Strong Emotional Reactions to Traumatic Events: Tips for Parents and Teachers. NASP Resources> Crisis>Trauma. www.nasponline.org/communications

NASP Online Resources for Parents
V. S. Harvey (2007). Schoolwide Methods for Fostering Resiliency. Promoting Resiliency in Your Child. Adapted
from V. S. Harvey (2003). Resiliency: Strategies for Parents and Educators in Helping Children and Home and School II: Information for Parents and Educators. Bethesda, MD: National Association of School Psychologists.

www.nasponline.org/communications

NASP Online Resources for Parents
Building Resiliency: Helping Children Learn to Weather Tough Times. Adapted from V. S.
Harvey (2003). Resiliency: Strategies for Parents and Educators in Helping Children and Home and School II: Information for Parents and Educators. Bethesda, MD: National Association of School Psychologists.

V. S. Harvey (2005). Fostering Resilience: A Handout for Teachers and Parents. NASP Communiqué`, 34(3).

www.nasponline.org/communications

NASP Online Resources for Members
Research Articles:
Harrington, P. L. (Ed.). (1998). Resilience Applied: The Promise and Pitfalls of School-Based Resilience Programs. School Psychology Review, 27(3). Smith J. & Cochrane, W. S. (2006). Interventions to Enhance Resilience for Children At Risk for Disruptive Behavior Disorders. NASP Communiqué`, 35 (4). www.nasponline.org/communications

NASP Online Resources for Members
Goldstein, S. & Brooks, R. (2005). Defining a Clinical Psychology of Resilience. NASP Communiqué 33(5). R. B. Armistead, K.C. Cowan (2005, November). Resilience. NASP Communiqué: Communication Matters, 34(3).

www.nasponline.org/communications