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RESILIENCE: POSITIVE
ADAPTATION
Strengths, Health, & Thriving
FACTORS THAT INFLUENCE HEALTH
Environment 22%
Genetics 17%How We
Live 51%
Health Care
10%
Source: USDHEW, PHS, CDC. “Ten Leading Causes of Death in US 1975, Georgia Bureau of State Services, Health Analysis and Planning for Preventive Services, p. 35, 1978
ACE REDUCTION: A POWERFUL FRAMEWORK FOR THRIVING
Adapted from Shonkoff, J.P., “Building a New Biodevelopmental Framework to Guide the Future of Early Childhood Policy,” Child Development, Jan./Feb. 2010.
Foundations of
Healthy Development and
Sources of Adversity
Developmental Determinants of HealthLife-Span Outcomes
Nutrition
Genetic Predispositions
Physical, Chemical, &Built Environment
Relational Environment
Skill-Building Stress:Short-Term Stressors in Supportive Environments; Protection in Sensitive Developmental Periods
Societal Expectations and Response to Behavior
Health-Related Behavior
Physical & Mental Health
Prosperity
Physiologic Adaptation; Hard-wired RapidStress Response
C: Improve Societal Expectations and Response to High ACE People to Reduce Secondary Trauma, Reduce Burden of Chronic Disease and Optimize Wellbeing Through The Lifespan.
A: Improve General Community Capacity to Come Together, Identify and Address Issues that Matter Most.
B: Reduce Median Adverse Childhood Experiences (ACEs) Scores from One Generation to the Next.
Epigenetics:Individual
Experience Affects Gene Expression
Toxic Stress:Cumulative Stressors Over Time; Sensitive Developmental Periods
Adapted to Relational, Benevolent World – Well Matched to Societal Expectations
WHAT IS RESILIENCE?
The capacity to absorb disturbance and re-organize while undergoing change, yet still retain essentially the same function, structure, identity, feedbacks.
(Walker et al., 2002)
The ability of an individual, system or organization to meet challenges, survive, and do well despite adversity.
(Kirmayer, 2009)
RESILIENCE OCCURS AT ALL LEVELS:
The natural human capacity to navigate life well.(HeavyRunner & Marshall, 2003)
Community
Individual
Family
National, Global, Ecosystem
PHASES IN RESILIENCE RESEARCH
Descriptive – What do resilient individuals have in common?
Predictive – How questions: identify and understand processes that might lead to resilience, including risk and protective factors.
Contextual –Why ages, stages, personal and family history, community context matter for promotion of resilience.
Integrative – Encompasses rapid advances in the study of genes, developmental neurobiology, neural plasticity, and the conditions, contexts, and processes that affect positive adaptation throughout the lifespan.
“Resilience rests, fundamentally, on relationships”.Suniya Luthar; Resilience in development: A synthesis of research across five decades; 2006, p. 780
RESILIENCE AS A DEVELOPMENTAL PROCESS
• None of us is perfect—we’ll all have moments when we don’t appear to be very well adapted to the conditions we’re facing.
• Resilience is complex; it is possible to be resilient in one setting and pathological in another.
• We develop competencies & characteristics that prepare us to be effective in the world we’re growing into.
• We develop the capacity to adapt in the face of challenges.
Developmental Framework for
Resilience
Age Related Patterns of
Competence
Multiple Contexts
Age-Appropriate
Social Behavior
(Developmental Tasks)
Interactions Among
Biology, Psychology,
Social Factors
Developmental Framework for
Resilience
Age Related Patterns of
Competence
Multiple Contexts
Age-Appropriate
Social Behavior (Developmental
Tasks)
Interactions Among Biology,
Psychology, Social Factors
Growth
Nourishment
Protection
Wholeness
FINDING MEANING
TEMPERING MASTERY
RECONSTRUCTING IDENTITY
NORMALIZING
AMBIVALENCE
REVISING ATTACHMENT &
BELONGING
HOPE
RELATIONAL
EXPERIENCE
From: Loss, Trauma, and Resilience; Therapeutic Work with Ambiguous Loss; Dr. Pauline Boss; 2006
THREE CORE PROTECTIVE SYSTEMS
1. Community, Spiritual & Cultural Life
2. Attachment & Belonging
3. Capabilities
“Nurturing the healthy development of these protective systems affords the most important preparation or ‘inoculation’ for overcoming potential threats and adversities in human development. Similarly, damage or destruction of these systems has dire consequences for the positive adaptive capacity of individuals.”
Ann Masten, 2009
CAPABILITY
• Intellectual & employable skills• Self regulation – self control,
executive function, flexible thinking
• Ability to direct & control attention, emotion, behavior
• Positive self view, efficacy
ATTACHMENT &
BELONGING
• Bonds with parents and/or caregivers
• Positive relationships with competent and nurturing adults
• Friends or romantic partners who provide a sense of security & belonging
COMMUNITY, CULTURE,
SPIRITUALITY
• Faith, hope, sense of meaning• Engagement with effective orgs –
schools, work, pro-social groups• Network of supports/services &
opportunity to help others• Cultures providing positive
standards, expectations, rituals, relationships & supports
KEY SYSTEMS
FOR RESILIENCE
Nourishment
Protection
GrowthWholeness
COMMUNITY, CULTURE, SPIRITUAL LIFE
PRENATAL – INFANCY PRE-SCHOOL MIDDLE CHILDHOOD PRE-TEEN & TEEN YEARS
COMMUNITY, CULTURE, SPIRITUAL RITUALS &
TRADITIONS IN
CHILDHOOD
Spiritual engagement that demands active
participation in a community of faith
Structure, rules, & responsibility to
contribute to family and community
Parents/Family has: Spiritual engagement demands active participation in a community of faithRituals & traditions supporting connection with the land (for some people)
Value systems that include notions of personhood, ethics, religion or spiritualityCultural knowledge and practices supporting coherence and a source of stability & support
PRE-CONCEPTION PREGNANCY WITH YOUNG CHILDREN
MOVING TOWARD MID-LIFE
ADULT PROTECTIVE
COMMUNITY, CULTURE, SPIRITUAL RITUALS &
TRADITIONS
Spiritual engagement that demands active participation in a community of faith
Rituals & traditions supporting connection with the land (for some people)
Value systems that include notions of personhood, ethics, religion or spirituality
Cultural knowledge and practices supporting coherence and a source of stability & support
SUPPORTING ATTACHMENT & BELONGING
PRENATAL – INFANCY PRE-SCHOOL MIDDLE CHILDHOOD PRE-TEEN & TEEN YEARS
ATTACHMENT & BELONGING IN
CHILDHOOD
Four or fewer children; 2+ years between siblings
Maternal competence: proportion of positive interactions with child
Close bond with caregiverParents have circle of people they can count on for
help and support
Emotional support from friends and family
Caregiver sensitivity and responsiveness to infant needs
No prolonged separation from parent in first year
Sources of support that increase competencies, efficacy, opportunity to develop strengths, gifts and interests, and
decrease stressful life
PRE-CONCEPTION PREGNANCY WITH YOUNG CHILDREN
MOVING TOWARD MID-LIFE
ADULT ATTACHMENT &
BELONGING
Number of stressful life events reported in
childhood, adolescence
Establish relationship with helper (doula,
visitor, etc.) opens door to whole program of
help, improves quality in relating with child
Find ecological Niche for child – support in family,
social network
Number of persons the individual turned to in
times of crisis
Help seeking; social network building (which also helps to mitigate the
negative effects of poverty)
Rewarded with repeated promotions contributes to
sense of pride
NURTURING CAPABILITYPRENATAL – INFANCY PRE-SCHOOL MIDDLE CHILDHOOD PRE-TEEN & TEEN YEARS
CAPABILITY IN CHILDHOOD
Developmentally appropriate physical activityParental involvement in, promotion of, learning
Good health & nutrition; SafetyAbility to seek comfort, support or inspiration from others
Stimulation – sound, sight, touchPlay, laughter, exploration
Scholastic competenceAutonomy, social maturity, self efficacy,
mastery motivation
PRE-CONCEPTION PREGNANCY WITH YOUNG CHILDREN
MOVING TOWARD MID-LIFE
PARENTAL CAPABILITY
Exercise, e.g. walking at 60% of vital capacityIdentifying and using one’s core gifts
Good health; SafetyAbility to seek comfort, support or inspiration from others
Resourceful and realistic in
educational and vocational plans
Imagine self as mother, dream interaction with child; redefine
self
Continuing education: academic and vocational skills
acquiredPractice of seizing
opportunities
Opening of opportunities
Successful adaptation at midlife
RISK & PROTECTION INTERACT IN A CULTURAL CONTEXT
Wholeness
Protection
Nourishment
Growth
CompensatoryIndividuals Protective
Challenge
Caring, Cohesion, Belief in Each ChildBelonging with Peers, School, Circle of Success
Family & Community Non-punitiveProvisions and Resources to Assist Belief in Societal Values
SpiritualityTraditional Activities
Cultural Traditional LanguagesTraditional healingElders
Before
Neighbors Unite To Build Community Park
WALLA WALLA COMMITMENT TO COMMUNITY
EXAMPLES OF PROGRAM & POLICY ACTIONS
• Safe Harbor Crisis Nursery in the Tri-Cities has incorporated ACEs and trauma into its day-to-day strategies and case management resulting in improved outcomes for families.
• Children of Incarcerated Parents; the Legislature has mandated the executive branch to engage in an initiative to address the needs of children of incarcerated parents. The initiative and its processes are framed to address the likelihood that these children have more than this one ACE.
• With the help of the Mental Health Transformation Grant and the Office of the Superintendent of Public Instruction (OSPI), Spokane is exploring the creation/implementation of trauma sensitive practices in public schools.
• OSPI introduced the Compassionate Schools initiative, which supports local school districts in reducing the non-academic barriers to schools success that are created by trauma (2008). (http://www.k12.wa.us/CompassionateSchools/default.aspx)
• Parent Trust for Washington Children has incorporated the ACE questions into their work with addicted parents facing court action (DV, termination of parental rights) resulting in: 1) improved outcomes in parenting classes and 2) reduced relapse among parents with 4 or more ACEs.
PORT GAMBLE S’KLALLAM TRIBE – CHI-E-CHEE (THE WORKERS) NETWORK
ADVERSE CHILDHOOD EXPERIENCE DRAFT
We Can All Help
1. Build Capacity To Reduce Adverse Childhood Experience
2. Promote Resilience
1. Expectation for Thriving Despite Oppression
2. Strength Based ≠ Solutions
3. Attending to Characteristics & Factors that Promote Resilience – Only Part of the Story
CAUTIONS ABOUT THE RESILIENCE APPROACH
PARAMETERS FOR INTERVENTION
3. Enhance the relationship between person & context.
4. Embed interventions in familiar to social setting/community contexts.
5. Attend to possibilities for lasting impact & enduring change.
1. Pay attention to critical periods and cultural context.
2. Understand resilience as both how we engage with other people and how we interact with our environment.
ENHANCING COMMUNITY CAPACITY
A DYNAMIC PROCESS OF CONNECTION
GENERAL COMMUNITY CAPACITY DEVELOPMENT MODEL
FAMILY POLICY COUNCIL
General Community Capacity is:capacity to not only sustain programs, but also to identify new community problems as they arise, and develop ways of addressing them.
General Capacity Development is a dynamic process that enhances the infrastructure, skills, and motivation of a community – changing the way we live with one another day-to-day.
Literature strongly supports the importance of general capacity building in the process of promoting effective prevention. (Livet, 2008)
This model is powerful because success in one phase propels success in the next. It is a virtuous cycle that has the power to improve population health.
VIRTUOUS REINFORCING CAPACITY BUILDING - SUSTAINABLE THRIVINGThis model is powerful because success in one phase propels success in the next. It is a virtuous cycle that has the power to improve population health.
CAPACITY BUILDING HAS POWERFUL EFFECTS
Foundations for Healthy Development ImproveFive or more different problem rates come down (http://www.fpc.wa.gov/publications/technicalpaper-ver3.pdf)
ACE Score Is Reduced from One Generation to the NextThe average ACE score of youth transitioning into adulthood and parenthood is reduced in high capacity communities. Fewer people have 3 or more ACEs, thus preventing many health problems (http://www.fpc.wa.gov/publications/Relationship%20between%20ACEs%20and%20%20BH%20and%20PH%20%206%2024%2010.FINAL.pdf)
Improved Social Responses to High ACE People Result in Better Life CourseIn high capacity communities, youth who have experienced Adverse Childhood Experiences are much less likely to use alcohol, marijuana and tobacco; thereby dramatically reducing their risk for disease, disability and problems at work, home and community (http://www.fpc.wa.gov/publications/FPC_High%20Risk%20Protect%20Youth_Nov%2009.pdf & http://www.fpc.wa.gov/publications/FPC_Social-Normative%20High%20Risk%20High%20Capacity_Dec%2009.pdf)
5.14
2.33
1.51.43
0
1
2
3
4
5
6
First Second Third FourthQuartile Levels of Community Capacity
1997-2007
Number of Better-
than-State Trends
1998 - 2006
CAPABILITY
ATTACHMENT &
BELONGING
• One question in BRFSS indicates attachment & belonging, and gives clues about community capacity: How often do you get your social/emotional needs met?
COMMUNITY, CULTURE,
SPIRITUALITY
• Family Policy Council Community Capacity Dynamics model + decade of measurement quantify neighborhood/community transformation outcomes
FAMILY POLICY COUNCIL RESILIENCE MEASURES
MEASURES1. Focus2. Learning3. Leadership 4. Results
Before
Neighbors Unite To Build Community Park
WALLA WALLA COMMITMENT TO COMMUNITY
EXAMPLES OF PROGRAM & POLICY ACTIONS
• Safe Harbor Crisis Nursery in the Tri-Cities has incorporated ACEs and trauma into its day-to-day strategies and case management resulting in improved outcomes for families.
• Children of Incarcerated Parents; the Legislature has mandated the executive branch to engage in an initiative to address the needs of children of incarcerated parents. The initiative and its processes are framed to address the likelihood that these children have more than this one ACE.
• With the help of the Mental Health Transformation Grant and the Office of the Superintendent of Public Instruction (OSPI), Spokane is exploring the creation/implementation of trauma sensitive practices in public schools.
• OSPI introduced the Compassionate Schools initiative, which supports local school districts in reducing the non-academic barriers to schools success that are created by trauma (2008). (http://www.k12.wa.us/CompassionateSchools/default.aspx)
• Parent Trust for Washington Children has incorporated the ACE questions into their work with addicted parents facing court action (DV, termination of parental rights) resulting in: 1) improved outcomes in parenting classes and 2) reduced relapse among parents with 4 or more ACEs.
PORT GAMBLE S’KLALLAM TRIBE – CHI-E-CHEE (THE WORKERS) NETWORK
ADVERSE CHILDHOOD EXPERIENCE DRAFT
We Can All Help
1. Build Capacity To Reduce Adverse Childhood Experience
2. Promote Resilience
1. Expectation for Thriving Despite Oppression
2. Strength Based ≠ Solutions
3. Attending to Characteristics & Factors that Promote Resilience – Only Part of the Story
CAUTIONS ABOUT THE RESILIENCE APPROACH
PARAMETERS FOR INTERVENTION
3. Enhance the relationship between person & context.
4. Embed interventions in familiar to social setting/community contexts.
5. Attend to possibilities for lasting impact & enduring change.
1. Pay attention to critical periods and cultural context.
2. Understand resilience as both how we engage with other people and how we interact with our environment.
ENHANCING COMMUNITY CAPACITY
A DYNAMIC PROCESS OF CONNECTION
GENERAL COMMUNITY CAPACITY DEVELOPMENT MODEL
FAMILY POLICY COUNCIL
General Community Capacity is:capacity to not only sustain programs, but also to identify new community problems as they arise, and develop ways of addressing them.
General Capacity Development is a dynamic process that enhances the infrastructure, skills, and motivation of a community – changing the way we live with one another day-to-day.
Literature strongly supports the importance of general capacity building in the process of promoting effective prevention. (Livet, 2008)
This model is powerful because success in one phase propels success in the next. It is a virtuous cycle that has the power to improve population health.
VIRTUOUS REINFORCING CAPACITY BUILDING - SUSTAINABLE THRIVINGThis model is powerful because success in one phase propels success in the next. It is a virtuous cycle that has the power to improve population health.
CAPACITY BUILDING HAS POWERFUL EFFECTS
Foundations for Healthy Development ImproveFive or more different problem rates come down (http://www.fpc.wa.gov/publications/technicalpaper-ver3.pdf)
ACE Score Is Reduced from One Generation to the NextThe average ACE score of youth transitioning into adulthood and parenthood is reduced in high capacity communities. Fewer people have 3 or more ACEs, thus preventing many health problems (http://www.fpc.wa.gov/publications/Relationship%20between%20ACEs%20and%20%20BH%20and%20PH%20%206%2024%2010.FINAL.pdf)
Improved Social Responses to High ACE People Result in Better Life CourseIn high capacity communities, youth who have experienced Adverse Childhood Experiences are much less likely to use alcohol, marijuana and tobacco; thereby dramatically reducing their risk for disease, disability and problems at work, home and community (http://www.fpc.wa.gov/publications/FPC_High%20Risk%20Protect%20Youth_Nov%2009.pdf & http://www.fpc.wa.gov/publications/FPC_Social-Normative%20High%20Risk%20High%20Capacity_Dec%2009.pdf)
5.14
2.33
1.51.43
0
1
2
3
4
5
6
First Second Third FourthQuartile Levels of Community Capacity
1997-2007
Number of Better-
than-State Trends
1998 - 2006
CAPABILITY
ATTACHMENT &
BELONGING
• One question in BRFSS indicates attachment & belonging, and gives clues about community capacity: How often do you get your social/emotional needs met?
COMMUNITY, CULTURE,
SPIRITUALITY
• Family Policy Council Community Capacity Dynamics model + decade of measurement quantify neighborhood/community transformation outcomes
FAMILY POLICY COUNCIL RESILIENCE MEASURES
MEASURES1. Focus2. Learning3. Leadership 4. Results
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