Family Resilience Framework

This article presents an overview of a family resilience framework developed for clinical practice, and describes its advantages. Drawing together findings from studies of individual resilience and research on effective family functioning, key processes in family resilience are outlined in three areas:

• family belief systems,
• organizational patterns, and
• communication/problem-solving

Clinical practice applications are described briefly to suggest the broad utility of this conceptual framework for intervention and prevention efforts to strengthen families facing serious life challenges.

"Most studies focused on individuals who thrived despite a parent's mental illness or maltreatment and tended to dismiss the family as hopelessly dysfunctional and to seek positive extra-familial resources to counter the negative impact. Thus, families were seen to contribute to risk, but not to resilience."

I wonder if this is why - related to family engagement - we give up before we even get started? How many times is "enough" when it comes to reaching out to parents of children with mental illness or pyschosocial problems?

Families Can Talk About It

Studies have demonstrated the importance of open communication about emotions within the family to socio-emotional competence in children.

Parental discourse about emotions is also related to children's social interactions and relationships with peers, and children's emotional resilience and ability to cope constructively with challenging situations.

Differences have been described in parents' capacity to assist their children with emotional expression. It has been observed that parents who are aware of emotions, particularly negative emotions, can talk about and accept these emotions in themselves. These parents also are aware of emotions in their children and have the ability to assist their children in understanding their emotions.

Openness in discussing one's emotions is often described as an essential component in coping with anxiety that may be associated with distressful events.

Many theoretical perspectives, such as psychodynamic and cognitive-behavioral theories, hypothesize a direct relationship between healthy coping and openness in disclosing information about one's emotions and feelings.

Research supports the theoretically defined relationship between disclosure of emotions and healthy coping.

Talking about feelings associated with traumatic or distressing events is linked to psychological well-being, improved functioning, better self-reported health, and better immune responses.

The presence of open communication styles in individuals can support or enhance their ability to accurately process and cope with distressing events, which are key aspects to successful resolution of distressing experiences.

Indeed, communicating openly about one's feelings and emotions is commonly recommended and encouraged by mental health professionals for both adults and children who are coping with frightening events. This enables adults and children to reflect on their emotions aroused by the event and perhaps allows them to engage challenging situations more effectively.

In this way, open discourse about emotions is considered an important characteristic of protective processes that underlie resilience in stressful times (Lutz, 2007).

Paulo's Download

I was struggling to establish myself as a writer and to follow my path despite all the voices telling me it was impossible.

And little by little my dream was becoming a reality.

A personal calling is God's blessing, the path that God chose for you here on earth.

Whenever we do something that fills us with enthusiasm, we are following our legend.

However, we don't all have the courage to confront our own dream.

We are told since childhood that everything we want to do is impossible.

Those who genuinely wish us well want us to be happy and are prepared to accompany us on that journey.

The path of the personal calling is no easier than any other path, except that our whole heart is in this journey.

Then, we warriors of light must be prepared to have patience in difficult times and to know that the Universe is conspiring in our favor, even though we may not understand how.

When we first begin fighting for our dream, we have no experience and make many mistakes.

The secret of life, though, is to fall 7 times and to get up 8 times.

Once we overcome the defeats - and we always do - we are filled by a greater sense of euphoria and confidence.

In the silence of our hearts, we know that we are proving ourselves worthy of the miracle of life.

The mere possibility of getting what we want fills the soul of the ordinary person with guilt.

If you believe yourself worthy of the thing you fought so hard to get, then you become an instrument of God, you help the Soul of the World, and you understand why you are here.

Paulo Coelho
2002

Writers, artists, musicians, and scientists tap into the transcendental force and write, create, play or discover the universal truth that resonates in all our souls. Paulo wrote it, but we all read it and feel like he stole it from our very own deep, dark secret soul and in a manner of speaking, he did. Could not have said it better myself, Paulo, but our spirit moves us to try anyway.

Abstract about what to look out for...

A prospective study of childhood psychopathology: independent predictors of change over three years

Tamsin Ford, Stephan Collishaw, Howard Meltzer, Robert Goodman

Background: Whilst the correlates of child mental health problems are well understood, less is known about factors that operate to maintain healthy or unhealthy functioning, or that contribute to change in functioning. A range of factors may be of interest here, including relatively stable characteristics of children or their environment, that may have long lasting and enduring consequences for their mental health, along with events that prompt changes in a child’s mental state.

Methods: Children were followed up 3 years after the original survey for a sub-sample of the 1999 British Child and Adolescent Mental Health Survey (N = 2,587 children). Latent mental health ratings drew on data provided by parent, teacher, and youth versions of the Strengths and Difficulties Questionnaire at baseline, and at follow-up. A residual scores method was used to assess change in functioning over time.

Results and Conclusions: Latent mental health scores showed strong stability over time (r = 0.71) indicating the need for effective intervention with children who have impairing psychopathology, since they are unlikely to get better spontaneously. A poorer outcome was associated with:

• externalizing as opposed to emotional symptoms
• reading difficulties
• living in a single-parent or reconstituted family at baseline
• and after exposure between Time 1 and Time 2 to parental separation, parental mental illness, child illness, and loss of a close friendship.

All these factors could be targeted in public health or clinical interventions, particularly as predictors of change in child mental health were closely comparable across the range of initial SDQ scores, suggesting that they operated in a similar manner regardless of the initial level of (mal)adjustment.

Key words child mental health – prognosis – stability – change – epidemiology

So these are the kids that need help the most (those acting out behaviorally, those with reading problems, those in single-parent or blended families, and those recently faced with parental separation, parental mental illness, child illness and loss of a close friendship).

This article calls for universal - school-wide or community-wide approaches - to build resilience in all children and attend to these children. Without mental health intervention, they are unlikely to get better on their own.

One question is, how can we systematically screen for these kid populations in our schools rather than wait for someone to notice them and refer? I think waiting around in pain to be noticed, referred and treated is one of the saddest states for our kids. It is what is meant as "falling through the cracks."

How can we do better? That is, what can we do differently? Because redoubling our efforts when we are now doing more with less is what is meant as "dying on the vine." Kids matter and their grown-ups matter, too. This includes their parents, teachers, and all the mental health providers who care about them. There are better and more efficient ways. Interested?

I Heart Book Chapters on "Building Resilience in All Children"

Building Resilience in All Children

A Public Health Approach

Emily B. Winslow, Irwin N. Sandler, and

Sharlene A. Wolchik

In this chapter, we present a conceptual framework for the promotion of resilience in children that integrates concepts from the study of resilience with a public health approach to improving mental health at the population level. The chapter begins with a review of resilience and public health concepts and describes how these perspectives can be integrated within a broad framework for the promotion of health and prevention of dysfunction.

We then present examples of evidence-based preventive interventions and policies that have successfully implemented components of this framework. Given our focus on promoting resilience, we limit discussion and examples of interventions to those designed to create resources for children not diagnosed with mental health disorder, although the framework could readily be extended to interventions for children with clinical levels of dysfunction. Finally, we provide an overview of how the framework might be used by planners to create resources in their communities that will promote resilience, as well as examples of tools currently available to assist planners in this process.

Okay, this is when I think that everything I have done, seemingly intentionally or not, has lead me to this moment. Before grad school (MSW), I worked in health education/health promotion. I was immersed in a public health approach to prevent and address HIV, substance abuse, teen pregnancy, etc. I learned some great theories and frameworks for conceptualizing problems and developing programs and intervention strategies. It only makes sense that I would gravitate to this way of thinking when addressing school-wide mental health and resilience.

It's like the story about the two social workers who went fishing and found dead bodies floating around their boat. As they pulled one body into the boat and attempted to resuscitate it, they immediately saw another in the water. And so on, and so on, and so on... Finally, one of the two social workers said, "I'll leave you to continue this work while I swim upstream and try to figure out what the heck is causing all these dead bodies in the first place!"

It's all important - universal interventions for all (tier one), selected interventions for some (tier two) and intensive interventions for a few (tier three). But if we really do tier one interventions well, then there are less people needing more - which means more healthy people in the first place.

I Heart Resilience Article Abstracts

Assessing Strengths, Resilience, and Growth to Guide Clinical Interventions

Richard G. Tedeschi and Ryan P. Kilmer

University of North Carolina at Charlotte

Recently, the field of mental health has incorporated a growing interest in strengths, resilience, and growth, psychological phenomena that may be associated with healthy adjustment trajectories and profitably integrated into strategies for clinical assessment and practice. This movement constitutes a significant shift from traditional deficit-oriented approaches. Addressing clinical practitioners, this article...

(a) provides a broad overview of these constructs and phenomena,

(b) discusses their relevance for clinical assessment and intervention, and

(c) describes selected strategies and approaches for conducting assessments that can guide intervention.

I am glad to see that the field of mental health is moving toward a strengths-based approach - a long-time hallmark of social work values and practice. I think it's interesting that the field of mental health has historically been a male-dominated field and social work has been a pink collar profession. I wonder if these gender differences contributed to why it took so long for the field of mental health to integrate strengths, resilience and growth with risks, deficits and pathology?

This reminds me that when you are not in a powerful position, have limited status, feel like a nobody-nobody in an audience of somebody-somebodies - it really matters to speak up. They don't know it all. And even if they know what they know well, they don't know what you know. They have never stood in your shoes and don't have your perspective. And the truth is, we all need to share our perspectives. Nobody sees the whole, everyone has a piece. The world is waiting for your piece of the puzzle. Share your perspective. Speak it. Louder.

And read this article! 8 pages to a more resilient clinical practice! That's good for both clinician and client! Who said social work can't be fun? Start your own resilience revolution...

I Heart Attachment Article Abstracts

Annotation: Attachment disorganisation and psychopathology: new findings in attachment research and their potential implications for developmental psychopathology in childhood

Jonathan Green and Ruth Goldwyn

University of Manchester, UK

Background: The past 10 years have seen a fruitful line of enquiry building on identification of previously unclassifiable patterns of infant–mother interaction. A critical review of these new findings inattachment theory, highlighting their potential relevance to child psychopathology, is presented.

Method: Selective literature review relating to disorganised attachment in childhood.

Results: Disorganised patterns of attachment have only relatively recently been described. They show characteristic patterns of evolution in development. There is evidence that disorganised attachments are associated with specific forms of distorted parenting, which are distinct from general parental insensitivity and are associated with unresolved loss or trauma in the caregiver. There are also links with aspects of neurodevelopment vulnerability in the child. Attachment disorganisation is a powerful predictor of a range of later social and cognitive difficulties and psychopathology.

Conclusions: The identification of disorganised attachment has greatly increased the potential relevance of attachment theory to general clinical work. However, the concept raises many methodological and theoretical issues. Among issues needing further exploration is the way in which attachment disorganisation relates to children’s general mental states and may be affected by cognitive functioning and developmental impairment.

Keywords: Attachment, parent–child relationships, risk factors, social behaviour, disorganisation.

When I read this I understand clearly what Bowlby meant when he said, many decades before, that if we care about children, then we need to care about their parents.

If disorganized attachment results when parents have unresolved loss or trauma and disorganized attachment is such a powerful predictor of social and cognitive problems later on, including psychopathology, then it makes sense to me that child therapy is family therapy. Can I get an amen?