Enhancing Resilience in Children: A Proactive Approach

Enhancing Resilience in Children: A Proactive Approach

Enhancing Resilience in Children: A Proactive Approach

Enhancing Resilience in Children: A Proactive Approach

Mary Karapetian Alvord and Judy Johnson Grados Alvord, Baker & Associates, LLC

Many clinical practitioners today are interested in helping children be more resilient. The authors briefly review the literature and identify protective factors that are related to or foster resilience in children. After discussing individual and family intervention strategies currently in use, the authors present a practical, proactive, resilience-based model that clinicians may use in a group intervention setting. The model entails interactive identification of protective factors with children, free play and behavioral rehearsal, training in relaxation and self-control techniques, practice in generalizing skills acquired, and active parent involvement. Implications of this group intervention model are discussed. Enhancing Resilience in Children: A Proactive Approach

ORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE PAPERS

Keywords: resilience, children, social skills, groups, cognitive– behavioral therapy

Vala is a 16-year-old Russian girl who first came to our practice at age 6. Neglected as a child, separated from her younger sister, and taken to an orphanage following her mother’s suicide, she was adopted by an American family and came to this country. The tribulations she experienced were extreme. However, because of her intelligence, easygoing temperament, and other personal strengths, as well as loving support of family and friends and a positive school environment, she is functioning well today and appears to be successful and happy.

Many children encounter fewer and less severe traumatic expe- riences than did Vala. Yet they do experience the inevitable stresses and adversities in life that may challenge their healthy development and successful functioning. In the past three decades, a group of children have been identified in the research who appear to have fared well despite exposure to severe adversity. These children, who have been referred to as stress-resistant, invulner- able, and, more recently, resilient, were found to possess certain strengths and to have benefited from protective influences that helped them to overcome adverse conditions and to thrive. As practitioners, we must understand what environmental factors place children at risk and what protective factors may be fostered to enhance and strengthen resilience in children.

In this article we define resilience and provide an overview of the literature and recent advances that are guiding work in the field today. We then define and discuss protective factors linked with the resilience process. Finally, we offer clinical implications for individual, family, and group therapy with children.

Definitions of Resilience

The term resilience has been defined in many ways. Masten, Best, and Garmezy’s (1990) definition of resilience as “the process of, capacity for, or outcome of successful adaptation despite chal- lenging or threatening circumstances” (p. 426) is one of the more familiar and widely accepted in the field. Many definitions of resilience require specification of an identified risk or challenge to which an individual is subjected, followed by some defined mea- sure of positive outcome. However, controversy remains regarding what constitutes resilient behavior and how to best measure suc- cessful adaptation to adversity. Some have suggested that a resil- ient person must show positive outcomes across several aspects of his life over periods of time (Cicchetti & Rogosch, 1997). Further, resilience is not a one-dimensional, dichotomous attribute that persons either have or do not have (Reivich & Shatté, 2003). Rather, resilience implies the possession of multiple skills, in varying degrees, that help individuals to cope. Enhancing Resilience in Children: A Proactive Approach

For the purpose of this article, we define resilience broadly as those skills, attributes, and abilities that enable individuals to adapt to hardships, difficulties, and challenges. Although some attributes are biologically determined, we believe resilience skills can be strengthened as well as learned. Enhancing Resilience in Children: A Proactive Approach

Early Studies in Resilience

Early clinical case descriptions spawned an interest in determin- ing why some children manage to cope with adversity whereas others succumb. One such case of a 14-year-old Swiss girl was described by Bleuler (1984; as cited in Anthony, 1987a). “Vreni,” in the absence of her mother (who was hospitalized with mental illness), raised her siblings, cared for her alcoholic and physically compromised father, and later reported having a happy marriage and contented life. Anthony’s description of “invulnerable” chil- dren (Anthony, 1987b) and Murphy and Moriarty’s “good copers” Enhancing Resilience in Children: A Proactive Approach

MARY KARAPETIAN ALVORD received her PhD from the University of Maryland in 1977. She is currently the director of the Group Therapy Center at Alvord, Baker & Associates, LLC, an independent therapy practice in the Washington, DC, metropolitan area. Her interests are focused on resilience and social skill development of children and adoles- cents. JUDY JOHNSON GRADOS received her PsyD from Indiana State University in 1995. She currently practices with Alvord, Baker & Associates, LLC. Her research interests include social skills training for children and resilience in children and adolescents. WE GRATEFULLY ACKNOWLEDGE Dr. W. Gregory Alvord, Dr. Patricia K. S. Baker, and Ms. Anne McGrath for their support and editorial comments. We also thank Mrs. Maria Manolatos for assistance in the preparation of the manuscript. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Mary Karapetian Alvord, Alvord, Baker & Associates, LLC, 11161 New Hamp- shire Avenue, Suite 307, Silver Spring, MD 20904. E-mail: MAlvord@alvordbaker.com

Professional Psychology: Research and Practice Copyright 2005 by the American Psychological Association 2005, Vol. 36, No. 3, 238 –245 0735-7028/05/$12.00 DOI: 10.1037/0735-7028.36.3.238

238

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

(Murphy & Moriarty, 1976) sparked early interest as well. Rutter’s Isle of Wight studies (Rutter, Tizard, Yule, Graham, & Whitmore, 1976), large-scale longitudinal undertakings such as Project Com- petence (Garmezy, Masten, & Tellegen, 1984; Masten, 2000), and Werner’s now four-decade-long study of high-risk infants born into poverty on the Hawaiian island of Kauai (Werner, 1993; Werner & Smith, 2001) have helped to lay the groundwork for what we know today. Enhancing Resilience in Children: A Proactive Approach

Recent Advances

The emerging research in the area of resilience encompasses many areas. These include investigations of children from various cultures (Grotberg, 1995; Hart, Hofmann, Edelstein, & Keller, 1997), studies of the influences of biological mechanisms (Curtis & Cicchetti, 2003; Rutter, 2002), new findings in recovering to normal functioning in varying stages of development, research on the impact of internal challenges, and theories on the processes that promote resilience under nonrisk conditions. We consider the latter three areas below.

Evidence that children can recover and develop normally comes from a recent study of Romanian children who experienced severe deprivation in orphanages and were later adopted into nurturing homes in the United Kingdom. At the time of adoption, most of these children showed substantial gross physical and cognitive lags in development. Later, when assessed at age 4, many of these adoptees showed significant “catch-up,” both physically and cog- nitively (Rutter & The English and Romanian Adoptees (ERA) Study Team, 1998; Rutter, Pickles, Murray, & Eaves, 2001). Follow-up in Werner and Smith’s (2001) Kauai study revealed that even those individuals who were troubled as adolescents were able to change the course of their lives in dramatic ways by making wise choices and taking advantage of opportunities, for example, by continuing their education, learning new skills, joining the military, relocating to break ties with deviant peers, and choosing healthy life partners.