RESEARCH BASED PROGRAM THAT FOSTER RESILIENCE



Start with what they know; build with what they have.

-- Lao Tau, 100 B.C.


Reviewing the literature on programs which attempt to foster some aspect of resilience is an uplifting enterprise as one discovers the sheer multitude of people trying to make life better for others. It is also a daunting task as there are well over a thousand articles written about these programs. Unfortunately, most have not been evaluated adequately to warrant widespread replication. In consultation with Bonnie Benard, I have chosen ten of these programs which have some outcome data to review here. Most do not describes themselves as "programs designed to foster resilience. " However, by virtue of how they do what they do, they enable people to call upon or develop the resources which comprise what we are calling resilience.

When we look at different programs, we become aware of just how important it is to understand risk and protection as processes, and to understand how these processes -- and by implication, the programs -- work to foster change. In the words of Benard, "Resiliency research has clearly shown that fostering resilience, i.e., promoting human development, is a process and not a program. It forces us to consider not just content -- what we do -- but also the process -- how we do what we do" (1996).

A GENERAL APPROACH APPLIED IN DIFFERENT SETTINGS

Health Realization/Psychology of Mind
Dr. Roger Mills and Associates, Long Beach California

Health Realization programs, which have been widely applied in clinical, educational, and community settings, are based on the resiliency or strengths- based paradigm known as Psychology of Mind (POM). Community psychologist, Dr. Roger Mills, and his colleagues began developing POM some twenty years ago in response to their recognition that existing paradigms were inadequate to address the multitude of personal and societal problems of their clients and the world they lived in.

POM proceeds from three assumptions about the basic nature of human psychological functioning:

  1. Thought is the source of human experience.
  2. Regardless of their current state of mental functioning, all people have the same innate capacity for healthy psychological functioning.
  3. There are two modes of thought, one related to memory and the other to healthy, common-sense, wiser intelligence.
    (Mills, 1995; Pransky, et al., 1997)

POM differs from cognitive therapy in that the latter proceeds from the premise that problems result from irrational beliefs, and that it is the content of thoughts that is at fault. POM, in contrast, focuses on the process of thought -- i.e., how we think. It is the quality of our thinking, not the content, which determines our stability. By coming to understand the process of our thinking, we can achieve an adaptive distancing from problems and can find healthy, hopeful, common sense approaches to dealing with those problems.. Pransky et al., (1997) provide the following comparison of cognitive and POM approaches:

Point of Comparison Cognitive POM
Source of Problems Irrational beliefs and unrecognized assumptions Failure to see, in the moment, what thought is and what it does
Specific Focus on Thought Focus on what we think Focus on that we think and how we think.
Assessment To identify dysfunctional beliefs and assumptions To discover client’s present understanding of and use of thought as a function
Objective of Therapy To renovate client’s schema To teach client to recognize the role of thought, moment to moment
The Therapy Process Strategies and techniques to address thought content Education to teach an understanding of relevant generic human psychological functioning
View of Moods and the Past Thinking is influenced by moods and the past Moods and memory are themselves thoughts
View of Reality Thought interprets reality Thought creates reality

Mills and his colleagues call POM an educational process, and they do provide training in a specific skill. However, they do so via the community psychology model of enlisting the interest and support of concerned and influential people in the community and by providing a facilitating environment staffed by exceedingly well trained and supervised "teachers." Benard notes that the Health Realization helper "sees all people as ‘doing the best they can, given how things appear to them,’ listens with compassion and without blame, and welcomes clients’ active participation and ownership, being merely a guide and a coach in their quest to access their innate wisdom " (1994). She goes on to note that, while a number of traits of resilience are fostered throughout this process, the emergence of a strong sense of self-efficacy, social competence, problem-solving abilities, autonomy, and a sense of a bright future among previously " disempowered" people are especially noteworthy.

The Health Realization model has been applied in a variety of settings – with psychiatric inpatients and outpatients, in drug and alcohol rehabilitation programs, in schools, and in prisons. But perhaps nowhere are the data so compelling as in Mills’ work in communities, especially in "hopeless" housing projects in urban areas such as Miami, the South Bronx, Minneapolis, and Oakland. After three years, results of the Health Realization project which served 150 families and 650 youth in the Modello and Homestead Gardens Housing Projects in Miami were as follows:

RISK FACTORS

Households selling or using drugs
Overall crime rate
Teen pregnancy
School dropout rates
Child abuse and neglect
Households on public assistance
School absenteeism/truancy
Parent unemployment rate

BEFORE

65%
endemic
50%+
60%
endemic
85%
65%
85%

AFTER

20%
70-80?% decrease
10%
10%
70%+ decrease
35%
Negligible
35%
(Mills, 1997a; 1997b)

Similarly, for Coliseum Gardens, a 200 unit public housing project which had the highest rates of homicide and drug related arrests in the city of Oakland, California, Mills reports the following results for the Health Realization program:

  • homicides dropped by 100% (none reported in years two).
  • violent crime was reduced by 45%.
  • drug possession/sales was reduced by 16%.
  • assault with firearms was reduced by 38%.
  • youth attendance and involvement in Boys and Girls Clubs increased by 110%.
  • gang warfare and ethnic clashes between Cambodian and African American youth ceased.
  • 62 families have members gainfully employed.
  • 80% participation in regular meetings with housing management and community police.
  • 45 residents regularly participated in weekly empowerment classes.
    (Mills, 1997a; 1997b)

While these and other data are impressive, Mills notes the need for a more rigorous evaluation process for the various Health Realization programs.




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