Harnessing ‘Resilience’ in Practice with Vulnerable Children

Scoping parent and worker perceptions and congruence with the literature

Edwina Farrall, Fiona Arney, & Annette Michaux

An International Partnership…

• UK: – Centre for Learning in Child Protection– University of Stirling– Barnardo’s

• Prof. Brigid Daniel, Dr Sharon Vincent, Ms. Jane Glover, Ms. Barbara Robinson

• Australia:– The Australian Centre for Child Protection– The Benevolent Society

• Dr Fiona Arney, Dr Edwina Farrall, Ms. Kerry Lewig, Ms. Annette Michaux

With a burning question…

How is the Concept of Resilience Operationalised in Practice with Vulnerable Children?

• When an organization has the explicit aim of nurturing resilience in vulnerable children,

– How do practitioners translate that aim into practice, and– How congruent is the described practice with the principles

indicated by the existing literature on resilience?

Method: Sampling and Measures

• UK and Australia: Survey administration and detailed case studies within the organizations

• Survey: Target 100 service practitionersAIM: To obtain practitioners’ views about their understanding of the

concept of resilience, how they put it into practice and its perceived strengths and weaknesses.

• Case Studies: Target 20 filesAIM: To produce a detailed description of the work with vulnerable

children and their families in a setting where practice is explicitly resilience-lead, and to analyse it with reference to the research evidence about factors associated with resilience.

The Resilience Literature…

• How is resilience defined?• A convergent definition:

…a process or phenomenon reflecting positive adaptation despite experiences of significant adversity or trauma

• Difficulties in delineating ‘adversity’ and ‘adaptation’

• How is resilience nested within principles of practice?– Reduce vulnerabilities and risk– Reduce number of stressors and pile-up– Increase available resources (internal and external)

Participants and Services Involved…

Surveys• 108 in UK and 93 in Australia

Case Studies• 18 children in UK

– aged 7-10 years; 83% male– 83% white

• 14 families in Australia (reflecting 28 children), – aged 9 months to 18 years; complete gender balance– 93% white

The Services

Type of work carried out in Australia and UK

Nature of the work undertaken

Resilience-related issues addressed by services:

A major point of difference…

• UK vs. Australia: Service orientation and targeted receiving group– UK: Two children’s services working with kids in an out-of-home

setting, focusing on social and emotional well-being of individual children only

• England: Improve children’s emotional resilience. Use of Daniel and Wassel’s (2002) resilience intervention model

– Target: Secure Base, Friendships, Talents and Interests, Education, Positive Values, and Social Competencies

• Scotland: Nurture Group. Target children’s aggressive and/or maladaptive behaviours.

In contrast…

Australia: • Focus on working with parents as the client• Service 1:

– Child Protection role– Referrals from DOCS– Prevent ongoing ROH and bolster chances of the family unit not

entering the statutory CP processes again

• Service 2:– Early Intervention role– Referrals from DOCS and the Community– Work with vulnerable families (identified as such across a variety

of criteria) to enhance parenting capacity and the well-being of children and parents alike

FINDINGS

• Survey and Case Studies together (emphasis on Australian data)

• Analyses proceeded along four key dimensions:1. Understanding of resilience2. Assessment and measurement of outcomes in

resilience-based practice3. Principles and features of resilience-led work with

vulnerable children and families4. Strengths and weaknesses of the concept of resilience

for practice

1. Understanding ‘Resilience’…

Generally, concept of resilience was• Well-known and seen as easily applied• Held to hold explicit and implicit relevance to their work

Definitions: • were mostly concerned with resilience as a process that

enables coping and adaptation to challenges and adversity

• Internal and external factors promoting coping or adaptation less frequently discussed

Some example definitions:Coping with or adapting to adversity, with common

reference to inner or innate qualities:‘A person’s ability to weather the storms in life and bounce

back. Ability to have internal resources to call upon in times of need’.

‘Being able to 'bounce back', achieve developmental milestones and wellbeing in spite of abuse, neglect, hardship’.

‘The feature of coping well with life adversities, and recovering quicker from a stressful event… more about the individual, and their resources’

‘It’s in the strengths of the person and the way they’re able to cope in challenging times’

Understanding Resilience – Implications…• Need a clearer understanding of resilience if it is to be

used to guide practice• Policy documents referring to resilience must set out their

operational definitions• Relationships amongst various working definitions,

interventions, and subsequent outcomes for children should be ascertained

The parameters or scope of ‘resilience’ must be set out if the concept is used to influence practice and policy.

Consistency in definitions within services invoking its usage is the crux of the matter.

Theories and Models in Use‘…it’s very holistic and eclectic. There’s no one size fits all for

anyone, you need to draw on the best parts’ (worker, NSWb)‘…it’s very practical and holistic… it’s about digesting issues’

(worker, NSWa)‘We use a strengths-based model, because when I do the case

plan, I do it with the client, with the family, to make it totally about them. That works extremely well as it gives families total ownership of their problems’ (worker, NSWb)

‘I believe everybody’s got the potential to change, and focusing on people’s strengths is, in my experience, the only way you can do that… the key to resilience or strengths-based work is the relationship you begin with I guess…’ (worker, NSWa)

•  

2. Measuring Resilience - Assessment

UK: Boxall Profile, Daniel & Wassell’s (2002) ModelAustralia: Family Strengths and Needs questionnaire,

parental capacity and needs assessment • Importance of Case Planning tool and process• Eclectic assessment:

‘I do a lot of observations when I first go into a family. I sort of work out what is needed in the family, because every family is different’ (worker, NSWa)

‘…assessment is about engagement, talking, to let clients have a voice… it’s ‘inner work’, seeing the world through their eyes’(worker, NSWb)

Measuring Resilience - Outcomes

OUTCOMES:• Measured through informal channels and processes:

– feedback from parents and other agencies, observations, anecdotal evidence, children’s art

• Positive (presence) and negative (absence) indicators of resilience:– Improved social skills, decreased anxiety, increased

emotional regulation, better school performance, engagement in community activities

Measuring Resilience – Implications…

• Consistency in outcome measurement to aid evaluation• Policy: Focused drive to incorporate sound outcome

measurement• Research to examine breadth of assessment and

measurement tools – recommend utility and relevance in the context of actual outcomes for clients

Again, the emphasis lies on consistency of usage: Assessment and outcome measurement procedures need to align to a resilience-based framework if this is the approach being explicitly espoused by the organization

3. Resilience-Based PracticeThree Main Principles: • Inclusive, respectful and

engaged practice• Strengths-based practice• Solution focused approachesAlso,• Fostering community and

social connectedness• Attachment theory and Circle

of Security

Differences in ecological emphases: Australia vs. UK

Resilience in Practice - UK

Intervention Themes:

• Improvement of self-esteem / to like self more

• Improvement of peer relationships

• Improvement in school experience / behaviour

• Control of anger / managing disagreements

• Naming feelings / emotional literacy

Resilience in Practice- AustraliaIntervention Themes Subtypes Occurrence

1. Health a) Physical/Medical 11%

b) Mental/Behavioural 4%

2. Emotions & Attachment a) Parent-child dyads 14%

b) Broader family r/ships 3%

3. Parenting Skills & Confidence a) Expectations/boundaries 22%

b) Support: Peer/Playgroups 7%

4. Legal Issues 5%

5. Employment & Education or Training

8%

6. Finances & Housing 5%

7. External Supports for CHILDREN

a) From the School 7%

b) From the Community 4%

8. Reduce Social Isolation 10%

Australian Practice… Chains of Support

• NSWb1:

Address mother’s social isolation  link mother with community supportive playgroup mother-child bonding and attachment is facilitated new social networks and connections with the community are created

• NSWa1

Address uncontrolled behaviour, aggression in children/poor attachment evident  assist father in putting strong boundaries, routines and expectations in place at home children seen as having greatly improved emotional regulation, able to cope in new spaces or with new people father more competent and relaxed

Mapping interventions against the Literature

1. Health2. Emotions & attachment3. Parenting confidence

and skills4. Legal issues5.Employment/E&T/edn/

training6. Finances/Housing7. External supports for

children8. Reduce Social

Isolation

Resilience-based Practice – Implications…

• Practice should aim to target all ecological levels to align to a comprehensive view of resilience

• Policy: Ecological supports, especially community level investment

• Building a common language around resilience to promote strategic change as disciplines and agencies endeavour to work in concert

• Flexibility for assessment and practice frameworks – creativity and individualisation

Resilience-based Practice – Implications… cont’• Comparative research: Underlying processes vs.

behaviours; impacts of various ecological levels• Impact and unique predictive value of attachment as

central to intervention efforts• Family definitions of adversity and their priorities for help• Evaluate, evaluate, evaluate! Assessment of outcomes to

see if resilience-based interventions work!!

Essentially, resilience-based practice needs to aim for consistency in scope and application + flexibility

Outcome evaluation as critical for determining best practice

4. Strengths and Weaknesses of the Concept: Harnessing Resilience in Practice‘All work with children and young people should be based on their

needs and undertaken at their pace, including and involving them wherever possible. Working with resilience should be central to all practice, as it means working with strengths, optimism and respect for the young person and their experiences.’

‘A strengths-based approach is beneficial to the clients as well as the workers. It decreases burn-out in workers and makes them have a more positive approach to their work whilst achieving good outcomes.’

‘The benefit is it helps them [clients] to keep focused on hopeful solutions…’

‘It helps me to maintain a relationship with hope, about some of my high-risk families…’

Strengths and Weaknesses… cont’

‘I'm not convinced that resilience is the best framework to apply. It can be a mask on occasions to more maladaptive functioning.’

‘Families need to want to have us on board. They have to be prepared to acknowledge challenges and… to be willing to make some changes. Motivation is a very big thing!’

Conceptual Strengths and Weaknesses – Implications…• Beware ‘apparent resilience’

– Practice: Assessment procedures– Research into how best to combat unsustainable coping

• Beware hype and hand-balling of responsibilities– Policy makers must remain critical and mindful of human

impact– Greater articulation and agreements re the role of

statutory vs. non-statutory services

Potential role of resilience frameworks as providing a delineation between areas of need and for promoting hope in a stressed and under-resourced workforce…

Trends and Messages from this International Project• Importance of end-user participation and readiness• Engagement, receptiveness, and client investment…

“They have made things so much better… I’ve never been this good, forever, I reckon! I’m at my best, the best I’ve been” (father, NSWa)

“We can function as a family now… they [sons] have become more secure, more loving; they know how to hug me, to receive love…” (mother, NSWa)

“…I’ve managed to come out the other side, well, and happy” (mother, NSWb)

Future challenges and Foci

• Resilience as based on ‘capacities’ or ‘abilities’• Mechanisms of adversity less well understood

• Challenge of differentiating Resilience vs. Strengths-based approaches?

• Organizational considerations: Transfer of ideals and agendas

• Major focus of next stage needs to be on outcome evaluation in services working with vulnerable children and families

Acknowledgements…

Many thanks to the practitioners, managers, children, parents and carers who participated in this research. Your input was so greatly appreciated!

Thank you

Questions and comments…

‘It’s like they need another level of intervention, for those families escalating into the child protection system that DOCS doesn’t have the capacity to pick up… People forget our clients are the children!’‘If you look at any family with an identified problem, sure you can say it’s early intervention, but when you get in there, you find that the problem has been escalating for years!’