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Harnessing Three Critical Resources to Advance Mental Wellness:
Hope
Resilience Science
Leadership
Karen R. Elliott, JDKathryn D. Scott, DrPHMind Your Mind ConferenceNovember 4, 2016Eugene, Oregon
Workshop Objectives
• Learning objectives:
• 1. Participants will be able to state why systems thinking is important to advancing mental wellness
• 2. Participants will be able to state two leadership attributes that foster the building of resilience
• 3. Participants will be able to define the term resilienceand describe the difference between hope and optimism.
Roadmap for Today
• Slide presentation
• Short Q/A
• Exercise
• Evaluation
Applying Resilience Science to Advance Mental Wellness
• Resilience science generates hope for an equitable future
• Interdisciplinary perspectives and collaboration
• We must work collaboratively and strategically to:
1. Build capacity for resilience in individuals, families, communities;
2. Eliminate policies that systematically exclude people and undermine their health, wellness, and resilience.
• Odds for wellness are not equal.
Individual’sAdaptiveCapacity
Individual Resilience Multiple Contributors
Environment – culture, context
-Genetics, neurobiology-Stress-hardiness-Family, cultural, spiritual-Self-efficacy-Optimism-Social competence and connectednessSocial exclusion
-Literacy, language,-Health status
-Trauma history
Organization’sAdaptive Capacity
Multiple Contributors
-Leadership-Culture-Org history (trauma) - Leader, mgr., employeeresilience
-Feedback loops-Employee engagement
-Adult learning needs-Programs-Health status
-Community resilience-Preparedness
Organizational Resilience
Community Resilience
Emergency Preparedness
Children and
Families
Built Environment
Organizations
Culture and Faith-Based Groups and
Organizations
Environment
-Social capital-Networks-Community cohesion-Collective efficacy
Norris, et al (2011)
Multiple - Contributors- Definitions
Resilience is the process of harnessing biological, psychosocial, structural and cultural resources to sustain well-being.
Panter-Brick and Leckman(2013)
Resilience in child development – interconnected pathways to well-being.Journal of Child Psychology and Psychiatry.
• Individuals have great capacity and potential to adapt in the face of adversity
– People can learn to become more resilient –BUT
– Resilience develops in the context of available resources
• Odds are not same for all• Adverse childhood experiences study
• Social determinants of health and mental health
• Impact of social exclusion
Meaning-Making and a Sense of Hope
• What matters to individuals facing adversity is a sense of “meaning-making” – and what matters to resilience is a sense of hope that life does indeed make sense, despite chaos, brutality, stress, worry or despair.
Catherine Panter-Brick (2013)
An Alternative Definition of Leadership
1. An alternative definition of leadership “The capacity of a human community – people living and working together – to bring forth new realities.”
Leading Beyond the Walls, (1999). Emphasis added
2. Systems thinking is a discipline for seeing wholes.
According to Senge, by seeing wholes we learn how to foster health.
The Fifth Discipline: The Art and Practice of the Learning Organization, (Rev.Ed.2006).
*Collaborative LeadershipTurning Point Collaborative
-Assess environment to understand context
-Develop clarity
-Develop trust, create safety
-Share power and influence
-Develop people through mentoring and coaching; selfreflection
Leading in Complex Systems
*Adaptive LeadershipHeifetz, et al. (2009)
- Focuses on need for change in organizations
- Rooted in leadership theory,links to evolutionary biology
-Adaptation relies on experimentation and diversity
-Diagnose challenges, compareorganizations to ecosystems
Resilient Leadership• Everly, Strouse, and Everly (2010)
• Six essential skills for leading in adversity
– Acting with integrity
– Communicating effectively
– Harnessing the power of decisive, optimistic leadership and self-fulfilling prophecy
– Persevering and taking responsibility for your actions
– Building a resilient culture, and
– Developing behavioral body armor or using stress management as a competitive advantage
Society
Communities
Organizations
Schools
Cultures
Families
Individuals
Characteristics of Complex Adaptive Systems
Interconnected, interactingsocio-ecological systems
Capacity to adapt
Subject to ABRUPT change
Feedback loops
Some more or less resilientthan others
Cause and effect not apparent
WHERE WE ALL LIVE, LEARN, WORK, AND PLAY
Society
Communities
Organizations
Schools
Culture
Families
Individuals
How We Work Where We Live, Work
Planning Programs
Research
and
Practice
Policy
Linear PROCESSES Non-Linear SYSTEMS
Adaptive Capacity
Adaptation: The adjustment or changes in behavior, physiology, structure of an organism to be more suited to an environment. http://www.nas.edu/evolution/definitions.html
• Capacity to adapt extends beyond the person into other social and cultural systems
• Basic adaptive systems are important for resilience under many different circumstances– Family, attachment relationships, neurocognitive, mastery and
motivation . . Masten (2014)
Uniformly high for some populations
Acute, chronic
Trauma
Adverse childhood experiences
Social determinants of health & mental
health
Stress
Heterogeneity in Responses to Stress
*Chronic stress burden*War, conflict, migration
Systems, Human Development, and Resilience
• Ecology of human development – 5 systems– Bronfenbrenner and Ceci (1994)
• Individual; micro-level(family, peer, school); meso/exolevel (neighborhood); macro-level (society and culture); chrono (time)
• What is resilience within the social ecology of human development?
• Parallels Bronfenbrenner’s systems analysis
– Ungar, Ghazinour, Richter, Journal of Child Psychology and Psychiatry, 54-4 (2013)
Systems factors that impact resilience and wellness
• Individuals, families, groups, communities
• Individual embedded in multiple, interconnected systems
• Some systems more resilient that others
•Non-medical factors that impact health
• Systematic exclusion – requires upstream work on social determinants of health
• Loss of hope
Systems factors that impact resilience and wellness
• Organizations– Mission and risk for organizational trauma
– Political ecology
– Nature of bureaucracies
– Organizational culture
• Risk for burnout, attrition
• Leader, manager, staff trauma
• Lack of, or exclusion from, professional development
• Loss of hope
– Leadership challenges/losses/attrition/leadership deficit
• Gaps in leadership development, communication
• Loss of hope
Building Capacity for Resilience -An Expanded Leadership Perspective
Transactional
Transformational
- Collaborative
- Adaptive
- Resilient
Staying Engaged: Hope and Optimism
Findings of 2012 Alarcon et al study:
• Hope and optimism are distinct constructs
• Both related to indicators of psychological and physical well-being (e.g., happiness, depression and stress)
• Optimism overlaps with the personality traits resilience and self-esteem
• *Hope was distinct from other personality traits
Staying Engaged: Hope and Optimism
Similarities
• Generally stable personality traits
• Reflect extent to which a person believes his or her future will be favorable
Differences• Optimism: positive
generalized outcome expectancies
• Hope: Based on sense of successful agency (goal-directed determination) and pathways (planning of ways to meet goals)
Increasingly connected, complex world
Complexity Theory
Individuals, families, organizations, communities are “complex adaptive
SYSTEMS”
Resilience science doesn’t always translate to effective
public policy
Funders want multi- or interdisciplinary approaches
-Interdisciplinary perspectives
Social ecology, sociology, psychology, anthropology, medicine,
management, business, disaster preparedness
Distractions amplified in context of:
*Urbanization
*Globalization
*Climate Change
Emerging Understanding -Measuring Resilience
It’s complicated –• Self-report measures
• Emerging knowledge: quantitative and qualitative
– Mixed methods, longitudinal studies needed
– Operational definitions important
• Cautionary re: interpretation
– Normative populations
– Homogeneous
– Culture and meaning
– Compare language – indicators, determinants, risk factors, protective factors
Individuals are embedded in
interacting systems
Culture and Context Matter
Resilience develops in the context of
available resources
A focus on individual
pathology places the burden on the person rather than contextual factors
Contextual factors:
Work, family home, school, community, social determinants
Emerging Understanding – Resilience Science
Resilience can be enhanced on many levels
Domains of resilience
A strengths-
based, holistic process*
Resources matter
People can learn to be more resilient
Context and
culture matter
Emerging Understanding - Resilience Science
*Ungar*, Dalhousie Univ.
Nova Scotia, Canada
*Panter-Brick*Yale Univ., USA
Morris, Whitacre,
Ross, Ulieru, New
Brunswick
Canada
Munford
Massey Univ.
New Zealand
Theron
North-West Univ.
South Africa
Bell
Univ. Illinois, USA
Emerging Understanding: Culture and Resilience
Clauss-Ehlers, Rutgers, USA
Emerging Understanding: Resilience Across the Lifespan
• What contributes to positive development under stress?
• What contributes to how we respond to trauma?
– More emphasis on environment
– Growing up in challenging environments
– Availability of resources from multiple systems
Defining resilience Experiencingresilience
• No one definition
• Many definitions of resilience are linked to specific research methodologies and disciplines
– Operational definitions
Resilience is experienced as a social narrative
Understand the event from the perspective of the person experiencing
“The cultural ecology of resilience starts with narratives”.
Catherine-Panter BrickPathways to Resilience Conf.(2015)
Resilience Definitions, Theory, Challenges
Southwick, Bonanno, Masten, Panter-Brick, and Yehuda (2014) – Interdisciplinary Panel - Perspectives
Resilience is:
-Complex construct
-Defined differently in context of individuals, families, organizations, societies, and cultures
-Most panelists’ definitions include concept of healthy, adaptive or integrated positive functioning over the passage of time in the aftermath of adversity
- Empirical studies should address multiple variables – genetic,
epigenetic, developmental, demographic, cultural, economic, and social
“Resilience refers to the capacity of a dynamic system to adapt successfully to disturbances that threaten the viability, the function, or the development of that system”. Masten (2014)
According to Masten, this type of definition:
1. Facilitates the ability to think through and work together with people who are trying to prepare populations for dealing with disasters
2. Is also the kind of definition you can use across system levels, from a molecular level to the levels of human behavior in family, community, or even societal contexts.
Defining Resilience
• Bonanno
– Resilience as a stable trajectory of healthy functioning after a highly adverse event
– What we call a resilience trajectory is characterized by a relatively brief period of disequilibrium, but otherwise continued health
(Bonanno, 2004, Bonanno et al, 2011).
• Yehuda
– Resilience may co-occur with PTSD, moving forward in an insightful and integrated positive manner
(Southwick et al, 2014).
Defining resilience -Navigating and Negotiating Systems
• Michael Ungar – Resilience Research Centre, Dalhousie University, Nova Scotia, Canada
– Collaborative research in 12 + countries
In the context of exposure to significant adversity, resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided and experienced in culturally relevant ways.
(Ungar, 2008)
SYSTEMS: Building, Maintaining, Intervening
“Resilience is built and then maintained by fostering the natural resources of both the system and the individual. The lack of such support tends to erode the resilience of the individual.”
Everly, Strouse, and Everly, 2010.The Secrets of Resilient Leadership.
Question: How do we promote resilience to stress and trauma where human responses to adversity take place?
-Resilience is bi-directional
-Intervene at the level of social systems-Capacity for adaptation of an individual will be distributed across interacting systems.
Sippel cites Masten (2014)
How does social support enhance resilience in the trauma-exposed individual?Sippel, et al, 2014, Ecology and Society.
Some baseline activities to build capacity
• Literacy - relationship between literacy, social competence, social connectedness, and resilience – Yale White Paper
• Public Health (e.g. immunizations)
• Leadership development
– Expand perspectives
• Mobilize knowledge
• Engage stakeholders
• Provide FEEDBACK to policymakers
• Program development
– Apply research on ACES, social determinants, TIC
Share what we know about:
1. Resilience in individuals, families, workers, organizations, communities, populations, neighborhoods
2. Need to eliminate social
exclusion
3. Pervasive impact of social
exclusion
on health and resilience
Social exclusion is
the laws, policies, decisions, institutional behaviors and structures that serve to systematically exclude entire communities of people from rights, opportunities and resources that are available to most other people in society. Institute for Social Exclusion, Adler University
- Resilience resources are multi-systemic
- Resilience is developed in the context of
available resources
-Work upstream
A. Exclusion from easy access to equitable housing, employment, health care, civic engagement, democratic participation
B. Neuroscience research
Mobilize knowledge
Promote/advise strategies to change the odds
Equity-based planning and progam development
(e.g., social determinants of mental health)
Mobilize knowledge, critical mass, collective efficacy,
stewardship
Inform/advise polices to eliminate social exclusion
WORK
UPSTREAM
-Harnessing Three Critical Resources –Translating Theory, Research, and Experience to Practice
The challenges
• Facilitating stakeholder engagement to mobilize accurate & emerging knowledge/information
• Providing structure for working on complex issues in complex systems
• Developing, maintaining & evaluating an inclusive, equity-focused process
A New Translational Tool
10 Step Systems Thinking Framework to Build Capacity
for Resilience
Apply systems thinking to“see wholes”
10 Step Systems Thinking Framework to
Build Capacity for Resilience
1 Identify person, group, populations
2 Gauge environment, equity & inclusion
3 Assess stressors, social exclusion
4 Integrate & share knowledge
5 Survey multi-systemic resilience resources
6 Engage stakeholders, organizations & communities
7 Evaluate policy & political ecology
8 Plan prevention & intervention strategies
9 Address professional development gaps (leadership)
10 Obtain ongoing feedback
Operationalizing A Multi-Systemic Perspective
Leader/Stakeholder Attributes for Harnessing Resources
• Do no harm
• Listen to and include others
• Lead for social change change the odds
• Strive for cultural understanding
• Be a responsible steward of resources
• Share power, share credit for good work
• Sustain and generate hope
• Cultivating resilience within individuals, families, organizations, and communities enhances the odds that individuals will reach their full potential
• Informed, ethical leadership and stewardship to guide the development of policies that support resilience for all people in all places is vital.
• The capacity for resilience in humans is distributed across many interconnected systems.
• Promoting resilience in social systems can enhance resilience in the individual
Stewards of resilience emphasize
Stewards of resilience emphasize
• Social exclusion undermines the resilience of many people and prevents them from reaching their full potential
• Strategies for improving resilience must incorporate upstream work on the non-medical factors that impact heath, wellness, and resilience.
• Developing equity-focused policies requires leadership, systematic inclusion of stakeholders, participation, dialogue, the generation of hope, and political will.
• The world needs leaders who are stewards of resilience
Poet Haki Madributi -
“ We cannot minimize culture. We cannot minimize vision.
We cannot minimize the internal struggle within all of us to make our mark, to say something that is meaningful, important and critical.
We must be skilled doers in the world, walking and working with a humility that is focused on wellness.”
Exercise
