Angie Hart Academic – Professor of Child, Family and Community Health -Child and Family Psychotherapist (National Health Service, working with schools and families) -Adoptive parent of three children with complex needs

CAPABILITY AND RESILIENCE: BEATING THE ODDS FIGURE 1: IDENTIFICATION OF RESILIENCE Outcome Adversity LowHigh Positive Negative A.Favourable experience of life B. Resilience: Unexpected positive outcome C.Unexpected negative outcome D. Risk and vulnerability (reference and downloadable copy: Capability and Resilience: Beating the Odds Edited by Professor Mel Bartley, published by UCL Dept Epidemiology and Public Health on behalf of the ESRC Priority Network on Capability and Resilience ( ). Professor Angie Hart

‘…protective processes that are advantageous to those experiencing risk, but that have no influence on those in low-risk environments; promotive or compensatory processes that have an equally beneficial effect on children in both low- and high-risk environments; and a challenge model of resilience where the benefit of the process is dependent on the level of risk exposure…’ (Ungar, 2011, p.2).

Believe in the almost impossible Professor Angie Hart

Resilient approaches: The kinds of things we need to make happen (e.g. events, parenting strategies, relationships, resources) to help children manage life when it’s tough. Plus ways of thinking and acting that we need ourselves if we want to make things better for children.’ (Aumann and Hart)

Professor Angie Hart ‘Adequate provision of health resources necessary to achieve good outcomes in spite of serious threats to adaptation or development.’ Source: Ungar 2005b: 429

‘Resilience is an emergent property of a hierarchically organized set of protective systems that cumulatively buffer the effects of adversity and can therefore rarely, if ever, be regarded as an intrinsic property of individuals.’ Source: Roisman, Padrón et al. 2002: 1216 'Resilience does not constitute an individual trait or characteristic…Resilience involves a range of processes that bring together quite diverse mechanisms…' Source: Rutter 1999: 135

‘Parents, carers and everyone in day-to-day contact with children and young people need a better understanding of child development, the causes of mental health problems and things they can do themselves to build resilience and deal with issues as they emerge, whatever age their child.’ Source: CAMHS Review 2008

Professor Angie Hart

Strands of Resilience Research Individual attributes Social factors Processes and mechanisms Cultural context Children & young people Adults (Reich et al 2010) Communities Resilient practices (Aumann & Hart 2009)

Daud, Refugee children from Iraq. Some children who had a traumatised parent did as well as some of those who didn’t. WHY?

The risk factors and their consequences are widely known and routinely used in describing both research and programs...The sad truth is that far more is invested in research to understand the consequences of risk factors for young children and parents than in designing, testing, and taking to scale interventions that might change the all too predictable negative trajectories.’ Source: (Knitzer & Cohen 2007, p.358). The risk factors and their consequences are widely known and routinely used in describing both research and programs...The sad truth is that far more is invested in research to understand the consequences of risk factors for young children and parents than in designing, testing, and taking to scale interventions that might change the all too predictable negative trajectories.’ Source: (Knitzer & Cohen 2007, p.358).

Resilient Therapy (RT) (Hart & Blincow 2007) RT strategically harnesses selected therapeutic principles and techniques Originally developed in relation to children, families and young people Now exploring relevance beyond that (adults – communities) Developed for use across contexts and by different practitioners, including parents and young people themselves Designed to work in people) as co-collaborators in the development of the methodology rather than as recipients Is user-friendly and readily accessible – you don’t need a lengthy specialised training Non-pathologising – ‘upbuilding’

Examples of projects and activities that have explicitly taken a theoretically robust resilience approach (focusing on individuals or communities) Various ones we’ve done Empower children (early years) The Army and various Schools ones Carnegie’s Exploring Community Resilience Treatment foster care British Red Cross ( o_tcm asp) o_tcm asp Outdoor education courses and gardening

Professor Angie Hart

Ten steps to applying Resilient Therapy Get familiar with the RT framework (Basics, Belonging, Learning, Coping, Core Self). Have it to hand. Remember the noble truths (Accepting, Conserving, Commitment, Enlisting). Use the framework to map out where the young person is at. Does one or other potion bottle shout out at you? Pick your priorities to make the most resilient moves (what’s most urgent, what’s most doable, quick wins, what you’re up for, what the child/family wants, what the child/family can most easily manage, time available). Come back to the noble truths. How can they help you here? Make your resilient moves. Check out with them, and yourself. How well did it go? What have I learnt for another time?

Raising aspirations for young people in care: A resilience-based approach Builds up and draws upon the expertise of 12 diverse young people Explores the mechanisms that contribute to raising young people’s aspirations and to doing well. Explores how the young people want to communicate the findings to professionals, carers and the community. Builds the capacity of the young people Adopts a youth participatory action research approach (YPAR) Enables YP to identify the problems they want to improve in this area, to further understand the nature of the issues and finally supporting them to advocate for actions to facilitate change. (London, Zimmerman, & Erbstein, 2003).

Bouncing Back communities of practice... Parents, Practitioners, Academics, Policy Makers Combining knowledge/experience to improve wellbeing Exploring how the ‘resilience’ research base and RT can link with their existing work Eager to critique and develop resilience-based practice further Inter disciplinary, cross agency Collaborating for mutual benefit Facilitated monthly 3 hour meeting over a year Evaluating the processes and outcomes

Two positive adult roles model Three worthy hobbies Doing good for two people, at least once a week Steer towards positive kids ‘Autobiographical narrative’ – find two positives Point out meaning and joy in three small things Keep their future in mind and help them to, too Tackle inequalities in their life Benevolent boot camp Attend to your own resilience If at first you don’t succeed, try again later Two positive adult roles model Three worthy hobbies Doing good for two people, at least once a week Steer towards positive kids ‘Autobiographical narrative’ – find two positives Point out meaning and joy in three small things Keep their future in mind and help them to, too Tackle inequalities in their life Benevolent boot camp Attend to your own resilience If at first you don’t succeed, try again later

Some kids do better than others having had very similar disadvantages in life – one thing that you do could make a big difference ‘Resilience’ gives us a framework within which to plan positive chain reactions and to fight back from negative chain reactions For young people doing risky things it is especially helpful to get some protective processes going We need to focus on the fine grain – ‘management of effective detail’ Use the resilience evidence base to challenge custom and practice in policy and organisations There is hope for everybody! Every little can help. Professor Angie Hart

In response to practitioners and parents.. Lit review of resilience-based interventions for 14 pluses (realist review) Massive field Very little for disabled young people Hardly anything properly participatory Interventions and evaluation very costly Mostly focus on a specific area, not ecological Some confirmation that certain activities (e.g problem solving are worthwhile)

Further reading Hart, A. and Blincow, D. with Thomas, H. (2007) Resilient Therapy: Working with children and families. London: Routledge Aumann, K. and Hart, A. (2009) Helping children with complex needs bounce back: Resilient Therapy for parents and professionals. London: Jessica Kingsley Tedex talk: Website: Professor Angie Hart