Understanding and Promoting Well-Being Isaac Prilleltensky

Kerala: A state in Southwest India. The name "Kerala" probably means "land of coconuts." Kerala: A Community Strengths Story Population: 31.8 million Kerala's population is the same as Canada's.

IndicatorKeralaIndiaLow income countries USA Per Capita GDP $ ,260 Adult Literacy Rate (%) Life Expectancy in Years Males (f) Females (f) Infant Mortality per 1, Birth Rate Per 1,

Well-Being in Kerala Community Well-Being Relational And Organizational Well-Being Personal Well-Being Tenancy laws Nutrition in school Distribution Of resources Land reform Infant mortality Literacy Nutrition Life expectancy Social support Sense of cohesion Personal Empowerment Social Movements Government Action Outcomes Processes

The State of Wellness Wellness is a positive state of affairs, brought about by the simultaneous satisfaction of personal, relational, organizational and collective needs

Part I: Understanding Well-Being There cannot be well-being but in the combined presence of personal, relational, organizational and community well-being

Personal Well-being Sense of control Physical health Love Optimism Competence Dignity and integrity Growth Self-esteem Meaning and spirituality

Effects of lack of control and disempowerment on mortality

Relational Well-Being Support Affection Bonding Cohesion Collaboration Respect for diversity Democratic participation

Effects of Social Support Less likely to have heart attacks More likely to survive cancer More likely to resist common cold virus Lower mortality Less degree of stress More positive outlook on life Resilience

Organizational Well-Being Efficient structures Clear roles Monitoring mechanisms Planning and accountability Growth opportunities Fulfillment of needs Identity and meaning

Low High Low Effective Environment Affective Environment Reflective Environment Organizational Well-Being: ERA Environments

Community well-being Economic prosperity Social justice Adequate health and social services Low crime Adequate housing Clean environment Support for community structures

Probability of death bet ages in 2020 – males -- Interactions

Male Life Expectancy by Inequality

Colombia: Happy but Dead Highest rate of murders per capita in the world Highest number of kidnappings in the world Colombia 5181 in 7 years Mexico 1269 Brazil 515 Venezuela 109 Severe under reporting Colombians report highest level of satisfaction 8.31 (out of 10) in the world in the 90s

South Africa: 6.08

Is happiness really a genetic phenomenon? Lykken and Tellegen (1996, Psychological Science). In the Minnesota twins study, authors report, “Neither socioeconomic status, educational attainment, family income, marital status, not an indicant of religious commitment could account for more than about 3% of the variance in WB” (in monozygotic twins) “We estimate that the heritability of the stable component of subjective well-being approaches 80%”

Change in life satisfaction over the years (Inglehart, 2004)

Russia’s happiness and satisfaction plunges Two African Countries

Income is not everything though Two African Countries

Wealth matters for life expectancy

Chinese happiness and democracy

Preliminary Summary Subjective reports of happiness incongruous with physical evidence of illness, mortality, and crime Within countries Poor report high levels of happiness but have low levels of physical and mental well-being Across countries Some poor countries report low levels of happiness and others fairly high All poor countries show low levels of physical and mental well-being Subjective well-being goes up and down depending on social circumstances (Russia, Belgium, Switzerland)

Preliminary Summary Absolute poverty predicts low levels of physical and mental well-being, within and across countries (Kleinman, Eisenberg, etc.) Relative deprivation predicts social gradient in physical and mental well-being within countries (Marmot, Wilkinson) Freedom is important in subjective well-being, but there are exceptions like China Wealth does not necessarily lead to a happy or meaningful life (Adams, Cushman, Sloan, Ryan)

New definition of well-being Well-being is a positive state of affairs in individuals, relationships, organizations, communities, and the natural environment, brought about by the simultaneous and balanced satisfaction of objective and subjective needs; and by the behavioral manifestation of material and psychological justice in these five ecological domains.

Ecological Model of Well-Being Sites of Well-Being IndividualRelationalOrganizationalCommunalEnvironmental Objective signs health networks resourcessocial capital low emissions Subjective Signs efficacyvoicesupport belonging safety Values as source and strategy autonomy caring participation diversityprotection of resources Justice as source and strategy My due/Our due Your due/Our due Its due/Our due Their due/Our due Nature’s due/Our due

Model of Well-Being: Some positive and negative factors Sites of Well-Being IndividualRelationalOrganizationalCommunalEnvironmental Objective signs+health - illness +networks -isolation +resources - lack of resources -social capital -lack of trust +clean air -pollution Subjective signs +efficacy -lack of control +voice -repression +support -isolation +belonging -rejection +safety -fear Values as source and strategy +autonomy -lack of power +caring -neglect +participation -marginality +diversity -discrimination +protection of resources -depletion of resources Justice as source and strategy My due/Our due Your due/Our due Its due/Our dueTheir due/Our due Nature’s due/Our due

Part II: Promoting Well-Being From Deficits Reactive Arrogance Individual blame To Strengths Prevention Empowerment Community Change

The Grameen Bank 1960s Strengths, Prevention, Empowerment, Community change

Lesson #1: Strengths We all have strengths We all need to be treated with respect We all need to be given a chance

9/7/1854…Removing the Handle of London’s Broad Street Pump

Lesson #2: Prevention “No mass disorder, afflicting humankind, has ever been eliminated, or brought under control, by treating the affected individual” HIV/AIDS, poverty, child abuse, school drop out, addictions, powerlessness are never eliminated one person at a time Must focus on prevention to reduce the incidence of psychological, behavioral, and social problems in children and youth

10/10/2015 Prilleltensky34 Too much reaction, not enough prevention Investments in Reactive vs. Proactive Interventions in Health and Community Services (Nelson et al, 1996; OECD, 2005; de Bekker-Grob et al., 2007) Investments in Prevention: Italy 0.6% USA 3% Netherlands 4.3% Canada 8%

Ratio of Benefits to Costs (Lynch, 2007, page 19)

Strengths, Prevention, Empowerment, Community change

Lesson #3: Empowerment Identifying the external source of oppression in life can be empowering Empowerment is a means and an end in itself Empowerment can be a tool for social change and personal healing at the same time

Strengths, Prevention, Empowerment, Community change

Lesson #4: Community change “The psychotherapist, social worker or social reformer, concerned only with his (her) own clients and their grievance against society, perhaps takes a view comparable to the private citizen of Venice who concerns himself only with the safety of his own dwelling and his own ability to get about the city. But if the entire republic is slowly being submerged, individual citizens cannot afford to ignore their collective fate, because, in the end, they all drown together if nothing is done.” (Badcock, 1982)

Place and class in infant mortality

Social capital and community well-being Low SC: LA, MS, GA Med SC: CA, MO, OK Hi SC: ND, SD, VT, MN

Example 1: Miami SPEC project Organizational conditions leading to transformative practice: Findings from a multi-case study, action research investigation University of Miami SPEC Team Isaac Prilleltensky Ora Prilleltensky Scot Evans Adrine McKenzie Debbie Nogueras Randy Penfield Corinne Huggins Nick Mescia

What is transformative practice? In the context of community, educational, health, and human service organizations, we define transformative practice as consisting of four principles Strengths Prevention Empowerment Community change

10/10/2015 Prilleltensky44 DRAIN VS. SPEC APPROACHES Drain Approach Deficits-based Reactive Alienating Individualistic Problems Too little Too late Too costly Too unrealistic SPEC Approach Strengths-based Primary Prevention Empowerment Community change Opportunity Built to last Starts early and saves $$$ Creates civic engagement Builds social movement

Quadrant III Examples: Crisis work, therapy, medications, symptom containment, case management Quadrant I Examples: Community development, affordable housing policy, recreational opportunities, high quality schools and accessible health services Quadrant II Examples: Skill building, emotional literacy, fitness programs, personal improvement plans, resistance to peer pressure in drug and alcohol use Quadrant IV Examples: Food banks, shelters for homeless people, charities, prison industrial complex Collective Proactive Individual Reactive Time and place of interventions THIS IS WHERE WE ARE THIS IS WHERE WE NEED TO BE

Quadrant I Examples: Voice and choice in celebrating and building competencies, recognition of personal and collective resilience Quadrant II Examples: Voice and choice in deficit reduction approaches, participation in decisions how to treat affective disorders or physical disorders Strength Empowerment Deficit Detachment Focus and engagement in interventions Quadrant III Examples: Labeling and diagnosis, “patienthood” and clienthood,” citizens in passive role Quadrant IV Examples: Just say no! You can do it! Cheerleading approaches, Make nice approaches THIS IS WHERE WE ARE THIS IS WHERE WE NEED TO BE

Context of Investigation Action research with 5 community based organizations (CBOs) to promote Strengths, Prevention, Empowerment, Community Change Three year study consisting of 1. Training 2. Team work 3. Consultation 4. Professional development 5. Action research

Context of Investigation Organizations selected on basis of “readiness” Organizations consist of Major local funder (MF) Major provider of health services for poor (HS) Organization that promotes early interventions (EI) Local civic coalition (LC) Local human service (HS) Budgets range from $ 1 million to over $ 100 million Personnel ranges from 15 to 700

Context of Investigation Intervention components 1. Training Each organization sends reps to 18 person class 3 hours biweekly Lecture, discussion, application 2. Team work Transformation teams meet biweekly 3. Consultation A researcher assigned to each organization Weekly or biweekly consultations 4. Professional development 5. Action research

Research Design Action Goal of overall project: Promote SPEC practices in organizations to improve community well-being Research Goals of overall project: Assess whether organizations become more aligned with SPEC principles as a result of interventions If so, how Data collection Quantitative and qualitative methods at baseline, year one, and end of project Goal of present study: Examine organizational conditions leading to SPEC based on qualitative data gathered through interviews, focus groups, and field notes with about 80 different participants in the five organizations

SPEC INTERNAL AND EXTERNAL Child and Family OrganizationsCommunity Strengths Prevention Empowerment Community Change

Skills for SPEC I VALUE IT 1. Inclusive host 2. Visionary 3. Asset seeker 4. Listener and sense maker 5. Unique solution finder 6. Evaluator 7. Implementer 8. Trendsetter

Findings: Organizational Conditions for Transformative Practice

Organizational Conditions for Transformative Practice

Climate Effective Enabling structures; good communication; timely completion of tasks; efficiency; accountability and follow-through, etc. Most of the organizations noted at least some deficiency in this domain, including duplication of efforts; inconsistent policies; and bureaucracy Reflective Learning opportunities; organizational learning; asking “big questions”; challenging old notions; evaluating practice, etc. Organizations vary on this dimension, with some presenting as highly reflective and others describing an environment where there is insufficient trust to challenge old notions and practices. (“you ain’t gonna rock the boat.”) Affirmative Climate of acceptance and appreciation; employee strengths are highlighted and utilized; voice and choice; sense of control; team work and conviviality Distinction made between voice and choice in a number of organizations where empowerment is espoused as an organizational value, but not always practiced well. In other organizations, staff empowerment is not even part of the organizational radar.

Resources Human Adequate number of workers to meet demands; high skill level; capacity; dedication; motivation; initiative Largely described workers as caring, conscientious and committed to meeting the needs of their constituents Variable level of skill across organizations Concern in some organizations that people are spread too thin due to a broad, overly ambitious mission Financial Adequate financial resources to support positions; programs; etc. A major barrier for most organizations in the current economic climate Cuts in positions and lack of job security are a source of strain For funding organizations, ongoing concern to make sure investments provide good return Organizational Appropriate organizational structures to meet vision and mission; adequate time, space, etc. Most organizations described as committed to vision and mission Some noted that rapid and poorly communicated policy changes lead to inconsistent practices and poor PR with other agencies In one case, solicitation of input from “boots on the ground” was seen as a necessary condition for improved buy-in to vision and mission

Support and Legitimacy Leadership for SPEC Leadership provides legitimacy and support to SPEC principles and practices; leader(s)“walk the talk” in their support of the vision and mission of the organization Organizations whose leaders are involved in all aspects of the SPEC training (class, T-Team, etc.) experience greater legitimacy and support for SPEC practices and principles Lower level of leaders involvement is associated with fewer SPEC practices Board support and legitimacy for SPEC Board of Directors provides legitimacy and support to SPEC principles and practices ; board members“ walk the talk” in their support of the vision and mission of the organization Some describe difficulties in dealing with board members who come from a corporate background and unfamiliar with nonprofit Some board members advocate for special interest groups Funder support for SPEC Funders provide legitimacy and support to SPEC principles and practices; funders “walk the talk” in their support of the vision and mission of the organization Some indication that funders may not always walk the talk, despite the theoretical support of SPEC; some feel micromanaged by funders

Consciousness Justice Organization espouses a justice orientation; considers issues of fairness and justice in understanding community problems and devising solutions Large variation between organizations. For some, themes of “economic justice” and “social justice” are espoused and central to the organizational mission. For others, justice is described as enabling access to services, regardless of client background, legal status, etc. Power Organization is highly aware of power issues in the community; sensitive to how differences in power affect voice, choice and wellbeing; considers power issues when understanding problems and devising solutions Awareness and sensitivity to power issues in the community are at times inconsistent with internal practices with employees. Ecology Organization espouses an ecological orientation; considers personal, organization, and systemic factors in understanding problems and devising solutions A shared understanding that social and economic conditions are at the root of people’s struggles does not always translate to more systemic organizational practices

In every act, in every interaction, in every social action, we hold each other accountable to promote People’s dignity, safety, hope and growth Relationships based on caring, compassion and respect Societies based on justice, communion and equality We are all better when these values are in balance To put these values into action, we will: Share our power Be proactive and not just reactive Transform the conditions that create problems for youth Encourage youth and families to promote a caring community Nurture visions that make the impossible, possible We commit to uphold these values with Youth and their Families Our Employees Our Organization Our Community This is a living document. We invite you to discuss it, to critique it, to live it