1. Parenting to Build Resilience In the Face of Risk Factors (J. Eric Vance M.D.)

2. Children Surviving Hardship Studies on the children of psychotic parents revealed the “invulnerable child” (Bleuler, Anthony, Garmezy) Studies on the children of psychotic parents revealed the “invulnerable child” (Bleuler, Anthony, Garmezy) Inner city children at risk for delinquency (Glueck, Vaillant, Felsman, Robins, Farrington) Inner city children at risk for delinquency (Glueck, Vaillant, Felsman, Robins, Farrington) Sons of men from the Great Depression (Elder) Sons of men from the Great Depression (Elder) Women reared in institutional orphanages (Rutter) Women reared in institutional orphanages (Rutter) Children at high risk of maltreatment (Egeland, Farber) Children at high risk of maltreatment (Egeland, Farber) Prospective longitudinal studies of community cohorts grown up (Werner, Smith, Rutter, Offord) Prospective longitudinal studies of community cohorts grown up (Werner, Smith, Rutter, Offord) The power of computers to reveal relationships between multiple psychosocial factors and life outcomes

3. The Dangers of Risk Factors Common Risk Factors for bad outcomes (addiction, emotional disorders, delinquency, school drop-out, other life problems): Stressful pregnancy/early life, poverty, moves, family conflict/violence, abuse, parent problems, parent break-ups, childhood disorders, bullying, negative peers, substance abuse, school problems Stressful pregnancy/early life, poverty, moves, family conflict/violence, abuse, parent problems, parent break-ups, childhood disorders, bullying, negative peers, substance abuse, school problems Four or more risk factors exponentially impacts outcome Four or more risk factors exponentially impacts outcome

4. Parental and Family Risk Factors Stressful pregnancy Stressful pregnancy Fetal substance exposure Fetal substance exposure Complications of birth or pregnancy Complications of birth or pregnancy Poor attachment Poor attachment Long maternal absences Long maternal absences Poverty Single parenthood Crowded family Close born siblings Frequent family moves Parental SA, mental or emotional disorder, or criminality

5. Risk Factors of the Child Behaviorally inhibited Behaviorally inhibited “difficult” temperament “difficult” temperament Developmental delays Developmental delays Neurological disorder or head injury Neurological disorder or head injury Mental retardation Mental retardation Serious medical problems Serious medical problems Early aggression, <6 yo Childhood psychiatric disorder Early legal problems, <12 yo Early substance use, <12 yo Learning disorder or school behavioral problems

6. Experiential Risk Factors Exposure to chronic conflict or violence in the home or neighborhood Exposure to chronic conflict or violence in the home or neighborhood Child neglect Child neglect Physical abuse or harsh punishment Physical abuse or harsh punishment Sexual abuse or molestation Sexual abuse or molestation Chronic parent-child conflict Chronic parent-child conflict Predominance of negative peers Predominance of negative peers Removal from home Removal from home

7. Good News! P rotective Factors and Resilience Protective factors are characteristics of the individual or life experiences that facilitate good life outcomes in the face of multiple risk factors Protective factors are characteristics of the individual or life experiences that facilitate good life outcomes in the face of multiple risk factors Resilience amounts to effective stress coping, through the possession of protective factors Resilience amounts to effective stress coping, through the possession of protective factors Greater burdens of risk require greater numbers of protective factors to buffer the effects Greater burdens of risk require greater numbers of protective factors to buffer the effects Like risk, it’s not which, but how many Like risk, it’s not which, but how many Life outcomes often depend on the balance of risk and protection Life outcomes often depend on the balance of risk and protection

8. Family and Parental Protective Factors Secure mother-infant attachment Secure mother-infant attachment Warm, positive child- parent relationship Warm, positive child- parent relationship Parental employment Parental employment Parental HS education Parental HS education Availability of social support for parents Availability of social support for parents Consistent routines, rules, and rituals Fair discipline with discussion Family involvement with organized religion Parental attention to child’s activities and peers

9. Protective aspects of the child First born child First born child Easy, adaptable temperament type Easy, adaptable temperament type Independent, outgoing toddler Independent, outgoing toddler Above average intelligence Above average intelligence Seen as likeable Gets along with peers Gets along with adults Good sense of humor Shows empathy and nurturance

10. Protective Supports and Involvements Regular structured activity or hobby Regular structured activity or hobby Job, care-giving, or volunteer work Job, care-giving, or volunteer work Youth group Youth group Adult mentors outside the family Adult mentors outside the family Close, positive peer support Close, positive peer support Adult monitoring of youths in the neighborhood Adult monitoring of youths in the neighborhood

11. Protective School-based Factors Capability in the student role Capability in the student role Good problem-solving skills Good problem-solving skills Good reading abilities Good reading abilities Adult mentor within the school Adult mentor within the school Motivation towards college Motivation towards college

12. Protective Perceptions and Outlooks Perceived competency at some skill or talent Perceived competency at some skill or talent Internal locus of control Internal locus of control Realistic hopes and expectations for the future Realistic hopes and expectations for the future Perception that parents care Perception that parents care Use of inner faith or prayer Use of inner faith or prayer Acceptance and perspective on past problems Acceptance and perspective on past problems

13. Planning to Build Resilience Complete understanding of BOTH risk and protective factors Complete understanding of BOTH risk and protective factors Identifying the existing strengths and protective factors Identifying the existing strengths and protective factors Finding the “holes” in the protective profile Finding the “holes” in the protective profile Using the existing strengths to build new sources of resilience Using the existing strengths to build new sources of resilience

14. Some examples Artistic skills, but no peer relations Artistic skills, but no peer relations Plenty of peer relations, but no involvement Plenty of peer relations, but no involvement Great social skills, but no mentors Great social skills, but no mentors Great athlete, but lousy social skills Great athlete, but lousy social skills Overwhelmed family, but mentor aunt Overwhelmed family, but mentor aunt Inner faith, but no affiliation Inner faith, but no affiliation Protective home and family, but no activities Protective home and family, but no activities

15. Protection in the Family Home Building parents up Building parents up Parenting Skills: warmth in relationships, emotional control, discipline with discussion/problem-solving/apologies Parenting Skills: warmth in relationships, emotional control, discipline with discussion/problem-solving/apologies Rules, structure, chores, and rituals Rules, structure, chores, and rituals Homework and reading Homework and reading Staying involved in the teen years Staying involved in the teen years Monitoring and meeting the friends Monitoring and meeting the friends Being a coach and a cheerleader Being a coach and a cheerleader Talking about the future Talking about the future

16. Protection in the Free Time Requiring structured activities for self- esteem Requiring structured activities for self- esteem Sports, arts, music, martial arts, clubs, scouts, jobs Sports, arts, music, martial arts, clubs, scouts, jobs Faith with family or friends Faith with family or friends Volunteer work builds empathy Volunteer work builds empathy Know the Peers Know the Peers Positive peers, boyfriends, and girlfriends makes ALL the difference Positive peers, boyfriends, and girlfriends makes ALL the difference You CAN pick their friends (if need be) You CAN pick their friends (if need be)

17. Mentors Adult friends that care and endure Adult friends that care and endure Rituals of the relationship Rituals of the relationship Advice, coaching, and skill-building Advice, coaching, and skill-building Teaching the manners of friendship Teaching the manners of friendship Acts of kindness and contrition, both ways Acts of kindness and contrition, both ways Helping to clean up messes Helping to clean up messes Talking about families, friends, and future Talking about families, friends, and future

18. Activities to build resilience Daily chores and responsibilities Daily chores and responsibilities Daily reading, journaling, or homework Daily reading, journaling, or homework Chosen skill-building activity or job Chosen skill-building activity or job Volunteer or care-taking activities Volunteer or care-taking activities Outings to novel settings Outings to novel settings Outings to anticipate the future Outings to anticipate the future Discussions of the future possibilities Discussions of the future possibilities Building a faith of choice Building a faith of choice

19. Processing Conflict Because conflict happens so often, and processing is the first step to healing Because conflict happens so often, and processing is the first step to healing Builds protective factors: problem- solving and empathy Builds protective factors: problem- solving and empathy Repairs relationships, and can include restorative justice Repairs relationships, and can include restorative justice Punishment alone, even when deserved, is never enough Punishment alone, even when deserved, is never enough

20. Discipline with Discussion Wait until everybody’s cooled off Wait until everybody’s cooled off Recount the incident, dissect into the past Recount the incident, dissect into the past Talk about the feelings caused, to build empathy Talk about the feelings caused, to build empathy Finding something to apologize for Finding something to apologize for Think of other solutions for next time Think of other solutions for next time Fake it till you make it Fake it till you make it

21. Take Home Message We can’t always prevent risk factors entering our lives, but we can always build protective factors to make life more bearable. We can’t always prevent risk factors entering our lives, but we can always build protective factors to make life more bearable. There is growing evidence we may even be able to repair stressed nervous systems by activating protective anti-stress chemical systems. There is growing evidence we may even be able to repair stressed nervous systems by activating protective anti-stress chemical systems. Even in the face of the worst hardships, we can always improve our child and family’s life outcome by enhancing resilience. Even in the face of the worst hardships, we can always improve our child and family’s life outcome by enhancing resilience.