Resilience and risk competence in schools: theory/knowledge and international application in project rebound

The concept of resilience in childhood disability: Does the International Classification of Functioning, Disability and Health help us?

BACKGROUND

The concept of resilience is popular in both the mainstream media and in health and human services research. Over the last 40 years, the term has been moulded and transformed from the idea of a trait that can be fostered within the individual towards a transactional concept with an emphasis on environmental factors. Although many current definitions are used to describe and talk about resilience, the dynamism of the concept is a common element across most current discussions and research applications. This paper provides an opportunity to place the concept of resilience within a framework for future application at the clinical frontlines.

METHODS

An extensive scoping review on the existing literature was undertaken to explore recurring themes associated with resilience in families and children, particularly in the context of childhood disability. This literature was mapped and categorized in the context of World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to create recommendations for practical application by health professionals.

FINDINGS

Three major themes emerged: (a) the idea of resilience as a state of an individual at a specific point in time rather than a built-in trait; (b) the idea of resilience as dynamic rather than static; and (c) the value of a framework into which to place the components of "resilience."

CONCLUSIONS

The relative ease with which resilience concepts is situated within the ICF is an indication that the ICF framework provides a useful way to incorporate concepts of resilience for clinical application.

Resilience Intervention for Young Adults With Adverse Childhood Experiences

BACKGROUND

Adverse childhood experiences (ACEs) are correlated with risk behaviors of smoking, disordered eating, and alcohol and substance abuse. Such behaviors can lead to significant public health problems of chronic obstructive pulmonary disease, obesity, liver disease, and hypertension, yet some individuals do not appear to suffer negative consequences but rather bounce back.

OBJECTIVE

To pilot the feasibility and potential efficacy of the Empower Resilience Intervention to build capacity by increasing resilience and health behaviors and decreasing symptoms and negative health behaviors with young adults in an educational setting who have had ACEs.

DESIGN

A two-group pre-post repeated measures design to compare symptoms, health behaviors, and resilience and written participant responses.

RESULTS

There was a statistically significant cohort by time interaction for physical activity in the intervention group. There was no significant change in risk behaviors or resilience score by cohort. Young adults in the intervention group reported building strengths, reframing resilience, and creating support connections.

CONCLUSIONS

An increase in health behavior is theoretically consistent with this strengths-based intervention. Evaluating this intervention with a larger sample is important. Interrupting the ACE to illness trajectory is complex. This short-term empower resilience intervention, however, holds promise as an opportunity to reconsider the negative effects of the trauma of the past and build on strengths to develop a preferred future.