Pathways to Resilience III: Beyond Nature vs. Nurture

Resilience of Mind and Spirit:

Abstract #73
Resilience and Spiritual Health: Intersections and Understandings
Presenter: Holly Richardson
Abstract:
Resilience in the context of life-threatening illness among children is tied to the spiritual. This presentation will include an exploration of the intersections between suffering, the spiritual, and resilience and the unique ways that ill children express hidden capacities and wisdom. It will offer suggestions for engaging children in conversations about illness meanings and the spiritual that recognize the complexity in language, and provide insight into how children make sense of and live well despite being seriously ill. Because the spiritual does not always wait for experts to arrive, findings are relevant to all healthcare providers and caregivers of ill children who are interested in nurturing resilience. Implications for interprofessional research, education, and practice will also be explored.


Abstract #106
Providing Relationship-Based and Trauma-Sensitive Care: Lessons From The TCI System and Care Practice Model
Presenter: Martha Holden Co-presenter: Jack Holden
Abstract:
There is substantial evidence that children and adolescents placed in therapeutic residential settings, group care, foster care, psychiatric hospitals, or juvenile justice settings have experienced significant trauma such as abuse, neglect, domestic and community violence. A consequence of placing these high needs and often aggressive children in out of home care is that many of these settings use behavior management practices that are overly controlling and punitive, and often trigger increased dysregulation and reactivity, sometimes resulting in increased risk of violence and injury. Some child welfare, mental health and juvenile justice communities have responded by implementing crisis and management systems and program models with therapeutic principles that meet the trauma sensitivity needs of these children by employing relationship based, non-coercive, non-confrontational, strength-based strategies to enhance resiliency and improve their well-being. This presentation will present results on the frequency and rate of restraints in one multi-faceted child and family services agency using the combination of the research informed Therapeutic Crisis Intervention (TCI) system and Children and Residential Experiences (CARE), a principle based residential program model.  In addition, results from the implementation of the CARE model on aggressive incidents, youth perceptions of staff behaviors (including attachment behaviors) will be presented and discussed.

Abstract #131
Prediction Of Mental Health From Resilience After Having A Child Under Intensive Care
Presenter: Rocío Rodríguez-Rey Co-presenter: Jesús Alonso-Tapia
Abstract:
It is broadly assumed that having a child severely ill is a potentially traumatic experience for parents, which can lead to long term adverse effects. The aim of this study was to elaborate a predictive model of parental mental health that included their reported pre-crisis level of resilience. We used a prospective longitudinal cohort design. A total of 196 parents whose children had been recently discharged from intensive care were assessed resilience, severity of the child’s condition, social risk and stress. Three (N=158) and six (N=143) months later parents answered anxiety, depression and posttraumatic stress disorder questionnaires. Confirmatory regression analyses and multiple-group analyses using structural equation modeling were conducted. Results showed that 74% of the total variance in psychopathology three months after the child’s discharge, and 49% of the total variance six months after the child’s discharge could be predicted by resilience, social risk, and severity of the child’s condition mediated by stress and emotions (X2/df =1.56; GFI=.80; CFI=.88; IFI=.88; RMSEA=.06). These results showed that resilience is a protective factor against psychopathology after critical events. Gender differences were found, being resilience more predictive for women. Implications for intervention to prevent distress and nurture well-being among these families will be discussed.