Transcript Lorem Ipsum - University of Miami

Promoting Well-Being:
Strategies for Community Change
 Dr. Isaac Prilleltensky
 Dr. Ora Prilleltensky
 Dean, School of
 Department of
Education
 University of Miami
 [email protected]
 www.education.miami.edu
/isaac
Educational and
Psychological Studies
 University of Miami
 [email protected]
The
Grameen
Bank
Overview of Presentation
 Well-Being

Signs and Sources
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Personal
Organizational
Community
Strategies
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
SPEC approaches
ROWS assessments
I VALUE IT techniques
Part I
Signs and Sources
of Well-Being
What is Well-being?
Well-being is a positive state of affairs, brought
about by the simultaneous satisfaction of
personal, organizational, and collective needs of
individuals and communities
Research on Well-being
 There cannot be well-being but in the
combined presence of personal, organizational
and community well-being
Signs of Personal Well-Being
 Hope and optimism
 Sense of control and self-determination
 Environmental mastery and self-efficacy
 Growth and meaningful engagement
 Love, intimacy, and social support
Risk of Death by Employment
and Level of Control Marmot, Whitehall Studies
4
3.5
3
2.5
2
1.5
1
0.5
0
Adminis
Prof
Clerical
Other
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
Sources of Personal Well-being
 Biological and constitutional factors
 Early parenting experiences
 Emotional intelligence
 Supportive relationships in multiple contexts
and settings
 Opportunities for growth, engagement and
self-determination
Signs of Organizational Well-Being
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Efficient structures
Clear roles
Monitoring mechanisms
Planning and accountability
Growth opportunities
Fulfillment of needs
Identity and meaning
Collaboration
Democratic participation
Signs of Organizational Well-Being:
ERA Environments
High
Reflective Environment
High
Low
Low
Affective Environment
Low
High
Effective
Environment
Signs of Organizational Well-Being:
Effective Environments
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Efficient
Task-oriented
Well-organized
Accountable
Responsible
Communicate well
Anticipate challenges
Enabling structures
Program evaluation
Signs of Organizational Well-Being:
Reflective Environments
 Learning opportunities
 Organizational learning
 Challenge old notions
 Take risks
 Ask big questions
 Promote innovation
 Stimulating
Signs of Organizational Well-Being:
Affective Environments
 Climate of acceptance
 Appreciation
 Affirmation
 Respect
 Safe place
 Sense of control
 Conviviality
 Voice and choice
Sources of Organizational Well-Being:
Values, interests, power (VIP)
 Competing tendencies within people and groups
Values
Power
Interests
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
Signs of Community Well-being
 Social justice and equality
 Liberation from oppressive forces
 Quality education
 Adequate health and social services
 Economic prosperity
 Adequate housing
 Clean and safe environment
 Support for community structures
Sources of Community Well-being
 Poverty
 Power
 Participation
Social capital and community well-being
crime
tolerance
education
welfare
health
low
med
high
Low SC: LA, MS, GA
Med SC: CA, MO, OK
Hi SC: ND, SD, VT, MN
Male Life Expectancy by Inequality
78
77
76
Swed/Jap
Can/Fra
UK/Aust
USA
75
74
73
72
GINI 24.5
GINI 31.5
GINI 35.5
GINI 40
Life expectancy at age 15 - males
60
58
56
54
52
50
48
19
80
19
82
19
84
19
86
19
88
19
90
19
92
19
94
46
44
Nordic
CCEE
Russia
Cake of Well-being
Easy temperament
Physical health
Adequate birth weight
Values, Resources
Programs, Policies
Child care
Good schools
Adequate housing
Cohesion
Access to health care
Good parenting
Mutual Support
Good mental health
Values, Resources
Programs, Policies
Values, Resources
Programs, Policies
Values, Resources
Programs, Policies
Employment
Justice
Safety nets
Quality education
Mountain of Risk
Poor temperament
Poor health
Birth weight
Values, Resources
Programs, Policies
No child care
Poor housing
Lack of cohesion
Crime
Values, Resources
Programs, Policies
Values, Resources
Programs, Policies
Values, Resources
Programs, Policies
Teen parenting
Family size
Stressors
Poor parenting
Addictions
Poor mental health
Poverty
Injustice
Violence
Discrimination
Part II
Strategies for Well-Being
9/7/1854…Removing the Handle
Getting To The Bottom Of It….
 No mass disorder, afflicting humankind, has ever
been eliminated, or brought under control, by
treating the affected individual
 HIV/AIDS, poverty, child abuse, powerlessness
are not eliminated one person at a time.
Changing how we work:
The SPECS of Well-Being
From
 Deficits-based
 Reactive
 Arrogance
 Individual blame
To
 Strengths-based
 Primary Prevention
 Empowerment
 Community Change
Strategies: Time and Place
Collective
X
Reactive
Proactive
Individual
Strategies: Time and Place
Collective
Quadrant IV
Examples:
Food banks, shelters for
homeless people, charities,
prison industrial complex
Quadrant I
Examples:
Community development,
affordable housing policy,
recreational opportunities, high
quality schools and health services
Reactive
Proactive
Quadrant II
Quadrant III
Examples:
Crisis work, therapy,
medications, symptom
containment, case
management
Individual
Examples:
Skill building, emotional literacy,
fitness programs, personal
improvement plans, resistance to
peer pressure in drug and alcohol
use
Too Little, Too Late
CONTINUUM OF SERVICES
Wellness
Promotion
Prevention
1%
BUDGET ALLOCATION
Treatment
99%
Prevention Saves Money
Mismatch between spending and opportunity
Decline of brain flexibility
in young age
Brain dev.
Spending
Increase of
public spending
in old age
0.00
1.00
3.00
10.00
Age
60.00
80.00
90.00
Strategies: Abilities and Participation
Strengths
X
Detachment
Empowerment
Deficits
Strategies: Ability and Participation
Strength
Quadrant I
Examples:
Voice and choice in celebrating
and building competencies,
recognition of personal and
collective resilience
Quadrant IV
Examples:
Just say no! You can do it!
Cheerleading approaches, Make
nice approaches
Detachment
Empowerment
Quadrant III
Quadrant II
Examples:
Labeling and diagnosis,
“patienthood” and clienthood,”
citizens in passive role
Examples:
Voice and choice in deficit
reduction approaches,
participation in decisions how to
treat affective disorders or
physical disorders
Deficit
ASSESSING FOR WELL-BEING
 Why do we need it?
 How do we do it?
THIS IS NOT ALGEBRA, BUT…
B = f(PE).
Bronfenbrenner’s Ecological Theory
 Microsystem
MICRO
 Mesosystem
MESO
 Exosystem
EXO
 Macrosystem
MACRO
Context Minimization Error
 “Tendency to ignore the impact of enduring
neighborhood and community contexts on
human behavior. The error has adverse
consequences for understanding
psychological processes and efforts at social
change” (Shinn and Toohey, 2003, p. 428).
TRADITIONAL ASSESSMENTS…
 Minimize environmental barriers (Risks)
 Neglect environmental resources (Opportunities)
 Highlight personal deficits (Weaknesses)
 Underemphasize personal assets (Strengths)
ROWS for Well-Being
 Risks
 Opportunities
 Weaknesses
 Strengths
Strategies: I VALUE IT
I VALUE IT
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Inclusive host
Visionary
Asset seeker
Listener and sense maker
Unique solution finder
Evaluator
Implementer
Trendsetter
Strategies:
ABCs for Change Agents
ABCs of Change
 Affective - what your feel
 Behavioral - what you do
 Cognitive - what you think
Key Question
 How do you engage people -
affectively, behaviorally, and
cognitively-in the process of
promoting SPEC?
Strategies for Personal Change
 SPEC
 ROWS
 I VALUE IT
 Stages of Change
The ABC of challenging interactions
 Client ABC
 Helper ABC
STAGES OF CHANGE
 Pre-contemplation
 Contemplation
 Preparation
 Action
 Maintenance
PRECONTEMPLATION
 No intention to change behavior
 May be unaware of the problem
 May want to change circumstances and other people –
but not own behavior
 Usually resist change
 Need to “own” problem in order to move ahead
 Will progress toward change if given proper tools at
proper time
CONTEMPLATION
 Acknowledge problem and begin to think about
overcoming it
 May be far from making a commitment to action
 Evaluate options – but must avoid the trap of
chronic contemplation
 To move forward – must take small steps of
preliminary action
PREPARATION
 Planning to take action within the near future
 Includes some small behavioral changes
 Need to set goals and priorities
 Need to commit to a specific action plan
ACTION
 Modification of behavior, experiences and/or environment



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to overcome problem
Requires overt behavioral change
Considerable commitment of time and energy
Change is most visible and receives the most external
support
Key action-oriented change processes are required
MAINTENANACE
 Work to prevent relapse and consolidate gains
 Maintenance is a continuation of change
 Can last a lifetime for some behaviors
 Relapse is the rule rather than the exception for
problems such as addiction
TERMINATION
 When there is no longer temptation to return to
troubling behaviors
 Termination of treatment and termination of a
problem are not coincidental
IMPORTANT IMPLICATIONS
 Particular processes of change should be emphasized
during particular stages of change.
 Knowing a client’s stage along the change process can
provide us with important information as to what to do to
help that client move along the continuum.
 Treatments that are quite effective in one stage can be
ineffective or even detrimental in another stage
I VALUE IT
Strategies/ABC
Inclusive host
Visionary
Asset seeker
Listener and sense maker
Unique solution finder
Evaluator
Implementer
Trendsetter
AFFECTIVE
BEHAVIORAL
COGNITIVE
The Case of Sister Margaret:
 Personal well-Being
 Organizational Well-being
 Community Well-being
Strategies for Organizational Change
 SPECS
 I VALUE IT
 ROWS
New SPECs
Three-year action research project
Oasis Center
Martha
O’Bryan
Center
Bethlehem
Center
UNHS
Outcomes of NEW SPECS PROJECT
 New mission statements
 New outreach programs
 More youth and client involvement
 Assessment of projects in light of SPEC
 More prevention efforts
 Empowered counselors
 Blending of therapy with social change
Assessing the “SPECiness” of 166
programs: Strength-Based Programs
120
112
100
80
60
48
Total Programs
40
20
0
5
Community Individual Not SB
SB
SB
1
Unknow n
Prevention vs. Treatment
80
73
70
60
50
39
40
42
Total Programs
30
20
10
0
11
1
Universal Selective IndicatedTreatmentUnkown
Empowerment
By Number of Programs
140
132
120
100
80
Total
Programs
60
40
20
0
27
5
Community Individual E
E
2
Not E
Unknow n
Changing Community Conditions
By Number of Programs
149
150
100
Total
Programs
50
0
4
CCC
13
0
Changing
I&C
Individual
Unknow n
Little funding for community change
Millions
$7
$6
$5
$4
$3
$2
$1
$0
Funding Amount
CCC
Changing Individual
C&I
Unknown
Strategies for Community Change
 SPEC-type programs to promote family well-
being and prevent child maltreatment
 Promotion-prevention-early intervention
continuum

Focusing the intervention at different
ecological levels
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Length and intensity of intervention

Value-based partnerships
Effect Sizes for Proactive and Reactive
Interventions on Family Outcomes at
Post Intervention and Follow-up
0.6
0.5
0.4
Post
Follow-up
0.3
0.2
0.1
0
Proactive
Reactive
Source: MacLeod & Nelson (2000)
Multi-component
Programs – BBBF
• Better Beginnings, Better Futures is a multi-component
prevention program in 8 low-income Ontario
communities (Peters et al., 2000)
• There are child-focused, family-focused, and
community-focused programs in each community
• The program uses two types of comparison groups to
evaluate prevention program effectiveness (a baselinefocal cohort comparison and a longitudinal comparison
community design)
Impacts on Child Maltreatment:
Number of Open CAS Cases in
Highfield Community over Time
35
30
25
20
15
10
5
Source: Peters et al. (2002)
19
97
19
95
19
93
19
91
19
89
19
87
0
Effect Sizes for Preschool Interventions on Child and
Family Outcomes at K-8 by Length and Intensity of the
Intervention for Children
0.45
0.4
0.35
0.3
0.25
0.2
0.15
0.1
High
Low
0.05
0
Intensity
Length
Source: Nelson, Westhues, & MacLeod (2002)
Effect Sizes for Intensive Family Preservation
Programs on Out of Home Placement Rates
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
No
Yes
Parent Participation
Social Support
Component
Source: MacLeod & Nelson (2000)
Can SPEC Programs Promote Family Well-Being
and Prevent Child Maltreatment? YES!
• There is evidence of four best practice
dimensions that are quite important for
promoting the well-being of families and
preventing the maltreatment of children
• promotion programs that target
• multiple levels,
• are of long duration and intensity,
• and blend the strengths of professionals and
community members
Processes
Community Well-Being in Kerala
Personal
Empowerment
Outcomes
Personal
Wellness
Lower Infant
mortality
Higher Literacy
Better Nutrition
Longer
life expectancy
Social
Movements
Relational
Wellness
Social support
Sense of
cohesion
Government
Action
Community
Wellness
Tenancy laws
Nutrition in school
Distribution
Of resources
Land reform
It’s like Venice…..
Venice’s Lesson
 “The psychotherapist, social worker (teacher) or
social reformer, concerned only with his own
clients (and students) 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)
Can we do it? Can we Promote SPEC for
Children and Families?
 “Never doubt that a small group of thoughtful,
committed citizens can change the world. Indeed,
it is the only thing that ever has.”

Margaret Mead

1901-1978