Using a Resiliency Mindset to Choose Interventions for Children

Parents of neurodevelopmentally atypical children sometimes face what can be a bewildering array of clinical intervention (therapy) options. A clinical psychology of resilience provides a useful framework that can help parents better understand their options and guide the choice and application of clinical interventions.

Defining Resilience in Children and Youth

Early research on resilience identified protective factors present in the lives of people who exhibited healthy development and growth in the face of extreme adversity in childhood or adolescence. This early research assumed that resilient people who thrived in the face of extreme adversity were relatively extraordinary and that the protective factors in their childhood family and community environments that helped them thrive in the face of extreme adversity were relatively uncommon as well.

Later and recent research suggests that resiliency can be a part of any child’s development and that all children and youth are, or can be helped to become, resilient. This research points to personal and social-environment factors that facilitate adaptation across a wide range of stressors, not only extreme adversity. Structured interventions, including individual and family therapies, can help build resilience by fostering these personal and family protective factors.

Resilience Factors

Prince-Embury (2007) identifies three categories of personal and social-environmental resilience factors:

1. Mastery: Sense of competency, self-efficacy, positive expectations about the future, positive beliefs about one’s skills and abilities. Sense-of mastery is attained through large but also small, successful but also partially successful, interactions with the physical and social environment (family, school, peers).
2. Relatedness: Positive relationships with parents, with siblings and other relatives, with non-parent adults such as teachers, neighbors, or religious leaders, and with peers. Personal qualities that can promote a sense of relatedness include good social and communication skills, confidence in the availability of social partners, and secure attachment. Social environments characterized by available and trustworthy adults promote relatedness.
3. Ability to Self-Regulate Emotional Reactivity: Ability to modulate and modify negative emotions triggered by adverse events and circumstances. It is helpful to think in terms of the speed and intensity of negative emotional responses and time it takes to recover from negative emotional responses. The ability to adaptively self-regulate can be seen as a set of skills that can be learned.

It is important to note that sense of mastery can be even more important than actual mastery, and sense of relatedness can be even more important than actual relatedness. Sense of emotional control and not just actual control over-reactivity is important as well.

Many Child and Family Interventions Can Be Viewed as Promoting Resilience

Sense of mastery, relatedness, and emotional control are cognitive variables that can be a target of cognitive therapy. Resilience focused cognitive therapy might focus on promoting adaptive automatic thoughts and rules-assumptions and, especially, developing healthy core beliefs such as: "I am capable," "I can succeed," "I am able to learn," "I am likable," "I am lovable," "I can handle setbacks," "I can learn from challenges," "I have choices," "I can make my needs known," "people care about me," "someone can help me."

Cognitive therapy can work towards structuring experiences (e.g., step-by-step task completion and goal achievement) and responses from the social environment (e.g.; recognition and praise) that can help build a sense of mastery and relatedness. Cognitive strategies such as coping self-talk and imagery can be used to help children and adolescents control and modify negative emotions triggered by specific stressful situations.

Development of social and communication skills (that can help build social relatedness) and emotional regulation skills (that can help manage emotional reactivity) can also be a target of behavior therapy. Relaxation techniques and mindfulness meditation can be used to lower baseline, day-to-day emotional reactivity as well.

Solution-focused therapy highlights exceptions, that is times problems do not occur. Solution-focused therapists invite us to go on a "treasure hunt for exceptions" to keep an eye (and ear) out for islands of better functioning, to notice when something works and make it bigger, to take (and give) credit when things get better, and to recognize and reinforce step-by-step progress.

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Parent management training, which emphasizes positive reinforcement and working towards positive opposites (rather than focusing on the problem behavior), can help build social-emotional skills and develop a child’s or adolescent’s sense of mastery and relatedness (we tend to feel more connected with people who positively reinforce, rather than punish, us).

Cognitive-behavioral focused family therapy can help parents and families structure experiences and reinforce behaviors in ways that promote a sense of mastery; model and reinforce adaptive self-talk, rules and assumptions, and core beliefs; promote the development of social and communication skills; and model and teach and positively reinforce emotion regulation skills.

Structural and strategic family therapies can help identify and modify problematic family relationship patterns and enhance family cohesion, bonding, and emotional support in ways that promote not only a child’s sense of relatedness but also resiliency in all family members.

A Resiliency Mindset

A clinical psychology of resiliency can help parents choose clinical interventions (and clinicians) that focus on highlighting and expanding existing strengths and protective factors and building additional competencies rather than mostly focusing on identifying and correcting weaknesses and disorders. As Prince-Embury (2007) emphasizes, "the mindset of a resilient parent" helps in "raising a child with a resiliency mindset" and interventions should focus on "teaching parents how to identify and foster these qualities."