Understanding and Promoting Well-Being Isaac Prilleltensky

1. Understanding and Promoting Well-BeingIsaac Prilleltensky isaac@miami.edu www.education.miami.edu/isaac

2. Kerala: A Community Strengths Story Kerala: A state in Southwest India. The name "Kerala" probably means "land of coconuts." Population: 31.8 million Kerala's population is the same as Canada's.

4. Well-Being in Kerala Personal Empowerment Social Movements Government Action Processes Relational And Organizational Well-Being Community Well-Being Personal Well-Being Social support Sense of cohesion Tenancy laws Nutrition in school Distribution Of resources Land reform Infant mortality Literacy Nutrition Life expectancy Outcomes

5. The State of Wellness Wellness is a positive state of affairs, brought about by the simultaneous satisfaction of personal, relational, organizational and collective needs

6. There cannot be well-being but in the combined presence of personal, relational, organizational and community well-being Part I: Understanding Well-Being relational personal W organizational community

7. Personal Well-being • Sense of control • Physical health • Love • Optimism • Competence • Dignity and integrity • Growth • Self-esteem • Meaning and spirituality

8. Effects of lack of control and disempowerment on mortality

9. Relational Well-Being • Support • Affection • Bonding • Cohesion • Collaboration • Respect for diversity • Democratic participation

10. 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

11. Organizational Well-Being • Efficient structures • Clear roles • Monitoring mechanisms • Planning and accountability • Growth opportunities • Fulfillment of needs • Identity and meaning

12. High Low Reflective Environment High Low High Low Affective Environment Effective Environment Organizational Well-Being:ERA Environments

13. Community well-being • Economic prosperity • Social justice • Adequate health and social services • Low crime • Adequate housing • Clean environment • Support for community structures

14. Probability of death bet ages 15-60 in 2020 – males -- Interactions

15. Male Life Expectancy by Inequality

16. Colombia: Happy but Dead • Highest rate of murders per capita in the world • Highest number of kidnappings in the world • Colombia 5181 in 7 years • Mexico 1269 • Brazil 515 • Venezuela 109 • Severe under reporting • Colombians report highest level of satisfaction 8.31 (out of 10) in the world in the 90s

17. South Africa: 6.08

18. Is happiness really a genetic phenomenon? Lykken and Tellegen (1996, Psychological Science). • In the Minnesota twins study, authors report, • “Neither socioeconomic status, educational attainment, family income, marital status, not an indicant of religious commitment could account for more than about 3% of the variance in WB” (in monozygotic twins) • “We estimate that the heritability of the stable component of subjective well-being approaches 80%”

19. Change in life satisfaction over the years(Inglehart, 2004)

20. Russia’s happiness and satisfaction plunges Two African Countries

21. Income is not everything though Two African Countries

22. Wealth matters for life expectancy

23. Chinese happiness and democracy

24. Preliminary Summary • Subjective reports of happiness incongruous with physical evidence of illness, mortality, and crime • Within countries • Poor report high levels of happiness but have low levels of physical and mental well-being • Across countries • Some poor countries report low levels of happiness and others fairly high • All poor countries show low levels of physical and mental well-being • Subjective well-being goes up and down depending on social circumstances (Russia, Belgium, Switzerland)

25. Preliminary Summary • Absolute poverty predicts low levels of physical and mental well-being, within and across countries (Kleinman, Eisenberg, etc.) • Relative deprivation predicts social gradient in physical and mental well-being within countries (Marmot, Wilkinson) • Freedom is important in subjective well-being, but there are exceptions like China • Wealth does not necessarily lead to a happy or meaningful life (Adams, Cushman, Sloan, Ryan)

26. New definition of well-being • Well-being is a positive state of affairs in individuals, relationships, organizations, communities, and the natural environment, brought about by the simultaneous and balanced satisfaction of objective and subjective needs; and by the behavioral manifestation of material and psychological justice in these five ecological domains.

27. Ecological Model of Well-Being

28. Model of Well-Being:Some positive and negative factors

29. From Deficits Reactive Arrogance Individual blame To Strengths Prevention Empowerment Community Change Part II: Promoting Well-Being

30. Strengths, Prevention, Empowerment, Community change The Grameen Bank 1960s

31. Lesson #1: Strengths • We all have strengths • We all need to be treated with respect • We all need to be given a chance

32. 9/7/1854…Removing the Handle of London’s Broad Street Pump

33. Lesson #2: Prevention • “No mass disorder, afflicting humankind, has ever been eliminated, or brought under control, by treating the affected individual” • HIV/AIDS, poverty, child abuse, school drop out, addictions, powerlessness are never eliminated one person at a time • Must focus on prevention to reduce the incidence of psychological, behavioral, and social problems in children and youth

34. Too much reaction, not enough preventionInvestments in Reactive vs. Proactive Interventions in Health and Community Services (Nelson et al, 1996; OECD, 2005; de Bekker-Grob et al., 2007) Investments in Prevention: Italy 0.6% USA 3% Netherlands 4.3% Canada 8% Prilleltensky

35. Ratio of Benefits to Costs (Lynch, 2007, page 19)

36. Strengths, Prevention, Empowerment, Community change

37. Lesson #3: Empowerment • Identifying the external source of oppression in life can be empowering • Empowerment is a means and an end in itself • Empowerment can be a tool for social change and personal healing at the same time

38. Strengths, Prevention, Empowerment, Communitychange

39. Lesson #4: Community change • “The psychotherapist, social worker or social reformer, concerned only with his (her) own clients 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)

40. Place and class in infant mortality

41. Social capital and community well-being Low SC: LA, MS, GA Med SC: CA, MO, OK Hi SC: ND, SD, VT, MN

42. Example 1: Miami SPEC projectOrganizational conditions leading to transformative practice: Findings from a multi-case study, action research investigation • University of Miami SPEC Team • Isaac Prilleltensky • Ora Prilleltensky • Scot Evans • Adrine McKenzie • Debbie Nogueras • Randy Penfield • Corinne Huggins • Nick Mescia

43. What is transformative practice? • In the context of community, educational, health, and human service organizations, we define transformative practice as consisting of four principles • Strengths • Prevention • Empowerment • Community change

44. Drain Approach Deficits-based Reactive Alienating Individualistic Problems Too little Too late Too costly Too unrealistic SPEC Approach Strengths-based Primary Prevention Empowerment Community change Opportunity Built to last Starts early and saves $$$ Creates civic engagement Builds social movement DRAIN VS. SPEC APPROACHES Prilleltensky

45. Time and place of interventions THIS IS WHERE WE NEED TO BE 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 accessible health services Reactive Proactive Quadrant II Examples: Skill building, emotional literacy, fitness programs, personal improvement plans, resistance to peer pressure in drug and alcohol use Quadrant III Examples: Crisis work, therapy, medications, symptom containment, case management Individual THIS IS WHERE WE ARE

46. Focus and engagement in interventions THIS IS WHERE WE NEED TO BE 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 II Examples: Voice and choice in deficit reduction approaches, participation in decisions how to treat affective disorders or physical disorders Quadrant III Examples: Labeling and diagnosis, “patienthood” and clienthood,” citizens in passive role Deficit THIS IS WHERE WE ARE

47. Context of Investigation • Action research with 5 community based organizations (CBOs) to promote Strengths, Prevention, Empowerment, Community Change • Three year study consisting of • Training • Team work • Consultation • Professional development • Action research

48. Context of Investigation • Organizations selected on basis of “readiness” • Organizations consist of • Major local funder (MF) • Major provider of health services for poor (HS) • Organization that promotes early interventions (EI) • Local civic coalition (LC) • Local human service (HS) • Budgets range from $ 1 million to over $ 100 million • Personnel ranges from 15 to 700

49. Context of Investigation • Intervention components • Training • Each organization sends reps to 18 person class • 3 hours biweekly • Lecture, discussion, application • Team work • Transformation teams meet biweekly • Consultation • A researcher assigned to each organization • Weekly or biweekly consultations • Professional development • Action research

50. Research Design • Action Goal of overall project: Promote SPEC practices in organizations to improve community well-being • Research Goals of overall project: • Assess whether organizations become more aligned with SPEC principles as a result of interventions • If so, how • Data collection • Quantitative and qualitative methods at baseline, year one, and end of project • Goal of present study: Examine organizational conditions leading to SPEC based on qualitative data gathered through interviews, focus groups, and field notes with about 80 different participants in the five organizations