Michael Ungar, Ph.D. Professor, School of Social Work, Dalhousie University

1. Nurturing the Resilience of Children with Complex NeedsQuality in Alternative Care ConferencePrague, April 2011 Michael Ungar, Ph.D. Professor, School of Social Work, Dalhousie University Twitter @MichaelUngarPhD www.michaelungar.com www.resilienceresearch.org

2. What influences positive development? • A ‘strength/asset’ in one context acts differently than in another • ‘Strengths/assets’ and ‘resilience factors/processes’ are both the same and different • Resilience related factors/processes requires the experience of significant adversity or exposure to risk

5. Patterns of Positive Development Under Adversity-#2 RECOVERY Actual Level of Functioning Expected Acute Stressor/trauma Chronic Stressors Time

6. Patterns of Positive Development Under Adversity-#4 POST-TRAUMATIC GROWTH Actual Level of Functioning Expected Acute Stressor/trauma Chronic Stressors Time

7. Patterns of Positive Development Under Adversity-#5 PROTECTIVE: RESISTANT/HIDDEN Level of Functioning Actual Expected ‘Hidden Resilience’ Acute Stressor/trauma Chronic Stressors Time

8. The Research Sites • Halifax, Winnipeg, Vancouver, Saskatoon, and Montreal, Canada • Sheshatshiu, Eskasoni, Hopedale, Nain, Canada (Aboriginal) • Tampa, Florida • Imphal, India • Cape Town and Vaal Triangle, South Africa • Presidente Prudente, Brazil • Hong Kong, Beijing, and Jinan, China • Moscow, Russia • East Jerusalem and Gaza, Palestine • Tel Aviv, Israel • Medellin, Colombia • Serekunda, The Gambia • Njoro, Tanzania • New Zealand • Chiang Mai, Thailand

9. Resilience is… • In the context of adversity, • Resilience is one’s capacity to navigate towards, • And negotiate for, • Culturally and contextually meaningful resources. • And it is the capacity of one’s community to provide these resources.

10. Seven “Tensions” to be Resolved cultural adherence cohesion relationships identity accessto material resources social justice power & control

11. Mean Service Use Scores by Referring Service for Double Service Users (n=287) * One-Way ANOVA (p < 0.05)

12. -.03 -.21* .53* .18* -.14 .13 Contextual Risk Individual Risk Service Use Experience .33* -.38* -.17* .07 .01 -.30* Resilience .37* Functional Outcomes Life time Service Use Accumulation

13. -.03 -.21* .53* .18* -.14 .13 Contextual Risk Individual Risk Service Use Experience .33* -.38* .07 -.17* .01 -.30* Resilience .37* Functional Outcomes Life time Service Use Accumulation

14. Six Principles of Formal Service Design • Be multi-level, ecologically complex in their delivery • Be coordinated, challenging the barriers created by service silos • Emphasize continuity over time, in both the seamless delivery of multiple services and the engagement of staff with the individuals they serve

15. Six Principles (cont.) • Be negotiated, with services matched to people's cultures and contexts • Be designed along a continuum from least to most intrusive • Be effective, whether that effectiveness is demonstrated based on practice based evidence or rigorous evaluation of manualized interventions

17. Thank you! Michael Ungar, Ph.D. Professor, School of Social Work, Dalhousie University Twitter @MichaelUngarPhD www.michaelungar.com www.resilienceresearch.org

18. Participatory Research to Study Resilience Michael Ungar, Ph.D. Professor, School of Social Work, Dalhousie University Twitter @MichaelUngarPhD www.michaelungar.com www.resilienceresearch.org

19. Expression • Lewin’s original expression: B = f (P, E) • Revised Expression: In context of significant risk… RB(1,2,3…) = f (PSC, E) (OAv,OAc)(M)

20. Site specific sample questions • Gambia • Do you trust your parents to choose the person you will marry? • Does your parents’ security depend on your income? • Sheshatshiu • Do you have any knowledge in suicide intervention?

21. Video

22. Progression of the Exploratory FactorAnalysis Nested Ecological Model Minority World (Western) MODEL 1 Majority World (Non-Western) Girls MODEL 2 Boys High Social Cohesion MODEL 3 Low Social Cohesion MODEL 4

23. Qualitative Sequence Quantitative Sequence Research Phase Contextualization • Contextualization • Local Advisory Committee (LAC) defines construct • Core domains identified Measure Development • Develop Draft Measure • Aggregate questions from multiple LACs • Item Generation • Focus groups and LACs Sample Selection • Identify Population Variables • LACs identify population-wide risk factors Translation and Back-translation of Items • Final Item Selection • LACs comment on aggregated measure • Validation of translation/back-translation • Final Sample Selection • LACs identify community sample based on local and cross-national criteria • LACs interviewed regarding age of participants • Ethics reviews by LACs (where necessary) Data Collection Administer Pilot Measure • Qualitative Interviews • Youth selected by LACs who meet criteria Analysis of Findings • Coding of Qualitative Data • Negotiate coding structure between sites Exploratory Factor Analysis • Generation of Substantive Theory • Exploration of convergence Seeking Convergence/Explanation Convergence Item Reduction • Theory Informed Discussion of Quantitative Measure • Selection of final items • Revision of wording Finalized Measure