Articles from Reaching Today's Youth
Youth, The Community Circle of Caring Journal, is published by the National Educational Service.
|Complete citation for this article:
Osher, D., Kendziora, K. T., VanDenBerg, J., & Dennis, K. (1999). Growing
resilience: Creating opportunities for resilience to thrive. Reaching
Today's Youth, 3(4), 38-45.
Creating Opportunities for Resilience to Thrive
David Osher, Kimberly T. Kendziora,
John VanDenBerg, and Karl Dennis
Nine effective, risk-reducing, and resilience-building
programs provide powerful insights into what works for troubled children and how to build
places where resilience thrives.
We are all inspired by stories about people who have
persevered to achieve fulfillment in life. But who are the people who made it possible for
these stars to shine? We must recognize the family members, friends, teachers, counselors,
members of the faith community, and others who help make resilient outcomes happen. As we
begin to pay more attention to the places where resilience thrives, and not just to the
individuals who overcome obstacles to succeed, we can continue to make resilience a
possibility for a new generation of children at risk.
It is tempting to simply give up when faced with the
familiar litany of problems facing youth today (too much violence, sexual activity too
early, too many drugs, not enough morality or responsibility). We sometimes hear that
"nothing works" to help those who are at risk and in need. But in reality, there
are many exemplary, evidence-based, family-focused programs offering both help and hope
that reach beyond individuals to foster resilience. The following short list of such
programs, though incomplete, can provide some powerful insights into what works for
troubled children and how to build places where resilience thrives.
Seven of the nine programs described here were visited by
researchers connected with the Center for Effective Collaboration and Practice after the
programs (or models) were nominated as exemplary by panels of researchers, practitioners,
and family members. The other two programs described hereNurse Home Visitation and
Big Brothers/Big Sisters of Americaare both nationally recognized and have been the
subject of rigorous evaluation.
Key Elements of Resilience-Building Programs
What we know from the field about what works is being
reflected in research on effective, risk-reducing, and resilience-building programs.
Effective services provide contexts that both reduce the impact of risk factors and foster
the development of new or existing protective factors. These programs build on inherent
strengths within families, schools, and communities, and enable these institutions to help
children succeed. And more than just helping children, the best programs also support
those who care for and provide services to these children, thereby enhancing their
capacity to care. These programs address child development at a variety of stages, from
prenatal care through postsecondary employmentstages that some would even say are
too early or too late for appropriate intervention. These programs repeatedly demonstrate
that resilience, rather than being solely dependent on individual characteristics, can be
We begin our examination of resilience beyond the
individual by looking at programs that work with families during the prenatal
periodbefore a child is even born. We follow with programs that address preschoolers
and then schoolchildren, incorporating progressively broader ecological systems (schools,
community institutions) into their considerations of what it takes to develop resilient
children. Finally, we describe programs that move toward the ultimate goal of creating
resilient communities that enable children and families to expect and achieve successful
Key Elements of
Surveys of and information about other exemplary
preventative and resilience-enhancing interventions may be obtained through these World
Wide Web sites:
Blueprints for Violence Prevention:
Preventing Drug Use Among Children and Adolescents: A
Prevention and Early Intervention: Collaboration and
Strengthening Americas Families: Effective Family
Programs for Prevention of Delinquency:
|Nurse Home Visitation
What happens when a woman is poor, single, and pregnant? An ordinary
helper might point the mother-to-be in the direction of social services so that she could
receive the public assistance to which she may be entitled. However, in some parts of the
country, there are helpers who do much more. The Nurse Home Visitation Program, developed
by David Olds and his colleagues (Olds, Henderson, Kitzman, et al., 1998) in Elmira, New
York, offers more than a TANF paycheck to high-risk mothers. This program hires nurses who
visit families in their homes 9 times during pregnancy and 23 times during the
childs first 2 years of life. These visits focus on three areas:
- Improving the womens prenatal health and pregnancy
- Improving the quality of child care provided to the infants
once they are born in order to promote better child health and development.
- Improving the womens personal development in such
areas as educational achievement, career development, and future family planning.
This kind of very early, positive, uplifting intervention
can produce significant results, especially for those families at highest risk (both low
income and unmarried). When compared to high-risk women who had not received visits,
program participants in Elmira had 79% fewer verified reports of child abuse or neglect,
spent less time on public assistance, had 44% fewer maternal alcohol and drug abuse
problems, and had 69% fewer arrests. A 15-year follow-up of these womens children
showed that, compared to the children of high-risk women who had not received visits,
there were 60% fewer instances of running away, 56% fewer arrests, and 56% fewer days of
alcohol consumption (Olds, Henderson, Cole, et al., 1998). The program has been
successfully replicated in Memphis, Tennessee, and is currently underway in Denver,
Colorado. The costs of the program are recovered by the first childs fourth birthday
(Karoly et al., 1998).
Among currently active nurse home visitation programs, the
one developed by David Olds and his colleagues has the strongest research support. Other
programs have often not demonstrated the duration of effects on children seen here. For
example, the Infant Health and Development Program had dramatic effects at age 3 but
almost none at age 8 (McCarton, Brooks-Gunn, Wallace, & Bauer, 1997). Examples of
inactive programs include the Child Parent Enrichment Project (Barth, Hacking, & Ash,
1988) and the multiagency, interdisciplinary program studied by Huxley and Warner (1993).
|Early Intervention Centers
Risks for adverse child outcomes still exist beyond the prenatal and
infancy period. Toddlers who display high rates of emotionally intense, difficult behavior
are at risk not only for future mental health problems, but also for child abuse and
neglect. Promising interventions to build resilient families faced with such challenges
exist and offer real help to families struggling with hard-to-manage preschoolers.
The resilience-building preschool-age programs with the
most extensive research support are the Perry Preschool program, which pioneered the
High/Scope curriculum, and the Houston Parent Child Development Center. The Perry program
supports resilient outcomes by promoting school readiness in poor, underserved children
and by reaching out to their families through weekly home visits by teachers.
Data from a follow-up of children served by the Perry
Preschool program, conducted when participants were age 27, showed fewer chronic offenders
(7% vs. 35% had been arrested five or more times), fewer welfare recipients (59% vs. 80%),
and more high school graduates/GED recipients (71% vs. 54%), compared with a randomly
assigned nonparticipating group of children (Schweinhart, Barnes, & Weikart, 1993).
Training in the High/Scope curriculum is commercially available.
The Houston program included extensive supports for mothers
as well as children and produced impressive outcomes (e.g., success in improving the
quality of interaction between mothers and their children, reducing the incidence of
behavior problems, and enhancing school performance 5 to 8 years after completion of the
program [Johnson, 1989]). However, this program is not currently active. Head Start is by
far the largest preschool program serving children and families who are poor, but Head
Start lacks adequate research to support its impact (General Accounting Office, 1997).
Another impressive preschool program is offered through
Early Intervention Centers (EICs) run by the Positive Education Program, a Cleveland-area
agency serving children with serious emotional and behavioral problems and their families.
The Early Intervention Centers provide intensive, family-driven training and support to
children and their families from birth to 6 years of age. The goal of the EICs is to
provide young, high-risk children with the skills and behaviors necessary for integration
into an educational setting appropriate to their ages and ability levels.
The work of the EICs begins with a family-driven
assessment. Because parents actually implement the interventions with their children, the
program empowers families and helps them invest in finding solutions for themselves.
Experienced professionals and a parent paraprofessional staff provide guidance and
expertise. Although there is no financial cost to the family, participants "give
back" to the program by teaching their new skills to new families. Program outcomes
show that the sessions do work to develop skills in children that help them succeed in
During the 1997 fiscal year, 74 parents requested
assistance from the EICs in finding their children placements in or helping their children
make the transition to kindergartens, preschools, or daycare centers in the community. Of
these, 55% were successfully placed in special education community programs, and 45% were
successfully placed in non-special education community programs.
Routine follow-up contact with parents is primarily made
through telephone calls, which help determine whether EIC program graduates are not only
maintaining their progress but are also adequately being served within their current
placements. All 412 parents who received follow-up calls and 42 more who initiated calls
reported that they had received the assistance they requested and had successfully
maintained their children in the home and in the community programs where they were
The EICs support resilient families in large part because
they do not just treat clients. Many of the staff are program graduates, and can share
with other families their firsthand knowledge, skills, and resources for working with
children who are behaviorally challenging and helping these children develop the
behavioral skills that will help them succeed in school.
|First Step to Success
Once children make the transition to school, behavior that may have
been tolerable or even manageable at home can sometimes create problems in the classroom.
Children who are aggressive at school risk rejection by peers and teachers, personal
adjustment problems, and poor educational achievement. A proactive intervention during
kindergarten may help divert children from this pathway and build resilient schools in the
The First Step to Success program was developed by Hill
Walker and his colleagues at the University of Oregon. This program involves collaboration
between the home and the school in teaching aggressive children the specific skills they
need in order to succeed at school and build positive relationships. Like the Early
Intervention Centers, it provides adults (in this case, teachers and parents) with the
skills to support the development of children who are at risk of antisocial behavior. This
intervention has three components:
- Screening of all children to identify those needing help.
- School-based intervention that includes teachers, peers, and
- A parent-based intervention to support parents in training
their children in prosocial behavior and building self-esteem.
An evaluation of the initial trial of this program showed
that it produced increases in adaptive behavior and time on task, and reductions in
aggressive and inappropriate behavior. Improvements are still evident up to 4 years after
services are provided (Sopris West, undated document). The program has been replicated at
four sites in Oregon, three in Washington, and one in Kentucky.
Other early school-age programs that include an individual
or family focus and have evidence of their effectiveness include Promoting Alternative
Thinking Strategies (PATHS) (Greenberg, Kusche, Cook, & Quamma, 1995), the Seattle
Social Development Project (Hawkins, von Cleve, & Catalano, 1991), and the
Strengthening Families Program (Aktan, Kumpfer, & Turner, 1996).
to Journal Articles
|Families and Schools Together
Some families that are poor and socially
isolated may not reach out when they are having problems because they do not know where to
turn or because they find services to be aversive. Now they can turn to the Families and
Schools Together (FAST) program in 27 U.S. states, Australia, Canada, and soon in Germany.
Families and Schools Together is a collaborative prevention
and parent involvement program designed to address alcohol and drug abuse, violence and
delinquency, and school dropout. Founded by Lynn McDonald of the University of
Wisconsin Madison, the program capitalizes on the fact that elementary school
teachers are often among the first "outsiders" to notice signs of a childs
or a familys stress. In this program, a teachers recommendation leads to an
outreach home visit by a FAST parent graduate. During the visit, the entire family of an
"at-risk" child is invited to a meeting with 10 to 12 other families from that
school. The core of the program involves eight weekly meetings, usually held in the
school, during which positive, fun interactions for families are structured and
facilitated by a collaborative leadership team. Every meeting includes a family meal.
The ultimate goal of the process is to increase the
likelihood of the childs success in the home, school, and community. To achieve
improved child outcomes in these arenas, FAST builds the central protective factor of
family cohesion through five intermediate goals in three areas: strengthening the parents,
increasing parental involvement on multiple levels, and reducing the risk factors of
chronic daily stress, substance abuse, and chronic family conflict. To ensure that
families use all the social supports available, rather than becoming dependent on the FAST
trainers, the process also stresses community-building and family social networking
Of families who attend one meeting, over 80% complete the
8-week course and participate in a formal graduation ceremony. A majority of these parents
remain more involved in school activities even after the initial course is over. Families
then participate in monthly follow-up meetings, which they run for 2 years. An evaluation
of FAST by McDonald and Sayger (1998) showed that after program completion, there were
significant improvements in the childs classroom behavior, home behavior, and
self-esteem; in family closeness; in parent involvement in school; and reduction in the
familys social isolation. Two-year follow-up data on FAST program family graduates
suggest continued improvements among children.
Other successful programs that focus on school-age children
include Brys Behavioral Monitoring and Reinforcement Program (Bry, Conboy, &
Bisgay, 1986), and the Midwestern Prevention Project (Pentz, 1993).
to Journal Articles
Some schools have been described as hopeless and overrun with
"out-of-control" students, helpless teachers, and too many disciplinary
referrals. While many schools simply remove such children from their programs, Project
ACHIEVE offers one alternative answer to such school-wide problems. Developed by Howie
Knoff and George Batsche in the School Psychology Program at the University of South
Florida, Project ACHIEVE was originally implemented in schools in the Polk and
Hillsborough County school districts. Now, there are over 20 Project ACHIEVE sites across
Project ACHIEVE helps individual schools strategically plan
for and address both immediate and long-term student needs. It particularly emphasizes
improving and increasing students academic progress and success, social behavior,
social skills and aggression control, and reducing occasions of school-based violence
through organizational and resource development, comprehensive teacher inservice training
and follow-up, and parent and community involvement.
The major accomplishments of the longest-running Project
ACHIEVE school have included
- 28% fewer disciplinary referrals to the principals
- reduction of students receiving out-of-school suspensions
from 9% to 3%
- improvement in teachers perceptions of school climate
- 67% fewer students being placed in special education
- decline in student grade retentions from 6% of student body
to only less than 1%
- increase in the number of students scoring above the 50th
percentile on year-end achievement tests, especially for those involved at the youngest
- academic improvements for those students whose parents were
trained at the Parent Drop-In Center
Project ACHIEVE demonstrates that there is hope for even
the riskiest, most troubled schools. Because parents and communities are involved in the
effort, reform spreads beyond the individual school and brings promise to formerly
Other effective programs targeting the behavior of
school-age students include the Adolescent Transitions Program (Dishion & Andrews,
1995), Positive Adolescent Choices Training (PACT) (Hammond & Yung, 1991), and Second
Step (Grossman et al., 1997).
to Journal Articles
|Big Brothers/Big Sisters of
Many people say that nothing works with
troubled kids, especially with teens. A nationwide impact study of Big Brothers/Big
Sisters of America (BB/BS) (Tierney, Grossman, & Resch, 1995) has proven otherwise.
This program provides youth with the desperately needed positive experience of a nurturing
relationship and positive things to do outside of school hours. Youth who do not have
relatives and teachers to play the role of caring adult can still be positively influenced
and become more resilient and successful when they are paired with carefully selected and
BB/BS has served over a million children since it was
established in 1904. Over 500 local offices currently screen volunteers and match them to
youth in the community. BB/BS typically serves youth, ages 6 to 18, from single-parent
homes. A volunteer mentor will interact on a one-to-one basis with a young person in a
variety of settings. The pair meet regularly (about three times a month). BB/BS
distinguishes itself from other mentoring programs by its rigorous procedures that match
participating youth to a volunteer through youth assessments as well as volunteer
screening and orientation. All involved parties are supervised and supported during the
full duration of the program.
The evaluation by Tierney, Grossman, and Resch (1995) that
tracked youth involved with Big Brothers/Big Sisters of America reported that after 18
months in the program, youth who were poor and raised in single homes where there was a
high proportion of violence:
- were 46% less likely than unmentored youth to initiate drug
and alcohol use
- were 33% less likely than unmentored youth to engage in
- had reduced their school absenteeism by 52%
- were more likely than unmentored youth to have higher
quality relationships with their parents/guardians and peers
In addition to these positive outcomes, BB/BS shows that
using community volunteers not only helps the youth become more resilient but also builds
links across generations.
Some research supports the effectiveness of a number of
other mentoring programs, including Across Ages (LoSciuto, Rajala, Townsend, & Taylor,
1996), Denvers Gang Rescue and Support Project (GRASP) (Hritz & Gabow, 1997),
and Project Support (Hurley & Lustbader, 1997).
to Journal Articles
Services and Supports
Some children require more
intensive services than schoolwide approaches or even such targeted interventions as
mentoring or First Steps (Dwyer, Osher, & Warger, 1998). Many of these children and
youth can benefit from supports that are individualized, strengths-based, culturally
competent, and driven by their and their familys needs. These interventions must be
multisystemic, community-based, and unconditional (Burns & Goldman, 1999). Examples of
these supports include respite care for children and families, assistance in getting youth
up and out of the house so that they attend school, intensive tutoring, and therapy.
Programs that use these approaches include Treatment Foster Care (Chamberlain & Reid,
1998) and Multisystemic Treatment (MST) (Henggeler, Schoenwald, Borduin, Rowland, &
Chicagos Kaleidoscope program has also used such
approaches for almost 30 years in its work with youth who are experiencing multiple
stressors and who have multiple risk factors. Kaleidoscope maintains a "no reject, no
eject" policy. Once a child is referred, the staff will do "whatever it
takes" to work toward successful outcomes not only for the child, but also for the
entire family (Clark, Unger, & Stewart, 1993). Alaskas "Youth
Initiative" similarly employed such wraparound approaches in the 1980s to
successfully return all of its youth to their home communities (Burchard, Burchard,
Sewell, & VanDenBerg, 1993). Since 1991, the La Grange (Illinois) Area Department of
Special Education has employed teacheras well as childand family-driven
wraparound planning and supports to include students with emotional disturbance in regular
classes (Eber & Osuch, 1995). And since 1994, Wraparound Milwaukee has employed
similar approaches as a Medicaid managed-care behavioral health carve-out for 600 children
and adolescents who have serious emotional disturbances and are under court order in the
child welfare or juvenile justice system. Both Treatment Foster Care and MST have produced
impressive outcomes with youth who have juvenile justice, child welfare, substance abuse,
or mental heath needs.
to Journal Articles
|Systems of Care
Many children with behavioral, emotional, or mental health problems
need services and supports in a number of different areas, such as school, mental health,
and social services. In the past, care from these different kinds of agencies has been
conditional, disjointed, poorly coordinated, and agency-driven. Often youth received
services in restrictive settings, and frequently these services were provided outside of
the community. However, coordinating and thereby strengthening the disparate services that
a community already has in place has proven a powerful way to build resilient communities.
During the last decade, federal agencies have initiated
efforts to coordinate their fragmented service systems (Osher & Hanley, 1996). For
example, since 1992, the Center for Mental Health Services has supported the development
of local "Systems of Care." Effective Systems of Care are designed to allow
different organizations and families to collaborate in planning, implementing, and
evaluating approaches to providing individualized services for each child. Every child
team has a family advocate, and the emphasis is on identifying and building upon child and
family strengths. Teams may include representatives from mental health, education, child
welfare, juvenile justice, vocational counseling, recreation, substance abuse, or other
organizations. Evaluation of grantees in this program suggests that when these systems are
developed effectively and when children and youth receive appropriate services, there are
fewer hospital and out-of-home residential treatment placements; childrens behavior
and emotional functioning improves; school performance improves; there is less
law-breaking; and more children and families who receive services can be helped (Center
for Effective Collaboration and Practice, 1999).
to Journal Articles
The ultimate goal in growing resilience is the creation of
communities that can themselves buffer the various risks faced by all of its members and
foster protective factors through building skills, providing outlets for constructive
activity, and providing opportunities for meaningful relationships. One may think that
this kind of community-building is not possible in this alienated, disconnected age.
However, several communities have shown not only that they could come together to
serve their endangered members, but also that it could be done efficiently and done
well. These communities have developed new structures to develop resilient
neighborhoods built on community strengths and have added community resources in creative
One very exciting demonstration of this process of
"back-loading" social resilience is currently being implemented in Barrie,
Ontario (Simpson, 1998). In this efforta mix of community organizing and the
wraparound processthe community was divided into nine separate areas. Any citizen of
any age within these areas who has needs that cannot be met with traditionally funded
services or their own informal supports can request a wraparound plan. Each area has
individuals trained in wraparound process and planning. A central community team manages
the process and provides flexible funding to meet needs that cannot be funded any other
way. The effort is co-funded by United Way, local and regional service agencies, and
private individuals, and also involves churches and the business community.
Another innovative community development process is
exemplified by King County, Washington, in the Bothell area. This effort, called the
Family Support Network (Honey, 1997), has been developed by a group to provide a safety
net and network for families who have complex needs. One of the principal beliefs of the
effort is that "the more resourceful we are amongst ourselves, the more valuable a
resource we become to our families, our communities, and our world." The Family
Support Network recruits and trains community members as volunteers into the network to
provide support to each other. The effort maintains a village directory and databank that
contains member skills, hobbies, experiences, and resources to be shared. Organized as a
nonprofit organization, the effort helps community members who feel isolated, confused, or
Finally, other efforts being piloted by the grantees of the
Center for Mental Health Services Division of Knowledge Development and Systems
Change in over 40 sites often have included a strong focus on developing linkages to
community resources and to neighborhoods. An example of this type of effort has been the
Sacred Child Project in North Dakota, which uses cultural and spiritual linkages to help
keep youth on the reservation instead of placing them in residential or institutional care
(see page 69). Another example of a successful grant is the KanFocus effort in 13 counties
in southeast Kansas (James Rast, personal communication, Spring 1999). In this effort,
local community teams comprised of both formal, funded services and schools and informal
networks of supports like churches and service clubs have linked together to build large
resource pools that are available to families with complex needs.
If community-building efforts such as these are to succeed,
they must address three daunting challenges. First, they must overcome what John McKnight
(1995) described as the disabling function of the expert model of professionalized
services. Some Center for Mental Health Services Systems of Care grantees are
starting to accomplish this goal by supporting, for example, the development of new roles
for families (Osher, deFur, Nava, Spencer, & Toth-Dennis, 1999). Second, these efforts
must address the subtle and complex ways in which "isms"racism,
ethnocentrism, sexism, heterosexism, ableism, ageisminhibit the development of
community. Effective approaches to cultural competence suggest what can be done to create
organizations that value and address diversity (Osher & Mejia, 1999). Finally,
successful community building must address how poverty and the maldistribution of wealth
and power contributes to "rotten social outcomes" (Schor, 1995; Schorr, 1988).
Although these approaches are not easy, they can help develop the qualities that children
and youth need to become healthy, caring, and responsible.
David Osher is an editorial board member of Reaching
Todays Youth and a senior fellow at American Institutes for Research, where he
directs the Center for Effective Collaboration and Practice. He can be reached at the
Center for Effective Collaboration and Practice, 1000 Thomas Jefferson N.W., Suite 400,
Washington, DC 20007, telephone (888) 457-1551 or (202) 944-5400, fax (202) 944-5408,
Kimberly Kendziora is a research analyst at the American
Institutes for Research, where she works for the Center for Effective Collaboration and
Practice. She focuses her work on issues of prevention of mental health problems in
children. She can be reached at the American Institutes for Research, Pelavin Research
Center, 1000 Thomas Jefferson Street, N.W., Suite 400, Washington, DC 20007, telephone
(202) 944-5391, fax (202) 944-5454, e-mail firstname.lastname@example.org.
John VanDenBerg is the president of VanDenBerg Consulting
Inc. He is an international consultant on services system reform and the wraparound
process. He has trained in 49 states and in Canada, and in other countries. He can be
reached at VanDenBerg Consulting, 9715 Bellcrest Road, Pittsburgh, PA 15237, e-mail VDB@nauticom.net.
Karl Dennis has been the executive director of Kaleidoscope
Inc. in Chicago for the past 21 years. He is considered one of the countrys top
experts on community-based care and a pioneer of wraparound services, as well as one of
the national founders of intensive inhome family services and therapeutic foster care. He
has helped orchestrate state initiatives to return children from out-of-state placements
and has provided services to thousands of children and their families since 1973. He can
be reached at Kaleidoscope Inc., 1279 North Milwaukee, Suite 250, Chicago, IL 60622,
telephone (773) 278-7200 x297, fax (773) 278-0251.
to Journal Articles
|Reviews of Effective
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