Promoting Well-Being: Strategies for Community Change

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Promoting Well-Being Strategies for Community
Change

• Dr. Isaac Prilleltensky
• Dean, School of Education
• University of Miami
• isaacp_at_miami.edu
• www.education.miami.edu/isaac

• Dr. Ora Prilleltensky
• Department of Educational and Psychological
  Studies
• University of Miami
• ora_at_miami.edu

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The Grameen Bank
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Overview of Presentation

• Well-Being
• Signs and Sources
• Personal
• Organizational
• Community
• Strategies
• SPEC approaches
• ROWS assessments
• I VALUE IT techniques

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Part I

• Signs and Sources
• of Well-Being

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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

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Research on Well-being

• There cannot be well-being but in the combined
  presence of personal, organizational and
  community well-being

organizational
W
personal
community
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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

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Risk of Death by Employmentand Level of Control
Marmot, Whitehall Studies
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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

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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

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Signs of Organizational Well-Being

• Efficient structures
• Clear roles
• Monitoring mechanisms
• Planning and accountability
• Growth opportunities
• Fulfillment of needs
• Identity and meaning
• Collaboration
• Democratic participation

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Signs of Organizational Well-BeingERA
Environments
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Signs of Organizational Well-BeingEffective
Environments

• Efficient
• Task-oriented
• Well-organized
• Accountable
• Responsible
• Communicate well
• Anticipate challenges
• Enabling structures
• Program evaluation

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Signs of Organizational Well-BeingReflective
Environments

• Learning opportunities
• Organizational learning
• Challenge old notions
• Take risks
• Ask big questions
• Promote innovation
• Stimulating

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Signs of Organizational Well-BeingAffective
Environments

• Climate of acceptance
• Appreciation
• Affirmation
• Respect
• Safe place
• Sense of control
• Conviviality
• Voice and choice

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Sources of Organizational Well-BeingValues,
interests, power (VIP)

• Competing tendencies within people and groups

Values
Power
Interests
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In every act, in every interaction, in every
social action, we hold each other accountable to
promote   Peoples 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
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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

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Sources of Community Well-being

• Poverty
• Power
• Participation

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Social capital and community well-being
Low SC LA, MS, GA Med SC CA, MO, OK Hi SC ND,
SD, VT, MN
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Male Life Expectancy by Inequality
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Life expectancy at age 15 - males
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Cake of Well-being
Easy temperament Physical health Adequate birth
weight
Good parenting Mutual Support Good mental health
Child
Parental Family
Child care Good schools Adequate
housing Cohesion Access to health care
Community
Employment Justice Safety nets Quality education
Societal
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Mountain of Risk
Poor temperament Poor health Birth weight
Teen parenting Family size Stressors Poor
parenting Addictions Poor mental health
Child
Parental Family
No child care Poor housing Lack of cohesion Crime
Community
Poverty Injustice Violence Discrimination
Societal
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Part II

• Strategies for Well-Being

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9/7/1854Removing the Handle
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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.

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Changing how we work The SPECS of Well-Being

• From
• Deficits-based
• Reactive
• Arrogance
• Individual blame

• To
• Strengths-based
• Primary Prevention
• Empowerment
• Community Change

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Strategies Time and Place
Collective
X
Reactive
Proactive
Individual
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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
Proactive
Reactive
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
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Too Little, Too Late
CONTINUUM OF SERVICES
Wellness Promotion
Treatment
Prevention
1
99
BUDGET ALLOCATION
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Prevention Saves Money
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Mismatch between spending and opportunity
Decline of brain flexibility
in young age
Increase of public spending
in old age
Age
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Strategies Abilities and Participation
Strengths
X
Detachment
Empowerment
Deficits
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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
Empowerment
Detachment
Quadrant III Examples Labeling and diagnosis,
patienthood and clienthood, citizens in
passive role
Quadrant II Examples Voice and choice in deficit
reduction approaches, participation in decisions
how to treat affective disorders or physical
disorders
Deficit
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ASSESSING FOR WELL-BEING

• Why do we need it?
• How do we do it?

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THIS IS NOT ALGEBRA, BUT

• B f(PE).

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Bronfenbrenners Ecological Theory

• Microsystem
• Mesosystem
• Exosystem
• Macrosystem

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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).

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TRADITIONAL ASSESSMENTS

• Minimize environmental barriers (Risks)
• Neglect environmental resources (Opportunities)
• Highlight personal deficits (Weaknesses)
• Underemphasize personal assets (Strengths)

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ROWS for Well-Being

• Risks
• Opportunities
• Weaknesses
• Strengths

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Strategies I VALUE IT

• I VALUE IT
• Inclusive host
• Visionary
• Asset seeker
• Listener and sense maker
• Unique solution finder
• Evaluator
• Implementer
• Trendsetter

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Strategies ABCs for Change Agents

• ABCs of Change
• Affective - what your feel
• Behavioral - what you do
• Cognitive - what you think

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Key Question

• How do you engage people -affectively,
  behaviorally, and cognitively-in the process of
  promoting SPEC?

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Strategies for Personal Change

• SPEC
• ROWS
• I VALUE IT
• Stages of Change

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The ABC of challenging interactions

• Client ABC
• Helper ABC

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STAGES OF CHANGE

• Pre-contemplation
• Contemplation
• Preparation
• Action
• Maintenance

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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

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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

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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

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ACTION

• Modification of behavior, experiences and/or
  environment 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

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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

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TERMINATION

• When there is no longer temptation to return to
  troubling behaviors
• Termination of treatment and termination of a
  problem are not coincidental

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IMPORTANT IMPLICATIONS

• Particular processes of change should be
  emphasized during particular stages of change.
• Knowing a clients 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

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I VALUE IT
Strategies/ABC AFFECTIVE BEHAVIORAL COGNITIVE
Inclusive host
Visionary
Asset seeker
Listener and sense maker
Unique solution finder
Evaluator
Implementer
Trendsetter
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The Case of Sister Margaret

• Personal well-Being
• Organizational Well-being
• Community Well-being

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Strategies for Organizational Change

• SPECS
• I VALUE IT
• ROWS

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New SPECs Three-year action research project
Oasis Center
Bethlehem Center
UNHS
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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

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Assessing the SPECiness of 166 programs
Strength-Based Programs
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Prevention vs. Treatment
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EmpowermentBy Number of Programs
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Changing Community ConditionsBy Number of
Programs
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Little funding for community change
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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
• Length and intensity of intervention
• Value-based partnerships

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Effect Sizes for Proactive and Reactive
Interventions on Family Outcomes at Post
Intervention and Follow-up
Source MacLeod Nelson (2000)
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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
  baseline-focal cohort comparison and a
  longitudinal comparison community design)

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Impacts on Child Maltreatment Number of Open
CAS Cases in Highfield Community over Time
Source Peters et al. (2002)
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Effect Sizes for Preschool Interventions on Child
and Family Outcomes at K-8 by Length and
Intensity of the Intervention for Children
Source Nelson, Westhues, MacLeod (2002)
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Effect Sizes for Intensive Family Preservation
Programs on Out of Home Placement Rates
Source MacLeod Nelson (2000)
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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

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Community Well-Being in Kerala
Personal Empowerment
Social Movements
Government Action
Processes
Community Wellness
Relational Wellness
Personal Wellness
Social support Sense of cohesion
Tenancy laws Nutrition in school Distribution
Of resources Land reform
Lower Infant mortality Higher Literacy Better
Nutrition Longer life expectancy
Outcomes
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Its like Venice..
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Venices 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)

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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