As a full disclosure, I have had this write-up on my to-do list for about two months. I found myself rewriting the whole thing several times and frequently had to walk away for a day or a week as current events continue to unfold in the world around us - as well as in my direct “Self-Sphere of Influence.” Words may not be able to accomplish the same as direct action, but does sharing words count as direct action? Hopefully, this brief overview of “Resilience” can help at least one or two folks identify new resources & strategies to stay strong, stay healthy, and keep doing good things.
The Importance of Resilience
Resilience is important for health care providers to understand to fully support clients, our teams, and ourselves.
Resilience is a key area to target in supporting patients, clients, and communities. It strengthens relationships as an ally and advocate.
What is Resilience?
The report “Cultural Responsiveness, Racial Identity and Academic Success: A Review of Literature,” defines Resilience as “the conscious need to bounce back from disappointment and disaster and to have tools of humor and joy to renew life’s energy.” (Article prepared for The Heinz Endowments, June 2009).
Resilience was identified as a core component of the European World Health Organization (WHO) policy framework, “Strengthening Resilience: A Priority Shared by Health 2020 and the Sustainable Development Goals,” which highlights three main levels of resilience -
1. Individual Level Resilience
“The American Psychological Association defines individual-level resilience as the process of adapting well in the face of adversity, trauma, tragedy and threats. It also includes coping with significant stress caused by problematic and toxic relationships in the family or at the workplace and the capacity to bounce back from difficult experiences."
2. Community Level Resilience
Community level resilience is … the ability of social groups to withstand and recover from unfavorable circumstances.
3. Systems Level Resilience
From page 5 of the article, “system resilience is defined as the capacity of a system to absorb, adapt, anticipate and transform when exposed to external threats - and/or to forecast shocks that bring about new challenges and opportunities – and still retain control over its remit and pursuit of its primary objectives and functions.”
(Link to article: https://bit.ly/300sL6i).
It seems like all three of these levels of resilience are currently being tested simultaneously. It is important to remain resilient at the individual level, as well as collectively and within our communities to persevere in strengthening resiliency at the systems level.
Times are stressful. Collectively, we are witnesses to and active participants of many significant events. There are events outside of our locus of control, and collectively, we are trying to understand what our immediate day to day looks like while learning what we can and cannot control. Personally, I have been amazed, inspired, and honestly, overwhelmed by the amount of outstanding resources, adaptations, and overall ingenuity expressed by so many colleagues, communities, and professionals during the past few months.
There is one specific quote which has stuck with the most throughout all the presentations, webinars, and online meetings I have attended since February. A facilitator for a webinar on Autism Observation & Telehealth said,
“Families are still getting new diagnoses every day during this pandemic.”
It is a simple line – one short sentence yet powerful enough to frame current events. I think about this quote in context of the Black Lives Matter movement and persons with disabilities. There are links at the end of this entry to several significant recent cases of force used against, and even killing, individuals with disabilities. For example, the infamous incident in Miami in 2016 when a health care worker was shot by police when trying to work with his client/patient. Now think of a family who has a child with a complex disability and are also considered a minority demographic. Resiliency needs to be a point of emphasis in health care service delivery with so many intrinsic and extrinsic factors which can affect outcomes for clients and patients.
So, what can educators, allies, health care providers offer with with so much at stake for our neighbors, friends, patients, coworkers, families? First and foremost, we can actively listen. Active listening supports engagement and building cultural competence. Underlying this process is an understanding a family may not be able to prioritize a health provider’s recommendations over basic needs and security.
One concrete step is to learn skills to help clients/patients work with stress, trauma, disaster, loss, and disappointment. Resilience is not only a key area to target for clients and patients, but for oneself and community as well.
The State of Wisconsin Department of Human Services launched a plan during the Covid-19 epidemic called Resilient Wisconsin. The website contains many excellent resources including tips for individuals in challenging situations. This tool is regularly updated and is a valuable resource as we unite to stay resilient, support all our communities, and support one another’s total health - physically, mentally, and emotionally.
Resilience in Leadership
Building capacity and skills for Resilience is a critical component of health care service delivery. It is also an important tool for health care practitioners and leaders. Resilience is so important to leadership development and growth, the Maternal and Child Health Bureau (MCH) lists it as necessary to demonstrate competency in the area of “Self-Reflection.” (Source: mchb.hrsa.gov)
The conceptual framework for the MCH Leadership Competencies emphasizes developing spheres of influence which start with “SELF,” then extends to “OTHERS” (e.g., colleagues, patients), and ultimately extends to the “WIDER COMMUNITY.” Building one’s personal resilience will build a strong foundation for interprofessional impact first through ripples, then waves.
What can you do to support Building Resilience in yourself and others?
The Resilient Wisconsin campaign lists these seven strategies:
Prioritize healthy relationships
Take care of your body (mind and soul too!)
Avoid negative outlets
Practice self-awareness (see the paragraph on Resilience in Leadership for more info)
Learn from the past
Ask for help when you need it
Visit the campaign’s website for additional resources and strategies at https://www.dhs.wisconsin.gov/resilient/understanding-resilience.htm.
An excellent book for health care professionals which discusses issues of risk and resilience is "Understanding Families – Approaches to Diversity, Disability, and Risk" by Dr. Marci J. Hanson and Dr. Eleanor W. Lynch. (https://www.amazon.com/Understanding-Families-Supportive-Approaches-Disability/dp/1598572156)
Here are some links for additional resources on Resilience:
Here is a book available on Amazon from the director and co-founder of the Trauma Resource Institute (Elaine Miller-Karas): https://www.amazon.com/Building-Resilience-Trauma-Community-Resiliency/dp/0415820588
Community Resiliency Model by Elaine Miller-Karas (Link to PDF)
MCH Conceptual Framework: (https://mchb.hrsa.gov/training/leadership-00.asp)
The Heinz Endowments Report (link to PDF copy): http://www.heinz.org/userfiles/library/culture-report_final.pdf
World Health Organization, “Strengthening resilience: a priority shared by Health 2020 and the Sustainable Development Goals,” link to the website and PDF: https://bit.ly/300sL6i
Resilient Wisconsin: https://www.dhs.wisconsin.gov/resilient/index.htm.
Additional links and news reports:
No justice, no peace, no rest.
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