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cases

cases. Jeffrey as case: didn’t testify Girl on chair as case: her behavior makes sense Do the mirrors game…for atypical part YAP Angel’s Nest PYC…integrated, homeless shelter and women’s shelter in same place in SA IWK and case reviews: assess, but discontinuity in treatment

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cases

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  1. cases • Jeffrey as case: didn’t testify • Girl on chair as case: her behavior makes sense • Do the mirrors game…for atypical part • YAP • Angel’s Nest • PYC…integrated, homeless shelter and women’s shelter in same place in SA • IWK and case reviews: assess, but discontinuity in treatment • Disclosure and kids rehearsals…mandatory reporting can be bad too • Pathways to education • Mothers and treatment for addictions in India • Boy and gun video

  2. Principle 1: Decentrality • Nurture trumps nature • Clinical and Community Practice: • Changing the environment changes individual biology, cognitions and behaviour • Coordination of services and service providers makes client navigation seamless • Continuity of care means fewer providers over time working together to address treatment goals • Continuum of interventions provides a range of options from less to more intrusive

  3. Principle 2: Complexity • Multi-systemic; many good means to many good ends (equifinality) • Clinical and Community Practice: • Different environments affect individuals differently in different contexts over time (differential impact) • Earlier is always better, but it’s never too late developmentally to intervene • Social and historical forces will influence intervention design, implementation and success • Advocacy ensures services are available and accessible

  4. Principle 3: Atypicality • There is no “right” way to cope in challenging contexts—equifinality and multifinality • Clinical and Community Practice: • Negotiating with institutions increases availability and accessibility of resources that are meaningful (mirroring) • Deconstruct the cultural and contextual bias of the one “helping” • Find the evidence to show that individual and group coping strategies are effective

  5. Principle 4: Sensitivity (to context and culture) • Match, or resist, cultural and contextual norms • Clinical and Community Practice: • Inquire about people’s own solutions to the challenges they face • Explore “sameness” and “difference” within and between populations • Search for the intersectionality of multiple forms of oppression and sources of liberation • Demonstrate transparency with regard to the process of the intervention

  6. Resilience after Abuse: How Services and Supports Help Children Recover and Grow Michael Ungar, Ph.D. Killam Professor, School of Social Work, Dalhousie University Twitter @MichaelUngarPhD www.michaelungar.com www.resilienceresearch.org

  7. High Well-being Low “Disorder” High “Disorder” Low Well-being

  8. Resilience is… • In the context of exposure to significant adversity • resilience is the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well being, and… • their capacity individually and in groups to negotiate for these resources to be provided… • in culturally meaningful ways.

  9. Five things we know about Resilience: • Nurture trumps nature • But…The challenge is to know which protective factor is best suited to which type of abuse experience for which child in which context.

  10. Five things we know about Resilience: • Nurture trumps nature • Differential impact of strengths under stress

  11. Five things we know about Resilience: • Nurture trumps nature • Differential impact of strengths under stress • Resilience is cumulative

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

  13. Five things we know about Resilience: • Nurture trumps nature • Differential impact of strengths under stress • Resilience is cumulative • Context and culture influence what matters most

  14. Five things we know about Resilience: • Nurture trumps nature • Differential impact of strengths under stress • Resilience is cumulative • Context and culture influence what matters most • Long-term, not all adaptations are advantageous

  15. Who decides what kind of service use is most helpful?

  16. -.03 -.21* .53* .18* -.14 .13 Contextual Risk Individual Risk Service Use Experience .33* -.38* -.17* .07 -.30* Resilience .37* Functional Outcomes Life time Service Use Accumulation

  17. Service Use Experience .33* Resilience .37* Functional Outcomes

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

  19. Five patterns of service provider—caregiver—YPCN (Young Person with Complex Needs) interaction 2. System Responsibility 1. Family Empowerment YPCN YPCN Service Provider Service Provider Caregiver Caregiver 3. Conflicted Caregivers 4. Seeking an Alliance 5. Responsibilization YPCN YPCN YPCN Service Provider Service Provider Service Provider Caregiver Caregiver Caregiver Weak Relationship Conflicted Relationship Supportive Relationship

  20. Meta-principles and practice implications • Decentrality • Complexity • Atypicality • Sensitivity (to context and culture)

  21. What we’ve learned • The children who receive the most treatment are those who show the most individual problems • Children from more disadvantaged contexts do not receive more services • Children from more disadvantaged contexts are less satisfied with the services they do receive

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