Techniques for Helping Children Recover

Vol. 3, No. 1
April 1998

Techniques for Helping Children Recover

Every social worker knows the story: a boy who has been physically abused, lived in poverty all his life, and written off as a hopeless case by teachers, parents, and therapists somehow manages to succeed. He may not always be smiling, and he may deal with a great deal of pain, but eventually, through hard work, confidence, and a mysterious sense of hope, he becomes a mentally healthy adult, marries, and raises his children without the violence or pain he knew so well as a child.

Social workers also know that, unfortunately, such stories are all too rare. Many children survive abuse, poverty, poor nutrition, or a learning disability. However, when all of these risk factors, and more, are present, the chances are high that a child will grow up with serious mental or social problems. Surely, there must be something we can learn from the kids who beat the odds, something we can bring to our practice that will help more children overcome adversity.

The ability to recover from trauma, respond to stress, and maintain a sense of meaning, hope, and identity is called resiliency. Factors long associated with mental health seem to promote resiliency, and factors associated with behavioral difficulties, failure in school, and mental illness decrease the likelihood of a child being resilient. Of course, the children exposed to substance abuse, spousal abuse, poor nutrition, and other risk factors are the ones who most need to be resilient. Research into childhood resiliency has therefore concentrated largely on children at risk.

One of the pioneers of recent resiliency research is Michael Rutter. In 1987, he developed four techniques for promoting resiliency. No one is free from risk, but if these four techniques are used, the children we serve are more likely to cope positively and avoid more serious problems.

The four techniques Rutter outlined were: reduction of risk impact, reduction of negative chain reactions, establishment of self-esteem and self-efficacy, and opening up opportunities. These interventions are easy to remember and understand, but difficult to put into practice.

Reducing Risk Impact

Reducing risk impact may be the easiest intervention to envision and the hardest to accomplish. There are two ways to reduce risk. We can alter the risk itself, for example by providing an abusive parent with alternative means of discipline. Or we can alter the child's exposure to the risk, for example by working with families to improve supervision of children who are beginning to engage in antisocial behaviors like stealing or fighting.

Sometimes an indirect approach is best. For example, if one parent is overburdened and often yells at the children, the other parent can be encouraged to share more of the parental duties. One risk factor that seems simple to remedy is poor nutrition. However, families often eat poorly due to financial restrictions, and may find any criticism of their diet to be extremely offensive.

It is impossible to shelter children from all adversity. We often work with children who live in situations that are difficult to alter, for example, they may be poor or have parents who use drugs. Sometimes, risk factors truly cannot be altered, for example low birth-weight, past abuse, or serious medical conditions. Therefore, Rutter suggests some ways of mediating risk in the face of such adversities.

Reducing Negative Chain Reactions

Researchers generally agree about the existence of negative chain reactions, which occur when one event (e.g., suspension from school) cause negative effects in other, seemingly unconnected areas of life (e.g., arguments at home after the suspension lead the child to run away). Rutter points out that they play a crucial role in any long-term effects of exposure to risk factors. For example, the death of a parent is a tragic event in a small child's life, but it is not usually enough to cause serious psychological problems in the long run. However, if a child is institutionalized or not provided with a safe or affectionate caregiver, resilience is less likely.

When children are abused, they may be removed from the home quickly enough to prevent trauma. However, the pattern of abuse, even when it has ended, may cause them to adopt certain behaviors they feel necessary for survival, such as lying, avoiding physical contact, running away, or becoming violent when angry. Social workers can try to intervene before such patterns of behavior become set, thus enabling the child's natural resiliency to blossom.

The two above interventions—reducing risk impact and reducing negative chain reactions—require us to change the child's environment. However, changing environment is not always possible. Therefore, we want to know what kinds of personality traits will help a child survive serious adversity.

Promoting Self-Esteem and Self-Efficacy

Rutter found two traits that promote resilience: self-esteem (a sense of self-worth), and self-efficacy (a belief that one can "cope successfully with life's challenges"). This is, of course, easier said than done. However, research points to intimate relationships and the accomplishment of tasks as essential factors in promoting self-esteem and self-efficacy.

The most important relationship in early childhood is a secure attachment to a primary caregiver. Rutter's work tells us that, even in the face of massive obstacles such as poverty, poor education and nutrition, and mental illness, a secure relationship with a parent can enable a child to grow into a healthy adult. He also observes that succeeding at tasks—whether academic, artistic, athletic, occupational, or otherwise—helps build a positive self-concept and thus protects children from risk factors.

Providing Opportunities

Rutter's fourth and final technique for promoting resiliency is providing opportunities. Chances to receive academic tutoring, employment training, and positive social experiences serve two purposes. First, they give the child a skill, such as better reading, appropriate social interaction, or technical training. Second, they give the child a sense of hope for the future, and a sense that there is some meaning in life. Without the chance to grow and learn, a child has little incentive, and is less likely to be resilient. As social workers, we can make our clients and our clients' children aware of such opportunities and help them figure out which resources best suit their needs.

Reference

Rutter, Michael. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57(3), 316-331.