Running head: RESILIENCE THEORY 1

Resilience Theory:

A Strengths-Based Approach to Treatment

Sasha Gordon

University of Utah

PRT 6030

Dr. Matt Brownlee

December 10, 2016

RESILIENCE THEORY 2

Abstract

A recent shift within health and human services has seen the focus of treatment move to

strengths-based practices rather than on deficit reduction. Resilience theory supports this shift,

with its emphasis on how individuals are able to experience healthy development in spite of

exposure to risk. Years of research about resilience in children and adolescents have led to a

greater understanding of risk factors that lead to negative outcomes as well as protective factors

that can counteract the negative effects of risk exposure and lead to more positive outcomes.

Recreational therapy is one field that can benefit from an understanding of this theory, especially

as the profession begins to take a more strengths-based approach to treatment. Recreational

therapists can use the knowledge gained from research about resilience theory to develop

prevention and intervention programs that are designed to increase individual, family, and

community resources. The purpose of this review is to show how resilience theory can be useful

in developing a recreational therapy program for adolescents who suffer from depression.

Keywords: resilience, risk factors, protective factors, assets, resources

RESILIENCE THEORY 3

Introduction

In recent decades, a shift has taken place within health and human services, which has

largely moved the focus of treatment services away from deficit reduction to a focus on

strengths-based practices. This can be seen quite clearly in the positive psychology movement,

where increasing evidence shows that the most powerful ingredient common to effective

therapies may be the building of human strengths (Carruthers & Hood, 2007, p. 277). It can also

be seen within the field of recreational therapy with the development of the Leisure and Well-

Being Model, which is based on the notion that deficit reduction does not, in itself, lead towards

well-being. Rather, to increase ones well-being, it is necessary to cultivate and develop strengths

and abilities (Carruthers & Hood, 2007).

Resilience theory is one of many theories that support this shift to strengths-based

therapy and treatment. Zimmerman (2013) states that resilience theory provides a conceptual

framework for considering a strengths-based approach to understanding child and adolescent

development and informing intervention design (p. 381). Similarly, Zolkoski and Bullock

(2012) explain that this theory is focused on strengths rather than deficits, and attempts to

understand how some people experience healthy development despite exposure to risk and

trauma.

This literature review will begin by identifying some of the definitions of resilience that

have been provided in the literature in order to develop a working definition to be used within

the paper. This will be followed by a review of past and current research to identify the

implications of resilience theory for professionals working with individuals that have been

exposed to high levels of risk or trauma. In particular, it will focus on how resilience theory can
RESILIENCE THEORY 4

provide a framework for a strengths-based approach to recreational therapy treatment with

adolescents suffering from depression.

Defining Resilience

Throughout the literature, researchers have defined resilience in various ways. Some of

the definitions explain resilience as an outcome, while others view it as a process. The following

are some of the definitions that can be found in the literature:

The capability of individuals to cope successfully in the face of significant change,

adversity or risk. (Carp, 2010, p. 267).

Achieving positive outcomes despite challenging or threatening circumstances, coping

successfully with traumatic experiences, and avoiding negative paths linked with risks

(Zolkoski & Bullock, 2012, p. 2296).

A dynamic process involving an interaction between both risk and protective processes,

internal and external to the individual, that act to modify the effects of an adverse life

event (Olsson, Bond, Burns, Vella-Brodrick, & Sawyer, 2003, p. 2).

Successfully coping with or overcoming risk and adversity or the development of

competence in the face of severe stress and hardship (Doll & Lyon, 1998, p. 348).

The capacity of a dynamic system to adapt successfully to disturbances that threaten

system function, viability, or development (Masten, 2007, p. 923).

Despite there being many different definitions of resilience, there are similarities between

them that can be used to develop a working definition of this construct. For example, Werner

(1995) explained that the term is usually used to describe three things: achieving good

developmental outcomes in spite of exposure to risk or high-risk status, competence in the face

of stress, and the ability to recover from traumatic experiences. Rutter (2007) noted another
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similarity when he acknowledged that resilience should not be defined as an observed trait since

resilience in one outcome or circumstance does not guarantee resilience in others. Thus, for the

purpose of this paper, resilience will be defined as the ability to achieve healthy development and

positive outcomes in spite of exposure to risk, trauma, or stress.

History and Development of Resilience Theory

The study of resilience has deep roots in the field of medicine, and can also be traced to

studies in ecology, education, and psychology. Research on resilience within the behavioral

sciences began around 1970 (Zolkoski & Bullock, 2012). Since that time, much research has

been conducted to better understand resilience and why some people are able to experience

healthy development in spite of exposure to risk, trauma, and stress.

Historically, there have been three waves of research and development for this construct

of resilience. The first wave stemmed from researchers wanting to understand and prevent the

development of psychopathology. These early studies involved children who seemed to

experience relatively healthy development in spite of risky conditions. The main focus of

research during this first wave was risk factors. Patton (2013) explains that risk factors are

adverse circumstances or events which jeopardize a childs development and chances of

achieving good long-term outcomes (p. 649). Researchers were able to identify biological,

psychological, economic, and social factors that could hinder development. Some examples of

these factors include prenatal exposure to drugs, parental mental illness, and poverty (Aronowitz,

2005). Despite these advances, researchers began to realize that understanding risk factors was

not enough.

The second wave focused on identifying processes and factors associated with resilience.

Researchers began to identify and classify protective factors related to resilience, and that help
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explain why 50% to 70% of individuals faced with risk factors seemed to be able to overcome

that exposure to risk and experience healthy development (Patton, 2013). Protective factors are

the variables that modify the effects of risk exposure and lead to more positive outcomes (Luthar,

Lyman, & Crossman, 2014). Zimmerman et al. (2012) further explained protective factors by

dividing them into assets and resources. Assets are internal factors such as self-efficacy and

coping skills, while resources are external factors such as adult mentors and community

organizations that provide opportunities for engagement in positive activities. During this time

researchers also began to identify common themes among resilient individuals, and to better

understand the processes and systems associated with resilience (Zolkoski & Bullock, 2012).

Additionally, they found that individuals with many protective factors often experienced better

outcomes than those having only a few of them. They also began to realize that the presence of

some protective factors lead to the development of others (Eriksson, Cater, Andershed, &

Andershed, 2010). Once again, researchers recognized that understanding these protective

factors and processes was not enough. They needed to implement the things they were learning.

The third wave of research emerged due to a desire to help children growing up in the

face of these risk factors, and focused on how resilience could be promoted through prevention

and intervention programs (Zolkoski & Bullock, 2012). This research consisted largely of

experiments conducted to test the research findings regarding risk and protective factors directly.

Many of the researchers during this wave were professionals trained in clinical, community, and

educational psychology, and placed an emphasis on promoting competence and well-being

(Masten, 2007).

Masten (2007) also suggests that researchers are moving into a fourth wave of

development. This wave is characterized by resilience being defined as a systems construct,

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which refers to the capacity of dynamic systems to withstand or recover from significant

disturbances (Masten, 2007, p. 923). A large focus on this current research is that there may be

many more systems at play in developing resilience than just the individual and their

environment. Additionally, research has shifted to looking at how resilience is shaped by

interactions across multiple levels of analysis. Some of these include social, gene-environment,

person-media, and various other interactions (Masten, 2007). Although these ideas have been

theorized about for some time, the needed technologies were not available to test the ideas.

However, now that more technologies are available, Masten (2007) suggests that this fourth

wave of research has the potential to bring past theory and data gleaned from decades of earlier

work in the future through integrative studies across multiple levels of analysis (p. 927).

Resilience Theory in Research

According to Masten (2007), resilience theory was largely molded by the work of

pioneering researchers who set out to understand, prevent, and treat mental health problems

along with other threats to healthy development. Some of these researchers include Manfred

Bleuler, Michael Rutter, Norman Garmezy, and Emmy Werner (Zolkoski & Bullock, 2012). As

was the case with much of the first wave of research, many of these pioneering researchers

studied individuals in the face of risk and adversity, and tried to identify specific risk factors, as

well as resilience in spite of exposure to risk. Each of these individuals contributed to the

foundation of resilience theory as what it is today.

Manfred Bleuler began his studies on risk and resilience years before other researchers.

He conducted longitudinal studies of the families of individuals with schizophrenia. He reported

finding evidence of strength and health among these families in the midst of adversity (Zolkoski

& Bullock, 2012). His research led him to view schizophrenia in the context of predisposition,
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which Bleuler believed consisted of a disharmonious development of personality, which could

lead to an oversensitivity to stressors, to withdrawal, and even to schizophrenic symptoms

(Ernst & Angst, 1995, p. 609). In other words, he considered psychiatric disorders to be a result

of many etiologies, and believed it was dangerous to attribute a single cause to the development

of these disorders.

Michael Rutter conducted a series of studies called the Isle of Wight Studies that looked

at children faced with various risk factors such as low socioeconomic status, parental

delinquency, parental psychiatric disorders, and family or parental marital conflict. Rutter found

that the presence of a single stressor or risk factor did not have a significant effect on the

development of children. However, a combination of two or more of these factors lessened the

likelihood of positive developmental outcomes. Similarly, he found that the presence of

additional stressors increased the negative influence of others. Based on these findings, he

suggested that eliminating risk factors would greatly increase the possibility for positive

outcomes for these children (Zolkoski & Bullock, 2012).

Prior to the work of Norman Garmezy, much of the research was focused on areas of

vulnerability, and deficit-reduction. However, many say that his work on the development of

competence and resilience opened the door for a strengths-based approach, and understanding

protective factors that lead to resilience. In his early work, he attempted to understand the origins

of schizophrenia. However, through his studies on risk factors, he began to notice cases of

children that seemed to be doing well in spite of exposure to adversity. This led to a shift in his

research, as he recognized that understanding resilience might provide clues about how to

prevent mental illness and promote healthy development in adolescents. Garmezy founded the

Project Competence studies of risk and resilience. One of these studies followed Minnesota
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children into adulthood, and noted the importance of factors such as good parenting and

cognitive skills in developing resilience in children (Masten, Nuechterlein, & Wright, 2011).

Emmy Werners work also began to change the focus of research to understanding the

protective processes that make it possible for individuals to achieve competence in spite of risk

exposure. She followed a group of 660 individuals in Hawaii from birth to age 32 to look at the

outcomes of risk factors over time. About 30% of these children were considered high-risk

because they experienced four or more risk factors such as poverty, prenatal stress, family

discord, and parental mental illness. The findings from this longitudinal study found that one

third of these high-risk children overcome the odds and developed into competent adults

(Werner, 1995). She concluded, that in order to help vulnerable children become more resilient,

it is important to decrease their exposure to potential risk factors and increase their

competencies and self-esteem, as well as the sources of support they can draw upon (Werner,

1995, p. 84). As evidenced by this statement, research on resilience began to move towards a

strengths-based approach. She found that not only was it important to reduce exposure to risk,

but resilience could be encouraged by helping children and adolescents increase their strengths

and develop protective factors. Werners work, as well as that of other early researchers, helped

to lay the groundwork and foundation of resilience (Alvord & Grados, 2005).

Protective Factors

Following the work of these pioneering researchers and scientists, there was a large focus

on gaining a better understanding of protective factors and processes that can help individuals

overcome adversity and risk factors. Yates, Tyrell, and Masten (2015) explained, Fifty years of

resilience research converged on a set of core resources and protective processes that feature

prominently in individual, group, and structural competence in contexts of risk or adversity (p.
RESILIENCE THEORY 10

777). Researchers as early as Garmezy began to recognize that most protective factors fall into

three categories, what Garmezy called the triad of resiliency: personality disposition

(individual characteristics), a family support system, and the environment outside the family

(Richardson, 2002). In a broader categorization, other researchers have looked at internal and

external factors that lead to resilience. Zimmerman et al. (2012) defined these as assets (internal)

and resources (external). Assets are individual characteristics, while family and outside

environmental factors are external resources that lead to positive outcomes.

Internal protective factors. Eriksson et al. (2010) conducted a review of the literature

and identified several internal factors that have been found to influence positive outcomes. Some

of the factors on their list included positive temperament, effective problem solving, good coping

skills, internal locus of control, motivation, self-efficacy, positivity, emotional/self regulation,

and self-esteem. Within their review, they were able to cite several studies that have shown each

of these factors to be significant in healthy and resilient development. Similarly, Werners (1995)

Kauai Longitudinal Study found that resilient children have good communication and problem-

solving skills, are engaging to other people, and have high levels of self-efficacy.

Another study looked at the reciprocal relationships between beliefs of self-efficacy and

resiliency. The researchers found that not only does resilience predict the development of self-

efficacy, but it also works the other waypossessing self-efficacy was found to affect an

individuals ability to adapt and deal with difficult situations (Milioni et al., 2014).

Milioni and colleagues (2016) conducted a study to test the association between positivity

and resilience during the transition from adolescence to young adulthood. In their study, they

measured three dimensions of positivity against resilience. These dimensions were self-esteem,

life satisfaction, and optimism. They found that positivity was able to predict resilience over
RESILIENCE THEORY 11

time, and that there are strong associations between positivity and the ability to cope with

changing and demanding environments (Milioni, Alessandri, Eisenberg, & Caprara, 2016).

In an effort to understand factors that contribute to family resiliency, Benzies and

Mychasiuk (2009) identified several individual protective factors that contribute not only to

personal resilience, but also to resilient families. One of these was internal locus of control,

which is a persons belief that they have control and power to change their situation. One study

found that individuals with an internal locus of control were less affected by adversity, and felt

more empowered, which led them to put in the effort to make changes in their lives (Juby &

Rycraft, 2004). Another protective factor listed by Benzies & Mychasiuk was emotional

regulation. Findings show that children who are better able to regulate their emotions exhibit

cognitive and socio-emotional competence, as well as being able to form positive social

relationships (Alvord & Grados, 2005). Temperament was also listed as a protective factor,

meaning that children with easy or positive temperaments have been found to experience less

negative effects as a result of poor parenting (Benzies & Mychasiuk, 2009).

More recent research has begun to look at the connection between spirituality and

resilience. Religion and spiritual development have been identified as protective factors.

Findings suggest that religion can serve as a coping mechanism for managing and overcoming

adversity (Kim & Esquivel, 2011). Other researchers claim that not only do religion and

spirituality serve as protective factors that help reduce negative outcomes, but they can also serve

as assets that lead to positive outcomes (Kim & Esquivel, 2011). Studies have found that

spirituality is related to lower depression among adolescents, a lower likelihood of substance use,

and better academic achievement (Kim & Esquivel, 2011; Koenig, McCullough, & Larson,

2001; Wills, Yaeger, & Sandy, 2003; Park, 2001).

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External protective factors. Many studies show the importance of various external

resources that help build resilience. These external resources involve the family as well as the

community and environment outside of the family.

Several studies have shown the importance of parental support and monitoring in

overcoming risk factors. One example of this a longitudinal study done by Conger and Conger

(2002), which found that supportive and involved parenting led to positive adjustment, higher

self-confidence, and lower levels of antisocial behavior. Another example is the research

conducted by Eisman and colleagues (2015) who studied the effect of exposure to violence on

the risk of depression, and how family support may influence that risk. Their findings showed

that although exposure to violence was associated with higher levels of depression, having a

supportive mother was able to reduce the risk. Additionally, they found that having adult mentors

outside of the family was also able to lower the risk of experiencing depressive symptoms

(Eisman Stoddard, Heinze, Caldwell, & Zimmerman, 2015).

Werner (1995) found that resilient children usually have been able to establish a close

bond with at least one competent and stable adult. For some children, this was a parent, but for

others it was a teacher, coach, or other community member that became a role model and

supported these children through times of adversity and crisis. Similarly, Aronowitz (2005)

explained, Having a connected relationship with a caring, competent, and responsible adult has

been shown to decrease risk behaviors in adolescents (p. 206). In this study, Aronowitz looked

at how adults increased resilience in adolescents. Some specific behaviors adults engaged in to

foster resilience were modeling, monitoring, coaching, and countering stereotypes. Modeling

refers to exemplifying decision-making and problem solving skills, while monitoring means

being aware of their actions and setting limits to keep them safe. Coaching is when the adults are
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encouraging, supportive, and provided motivation. The adults instill a belief in the adolescents

about their own ability to succeed, and work with them to set and work toward goals. Countering

stereotypes refers to the way the adults refuse to buy into the many stereotypes about

adolescents, and encourage the adolescents to look past them as well (Aronowitz, 2005).

Many community factors beyond adult mentors have been identified as contributing to

the development of resilient adolescents. Some of these factors are community prevention and

intervention programs, support services, recreational facilities and programs, and accessibility to

adequate health services (Alvord & Grados, 2005). An example of this is in Fairfax County,

Virginia, where the Department of Community and Recreation Services created the Division of

Therapeutic Recreation and Teen Centers (TRTC). This center focuses on four components of

resilience in designing programs for teens: social competence, problem solving, autonomy, and

sense of purpose. Results of these programs indicated that these community programs led teens

to gain a greater sense of self-efficacy and build greater resilience (Ellis, Braff, & Hutchinson,

2001).

Other findings about protective factors. Eriksson et al. (2010) attempted to synthesize

what is currently known about protective factors. They identified additional information about

protective factors, and as well as what is still unknown. For example, they explained that

literature reviews show that possessing several protective factors generally leads to fewer

behavioral problems, but to a large extent, there is a lack of knowledge concerning whether there

might be especially favorable combinations of these factors that would lead to more positive

outcomes. Additionally, they acknowledged that protective factors act differently across different

ages and developmental stages. For example, some resources become more influential as time

goes on (such as those outside of the family), while others may become less influential
RESILIENCE THEORY 14

(Eriksson, et al., 2010). Similarly, the influence of various protective factors can depend on

different contexts and cultures. They determined that more information is needed to better

understand these differences.

Another important consideration that needs further research is related to the complexity

of protective factors. Not only are there some factors that protect youth from one type of

negative outcome and not others, but there also are some that have been identified as being both

protective and risk factors to the individual. More research is needed to understand these issues.

Eriksson et al. (2010) suggest that in order to find answers about these complexities, researchers

should not be satisfied with simply understanding what factors lead to resilience and positive

outcomes, but should also try to answer the questions of how and why they do so.

Models of Resilience

As greater understanding of protective factors and processes has been gained, models of

resilience have been developed and researched. Much of the literature on resilience theory

suggests that there are three basic models of resilience. These are the compensatory model,

protective factor model, and challenge model. Other sources suggest that there are additional

models that are extensions of the protective factor and challenge model (Fergus & Zimmerman,

2005). Each of these models provides an explanation of how protective factors interact with or

protect against negative outcomes in relation to risk factors in an individuals life. They have

been used to guide resilience research.

Compensatory model. Within this model, protective factors are believed to counteract,

or neutralize, exposure to risk. This means they have an opposite and independent effect on

development than exposure to risk (Zimmerman, 2013). An example of resilience within this

model is a study whose findings showed that parental support had a compensatory effect for risks
RESILIENCE THEORY 15

associated with violence and fighting. In other words, when adolescent children had strong

parental support, it predicted less violent behavior, even when exposed to fighting and violent

behavior (Zimmerman, Steinman, & Rowe, 1998). Another example is that youth living in

poverty are more likely to participate in violent behavior than those not living in poverty.

However, when these youth have parent support or some type of adult monitoring their behavior,

it can compensate for the negative effects of poverty (Fergus & Zimmerman, 2005).

Protective factor model. This model suggests that assets and resources modify or reduce

the effects of risk factors or negative outcomes. This means that protective factors interact with

risk factors in a way that can reduce the likelihood of a negative outcome (Zolkoski & Bullock,

2012). An example of this is the finding that high levels of parental support (protective factor)

can reduce the relationship between poverty (risk factor) and violent behavior (negative

outcome). The protective factor modifies the effect of poverty on the adolescents behavior

(Fergus & Zimmerman, 2005).

Some researchers have suggested three branches of protective factor models: protective-

stabilizing, protective-reactive, and protective-protective. The protective-stabilizing model refers

to times when the protective factor serves to neutralize the effects of risk exposure. When the

protective factor is absent, higher levels of risk lead to higher levels of a negative outcome.

However, when it is present, there is no relationship between the risk and outcome (Zolkoski &

Bullock, 2012). An example of this, is when youth experience the risk factor of no parental

support, those without the protective factor of an adult mentor may engage in delinquent

behaviors, while those with an adult mentor may not (Zimmerman, 2013).

In a protective-reactive model, the presence of a protective factor weakens, but does not

completely remove the relationship between a risk and an outcome. When the protective factor is
RESILIENCE THEORY 16

absent, the correlation between the risk and the outcome is higher than when it is present

(Zimmerman, 2013). An example of this model is that youth who abuse drugs (risk factor), are

more likely to engage in risky sexual behaviors (negative outcome). However, this correlation

may be lessened when these youth are exposed to comprehensive sexual education (protective

factor) in their schools (Zolkoski & Bullock, 2012).

The protective-protective model proposes that the presence of a protective factor can

serve to enhance the effects of another protective factor. An example of this is that parental

support may increase the positive effects of academic competence, and lead to more positive

outcomes than either factor would on its own. However, in order for this to be considered a

resilience model, it needs to be studied in the presence of risk factors (Zimmerman, 2013).

Challenge model. This model suggests that exposure to moderate levels of a stressor or

risk factor can lead to higher levels of competence. There is a fine balance within this model,

where the exposure need to be challenging enough to help the youth develop the necessary

coping skills, but not too challenging that it leads to negative outcomes and the inability to cope

(Zimmerman, 2013). The main idea is that moderate levels of exposure can be beneficial because

it provides the youth with a chance to practice skills and develop resources that can be used in

subsequent exposures to risk. An example of this is when moderate levels of interpersonal

conflict are experienced and resolved successfully, it can teach adolescents skills for dealing with

social tensions without violent behavior. This can help them avoid experiences such as gang

fights as a result of social tensions with others (Zimmerman, 2013).

Another type of challenge model is the inoculation model. This suggests that repeated

exposure to low levels of risk or stressors inoculate youth so that they can overcome more

significant risks in the future (Fergus & Zimmerman, 2005). It is similar to the challenge model,
RESILIENCE THEORY 17

but takes a more longitudinal, or ongoing developmental view on exposure to adversity. As

youth grow and mature, and are able to deal with increasing levels of risk, they become more

able to thrive in the face of risk exposure.

Application to Practice

Resilience theory sets a framework for taking a strengths-based approach to treatment

and therapy. Recreational therapy is one field that is moving towards a strengths-based approach.

Several models have been developed within this field to guide therapists in delivering treatment

services. One of these, the Leisure and Well-Being Model (see Figure 1), is based on the

recognition that solving problems does not automatically result in increased well-being. Rather,

it is necessary to develop resources and have positive experiences (Carruthers & Hood, 2007).

Well-being is identified as the distal goal within this model, and is defined as a state of

successful, satisfying, and productive engagement with ones life and the realization of ones full

physical, cognitive, and social-emotional potential (p. 280). While the authors recognize that

there are many dimensions that influence well-being, the two that are the main focus of

recreational therapy services are (a) increasing positive emotions and experiences on a daily

basis, and (b) cultivating ones full potential, strengths, and assets (Carruthers & Hood, 2007).

To accomplish these dimensions of well-being, the model incorporates two main

mechanisms within TR service delivery, which are enhancing leisure experiences and developing

resources. Resources are defined as the internal and external assets, strengths, and context upon

which one can draw in order to create a satisfying, enjoyable and productive life (Carruthers &

Hood, 2007, p. 288). The model suggests that these resources can be developed through positive

leisure experiences.
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Using a combination of resilience theory and the Leisure and Well-Being Model as a

guide, recreational therapists can design intervention and prevention programs that support the

development of the internal and environmental resources that are essential to well-being

(Carruthers & Hood, 2007, p. 287), Within this framework, the focus is no longer on risk

amelioration, but on helping adolescents develop resources that will help them when they are

exposed to risk, trauma, or stress (Zolkoski & Bullock, 2012).

Figure 1: The Leisure and Well-Being Model. (Carruthers & Hood, 2007).
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There are various ways knowledge gained from resilience theory can be used to support

professionals, including recreational therapists, in helping clients achieve well-being. For

example, Yates, Tyrell, and Masten (2015) explained, Comparable lists of promotive and

protective factors that can be developed for families, schools, communities, or nations to guide

practical efforts to improve the odds of successful adaptation (p. 777). The Leisure and Well-

Being Model has done this to some extent with the section on developing resources. The authors

reviewed the literature and determined that recreational therapists can help clients develop

psychological, social, cognitive, physical, and environmental resources. The model identifies

some of the more commonly recognized protective factors that have been shown to lead to

resilience and well-being (Hood & Carruthers, 2007).

Other researchers have also compiled lists of protective factors that can be used by

professional, families, schools, and communities. One specific example of this is the work done

by Wolin and Wolin, who are a husband and wife that have both done research on resilience in

their respective fields. Their research led to the development of Project Resilience, which is a

private organization that provides resources and training for professionals working with youth

and adults that are struggling to overcome hardships and trauma. Project Resilience is a

strengths-based approach to treatment and prevention (Wolin & Wolin, 1999). Within their

research, they found that survivors of trauma and adversity have certain strengths. They

categorized these strengths and established the Seven Resiliencies Model (see Figure 2). The

seven categories of strengths are insight, independence, relationship, initiative, humor, creativity,

and morality. The following is an explanation of each of these strengths (Wolin & Wolin, 1993):

Insight: the ability to ask difficult questions and give honest answers.
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Independence: being able to draw boundaries and keep emotional and physical

distance from sources of trouble in ones life.

Relationships: making fulfilling connections with others in a way that balances the

ability to meet your own needs while also giving to others.

Initiative: taking charge of ones own problems.

Creativity: using imagination and expressing oneself in creative ways.

Humor: being able to find the comic in difficult or tragic experiences.

Morality: acting on an informed conscience for the good of oneself and all

humankind.

Figure 2: The Seven Resiliencies. (Wolin & Wolin, 1999).

Additionally, they have expanded this to show three phases of developing these strengths

through childhood, adolescence, and adulthood (see Figure 3). Each circle of the diagram shows

one of these phases, with the one closest to the center representing childhood, adolescence in the

middle ring, and adulthood on the circle closest to the strength. This information can be helpful
RESILIENCE THEORY 21

in planning and implementing both treatment and prevention programs. It is helpful for

professionals not only to understand these developmental phases, but also to think about how

treatment can encourage the development of these strengths.

Figure 3: Phases of the Seven Resiliencies. (Wolin & Wolin, 1999).

Recreational therapists can use this information when planning and implementing

programs working with children, adolescents, and adults. They can plan interventions that

encourage the development of each of these strengths, based on the specific needs of their

clients. Understanding the phases of development for each strength can help therapists identify

where work needs to be done in developing these strengths for each client.

Another example is the work of Alvord and Grados (2005), who researched protective

factors and how to enhance resilience in children. In synthesizing their research, they identified

eight implications about how their findings can be used in clinical interventions. They suggest

that professionals should teach problem-solving skills, encourage children to express their

feelings, help children and families identify strengths and positive experiences, guide parents and
RESILIENCE THEORY 22

teachers in fostering self-esteem in children, teach optimistic thinking and perspective taking,

teach cognitive strategies for coping, and teach relaxation and self-control techniques. These

suggestions are all based on their findings about which protective factors can enhance resilience.

Other researchers have identified different approaches to facilitating competence in spite

of adversity. Yates, Tyrell, and Masten (2015) explained three different approaches that could be

used as three different lines of defense. The first is risk-focused techniques, which is primarily a

prevention approach that attempts to improve outcomes by reducing risks that are identifiable

and avoidable. The second line of defense is resource-focused techniques, which aim to improve

and develop resources and assets that can counteract risks. The third approach is process-focused

techniques, which seek to protect, activate, or restore basic adaptive systems that support

development (p. 778). Determining which process to use will depend on the purpose of the

program, as well as the needs and goals of individual clients. Additionally, a combination of

these approaches could be used to provide a stronger system of protective factors.

Finally, just as protective factors have been identified as individual characteristics, family

support, and environmental resources, recreational therapists can work with clients in each of

these areas through prevention and intervention efforts. They can establish programs that help

clients develop internal skills and assets such as self-esteem, problem-solving, coping skills, and

emotional regulation. They can provide family therapy programs that encourage and strengthen

family and parental relationships in a hope to increase resilience. Similarly, they can help the

clients integrate into the community and find resources that can benefit them in times of stress,

risk, and trauma. A combination of these would hopefully lead to more resilient and positive

outcomes, and more competent individuals who experience higher levels of well-being.
RESILIENCE THEORY 23

Resilience Theory with Adolescents with Depression

Resilience theory can be used to guide the development of a recreational therapy program

for adolescents in treatment for depression. Depression is widely considered a risk factor that

could lead to negative outcomes such as poor academic achievement, poor health, lack of social

relationships, other psychological disorders, and suicidal ideation. Additionally, depression is

often experienced in conjunction with other risk factors such as trauma or abuse, stress, and

poverty, all of which can increase the negative effects associated with depression (American

Psychiatric Association, 2003).

Adolescents with depression often have problems related to emotional regulation,

lowered self-esteem and self-efficacy, social withdrawal, lack of problem solving skills,

difficulty making decisions, limited locus of control, negative thinking, and difficulty

maintaining a healthy and balanced lifestyle (American Psychiatric Association, 2003). Research

of resilience has found evidence suggesting important protective factors relating to each of these

problems identified in adolescents with depression. An important role for the recreational

therapist working with these individuals would be to help them develop protective factors to

overcome the problems they are facing with their depression and any other risk factors they

might be exposed to.

In developing a recreational therapy program at a facility treating adolescents with

depression, a recreational therapist might consider including programs such as emotion

regulation, self-esteem training, coping skills, the power of positivity, social skills training, stress

management, problem solving, decision making, and healthy living. Although this is not a

comprehensive list, each of these programs could serve to develop strengths and resources that

would help adolescents cope with their depression and other stressors, and still experience
RESILIENCE THEORY 24

positive outcomes such as well-being. Essentially, it would be important for the recreational

therapist to assess the client to determine what strengths and assets they already have, as well as

which ones could be further developed. Using the Leisure and Well-Being Model as a guide for

service delivery, the recreational therapist could use the information gained from assessing the

client in combination with information from resilience theory to provide opportunities for the

adolescents to develop individual, family, and community resources.

Some of the desired outcomes for this program would be helping adolescents identify and

implement strategies for regulating their emotions, use positive thinking techniques, identify a

positive support system and find ways to improve their relationships, demonstrate coping skills

to manage stress, find strategies for making decisions, and make goals for living a healthy and

balanced life. The hope is that by helping them develop these protective factors, they will be able

to leave treatment more prepared to cope with and overcome the challenges they are faced with

in their lives.

Conclusion

All too often, in research and popular culture, there is a tendency to focus on what is

wrong with people, rather than on their strengths and abilities. Resilience theory provides a

framework to view individuals in light of their current strengths, and helps professionals find

ways to help their clients increase and develop other strengths that will help them cope and

succeed in spite of adversity. By understanding protective factors and processes that lead to

resilience, professionals, including recreational therapists, can support children, adolescents, and

adults in developing assets and resources that will benefit them and lead to more positive

outcomes in their lives. Knowledge of resilience can lead to the development of strengths-based

programs that promote competence in individuals even in the face of risk and adversity.
RESILIENCE THEORY 25

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