Adverse Childhood Experience Screening in the Primary Care Setting Part II: The Importance of Resilience 11/14/2019

In previous SmartCare Weekly editions, we reviewed the role resiliency-based interventions may play in a comprehensive pediatric Adverse Childhood Experiences (ACEs) screening campaign. According to Masten and Barnes, “Resilience is defined as the capacity of a system to adapt successfully to challenges that threaten the function, survival, or future development of the system.” (2018). Subsequently, “human resilience is common, dynamic, generated through myriad interactions of multiple systems from the biological to the sociocultural, and mutable given strategic targeting and timing”. Here, we will discuss the evidence supporting programs that leverage this approach and target resiliency in children and adolescents.

Parenting classes positively impact outcomes by “bolstering parenting resilience, focusing on the parent’s strengths, reducing parent stress levels, reducing acts of child maltreatment, and improving overall family functioning” (Bultas et al, 2017). They have been shown to be well attended when offered out of a primary care setting. There are a range of evidence supported methods of parenting classes, including Incredible Families, which is utilized locally at the Vista Hill ParentCare program. Nonetheless, larger scale studies are called for to evaluate the impact of parenting classes on child health outcomes.

A recent meta-analysis of school-based resiliency focused interventions showed positive outcomes (Dray et al, 2017). The study reviewed a range of programs that provided classes averaging 60 minutes per week over 5 to 32 weeks and targeted resilience protective factors such as cognitive competence, problem solving, cooperation and coping skills. These programs, implemented in different countries across the world, effectively decreased anxiety and general psychological distress for children, and decreased internalizing problems for adolescents.

Kinship Navigator Programs work to support grandparents taking care of children by connecting the caregivers with a broad array of services. Pandey and others found that a range of protective factors, including nurturing and attachment to the child could be enhanced by providing peer and case management support to caretakers (2019).

These are a few of the resiliency focused interventions that have been studied. Each of the analyses calls for more academic inquiry and at larger scale.

Bultas, M. W., McMillin, S. E., Broom, M. A., & Zand, D. H. (2017). Brief, Rapid Response, Parenting Interventions Within Primary Care Settings. Journal of Behavioral Health Services and Research, 44(4), 695–699.

Dray, J., Bowman, J., Campbell, E., Freund, M., Wolfenden, L., Hodder, R. K., … Wiggers, J. (2017). Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting. Journal of the American Academy of Child and Adolescent Psychiatry, 56(10), 813–824.

Masten, A., & Barnes, A. (2018). Resilience in Children: Developmental Perspectives. Children, 5(7), 98.

Pandey, A., Littlewood, K., Cooper, L., McCrae, J., Rosenthal, M., Day, A., & Hernandez, L. (2019). Connecting older grandmothers raising grandchildren with community resources improves family resiliency, social support, and caregiver self-efficacy. Journal of Women and Aging, 31(3), 269–283.







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