Resilience Builder Program: Author Spotlight

Resilience Builder Program: Author Spotlight
Rsilience Builder Program for Children and Adolescents

Dr. Mary Karapetian Alvord, author of Resilience Builder Program for Children and Adolescents: Enhancing Social Competence and Self-Regulation, discusses her book in an extensive interview detailing the practical and accessible components of RBP designed for counseling professionals working with children and adolescents.


What is the Resilience Builder Program®?

The Resilience Builder Program® (RBP) is a cognitive behavioral group therapy program for youth in grades 3 through 8. Adaptable for both younger and older youth, the curriculum promotes resilience and social competence by teaching skills and protective factors associated with resilience. The program is flexible and customizable. It includes 12 to 15 sessions per unit, allowing the leader to choose those sessions relevant to the needs of the members and the setting in which the groups are held. The program focuses on skills that encompass resilience and are transdiagnostic, meaning that they can be applied to a number of psychological and adjustment difficulties. The RBP has five components, including interactive-didactic (discussing and practicing the social and resilience skills of the day), free play/behavioral rehearsal (play situation for real-life skills practice), relaxation and self-regulation, generalization, and parental involvement.

Is resilience a teachable skill?

Yes! The RBP is a strength-based approach rather than a deficit model. It focuses on building skills and what kids and teens already do well, as well as those skills they need to develop, expand, and practice. We start with the definition provided by Masten, Best, and Garmezy (1990) that resilience is a dynamic process and involves a successful outcome to adversity and challenges. Alvord and Grados (2005) expanded the definition of challenges to include not only trauma and adversity but also psychological challenges such as AD/HD and learning disabilities. Resilience results in better coping and self-control, which in turn has significant positive trajectories for success in numerous aspects of life (for example, school, work, finances, relationships).

The factors that make up resilience include a proactive orientation to life; the ability to regulate one’s attention, emotions, and behavior; social relationships; development of special talents; a strong community; and proactive parenting (Alvord & Grados, 2005). And the literature supports the notion that these skills can be developed and improved over time, therefore allowing the child to be successful and even thrive in numerous domains.

How did you develop this program?

I developed the program in the early 1990s after working with children adopted from Eastern Europe. Many of the children adapted well after experiencing trauma, and I became intrigued with the skills they possessed that helped them be resilient and explored the research literature. For those who were struggling, and for other children who had difficulty with social relationships and self-regulation, I designed a program in my private practice to incorporate the protective factors that promote resilience and that can be learned. Clinicians in the practice contributed to improvements over time, and Drs. Zucker and Grados were coauthors of the book.

In what ways does your program differ from social skills programs?

Great question. Our focus is on social competence rather than simply skill building. By that I mean we focus on youths’ learning the skills, practicing them, teaching the skills to their parents, and then generalizing outside of the group. Weekly assignments ensure practicing skills outside of group to change behaviors/change habits. By developing broader resilience skills and competencies, we promote a more comprehensive approach to social competence, including a focus on self-regulation. Also, we know that experiencing and overcoming stressful circumstances can actually promote resilience (Rutter, 2006). In RBP, children have the opportunity to practice their skills through coping with potentially stressful situations with a peer group. Examples can include a socially anxious child role-playing in front of peers or two group members working through a conflict over which game to play. Thus, not only do group members have the opportunity to practice important skills, they also learn that they can overcome their fears and limitations. Perhaps most important, the RBP emphasizes skills generalization to promote lasting acquisition of skills. For instance, participants have at least one real-world practice during the semester (e.g., to a bowling alley). Continual contact with parents is also important in helping the learned skills be facilitated and implemented at home. Parents are included as partners. They receive a letter each week outlining the topic covered with suggestions for applying the skills at home.

In addition, the group program has now been implemented within a clinical setting since 1992. It has accounted for a major growth of the practice due to demand by schools and parents. Thus, this program was developed in a clinical setting by clinicians. We hope to have developed not only an evidence-based, effective protocol, but one that addresses the practicalities of implementation in a clinical setting. For instance, we are realistic in our inclusion of two semesters of attendance, which we know to be important in the maintenance of gains. In order to further promote the transportability of the RBP, research efforts to adapt and implement the RBP into school settings are ongoing.

What evidence do you have that the Resilience Builder Program® works?

Since 2009, we have collaborated with Dr. Brendan Rich of the Catholic University of America on a series of studies of the effectiveness of RBP. We have a research team at Alvord, Baker as well, including Dr. Lisa Berghorst, Dr. Colleen Cummings, and Dr. Nina Shiffrin, plus a dedicated research assistant, Lindsay Myerberg. The Group Foundation for Advancing Mental Health has provided us with a small grant for our research in schools. In youth with anxiety disorders, RBP resulted in significant improvement in teacher report of social functioning; parent, teacher and child report of improved positive emotions, emotion regulation, and reduced depressive symptoms; and parent report of improved family functioning (Watson et al., 2014). In youth with autism, we found that following RBP, parents endorsed improvement in their children’s social skills and affective functioning and children endorsed less negative emotion and increased emotion regulation (Aduen et al., 2014). Finally, in a large sample of youth with prominent deficits across psychosocial domains, we documented significant improvement in overall resilience and in such subdomains as relatedness, trust, and self-efficacy (Alvord et al., 2014). Overall, our results find that across informants (parent, teacher, child), settings (home, school, with peers), and types of impairment (AD/HD, anxiety, autism), RBP significantly improves functioning in multiple emotional, behavioral, social, and family domains.

How is this program best used by practitioners?

The curriculum is written in a detailed manner, with concrete examples, and includes a CD with letters to parents and assignments for all lessons. As long as practitioners stay true to its overarching evidence-based principles, practitioners can tailor the techniques to fit their specific setting and population. For instance, skills can be explained in a more concrete manner to meet the needs of young children or those with an autism spectrum diagnosis, and adolescent groups can include more group discussion (rather than free play). Similarly, the program can be implemented in clinical and academic settings, as well as in schools, hospitals, and a variety of other places. The program is designed for weekly hour-long sessions in small groups with generalization practice in between. In school settings, the curriculum is often adapted to run in 30-minute segments.

What populations would the Resilience Builder Program® best serve?

Children who demonstrate skill deficits in the areas of emotional regulation and social competence would be a good fit for the groups. Fortunately, the Resilience Builder Program® can serve a range of diagnoses, including AD/HD, anxiety, and mild autism spectrum disorders, although meeting full diagnostic criteria for one of these disorders is not necessary. Given that resilience is a protective factor, the group can be helpful both as a preventive approach for subclinical symptoms and as an intervention for more impaired children.

REFERENCES

Aduen, P., Rich, B. A., Sanchez, L., O’Brien, K., & Alvord, M. K. (2014). Resilience Builder Therapy program addresses core social deficits in high functioning ASD youth. Journal of Psychological Abnormalities in Children, 3(2), 1–10.

Alvord, M. K., & Grados, J. J. (2005). Enhancing resilience in children: A proactive approach. Professional Psychology: Research and Practice, 36, 238–245.

Alvord, M. A, Rich, B. A., & Berghorst, L. (2014). Developing social competence through a resilience model. In S. Prince-Embury & D. H. Saklofske (Eds.). Resilience interventions for youth in diverse populations (pp. 329–351). New York: Springer.

Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2(4), 425–444.

Rutter, M. (2006). Implications of resilience concepts for scientific understanding. Annals of the New York Academy of Sciences, 1094, 1–12.

Watson, C., Rich, B. A., Sanchez, L., O’Brien, K., & Alvord, M. K. (2014).  Preliminary study of resilience-based group therapy for improving the functioning of anxious children.  Child and Youth Care Forum, 43, 269–286.


For additional information about author Dr. Mary Karapetian Alvord, visit her author page.