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Part I:
Status of Research

Protective Processes Within Families

The development of resiliency is none other than a process of healthy human development that is contingent upon creating climates of caring, high expectations,and participation for our kids.

-Bonnie Benard(1992)

The resilience model holds that, as is the case with individuals, all families have "self-righting tendencies" that can flourish given an adequately facilitating environment. A critical problem that has emerged in the U.S. as the discrepancy between the haves and have-nots has grown wider is that the economic burden on the have-nots has increased to the point that many parents have little time or energy to attend to family life. The limited availability of educational, cultural, and economic resources and the accumulation of acute and chronic stressors that wear down people over time make low SES a major risk factor for family dysfunction and less-than-optimal parenting. Having said this, we must stress that, despite severe poverty, many families do manage to function well and to raise healthy, resilient children.

Throughout the discussion of traits of resilient individuals, we have identified various resilience-enhancing processes that go on in families. We will now turn to other researchers who have provided some answers to the question, "How do these families do it?" Virtually all successful families report some combination of caring relationships, high expectations and support, and opportunities for the children to be contributing members of the family from early on in life.

Gary et al., (1983)list 10 characteristics of strong, resilient African American families:

• Strong economic base
• Achievement orientation
• Role adaptability
• Spirituality
• Extended family bonds
• Racial pride
• Respect and love
• Resourcefulness
• Community involvement
• Family unity

In their early study of low-SES, resilient, African American children, Garmezy and Nuechterlein (1972) reported, among other things, the following:

• The home life reports of these competent children revealed households of the achieving lower-class children to be less cluttered, more "neat and clean," containing more books.
• Well-defined parent and child roles marked the families of these achieving youngsters. By contrast, mothers of underachieving children were often reported to appear more as pseudosiblings involved more pervasively in fulfilling their own needs to the exclusion of concern for those of their children.
• The parents of the competent children were more aware of the children as individuals. They were willing to permit the children greater self-direction in everyday tasks and to recognize the reality of the children's interests and goals.

Interestingly, at least in this study, the absence of the father did not relate to the child's academic achievement.

Garmezy (1991) also lists the nine factors Clark (1983) identified that characterized families of high achieving, poor, African American children:

• Frequent school contacts are initiated by parents.
• Child has exposure to stimulating, supportive school teachers.
• Parents expect to play a major role in the child's schooling and expect the child to do likewise.
• Parents establish clear, specific role boundaries and status structures while serving as the dominant authority.
• Conflict between family members is infrequent.
• Parents frequently engage in deliberate achievement-training activities.
• Parents exercise firm, consistent mentoring and rules enforcement.
• Parents provide liberal nurturance and support.
• Parents are able to defer to the child's knowledge on intellectual matters.

And Kumpfer and Alder (1998) cite other researchers who list five major types of protective processes within families:

• Supportive parent-child relationships
• Positive discipline methods
• Monitoring and supervision
• Family advocacy for their children
• Seeking information and support for the benefit of their children.

In a 1987 article, Garmezy stated that "positive family attributes" include "such elements as quality of the parent-child relationship, adequacy of family communication, degree of parents' perceptiveness about the child, and overall competence of the parent" (p. 170). He went on to say that family stability, organization, and cohesion served as protective factors, and that "children with these more advantageous family characteristics were more intelligent, more competent, and less likely to become disruptive under high levels of stress" (p. 170). The researchers operationalized family stability and organization by such events as numbers of family moves, marriages, jobs, and the upkeep of the home, and family cohesion by the frequency of family activities, levels of manifest affection, presence of rules regarding offspring's behavior, adequacy of communication in the family, and the like.

Masten et al. (1988) agree with Garmezy that the nature of parental supervision, provision of structure for the child, parental warmth, and family cohesion are probable protective factors, and Rutter (1979) adds a good relationship with at least one parenting figure. Masten's group further stresses that parenting quality relates as strongly as the child's intellectual ability to the child's social competence in school. Werner (1989) identified three key protective factors in the families of her resilient children: the parents were supportive of their children, they set and enforced rules in their homes, and they respected their children's individuality while maintaining family stability and cohesion.

Most would agree that a key protective factor in families is the perceived availability of parental emotional and instrumental support. In a study of 1,702 seventh to ninth graders (ages 12-15), Wills and Cleary (1996) found, as have other researchers, that this perceived support was inversely related to the adolescents' use of alcohol, tobacco, and marijuana. The researchers went on to examine the mechanisms though which this support was mediated, and they found that it both reduces the impact of risk factors (e.g., deviance-prone attitudes, negative peer affiliations, and behavioral undercontrol) and enhances the effect of protective factors (e.g.,more positive behavioral coping abilities and academic competence). The researchers elaborate on this process as follows:

When parents engage in supportive interactions with children, they demonstrate task-oriented problem-solving skills, which children then learn through observation and modeling....The observation of supportive communications between family members would be conducive to learning how to listen to others, empathize with others distress, and engage in cooperative efforts to master problems...A close parent-child relationship may enable an individual to enter adolescence with better self-regulation skills and with better ability to establish supportive relationships with persons outside the family (Wills & Cleary, 1996, p. 14).

As discussed in the section on Secure Attachment, "the variable parenting quality undoubtedly reflects a ransactional process in which the child's behavior influences that of the parent and vice versa" (Masten et al., 1988, p. 761). That is, an easy temperament and positive coping skills on the part of the child may enhance parenting skills, whereas difficult behavior on the part of the child may significantly challenge even the best parenting skills.

Research Addressing Family Reactions to Specific Illnesses

Several researchers have focused on family reactions to specific illnesses. For example, in the 1980s, Dr. Steven Wolin and his colleagues began to look at the factors that account for the transmission of alcoholism from one generation to the next (Bennett, Wolin, Reiss, & Teitelbaum, 1987). They soon became more interested, however, in those families that did not transmit alcoholism to the next generation. In a 1997 interview with Benard, Wolin listed four things the nontransmitter families did right. First, they showed deliberateness; at least one parent and some children "were extremely careful about how family life went because they sensed what the trouble was and knew they had to protect these zones of family life" (Benard, 1997, p. 18). They conceptualized a bright future for themselves, made a plan to get there, and carried it out. Second, both the family of origin and the new families created by the adult children attended to family routines and rituals such as a regular family dinner time, holidays,and other celebrations. The third and fourth characteristics have to do with the adult children. Compared to adult children in transmitter families, those in the nontransmitter families got more physical and emotional distance; they tended to live farther away from their parents and to visit them less frequently. Moreover, they took great care in selecting a spouse and sometimes deliberately looked for a healthy surrogate family to marry into.

Dyson (1991) focused her study on 55 families with a handicapped child (HC) (mean age, 4.4 years). Compared to a control group of 55 matched families with a non-HC child (mean age, 4.3 years), the HC families had higher degrees of stress, but "differed only minimally from other families in their family functioning" (p. 623). And Phipps and Mulhern (1995) found that, in families of children who had undergone pediatric bone marrow transplants, the key protective factors appeared to be perceived family cohesion and communication and expressiveness.

Other researchers have looked at the impact of mental illness on the family. In one study, Marsh and her colleagues (1996) asked about family strengths that had developed as a result of a family member's being mentally ill. Their subjects reported increased family bonds and commitments, expanded knowledge and skills, and increased advocacy activities. They were proud of their role in their relative's recovery, and they said they had become better, stronger, more compassionate people. They further stated that the experience had enabled them to make important contributions to their families, had enhanced their coping skills, had given them healthier perspectives, and had forced them to rethink their priorities. In the words of one sibling, "When a family experiences something like this, it makes for very compassionate people-people of substance" (Marsh & Johnson, 1997, p. 229).

Radke-Yarrow and Brown (1993) reported the results of a 10-year longitudinal study of 18 resilient children, compared to 26 troubled children, who had family risks of severe "affective illness in both parents and a highly chaotic and disturbed family life" (p. 581) The families were chosen initially on the basis of the mother's being diagnosed with unipolar or bipolar depression, and the fathers's carrying diagnoses of depression, anxiety, or no psychiatric disorder. Six years into the study, when the parents were again diagnosed, a number of fathers had developed substance abuse problems.

In reporting their findings, the researchers stress that "each child showed competing processes of vulnerability and coping," and that "resilience appeared variably robust or fragile depending on the combinations of risks and supportive factors present and the styles of coping with stress." Their "resilient children elicited more positive reactions from teachers, were more likely to be the favored child in the family,and had more positive self-perceptions" (p.581). They note that "development appeared to take its toll in the high-risk children. Of the 18 resilient children, only 27% were the older siblings; of the 26 troubled children, 69% were the older siblings" (p. 581). Moreover, somatic complaints were reported by 56% of resilient children, compared to 84% of troubled children, but only 21% of controls. Other differences among the children are shown in Table 3.

Table 3
Differences Between Resilient and Troubled Children

Source: R.Radke-Yarrow, M., & Brown, E. (1993). Resilience and vulnerability in children of multiple-risk families. Development and Psychopathology, 5, 581-592.

In response to the fact that children of parents with affective disorders are at greater risk to develop the disorders themselves, Beardslee and his colleagues (1997) have developed a resiliency-based intervention that they hope will actually prevent the development of psychopathology in children at risk. Their "approach is to target processes that are essential to development, are modifiable, and may contribute to positive outcome. Correspondingly, we attempt to addresses processes that could enhance resiliency by providing information about resilience (i.e., the importance of relationships and independent functioning), and about the importance of youngsters understanding their parents' disorder" (Beardslee et al., p. 111).

The intervention is a short-term, cognitive, psychoeducational approach for one family at a time with a clinician-facilitator. A manual is provided to standardize the intervention, but a key element is that the clinician links the cognitive material to the life experiences of the individual family. The goals are to help children develop adaptive capacities and help the parents focus on the needs of the children. Specifically, the intervention aims to develop self-understanding of all family members, to enhance perspective taking, and to foster communication about previously unspeakable issues (Beardslee & MacMillan, 1993).

An early report comparing the clinician-facilitated group with a lecture-discussion group looks promising. The study included 37 families with children between ages 8 to 15. The families were assessed before the intervention and again at an average of 30.9 weeks after the initial assessment or 8.6 weeks after completion of the intervention. A major goal was "to have an impact on a parent's ability to provide children with the support they require to develop a sense of mastery and negotiate developmental challenges" (Beardslee et al., 1997, p. 123). Parents in both groups reported improvement, but compared to the lecture-discussion group, the clinician facilitated group showed significant:

• Increases in parental understanding of their children's experience of the illness
• Adoption of new coping strategies
• Improved functioning in other areas of life
• Increased and/or improved communication between spouses
• Increased understanding of spouses' feelings
• Increased spousal understanding of subject's feelings
• Increased emotional closeness in the marriage

The hope of Beardslee and his colleagues (1997) is that "over time, enhancing communication in families about parental affective illness, and increasing children's understanding of parental depression will translate into more resilient outcomes during late adolescence and young adulthood" ( p. 123) Follow-up studies are planned to see if their hopes are realized.

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