Understanding and Promoting Well-Being

Isaac Prilleltensky

isaac@miami.edu

www.education.miami.edu/isaac

Kerala: A state in Southwest India. The name "Kerala" probably means "land of coconuts."

Kerala: A Community Strengths Story

Population: 31.8 million

Kerala's population is the same as Canada's.

Indicator Kerala India Low income countries

USA

Per Capita GDP $

566 460 420 34,260

Adult Literacy Rate (%)

91 58 39 96

Life Expectancy in Years

Males (f) 68 63 59 74

Females (f) 74 64 80

Infant Mortality per 1,000

12 65 80 7

Birth Rate Per 1,000

17 29 40 16

Well-Being in Kerala

CommunityWell-Being

RelationalAnd

Organizational Well-Being

Personal Well-Being

Tenancy lawsNutrition in school

Distribution Of resourcesLand reform

Infant mortalityLiteracyNutrition

Life expectancy

Social supportSense of cohesion

Personal Empowerment

Social Movements

Government Action

Ou

tcom

esP

roce

sses

The State of Wellness

Wellness is a positive state of affairs, brought about by the simultaneous satisfaction of personal, relational, organizational and collective needs

Part I: Understanding Well-Being

There cannot be well-being but in the combined presence of personal, relational, organizational and community well-being

Personal Well-being

Sense of control Physical health Love Optimism Competence Dignity and integrity Growth Self-esteem Meaning and spirituality

Effects of lack of control and disempowerment on mortality

Relational Well-Being

Support Affection Bonding Cohesion Collaboration Respect for diversity Democratic participation

Effects of Social Support

Less likely to have heart attacks More likely to survive cancer More likely to resist common cold virus Lower mortality Less degree of stress More positive outlook on life Resilience

Organizational Well-Being

Efficient structures Clear roles Monitoring mechanisms Planning and accountability Growth opportunities Fulfillment of needs Identity and meaning

Low

Low

High

Hig

h

HighLow

Effective Environment

Affective Environment

Reflective Environment

Organizational Well-Being:ERA Environments

Community well-being

Economic prosperity Social justice Adequate health and social services Low crime Adequate housing Clean environment Support for community structures

Probability of death bet ages 15-60 in 2020 – males -- Interactions

0

5

10

15

20

25

30

35

EME FSE CHN LAC OAI MEC IND SSA

Male Life Expectancy by Inequality

64

66

68

70

72

74

76

78

GINI24.5

GINI31.5

GINI35.5

GINI 45USA W

GINI 45USAAA

Swed/Jap

Australia

Canada

USA White

USA Afri. Amer.

Colombia: Happy but Dead

Highest rate of murders per capita in the world Highest number of kidnappings in the world

Colombia 5181 in 7 years Mexico 1269 Brazil 515 Venezuela 109 Severe under reporting

Colombians report highest level of satisfaction 8.31 (out of 10) in the world in the 90s

South Africa: 6.08

Is happiness really a genetic phenomenon? Lykken and Tellegen (1996, Psychological Science). In the Minnesota twins study, authors report, “Neither socioeconomic status, educational

attainment, family income, marital status, not an indicant of religious commitment could account for more than about 3% of the variance in WB” (in monozygotic twins)

“We estimate that the heritability of the stable component of subjective well-being approaches 80%”

Change in life satisfaction over the years(Inglehart, 2004)

Russia’s happiness and satisfaction plunges

Two African Countries

Income is not everything though

Two African Countries

Wealth matters for life expectancy

Chinese happiness and democracy

Preliminary Summary

Subjective reports of happiness incongruous with physical evidence of illness, mortality, and crime Within countries

Poor report high levels of happiness but have low levels of physical and mental well-being

Across countries Some poor countries report low levels of happiness and

others fairly high All poor countries show low levels of physical and mental

well-being Subjective well-being goes up and down depending on

social circumstances (Russia, Belgium, Switzerland)

Preliminary Summary

Absolute poverty predicts low levels of physical and mental well-being, within and across countries (Kleinman, Eisenberg, etc.)

Relative deprivation predicts social gradient in physical and mental well-being within countries (Marmot, Wilkinson)

Freedom is important in subjective well-being, but there are exceptions like China

Wealth does not necessarily lead to a happy or meaningful life (Adams, Cushman, Sloan, Ryan)

New definition of well-being

Well-being is a positive state of affairs in individuals, relationships, organizations, communities, and the natural environment, brought about by the simultaneous and balanced satisfaction of objective and subjective needs; and by the behavioral manifestation of material and psychological justice in these five ecological domains.

Ecological Model of Well-Being

Sites of Well-Being

Individual Relational Organizational Communal Environmental

Objective signs health networks resources social capital

low emissions

SubjectiveSigns

efficacy voice support belonging safety

Values as source and strategy

autonomy caring participation diversity protection of resources

Justice as source and strategy

My due/Our due

Your due/Our due

Its due/Our due

Their due/Our due

Nature’s due/Our due

Model of Well-Being:Some positive and negative factors

Sites of Well-Being

Individual Relational Organizational Communal Environmental

Objective signs +health- illness

+networks-isolation

+resources- lack of resources

-social capital-lack of trust

+clean air-pollution

Subjectivesigns

+efficacy-lack of control

+voice-repression

+support-isolation

+belonging-rejection

+safety-fear

Values as source and strategy

+autonomy-lack of power

+caring-neglect

+participation-marginality

+diversity-discrimination

+protection of resources-depletion of resources

Justice as source and strategy

My due/Our due

Your due/Our due

Its due/Our due Their due/Our due

Nature’s due/Our due

Part II: Promoting Well-Being

From Deficits Reactive Arrogance Individual blame

To Strengths Prevention Empowerment Community Change

The

Grameen Bank

1960s

Strengths, Prevention, Empowerment, Community change

Lesson #1: Strengths

We all have strengthsWe all need to be treated with

respectWe all need to be given a chance

9/7/1854…Removing the Handle of London’s Broad Street Pump

Lesson #2: Prevention

“No mass disorder, afflicting humankind, has ever been eliminated, or brought under control, by treating the affected individual”

HIV/AIDS, poverty, child abuse, school drop out, addictions, powerlessness are never eliminated one person at a time

Must focus on prevention to reduce the incidence of psychological, behavioral, and social problems in children and youth

04/21/23 Prilleltensky 34

Too much reaction, not enough preventionInvestments in Reactive vs. Proactive Interventions in Health and Community Services (Nelson et al, 1996; OECD, 2005; de Bekker-Grob et al., 2007)

0

10

20

30

40

50

60

70

80

90

100

Reactive Preventive

Investments in Prevention:

Italy 0.6%

USA 3%

Netherlands 4.3%

Canada 8%

Ratio of Benefits to Costs (Lynch, 2007, page 19)

0

2

4

6

8

10

12

14

16

18

Abecedarian CPC Perry Age 27 Perry Age 40

Strengths, Prevention, Empowerment, Community change

Lesson #3: Empowerment Identifying the external source of

oppression in life can be empowering Empowerment is a means and an end in

itself Empowerment can be a tool for social

change and personal healing at the same time

Strengths, Prevention, Empowerment, Community change

Lesson #4: Community change

“The psychotherapist, social worker or social reformer, concerned only with his (her) own clients and their grievance against society, perhaps takes a view comparable to the private citizen of Venice who concerns himself only with the safety of his own dwelling and his own ability to get about the city. But if the entire republic is slowly being submerged, individual citizens cannot afford to ignore their collective fate, because, in the end, they all drown together if nothing is done.” (Badcock, 1982)

Place and class in infant mortality

Social capital and community well-being

low med high

healthwelfare

educationtolerance

crime

Low SC: LA, MS, GAMed SC: CA, MO, OKHi SC: ND, SD, VT, MN

Example 1: Miami SPEC projectOrganizational conditions leading to transformative practice: Findings from a multi-case study, action research investigation

University of Miami SPEC Team Isaac Prilleltensky Ora Prilleltensky Scot Evans Adrine McKenzie Debbie Nogueras Randy Penfield Corinne Huggins Nick Mescia

What is transformative practice?

In the context of community, educational, health, and human service organizations, we define transformative practice as consisting of four principles Strengths Prevention Empowerment Community change

04/21/23 Prilleltensky 44

DRAIN VS. SPEC APPROACHES

Drain Approach Deficits-based Reactive Alienating Individualistic Problems Too little Too late Too costly Too unrealistic

SPEC Approach Strengths-based Primary Prevention Empowerment Community change

Opportunity Built to last Starts early and saves $$$ Creates civic engagement Builds social movement

Quadrant IIIExamples:Crisis work, therapy, medications, symptom containment, case management

Quadrant IExamples:Community development, affordable housing policy, recreational opportunities, high quality schools and accessible health services

Quadrant IIExamples:Skill building, emotional literacy, fitness programs, personal improvement plans, resistance to peer pressure in drug and alcohol use

Quadrant IVExamples:Food banks, shelters for homeless people, charities, prison industrial complex

Collective

Proactive

Individual

Reactive

Time and place of interventions

THIS IS WHERE WE ARE

THIS IS WHERE WE NEED TO BE

Quadrant IExamples:Voice and choice in celebrating and building competencies, recognition of personal and collective resilience

Quadrant IIExamples:Voice and choice in deficit reduction approaches, participation in decisions how to treat affective disorders or physical disorders

Strength

Empowerment

Deficit

Detachment

Focus and engagement in interventions

Quadrant IIIExamples:Labeling and diagnosis, “patienthood” and clienthood,” citizens in passive role

Quadrant IVExamples:Just say no! You can do it! Cheerleading approaches, Make nice approaches

THIS IS WHERE WE ARE

THIS IS WHERE WE NEED TO BE

Context of Investigation

Action research with 5 community based organizations (CBOs) to promote Strengths, Prevention, Empowerment, Community Change

Three year study consisting of 1. Training

2. Team work

3. Consultation

4. Professional development

5. Action research

Context of Investigation

Organizations selected on basis of “readiness” Organizations consist of

Major local funder (MF) Major provider of health services for poor (HS) Organization that promotes early interventions (EI) Local civic coalition (LC) Local human service (HS)

Budgets range from $ 1 million to over $ 100 million

Personnel ranges from 15 to 700

Context of Investigation

Intervention components 1. Training

Each organization sends reps to 18 person class 3 hours biweekly Lecture, discussion, application

2. Team work Transformation teams meet biweekly

3. Consultation A researcher assigned to each organization Weekly or biweekly consultations

4. Professional development5. Action research

Research Design

Action Goal of overall project: Promote SPEC practices in organizations to improve community well-being

Research Goals of overall project: Assess whether organizations become more aligned with

SPEC principles as a result of interventions If so, how

Data collection Quantitative and qualitative methods at baseline, year one,

and end of project Goal of present study: Examine organizational conditions

leading to SPEC based on qualitative data gathered through interviews, focus groups, and field notes with about 80 different participants in the five organizations

SPEC INTERNAL AND EXTERNAL

Child and Family

Organizations Community

Strengths

Prevention

Empowerment

Community Change

Skills for SPECI VALUE IT1. Inclusive host2. Visionary3. Asset seeker4. Listener and sense maker5. Unique solution finder6. Evaluator7. Implementer8. Trendsetter

OUTCOME: SPEC IN THE COMMUNITY

Strength based approaches

Preventive approaches

Empowering approaches

Community change approaches

ORGANIZATIONAL CONDITIONSClimate Resources Support Consciousness

INTERVENTIONS TO PROMOTE SPEC

Training T Team Consultation Action Research

Professional Development

Findings: Organizational Conditions for Transformative Practice

Organizational Conditions for Transformative Practice

Climate Effective

Enabling structures; good communication; timely completion of tasks; efficiency; accountability and follow-through, etc.

Most of the organizations noted at least some deficiency in this domain, including duplication of efforts; inconsistent policies; and bureaucracy

Reflective Learning opportunities; organizational learning; asking “big questions”; challenging

old notions; evaluating practice, etc. Organizations vary on this dimension, with some presenting as highly reflective and

others describing an environment where there is insufficient trust to challenge old notions and practices. (“you ain’t gonna rock the boat.”)

Affirmative Climate of acceptance and appreciation; employee strengths are highlighted and

utilized; voice and choice; sense of control; team work and conviviality Distinction made between voice and choice in a number of organizations where

empowerment is espoused as an organizational value, but not always practiced well.

In other organizations, staff empowerment is not even part of the organizational radar.

Resources Human

Adequate number of workers to meet demands; high skill level; capacity; dedication; motivation; initiative

Largely described workers as caring, conscientious and committed to meeting the needs of their constituents

Variable level of skill across organizations Concern in some organizations that people are spread too thin due to a broad, overly

ambitious mission Financial

Adequate financial resources to support positions; programs; etc. A major barrier for most organizations in the current economic climate Cuts in positions and lack of job security are a source of strain For funding organizations, ongoing concern to make sure investments provide good return

Organizational Appropriate organizational structures to meet vision and mission; adequate time, space, etc. Most organizations described as committed to vision and mission Some noted that rapid and poorly communicated policy changes lead to inconsistent practices

and poor PR with other agencies In one case, solicitation of input from “boots on the ground” was seen as a necessary condition

for improved buy-in to vision and mission

Support and Legitimacy Leadership for SPEC

Leadership provides legitimacy and support to SPEC principles and practices; leader(s)“walk the talk” in their support of the vision and mission of the organization

Organizations whose leaders are involved in all aspects of the SPEC training (class, T-Team, etc.) experience greater legitimacy and support for SPEC practices and principles

Lower level of leaders involvement is associated with fewer SPEC practices Board support and legitimacy for SPEC

Board of Directors provides legitimacy and support to SPEC principles and practices ; board members“ walk the talk” in their support of the vision and mission of the organization

Some describe difficulties in dealing with board members who come from a corporate background and unfamiliar with nonprofit

Some board members advocate for special interest groups Funder support for SPEC

Funders provide legitimacy and support to SPEC principles and practices; funders “walk the talk” in their support of the vision and mission of the organization

Some indication that funders may not always walk the talk, despite the theoretical support of SPEC; some feel micromanaged by funders

Consciousness Justice

Organization espouses a justice orientation; considers issues of fairness and justice in understanding community problems and devising solutions

Large variation between organizations. For some, themes of “economic justice” and “social justice” are espoused and central to the organizational mission. For others, justice is described as enabling access to services, regardless of client background, legal status, etc.

Power Organization is highly aware of power issues in the community; sensitive to how

differences in power affect voice, choice and wellbeing; considers power issues when understanding problems and devising solutions

Awareness and sensitivity to power issues in the community are at times inconsistent with internal practices with employees.

Ecology Organization espouses an ecological orientation; considers personal, organization,

and systemic factors in understanding problems and devising solutions A shared understanding that social and economic conditions are at the root of

people’s struggles does not always translate to more systemic organizational practices

     

In every act, in every interaction, in every social action,we hold each other accountable to promote

 People’s dignity, safety, hope and growth

Relationships based on caring, compassion and respectSocieties based on justice, communion and equality

 We are all better when these values are in balance

 To put these values into action, we will:Share our power

Be proactive and not just reactiveTransform the conditions that create problems for youth

Encourage youth and families to promote a caring communityNurture visions that make the impossible, possible

We commit to uphold these values withYouth and their Families

Our EmployeesOur OrganizationOur Community

This is a living document. We invite you to discuss it, to critique it, to live it