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This summary discusses one behavioural theory that underpins school health promotion, safety, social development and other similar programs. The summary is one of several that are being developed within this wiki-based web site. Please see our Call for Writers/Contributors/Sponsors on Behaviour Theories for a full listing of this series of summaries.

Using Resilience Theory to Improve School-based/linked Health Promotion & Social Development
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Authors: Doug McCall dmccall@cash-aces.ca, Colin Mangham colinm@phpa.ca
Editor: Doug McCall
Contributors:
Rough Draft Posted: March 6, 2009
Most Recent Major Update: January 20, 2010
Permissions: This summary is "locked". Comments can be made anonymously by clicking on the "thread" button at the bottom of the page or by using the Discussion feature in the top navigation bar.
Related Summaries in this Web Site: Resilience & Schools (GT) Resilience as an Emerging Concept (EE), Fostering Resilience through Transitions (EE), Fostering Resilience through Family Programs (EE), After School Programs, Healthy Development & Resilience (HS) Resilience & School Programs (HS) and Resilience & Schools (BT)
Webinars from this Paper: Use your computer to see and hear a recorded Webinar presented by the author of this paper by using the following link: How Schools Can Promote Resilience
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Contents

This summary includes these topics:
  1. Introduction
  2. Definition of terms
  3. Why is this Important? (Describe scope of action possible using resilience theory, including a discussion of potential outputs)
  4. Key aspects or elements of the resilience relative to school programs
  5. Current evidence of effectiveness of the school interventions that include resilience /Programs and resources that Match the Evidence
  6. Better Practices, Exemplars and Discussion of Evidence-based implementation strategies (successful case studies)
  7. Identify and discuss challenges to adoption, implementation and sustainability and ways to address those challenges
  8. Identify and discuss local mechanisms and strategic tactics (identifying champions, building alliances among organizations, using a local crisis, leveraging a directive etc)
  9. Identify and discuss successful initiatives that have built capacity, changed systems, adapted to specific cultural, geographical or economic contexts in order to adopt, implement or sustain the intervention
  10. Recommendations for national agencies/federal departments, provincial ministries, local school boards/health authorities/police departments, schools/clinics/professionals
  11. Provide links to key research references and reports/resources

1. Introduction

School-based and school-linked Health Promotion

School-based and school-linked programs to promote health, social development, safety and the welfare of children and youth must be based on sound and proven behavioural theories as well as a deep understanding about child and adolescent development. Such theories about human development need to be situated within ecological and systems-based thinking about school health promotion and social development so as to not lead us into focusing too closely on the individual instead of the social and physical environments in which we all live, learn, work and play. These theories have led to the development of comprehensive approaches, coordinated school-agency programs and whole school strategies that address the whole child and his/her interactions with the school within the context of the neighbourhood and family.

One key point derived from these comprehensive and coordinated models is that their coordinated, multiple interventions are best if they are aimed at influencing a number of factors, behaviours or conditions rather than just one or two targets.

Further, these ecological approaches have recognized that health, learning and social behaviours are a result of the complex, daily interactions between the characteristics of the individual (genetics, intelligence, traits etc), the risk/protective factors or determinants (economic status, gender, culture etc) that exist within social and physical environments (families, schools, neighbourhoods) that surround the individual.

A good understanding of these theories leads us to recognize that we must gradually build the capacity of these environments to support young people as they mature and grow and achieve at school. These theories and ecological approaches also help us to think more clearly about and plan more carefully for systems change in education, public health and other systems.

School-based and school-linked health promotion, social development and safety programs have also been influenced by these behavioural theories that have led to effective whole school and school-agency-community strategies and programs. Some of these overlap with resilience theory. These include:
  • Bandura’s theory of social learning that led to programs that addressed the various programs based on addressing social influences on behaviour (parents, peers, media etc)
  • Janz & Becker’s work on the health belief model led to including a focus on the personalization of risk as an element in several programs
  • Goleman’s work on social intelligence has led to a movement to integrate social and emotional learning
  • Risk reduction (including harm reduction) models have led to tailored programs that deescalate and deconstruct multiple problems by removing higher or more easily managed risks or safety concerns without condoning any of the behaviours
  • Ecological and earlier population health frameworks have led to comprehensive planning frameworks such as PRECEDE/PROCEED which has been used as the basis on hundreds of school health and public health interventions

The Contribution Made by Resilience Theory

Resilience theory joins other behavioural theories in guiding school-based programs to become more effective in helping students, staff and schools recover from significant challenges. This summary describes some of the evidence, experiences and examples of the use of resilience theory in the school setting. In brief, resilience theory has helped such programs to be more:
  • positive in their approach, recognizing strengths and assets in students, processes and school/community conditions
  • focused on student connectedness to and engagement in schools as well as trusting relationships with adults, peers and parents
  • concerned with the development of self-efficacy and self-knowledge among students
  • attentive to the needs of students experiencing significant challenges (such as poverty, family stress/abuse etc) as well as students who may be more vulnerable to normal life challenges because of particular processes or times in their lives.
Resilience offers us deep insights into the critical characteristics of the individual child, the environments in which they live, learn and play, and the interventions (policies, procedures, programs, practices) that shape their days and time in school. As well, resilience offers us a new lens to look at:
  • Developing and building strengths within individuals as they encounter risk rather than rushing to label and fix their problems
  • Identifying students who may be more at risk in certain situations or in certain transitions and helping us to intervene earlier
  • Looking at combinations of programs or interventions that can be more effective in certain situations or with certain groups of students
As part of this series of overviews, Masten has pointed out how resilience theory and research has developed and how it has influenced program and policy development. She notes that resilience research has added to our knowledge about child and adolescent development in these ways:

  • The use of resilience theory has helped us to clarify what we mean to achieve in respect to healthy development. She has noted that the most appropriate, basic benchmarks are those associated with the child achieving age-related developmental tasks. This helps us to situate specific health or social behaviours or problems more firmly within the context of child development. For example, by understanding that forming and joining peer groups as well as creating psychological distance from parents are healthy developments, we can target programs in ways to build on this, rather than resist them.
  • Resilience theory has also identified and labelled various “promotive” factors (conditions that are helpful to all children) and created a better balance with our attention to “risk” factors. This has led to transformation in child research and practice, leading to greater attention and monitoring of “assets” and “strengths”
Masten also describes the difference between promotive and “protective” factors. She notes that the protective factors are more like the antibodies that are created when a threat is identified in humans, while the protective factors are more like the overall immune system. She likens protective factors as more like a mother responding to the cries from her child, while promotive factors may be having a safe home. If we can identify these protective factors more clearly based on better understandings of resilience, we can modify the inherent capacity within individuals, modify some of the conditions in some environments and more effectively influence some of the interactions between the individuals and their environments during times of stress.

The key “protective factors” identified by Masten are attachment, family responses to members during times of stress, intelligence/problem solving, self-control/temperament, master motivation, belief systems (including spirituality, faith and religious beliefs) and the responses of various social institutions such as schools to children who are experiencing stress.

(Note: In our view, there will be confusion with the use of the term “protective factors” as described by Masten because the same term is used often by others in different ways. Consequently, we have substituted “response mechanisms” for the term “protective factors” used by Masten).

In essence, fostering resilience is synonymous with strengthening the response mechanisms within individuals, within organizations such as schools, or within social and physical environments such as communities or cultures or within the interactions between the individual and their surrounding social/physical environments. This strengthening of individual, organizational or interactive response mechanisms is different than, although complementary, to promoting healthy conditions or behaviours as well as preventing or reducing selected risks.

A strengthened response mechanism (or increased capacity for resilience) in the environment might be health services that focus on early recognition, referral and reintegration rather than just treatment after the problem is acute. A strengthened response mechanism (increased resilience) in the interaction between the individual and the environment might be illustrated in the field of mental health. Stigma about mental health problems and illness often causes people to not seek help. Most school curricula now teach skills relating to accessing health services (this is standard health promotion strategy) but if the interaction with the social environment still discourages help-seeking, then we will not be effective. Therefore, anti-stigma campaigns are a way to increase resilience by influencing that interaction. A response mechanism (capacity for resilience) within an individual is easier to identify and can include things such as temperament, intelligence and genetics. However, we need to examine all three levels of resilience.

The absence of resilience can also be a way to understand the term. Normally, most children will bounce back after the death of their pet. They have familiy, friends and other activities that sustain them. However, if they don't, they become more vulnerable, even to normal challenges, so their response mechanisms or capacity for resilience is diminished. As well, their capacity for resilience might be weakened by other interactions with their environment ocurring at the same time, such as the divorce of their parents, a move to a new neighbourhood or a bully at school.

Resilience then becomes a key addition to promotion/prevention programs and other strategies based on other behavioural theories. For example, we can encourage social and emotional learning among students as a health promoting strategy based on social intelligence and social learning theories. But we can add in resilience as an ingredient to SEL programs to do things such as:
  • strengthen the individual student capacity to manage stress/anger
  • to encourage parents, teachers and adults to attach/connect students undergoing stress to positive role models/peers or to trusted adults
  • have schools train staff in early identification and referral procedures or in brief counselling intervention techniques for students experiencing stress
Using Masten’s summary as a guide, let us now turn to the roles that schools can play in strengthening these protective factors or response mechanisms. As we do this, let’s keep in mind the general “promotive” role played by schools when working effectively with parents, other agencies and communities (as described above) as well as the necessary capacities that need to be supplied to the schools and front-line health/social service/law enforcement ministries and local agencies. In essence, we should start with and continue to build on the comprehensive approaches, coordinated programs and whole school strategies that have been developed to create and maintain healthy schools, safe schools, community schools and effective schools.

The Role of the School in Promoting Resilience

The school, by its very structure and purpose, is also important in fostering resilience. Several school-based protective factors seem to be associated with resilience: 60, 79, 94
  • Success in school socially and/or academically. These two spheres form the opportunities to experience a sense of relative “triumph” versus failure. A perceived sense of failure at both is a strong risk factor for dropout and other forms of escape or alternative behaviour
  • Positive engagement with peers. The school social environment teems with the opportunities and challenges of peer engagement.
  • Supportive and positive peer dynamics, the development of healthy friendships, and the social support that comes in these friendships
2. Definition of terms

Resilience

Resilience is an inherent capacity, or response mechanism, within all individuals, organizations and communities that is used to overcome significant challenges. Some individuals, organizations, communities or cultures are more resilient to significant challenges and risk factors and are able to bounce back from temporary problems or overcome long-term problems and achieve a level of competence and satisfaction in their lives. We see examples and evidence of resilience when the normal interaction among the traits of the individual, the conditions or factors within the environments in which they live, learn and work and the processes that shape those interactions results in some individuals surviving or flourishing when the odds against success would suggest otherwise.

Programs that include Resilience

Programs, strategies and approaches that include resilience theory and knowledge are different from risk-based models. The risk-based or medical model starts from the fact that we all have factors, problems or needs that are sometimes greater than that of others. Once identified by these factors or problems, populations can be identified as being vulnerable or at higher risk. These populations are then “targeted” for deficiency-based polices, programs and practices. These citizens are then defined as “clients”, or “consumers” of services. Treated as such, these clients can become dependent on these services. (Note: We need to be careful that we do not simply transform this deficiency-based model by labelling individuals or organizations or communities as needing a stronger, measurable dose of resilience.)

Capacity for Resilience in Organizations and Systems

The Arizona State University Resilience Group suggests that we need to move beyond this risk based model to a new key for health. They suggest first that we use ecological and systems theory to define resilience in social/physical environments such as schools. Resilience, they suggest, is related to:
  • the magnitude of the shock that can be absorbed into that system while retaining its original purposes
  • the flexibility and degree to which the system is capable of self-organization
  • the ability of the system to build capacity for learning and adaptation
The ASU team suggests that there are three major components of resilience for organizations, systems and communities. They are:
  • diversity of functions, responses to threats and opportunities, species/components etc
  • redundancy such that there is overlap between functions and sub-components so that if one becomes ineffective, its function can be assumed by another
  • feedback loops, that there are multiple feedback mechanisms allowing for quick responses to stressors
This view of resiliency in organizations is consistent with ecological and systems-based approaches to school-based human development in areas such as health promotion, social development and safety. These approaches suggest that schools are “open” to external influences at all levels, loosely coupled thereby making governance and decision-making through the various layers very time consuming, and staffed by “professional bureaucracies” who have their own professional cultures and procedures.
The ASU team also suggests that these strategies can be used to strengthen the resiliency of organizations and communities:
  1. Develop a shared understanding of the boundaries of their community.
  2. Take the time to identify and develop the strengths within the organization instead of looking for a quick fix in the form of a program and looking for results in one or two years
  3. Develop committed leadership at all levels in the organization
  4. Foster a high degree of civic and associational life
  5. Promote a diverse set of roles, skills, relationships
  6. Use a multi-functional approach to development; don’t focus on one or two issues but develop overall capacity
  7. Plan actions on the basis of assets rather than deficits
  8. Encourage a culture of learning and experimentation rather than looking for safe, proven ways
  9. Provide access to knowledge, skills and learning for all members of the community, not just a few
This may mean that in order for health promoting schools to be supportive of resiliency, they need to have diverse programs, offer redundant/multiple interpretations of health needs and strengths and have enough feedback loops to respond to the needs of students who are undergoing stress. In other words, a centrally controlled, deficit approach that stipulates that all students should be exposed to messages about a single health issue (such as obesity/overweight)may not be effective in nurturing resilience for those undergoing stress caused by other issues.

This may also mean that truly healthy schools would identify a set of health/social issues and programs to address them that are relevant to their students. For health systems and their health promotion cousins, this flexibility at the local level would likely not be a good fit with their standard operating procedures and culture.

Resilience in Individuals

Some researchers have characterized protective factors in as resting on four key pillars of personality37:
· Attachment, sense of connectedness with others
· Commitment to life and to overcoming difficulties
· Involvement with life and with others
· Belief in self, in others, in a purpose and meaning of life

Still other researchers have suggested five building blocks as a simple way to visualize the key underpinnings of resilience: 133
· Trust in others, a sense of security
· Autonomy, an ability to function independently
· Initiative, the drive to succeed, adapt and e
· Industry, the ability and willingness to exert effort
· Identity, a knowledge of who one is and what one can do

Each of these individual analysis of the key components of resilience points to common qualities. The crux is, whatever way we look at the construct of resilience we see the common factors of a sense of security and safety, personal sense of competence, positive view of self, and the capacity and confidence to exert effort.

Family Traits

Family environment and relationships appear to be powerful factors in forging resilience. Qualities of resiliency promoting families include14, 55, 70, 72,74, 104, 107, 111:
· High but reasonable expectations by parents of their children
· Warm relationships between parent and child and among siblings
· Affection shown among family members
· Parental caring, support and nurturance toward children
· Capacity to balance needs in the family
· Flexibility within the family in dealing with problems
· Sociability, exposure and role modelling of children to other people in healthy interaction
· Parental encouragement of their children
· Parental mental wellness
· Clear boundaries set for children and enforced lovingly
· Mentoring of younger members of the family by older siblings
· Social support and mentoring within the extended family

These attributes hold true widely across cultures, income, and education. 14, 46, 92, 104

School-based and school-linked Health Promotion/Social Development/Safety/Effectiveness

Effective school-based and school-linked human development (health promotion, safety, social development, environmental citizenship) employs comprehensive approaches, coordinated school-agency programs and whole school programs that include policy, instructional, support services, social support and physical environment interventions that address risk/protective factors and social determinants.

3. Why is this Important?

This section describes a scope of action possible using resilience theory, including a discussion of potential outputs.
Interventions within each of environments/settings such as can be reconfigured, adapted or introduced to enhance resilience. For schools, for example, resilience theory and knowledge has been used with other theories/knowledge to focus more on:
  • mental health/social development issues
  • connectedness to school or peers or adults within reach of the school
  • mentoring programs
  • peer helper programs
  • social and emotional learning
  • critical transitions in child/adolescent development or between levels of school (turning points)
  • assets or strengths within the students, community, families, neighbourhood
  • social climate within school (expectations, rules, procedures, organization, physical plant, facilities
4. Key aspects or elements of resilience theory relative to school programs

This section discusses how resilience theory is best applied in the school setting. The following wisdom has been identified in the research and professional experience with resilience-focused approaches, strategies and programs.

  • Children and teens have always needed mentoring and guidance76. The opportunities here abound. Mentoring need not be a paid or an institutionalized thing.
  • Efforts to promote resilient youth should not be based on a linear model. Causes are multiple and interactions are dynamic. There is a complex interplay at work between the personality and the environment. Efforts therefore should be whole school, and strategies student-identified.4, 9, 10
  • More combination of science and prevention is beneficial. For example, resilience based programs in prevention have been more successful than non-theoretical or less well planned programs. 13
Interventions within schools can be reconfigured, adapted or introduced to enhance resilience. For schools, for example, resilience theory and knowledge has been used with other theories/knowledge to focus more on:
  • mental health/social development issues
  • connectedness to school or peers or adults within reach of the school
  • mentoring programs
  • peer helper programs
  • social and emotional learning
  • critical transitions in child/adolescent development or between levels of school (turning points)
  • assets or strengths within the students, community, families, neighbourhood
  • social climate within school (expectations, rules, procedures, organization, physical plant, facilities
5. Evidence on the Impact of school programs that include resilience as a focus

This section examines current evidence of effectiveness of the school interventions on health, social development, learning, disparities or safety that include resilience. This brief review of the evidence is based on research reviews and landmark studies where they exist. If the research in this area is relatively new, we cite good case studies or well-documented assertions.

It is difficult to single out research studies that report on resilience-focused interventions because they are often mixed in with interventions based on other behavioural theories. Here are some examples of such interventions that include resilience and that have been proved to be effective:

Whole school Programs in Mental Health, Safety, Discipline

The research about whole school approaches to mental health, social development, safety and other forms of human development is very strong. Systematic reviews of multi-intervention programs on several of these topics have demonstrated benefits to health, social cohesion and learning. However, although these reviews often cite concepts related to resilience such as attachment, strengths/assets, self-knowledge/management skills, social-emotional learning, there is no definitive conclusion stating that including resilience enhances their effectiveness.

Here are some examples of whole school programs that have included resilience as an important element:
  • The Gatehouse Project involves the whole school in identifying risk and protective factors in the school environment. Results include increased school connectedness and engagement. 4
  • MindMatters is a national initiative in Australia focusing on creating a school environment conducive to learning. Focuses on supporting teachers in addressing mental health issues and building a positive classroom environment.120
  • PROMOTING SAFER SCHOOLS: An Introduction to Effective Behaviour Support (BC Council of Administrators of Special Education Publication) Problem behaviour occurs on a continuum from relatively mild and infrequent to frequent and severe. Effective Behaviour Support recognizes this and advocates that schools develop several integrated systems for responding to the behaviours along the continuum.
  • Positive Behavior Support A major advance in school-wide discipline is the emphasis on school-wide systems of support that include proactive strategies for defining, teaching, and supporting appropriate student behaviors to create positive school environments. Instead of using a patchwork of individual behavioral management plans, a continuum of positive behavior support for all students within a school is implemented in areas including the classroom and nonclassroom settings (such as hallways, restrooms). Positive behavior support is an application of a behaviorally-based systems approach to enhance the capacity of schools, families, and communities to design effective environments that improve the link between research-validated practices and the environments in which teaching and learning occurs. Attention is focused on creating and sustaining primary (school-wide), secondary (classroom), and tertiary (individual) systems of support that improve lifestyle results (personal, health, social, family, work, recreation) for all children and youth by making problem behavior less effective, efficient, and relevant, and desired behavior more functional.
  • From Challenges to Possibilities: Planning for Behaviour (Government of Manitoba)
    This is a planning resource intended to provide a support for student service administrators, principals, classroom teachers, resource teachers, school counsellors, clinicians, and other community professionals who will help in assisting schools in developing proactive and reactive approaches to behaviour. The resource will address the broad range of students with behavioural challenges that are found in all schools, from those who have discipline problems to those with severe emotional problems. It will offer a range of suggestions that can be implemented at the school-wide level as well as at the individual student le    vel.
  • Positive Action Program (Reviewed by SAMHSA, United States, December 2006)
    Positive Action is an integrated and comprehensive program that is designed to improve academic achievement; school attendance; and problem behaviors such as substance use, violence, suspensions, disruptive behaviors, dropping out, and sexual behavior. It is also designed to improve parent-child bonding, family cohesion, and family conflict. Positive Action has materials for schools, homes, and community agencies. All materials are based on the same unifying broad concept (one feels good about oneself when taking positive actions) with six explanatory subconcepts (positive actions for the physical, intellectual, social, and emotional areas) that elaborate on the overall theme. The program components include grade-specific curriculum kits for kindergarten through 12th grade, drug education kits, a conflict resolution kit, sitewide climate development kits for elementary and secondary school levels, a counselor's kit, a family kit, and a community kit. All the components and their parts can be used separately or in any combination and are designed to reinforce and support one another.
  • Positive Learning Environment Policy (Province of New Brunswick Education Ministry) Includes provisions for substance use on school premises.
  • Safe and Caring Schools Provincial Policy (Government of Newfoundland)
  • Creating a Positive School Climate (Manitoba Education)
    A positive school climate affects everyone associated with the school – students, staff, parents, and the community. It is the belief system or culture that underlies the day-to-day operation of a school. Improved school climate is a goal to pursue. Educators need to constantly work toward improving their school climate, culture, and conditions so that student learning is improved.
  • Character Development Initiative
    (Ontario Education)The goal of the Character Development initiative is to develop school environments in which all people – students, teachers, administrators and support staff – treat each other with care and respect. This initiative is based on four essential components: academic achievement, character development, citizenship development and respect for diversity. Specific goals include: improved academic achievement, improved interpersonal relationships, safe and orderly schools, reduced behavioural problems, improved life preparation, improved employability skills, positive school cultures and responsible citizenship in classrooms, schools and communities.
  • Caring School Community (Reviewed by SAMHSA February 2008)
    Caring School Community (CSC), formerly called the Child Development Project, is a universal elementary school (K-6) improvement program aimed at promoting positive youth development. The program is designed to create a caring school environment characterized by kind and supportive relationships and collaboration among students, staff, and parents. The CSC model is consistent with research-based practices for increasing student achievement as well as the theoretical and empirical literature supporting the benefits of a caring classroom community in meeting students' needs for emotional and physical safety, supportive relationships, autonomy, and sense of competence. By creating a caring school community, the program seeks to promote pro-social values, increase academic motivation and achievement, and prevent drug use, violence, and delinquency. CSC has four components designed to be implemented over the course of the school year: (1) Class Meeting Lessons, which provide teachers and students with a forum to get to know one another and make decisions that affect classroom climate; (2) Cross-Age Buddies, which help build caring cross-age relationships; (3) Homeside Activities, which foster communication at home and link school learning with home experiences and perspectives; and (4) Schoolwide Community-Building Activities, which link students, parents, teachers, and other adults in the school. Schoolwide implementation of CSC is recommended because the program builds connections beyond the classroom.
Social and emotional learning

  • Youth safe school committees (CAMH Fourth R Program)
    The Youth Safe Schools Committee (YSSC) is a key component of our school-based Fourth R program, helping to ensure that students receive a consistent message about preventing violence and promoting healthy relationships both in the classroom and in the school and community.
Life skills education and training (Including anger management, self-efficacy, self-knowledge, caring for others etc)

  • Lions Quest Skills for Adolescence (Reviewed by SAMHSA, United States, January 2007)
    Lions Quest Skills for Adolescence (SFA) is a multicomponent, comprehensive life skills education program designed for schoolwide and classroom implementation in grades 6-8 (ages 10-14). The goal of Lions Quest programs is to help young people develop positive commitments to their families, schools, peers, and communities and to encourage healthy, drug-free lives. Lions Quest SFA unites educators, parents, and community members to utilize social influence and social cognitive approaches in developing the following skills and competencies in young adolescents: (1) essential social/emotional competencies, (2) good citizenship skills, (3) strong positive character, (4) skills and attitudes consistent with a drug-free lifestyle and (5) an ethic of service to others within a caring and consistent environment. The learning model employs inquiry, presentation, discussion, group work, guided practice, service-learning, and reflection to accomplish the desired outcomes. Lions Quest SFA is comprised of a series of 80 45-minute sequentially developed skill-building sessions, based on a distinct theme, that may be adapted to a variety of settings or formats.
  • Second Step (Reviewed by SAMHSA, United States, December 2006) Second Step is a classroom-based social-skills program for children 4 to 14 years of age that teaches socioemotional skills aimed at reducing impulsive and aggressive behavior while increasing social competence. The program builds on cognitive behavioral intervention models integrated with social learning theory, empathy research, and social information-processing theories. The program consists of in-school curricula, parent training, and skill development. Second Step teaches children to identify and understand their own and others' emotions, reduce impulsiveness and choose positive goals, and manage their emotional reactions and decisionmaking process when emotionally aroused. The curriculum is divided into two age groups: preschool through 5th grade (with 20 to 25 lessons per year) and 6th through 9th grade (with 15 lessons in year 1 and 8 lessons in the following 2 years). Each curriculum contains five teaching kits that build sequentially and cover empathy, impulse control, and anger management in developmentally and age-appropriate ways. Group decisionmaking, modeling, coaching, and practice are demonstrated in the Second Step lessons using interpersonal situations presented in photos or video format.
  • All Stars (Reviewed by SAMHSA, United States, June 2007) All Stars is a multiyear school-based program for middle school students (11 to 14 years old) designed to prevent and delay the onset of high-risk behaviors such as drug use, violence, and premature sexual activity. The program focuses on five topics important to preventing high-risk behaviors: (1) developing positive ideals that do not fit with high-risk behavior; (2) creating a belief in conventional norms; (3) building strong personal commitments; (4) bonding with school, prosocial institutions, and family; and (5) increasing positive parental attentiveness. The All Stars curriculum includes highly interactive group activities, games and art projects, small group discussions, one-on-one sessions, a parent component, and a celebration ceremony. The All Stars Core program consists of 13 45-minute class sessions delivered on a weekly basis by teachers, prevention specialists, or social workers. The All Stars Booster program is designed to be delivered 1 year after the core program and includes nine 45-minute sessions reinforcing lessons learned in the previous year. Multiple program packages are available to support implementation by either regular teachers or prevention specialists.
  • Building Blocks For a Healthy Future The Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention created the "Building Blocks for a Healthy Future" program to educate parents and caregivers about the basics of prevention for children ages 3 to 6. "Building Blocks" reinforces the skills that enable parents and caregivers to better nurture and protect their children as well as helping their children develop healthy, pro-social behaviors and attitudes.
  • Two Legs to Stand On – Eight to Grow (Edmonton Asset Collaborative, Edmonton, Alberta, 2004)
    A set of fun, interactive and educational activities for parents to do withchildren, ages six to teen. Provides information and activities about eight asset categories.
  • Lions Quest Skills for Adolescence (Grades 6 to 8) Thrive! The Canadian Centre for Positive Youth Development
    Units include building self-confidence and communication skills, managing emotions in positive ways, strengthening family relationships and making healthy choices.
  • Roots of Empathy (Roots of Empathy, Toronto, ON)
    Classroom program that has shown significant effects in reducing levels of aggression and violence among school children, while raising social and emotional competence and increasing empathy. The program is intended for children in Kindergarten through grade 8.
  • Seeds of Empathy ((Roots of Empathy, Toronto, ON)
    Early Childhood program that fosters social and emotional competencies and early literacy skills and attitudes in children three to five years of age
  • Incredible Years (Reviewed by SAMHSA August 2007). Incredible Years is a set of comprehensive, multifaceted, and developmentally based curricula targeting 2- to 12-year-old children and their parents and teachers. The parent, child, and teacher training interventions that compose Incredible Years are guided by developmental theory on the role of multiple interacting risk and protective factors in the development of conduct problems. The three program components are designed to work jointly to promote emotional and social competence and to prevent, reduce, and treat behavioral and emotional problems in young children. The parent training intervention focuses on strengthening parenting competencies and fostering parents' involvement in children's school experiences to promote children's academic and social skills and reduce delinquent behaviors. The Dinosaur child training curriculum aims to strengthen children's social and emotional competencies, such as understanding and communicating feelings, using effective problem-solving strategies, managing anger, practicing friendship and conventional skills, and behaving appropriately in the classroom. The teacher training intervention focuses on strengthening teachers' classroom management strategies, promoting children's pro-social behavior and school readiness, and reducing children's classroom aggression and non-cooperation with peers and teachers. The intervention also helps teachers work with parents to support their school involvement and promote consistency between home and school. In all three training interventions, trained facilitators use videotaped scenes to structure the content and stimulate group discussions and problem solving.
  • Friends for Life (BC Ministry of Children and Family Development (MCFD) with the BC Ministry of Education)
    A school-based early intervention and prevention program, proven to be effective in reducing the risk of anxiety disorders and building resilience in children.
  • I’m Thumbody (Grade 3) (Canadian Mental Health Association)
    This program is presented in the classroom by trained volunteers as part of the school experience. Provides materials to parents and teachers to assist them in reinforcing the development of self-esteem and mental wellness in children
  • It’s Cool to be Alive in Nunavut (Aqsarniit School’s Sanginiq Program, Iqaluit, Nunavut)
    This program emphasizes the importance of collaborative skills, coping skills and communication. The content, processes and activities of this program are based on the fundamental belief that, even in the face of overwhelming life conditions, all children have a capacity for resilience.
  • SPEAK Workshop (Suicide Prevention Education Awareness Knowledge), Winnipeg, Manitoba
    In workshops with school-aged youth, presenter’s focus on the signs and symptoms of depression; taking away the stigma of having a mental illness, and thereby promoting help-seeking behaviours. If a peer helper system is not in place in a school
    students and teachers are encouraged to start one.
Asset-based programs and strategies

  • Search Institute Assets Program It emphasizes the building of 40 developmental assets in youth, through a variety of formal and informal community mechanisms that include youth, families, and communities. The institute has linked these attributes as protective factors buffering youth against an array of problems.

Peer helper programs


Youth engagement programs
  • Healthy Communities, Healthy Youth
    emphasizes informal role modelling and communities adopting a philosophy of communicating with and involving youth as active participants.[1]

Parent education, training and support programs
  • 15+ Make Time to Listen…Take Time to Talk (Published by SAMHSA, United States) Provides practical guidance for parents & caregivers on strengthening relationships with their children by spending at least 15undivided minutes with them daily
  • Building Blocks for a Healthy Future (Published by SAMHSA, United States) Building Blocks is an early prevention program for parents and caregivers of 3 to 6 year-olds. It is designed to educate about the basics of prevention in order to promote a healthy lifestyle.
  • Family Guide (Sponsored by SAMSHA) A Family Guide To Keeping Youth Mentally Healthy & Drug Free is a public education Web site developed by SAMHSA to communicate to parents and other caring adults about how they can promote mental health and prevent the use of alcohol, tobacco,and illegal drugs among 7- to 18-year-olds.
  • The Triple P – Positive Parenting Program Designed by Matthew Sanders in Australia, this is a parenting and family support program that emphasizes the prevention of problems and can move from simply providing parents with information and advice to intensive family intervention, if required. The Positive Parenting Program is designed for parents of children from birth to age 16, and helps parents learn positive parenting attitudes, skills and behaviours to prevent and reduce child problem behaviour and foster positive family relationships.
Mentoring programs

  • The Pathways to Education Program Is a proven effective model, first created and implemented in Regent Park by the Regent Park Community Health Centre. Our Mission is to ensure that young people from at-risk and/or economically disadvantaged communities achieve their full potential by getting to school, staying in school, graduating and moving on to post-secondary programs. The United Way of Greater Toronto (UWGT) and Pathways to Education Canada (Pathways Canada), two independent not-for-profit organizations with a shared dedication to building stronger and healthier communi-ties in the City of Toronto's priority neighbourhoods, have decided to form a strategic alliance to build on the suc-cess of Pathways in Regent Park and create additional opportunities to support the success of youth in other communities in Toronto. Bell Canada announced in 2006 that it will contribute 1.5 million over three years to Pathways Canada, which will support the replication of the award winning program in partnership with five com-munity based organizations, including Toujours ensemble in Quebec.
School Counselling Programs

  • Comprehensive Guidance and Counselling Program (Dept of Education, NS)
    Provides a framework for the integration of academic guidance and personal counselling programs in schools.

Brief Counselling/intervention programs
  • Children in the Middle (Reviewed by SAMHSA, United States August 2006) Children in the Middle (CIM) is an educational intervention for divorcing families that aims to reduce the parental conflict, loyalty pressures, and communication problems that can place significant stress on children. CIM consists of one to two 90- to 120-minute classroom sessions and can be tailored to meet specific needs. The intervention teaches specific parent-ing skills, particularly good communication skills, to reduce the familial conflict experienced by children. Each par-ent attending classes typically receives two CIM booklets ("What About the Children" and "Children in the Middle") that give advice for reducing the stress of divorce/separation on children and promote practice of the skills taught in the course. Each parent also watches the CIM video, which illustrates how children often feel caught in the middle of their parents' conflicts.
Web-based, Referral and Self-Help Programs

  • Mauve, developed by health Canada, provides an example of how technology can be used in an individualised approach to mental health promotion. It is a web/CD-ROM based set of resources for teens.
  • Yoomagazine.net (Centre for Excellence in (Centre of Excellence for Child and Youth Mental Health, ON) is an online, interactive health magazine for young people, parents and professionals. The resource focuses on teach-ing mental health literacy, facilitating early detection of health and mental health difficulties and promoting help-seeking in young people.
6. Better Practices, Exemplars, Issues in Implementation

This section identifies several frameworks for implementation of school programs that can be applied to programs that include resilience as a focus. Case studies of programs that have used evidence-based implementation strategies to foster resilience or related concepts are identified and discussed briefly. The section closes with a discussion how schools can implement resilience-focused programs.

There is considerable discussion in the research and program development research about selecting evidence-based school health programs. Unfortunately, there is considerably less discussion about using evidence-based planning and implementation models to plan, implement and sustain school programs. The following evidence-based implementation models can be used to implement programs that include a focus on resilience. (Follow the link noted here for a more complete explanation)
 Exemplars (Case Studies) in Implementation of Programs that include Resilience

The following examples discuss the implementation of evaluated, effective programs that include resiliency as one of the program goals.There needs to be further investigation of implementation strategies for programs that include resiliency. A key question would be if the inclusion of resiliency improves the acceptability, feasibility, complexity or perceived benefits/risks of the program.
  • Collaborative for Academic and Social Learning (CASEL) CASEL has published several case studies on SEL implementation in school boards and schools. They have also published several resources on implementation.
  • Search Institute (Assets-based Approaches) The Search Institute also has a wide variety of implementation tools.
  • The Implementation and Evaluation of Comprehensive School Guidance Programs in the United States: Progress and Prospects International Journal for Educational and Vocational Guidance Volume 1, Number 3 / October, 2001 The evolution of guidance in the schools of the United States from a position to a service to a program is de-scribed. Then the prevailing structure for guidance, the comprehensive guidance program is presented. This sec-tion of the article provides a brief overview of the basic elements of the program. Finally, the article closes with discussion of guidance program evaluation as well as presents the results of several studies that offer evidence of the impact of guidance programs. This revised version was published online in 2006.
  • Mindmatters in Australia (Description of their implementation process is to added)

Advice on Implementation of Resilience Oriented Programs

Some of the best practices in promoting mental health in school settings are:
  1. Recognizing the role of school as crucible of mental/emotional development comes from within the school, particularly at the policy-setting and administrative levels. No one group of society can possibly bear the burden of promoting mental health alone. The school is a necessary but alone, insufficient partner in the endeavour.
  2. Providing resources to schools means identifying existing resources such as those in substance misuse prevention, that focus on building resilient traits and encouraging healthy child development. Numerous resources exist that are evidence based and that focus specifically on building protective factors.
  3. Teacher support denotes giving teachers the resources and the time to carry out mental health promotion activities about mental health and the role of the school in providing natural opportunities for promoting resilience. It also means supporting teacher wellness. If teachers are stressed, burned out, or unhappy they will be in no position to help their students develop resilient traits themselves. Teacher health and well-being is important to the teacher and vital to the students.
  4. Practical student resources are essential. Practical resources mean tools that are easy to use, support the school curriculum, and are available and able to be used in the time and technological constraints of the classroom. Canadian organisations have produced examples of this such as Mauve.
  5. Fostering healthy school environments may constitute the strongest school-centred strategy for promoting mental health. The school environment forms the cauldron in which students develop. A healthy, health promoting school environment will be a fertile source of strength for students to form their self-concepts and develop the internal protective factors important in resilience.
  6. Emphasizing transitions in children’s lives may provide a key entry point for mental health promotion. Transitions carry with them stress and are the hills of life. Transitions include the changes and adaptation needed to meet change, for example in transition during changes in school settings, relating to moves, changes in family structure, loss, and changes in health status. Transition points provide opportunities because often, individual readiness and motivation to adopt actions to reduce stress and enhance resilience increases during these periods.
  7. Helping the Ministry of Education to expand its vision of the role of schools and the role of the school in the broader community is an important step. Schools may feel defensive given the demands so often made of them to do so many things for so many people. Ministries of education consequently may become themselves protective of schools. Negotiating clear and fair parameters as to just what role the school must play in ensuring the next generation is healthy may avert this unhealthy galvanisation.
  8. Identifying at- risk groups and providing behind-the-scene opportunities for helping them is a uniquely school-based opportunity. It is within the school setting that these groups become evident, and it is within the school that the resources may be made available for helping them. Premature departure from school, alienation from school and lack of bonding in school are paramount risk factors for costly human and health problems now and later.
  9. Focusing on helping children and youth learn how to reduce the frequency and intensity of stresses forms the foundation of academic and social success as well as mental well-being. The role of stress in health cannot be overemphasised.
  10. Striving to reduce and downplay myths of power or “eliteness” among youth has many potential values. These dynamics create winners and losers and even foster bullying. The change has to come from within the students and is a simple matter of making sure such eliteness is seen as the silly and trivial dynamic it is, to the student body.
It has been argued that building resilience in schools need not require a formal program. This possibility holds special appeal for schools, which are already overburdened with curricula demands. The processes of building resilient children in a school setting need not overburden the curriculum. There are many opportunities and daily processes that may do so in natural ways. Some of these include child involvement in assessing their own work, opportunities to collaborate and affiliate in a classroom community, and to solve problems in the classroom.121,127,152,161 The organizational culture of schools must, however, be open to adaptation.

7. Challenges and Barriers to Using Resilience in School Programs

This section identifies and discusses some of the challenges to adoption, implementation and sustainability of resilience-focused school programs.
  • Starting from the premise that all children, youth, families and communities have strengths that can be the basis for policy and program design is appealing and possible. However, schools will always be required to measure students against standards derived from statistical norms. Some students will fall below some of those norms and can then be labelled as being unsuccessful. However, all students will have some strengths that can be formally recognized by the system and applauded as such. This implies that high profile reward systems within schools need to go beyond traditional spheres such as academics, team athletics and traditional music and student leadership. Schools must also be a place where students can excel in entrepreneurship in service industries/trades, extreme and individual sports, gaming, alternative music, fashion, sales/marketing and more.
  • Promoting strengths in a medically driven public health system that is designed to identify problems early and address them in a singular fashion is problematic. The public health system, like the health care system, is a disease/problem driven culture, where the rewards and funding is directed at deficits and problems.
  • Further, the medical system is centrally driven, with higher priorities given to problems with higher mortality rates rather than morbidity rates. It would be quite revolutionary to giving front-line public health staff free rein to work with schools on an agenda of health/social problems that the schools identify as a priority rather than working on a health problem defined as being a priority by experts or bureaucrats.
  • Another essential premise for resiliency programs is the building and maintaining of positive relationships. However, schools cannot be expected to form intense relationships with all students. Most will come to school, have a decent experience and move on. Nor can schools be expected to control the relationships that develop among students. That is the role of parents. Some will form friendships with other teens that are not positive. Nevertheless, all students deserve an equal opportunity to be offered an opportunity to establish peer relationships within the school and to make connections with positive adult role models.
  • Recognizing that while resilience must be nurtured rather than taught, schools can teach students problem-solving skills such as critical thinking, anger management, stress reduction techniques and so on. However, schools and ensuing academic and vocational training institutions are bound by long-standing traditions that favour fact-based learning that can be measured and reported easily. Teachers are often successful students in this type of learning, so they are likely to favour didactic methods.
  • Schools can offer a safe haven, opportunities for building healthy relationships with fellow students in appropriate classroom and extra-curricular activities and ongoing, caring mentoring relationships with teachers, counsellors, other staff/volunteers but schools cannot be a substitute for early and ongoing bonding with parents, family members and the community. Seeking to “re-attach” kids who have been detached by ever-busy or stressed parents, by new media that encourage solitary activities or vicarious interactions through the Internet is very challenging.
  • Educators cannot provide crisis intervention, family & youth services, preventive care and other support services that must come from the community agencies and local professionals but schools can be the convenient, accessible site for the delivery of such services as well as a place where school staff, volunteers and even trained student peer helpers can identify other students experiencing difficulty and refer those students to treatment and re-integrate them after treatment.
  • Finally, and perhaps most importantly, we need to acknowledge one of the essential contradictions between the stated public goals of schooling (to provide equal or equitable educational opportunity and to enable all children to succeed) and the underlying and enduring roles of socialization into the accepted norms of the community (a form of social control) and the accreditation role that schools play in failing some students (thereby redirecting them to the workplace earlier than others) and graduating others to higher levels of education and ultimate economic opportunity. No matter what we do, no matter what we say about “caring” or “connectedness”, the students in all schools, in all societies, understand this essential competition and its implications. Recently, there has been an increased focus on enhancing the “connectedness” of students to school as a way of solving numerous health, social and educational problems. However, we also must recognize that such connectedness to the institution of school is fraught with this major dilemma or paradox. In other words, some students will know that they are failing to make the grade in the highest reward system in the school, academics. Enabling those students to feel connected is therefore, a really challenging task.
8. Local Mechanisms for Adopting Programs

This section identifies and discusses “local mechanisms”, strategic questions and appropriate tactics such as identifying champions, building alliances among organizations, using a local crisis to garner attention and resources, leveraging a directive etc. This is a relatively undeveloped area in school health and social development research. Consequently, it may be problematic to identify examples of programs that include resilience. We have identified a few models here for further consideration.

9. Successful Examples in Capacity Building/Systems Change

This section identifies and discusses successful initiatives that have built capacity, changed systems, adapted to specific cultural, geographical or economic contexts in order to adopt, implement or sustain the intervention
  1. Create decision-making processes that facilitate student, family, and community engagement; academic achievement; and staff empowerment.
  2. Provide education and opportunities to enable families to be actively involved in their children’s academic and school life.
  3. Provide students with the academic, emotional, and social skills necessary to be actively engaged in school.
  4. Use effective classroom management and teaching methods to foster a positive learning environment.
  5. Provide professional development and support for teachers and other school staff to enable them to meet the diverse cognitive, emotional, and social needs of children and adolescents.
  6. Create trusting and caring relationships that promote open communication among administrators, teachers, staff, students, families, and communities.

10. Recommendations for national agencies/federal departments, provincial ministries, local school boards/health authorities/police departments, schools/clinics/professionals

For National Research Agencies/Federal Departments/Professions
  1. Research agencies, federal departments and others should examine resilience and other behavioural theories in more depth to articulate their implications for program, policy and practice more clearly and in more practical terms. Knowledge translation activities such as analysis of systematic reviews, summaries of evidence/experience/examples, webinars, narrative inquiries, realist reviews should be considered.
  2. Health Canada, Public Health Agency of Canada, Human Resources and Skills Development Canada, Mental Health Commission, the Canadian Centre on Substance Abuse, relevant CIHR Institutes, the Social Sciences & Humanities research Council, the Health & Learning Knowledge Centre of the Canadian Council on Learning, the Centre of Excellence on Children with Special Needs and the PHAC Canadian Best Practices Portal should meet to develop an alignment of their knowledge development and exchange strategies with regard to resilience and other behavioural theories.
  3. Researchers and knowledge management organizations should review existing research reviews and meta-analyses to determine if resilience (ie paying more attention to strengthening response mechanisms in neighbourhoods, schools, families and individual students) can be used to identify more effective programs
For Government Health, Social Service, Law Enforcement, Welfare and Education Ministries

  1. Health ministries should ensure that their approach to health promotion explicitly supports asset-based approaches, policies, programs and practices.
  2. Health ministries should provide local health authorities and public health staff with tools to identify, document and plan responses health/social problems relevant to their communities and reduce the categorization of funds according to selected health problems so that local agencies can be more responsive and accountable for building system, organizational and community capacity.
  3. Education ministries should ensure that their health/personal-social development curricula includes skill development in areas such as self-knowledge, stress and anger management, help-seeking strategies and more.
  4. Education ministries, school boards, and schools should report regularly on surveys monitoring student and parent attachment/connectedness to schools.
  5. Education ministries should ensure that teacher education programs provide adequate pre-service training in matters related to resilience such as behaviour theories and child/adolescent development.
  6. Health ministries should ensure that pre-service preparation for public health professionals includes matters related to resilience such as behaviour theories and child/adolescent development
For Health Authorities, Social Service/Child Protection Agencies, Police Departments, School Boards

  1. School boards should undertake in-service training to enable teaching, administrative and counselling staff be adequately aware of matters related to resilience such as behaviour theories and child/adolescent development.
  2. Health authorities and social service agencies should undertake in-service training to enable current administrative and professional staff be adequately aware of matters related to resilience such as behaviour theories and child/adolescent development.
  3. Municipalities, police departments, municipal recreation programs should undertake inservice training to ensure that recreation and law enforcement staff are adequately aware of matters related to resilience such as behaviour theories and child/adolescent development.
  4. All local agencies should consider the adoption, adaptation, implementation and institutionalization of promotion and prevention programs, policies, professional and organizational practices that include resilience (ie strengthening response mechanisms)
For Schools, Local Clinics, Youth Centres, Health/Social Service and Police Officers

  1. Teachers should ensure that their teaching methods and classroom management practices reflect and include principles related to resiliency, social and emotional learning, asset building, and related matters.
  2. School principals should ensure that their school procedures and administrative practices reflect and include principles related to resiliency, social and emotional learning, asset building, and related matters
  3. Nurses, police officers, social workers, school counsellors, school psychologists, and other care-giving professionals should ensure that their administrative procedures and professional practices reflect and include principles related to resiliency, social and emotional learning, asset building, and related matters.

11 Research & Resources

This section contains some selected research and educational/planning resources. See the related Bibliography/Toolbox on Resilience also published in this wiki-based web site.

Key research references


Key reports/resources

This section contains a list of reports as well as policy, planning and assessment tools:
  • Safe and Caring Environment: Online Training for Administrators (Regina Public Schools & Saskatchewan Learning) As social changes impact on our communities and schools, it is vital to continue to build and sustain safe and secure learning and working environments for our students and staff. Creating safe, caring learning environments requires close collaboration within the school community and partnerships with both the neighborhood and the entire city
  • Progressive Discipline: A new approach to help make schools safer (Ontario Education) Ontario's new approach to making schools safer involves the whole school. It focuses on: Promoting positive student behaviour; Preventing inappropriate behaviour; Providing early and ongoing intervention; Practicing progressive discipline by addressing inappropriate behaviour with appropriate consequences (Guide).
  • Organizational Self-Assessment for Youth Involvement in Decision-making (CASH)Five Sets of Criteria to Assess Youth Involvement in Public Decision-Making. The following five sets of criteria assessing the effectiveness of youth involvement in public decision-making were developed from a variety of sources (See References). Each of these five sets includes several questions, derived from research, that assess the effectiveness of youth involvement programs and activities. Go to each of the five sets by clicking on the underlined titles. Your organization or institution can develop a clear understanding of their readiness to promote youth involvement in your decision-making by answering the questions found in this guide.
  • Let' Em Go: How to Support Youth in Creating Their Own Solutions (CAMH)This is a handbook for professionals who work with youth. Based on the experiences of working with street involved youth, this handbook provides specific guidelines on how to implement participatory methods with youth to develop a harm reduction product.
  • Tapping Hidden Strengths: Planning for Students Who are Alcohol-Affected (Government of Manitoba) This is a planning resource intended to provide a support for student service administrators, principals, classroom teachers, resource teachers, school counsellors, clinicians, and other community professionals who will help in assisting schools in developing approaches for students who are alcohol-affected. The resource will address the spectrum of students who are alcohol-affected, including those diagnosed with Fetal Alcohol Syndrome (FAS), partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), and Alcohol-Related Birth Defects (ARBD)
  • Acting On What We Know: Preventing Youth Suicide in First Nations (First Nations & Inuit Health, Ottawa)
    The recommendations from this report fall into four main themes: increasing knowledge about what works in suicide prevention; developing more effective and integrated health care services at national, regional and local levels; supporting community-driven approaches; and creating strategies for building youth identity, resilience and culture
  • Yellow Ribbon Gatekeeper Training (Light for Life Foundation – Alberta Chapter)
    The Yellow Ribbon Program supports and follows the Canadian National Suicide Prevention Strategy. The training program helps any “trusted adult” (including teachers) to recognize and understand the symptoms, risk factors and warning signs of suicide. To make approaching “trusted adults” easier, the Yellow Ribbon Program developed the “It’s OK to Ask 4 Help” card.

  • REDI for the Classroom: A Resilience Approach to Drug Education (Commonwealth Government, Australia)
    This training resource describes a whole school approach to preventing drug use using a resilience approach.











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