Most people will experience at least one highly stressful or traumatic event in their lifetime. Research shows that the occurrence of these substantially increases an individual’s risk of experiencing poor mental health. For example, we might experience the death of a loved one, lose a job, or live through a traumatic world event such as a natural disaster or, indeed, a pandemic. However, despite increased risk, the majority of people will not develop a serious or related mental health problem. In fact, some individuals may even be strengthened by or grow from their experience. This raises the question: In times of hardship, what gives people the strength to persevere?
For decades, the science of psychology has been trying to get a better understanding of these phenomena, which has been called resilience. Simply put, resilience is the capacity to bounce back from stress. It has been shown to protect against burnout and the development of many common mental health problems. According to the current state of knowledge, resilience is not a stable personality characteristic within a person but is instead composed of several modifiable factors that mitigate the negative effects of risk. An important implication of this is that people are not born resilient; rather, resilience is learned and developed over time. Following this line of reasoning, and in accordance with the growing emphasis placed on mental health promotion and prevention in recent years, interventions aimed at fostering resilience are becoming increasingly popular.
Space for Resilience is a new online program developed by SilverCloud Health that provides users with psychoeducation and tools to enhance their resilience and wellbeing. It is a broad program targeted at individuals in universal, preventive, and remedial contexts aiming to enhance their general resilience and wellbeing, prevent future mental health problems, or supplement face-to-face treatment. The program draws on the principles of positive psychology (i.e., the science of happiness and wellbeing) and incorporates mindfulness-based and cognitive-behavioral elements such as meditation, cognitive restructuring, and behavioral activation. By using these strategies, the program promotes the development of a number of well-evidenced resilience factors, including meaning or purpose in life, a sense of coherence, positive emotions, hardiness, self-esteem, active coping, self-efficacy, optimism, social support, and cognitive flexibility. These factors are enhanced over a series of seven modules which include five core modules, each focusing on a different domain of resilience:
Building Resilience
The opening module introduces the concept of resilience and its five core domains: purpose, self, connections, body, and mind. The user is invited to consider their strengths in each of these areas and set goals for the future. The practice of mindfulness meditation is also presented, and its role in promoting mental flexibility and adaptability is explained.
Purpose
This module highlights the importance of having a clear sense of purpose in order to live a meaningful life and deal with setbacks. The concept of flow is introduced, and users are encouraged to identify their values and passions and integrate them into their everyday lives. The user is also supported in finding a balance between the roles they play in key life areas (self, relationships, and work).
Self
This module focuses on enhancing self-esteem and self-efficacy. Users are encouraged to build awareness of their personal and signature strengths, put them into practice and align them with their values and passions. The practice of self-compassion is also introduced, and users are facilitated in replacing negative self-talk with kind and compassionate self-statements.
Connections
This module centres around strengthening relationships in order to foster a sense of belonging in users. The user considers their current social network and develops strategies to improve the quality of their personal relationships and community involvement. Lastly, information about communication styles, is provided and users learn communication skills to build and sustain healthy relationships.
Body
Maintaining a healthy lifestyle makes an important contribution to an individual’s resilience and overall wellbeing. This module provides information on the three central aspects of a healthy lifestyle (exercise, diet, and sleep) and offers tips for developing positive habits in each of these areas. Behavioral activation techniques for building motivation are explored, and the user reflects on the link between their lifestyle choices and mood.
Mind
The module explores the role of thoughts in developing resilience. The benefits of balanced optimism are considered, and users learn to notice, evaluate and replace their negative thinking with a more positive, realistic outlook. The role of gratitude in cultivating balanced optimism is also considered, and users are encouraged to make a habit out of focusing on the positive aspects of life.
Moving Forward
This module focuses on building active coping strategies. Users are supported in taking action or changing their response to problems, and a step-by-step guide for effective problem-solving is provided. Lastly, users reflect on the progress they have made in the five core domains of resilience and set additional goals for the future.
To examine the feasibility of the Space for Resilience program, we conducted a pilot randomised controlled trial with a sample of 83 college students in Dublin, Ireland. Primary outcomes were measures of resilience (Connor-Davidson Resilience Scale; CD-RISC) and wellbeing (Pemberton Happiness Index; PHI), and secondary outcomes included measures of self-esteem, stress, and symptoms of anxiety and depression. The program was delivered over an eight-week intervention period, and participants who received the intervention demonstrated significant improvements in resilience, wellbeing, self-esteem, and reductions in stress and symptomatology at post-intervention. Overall, users were satisfied with the program and were likely to recommend it to a friend or colleague, with approximately 79% of users saying that they found the program helpful or very helpful. In particular, participants liked the accessibility and flexibility of the program and endorsed its inviting layout and positive psychology approach.
The program is also currently being used in Talking Therapies, a mental health service within the Berkshire Healthcare NHS Foundation Trust, UK, where it has been well-received by psychological wellbeing practitioners (PWPs) supporting clients on the program:
“I really like the way it incorporates positive psychology and CBT. I also find it really helpful for people who are at a change in role stage of life...”
“... it has given us an opportunity to really support and reach out to clients who have engaged a number of times and are experiencing recurrent depression... Not only this group, but a larger group with challenging unchangeable life events ongoing have found the program to be extremely useful with fantastic recovery results.”
While further research is needed to evaluate the effects of the intervention on a larger scale, the pilot trial and qualitative feedback received provide preliminary support for the initial efficacy, acceptability, and real-world benefits of the Space for Resilience program. Importantly, the results of the pilot provide additional evidence that resilience is open to improvement. By developing the evidence-based skills and behaviors that promote positive adaption, a person can build their resilience and ability to overcome negative life events. Although we cannot always change a difficult situation, we can change the way we react and adapt to it, and in doing so, begin to see our problems as an opportunity to learn and grow.
References
Kalisch, R., Baker, D. G., Basten, U., Boks, M. P., Bonanno, G. A., Brummelman, E., ... Geuze, E. (2017). The resilience framework as a strategy to combat stress-related disorders. Nature Human Behaviour, 1(11), 784–790.
World Health Organization (2001). The world health report 2001 – Mental health: New understanding, new hope. Retrieved from https://www.who.int/whr/2001/en/whr01_en.pdf?ua=1
