A Research-Informed Human Behavior and Social Work Practice Approach: The Resilience-Enhancing Stress Model

Although it has undergone several iterations, there has been a long-standing movement to encourage social workers to use empirically sound research to inform their practice decisions (Council on Social Work Education, 2015, 2022; McNeece & Thyer, 2004; Webb, 2002). According to Rubin and Parrish (2007), evidence-based practice is “a process in which practitioners attempt to maximize the likelihood that their clients will receive the most effective interventions possible” (p. 409). That is, social workers gather evidence of the extent to which their practice is effective.

To evaluate whether an intervention was helpful to a client or constituency, social workers are asked to engage in five general steps: (a) formulating an answerable question regarding practice needs, (b) tracking down the best evidence available to answer that question, (c) critically appraising the scientific validity and usefulness of the evidence, (d) integrating the appraisal with their clinical expertise and client values and circumstances and then applying the outcome to practice decisions, and (e) evaluating the practice outcome (Thyer, 2008).

However, evidence-based social work practice has not been without controversy and debate, and its implementation has been fraught with difficulty (Webb, 2002; Witkin & Harrison, 2001). To further complicate the matter, the most recent draft of Council on Social Work Education’s (2022) Educational Policy and Accreditation Standards soon to go to the board of directors for approval does not reference “evidence-based” social work practice. However, it does mandate that social workers use research findings to inform and improve practice, policy, and programs as well as apply knowledge of human behavior and person-in-environment and other culturally responsive multidisciplinary theoretical frameworks when engaging, assessing, intervening with, and evaluating clients and constituencies in practice.

The authors of this editorial raise two questions in this regard: (a) Does the process of using and translating research evidence to inform and improve practice decisions, policy, and service delivery fall under the rubric of the evidence-based practice movement? and (b) Can advocates of this movement also advocate for social workers to adopt theories and models that are informed by research?

The Resilience-Enhancing Stress Model (RESM)

The RESM, a social work practice model that offers a research-informed base for understanding human behavior and practice, is used here as a case in point to illustrate how practitioners can adopt research-informed human behavior theory (Greene, 2014; Greene et al., in press, 2021, 2019). This four-phase model and its embedded skill set is intended to guide social workers through the process of engaging, assessing, intervening with, and evaluating diverse individuals, families, groups, organizations, and communities.

The RESM: a metatheory

The broad scope of the RESM suggested that a metatheory would be needed to meet “the technical flexibility of selecting interventions on the basis of specific client/problem/situation configuration” (Fischer, 1978, p. 237). Metatheories combine concepts from several theories to obtain the knowledge, attitudes, and skills required for this versatility. The theories incorporated into the RESM are risk and resilience theory, ecological theory, systems theory, and narrative theory:

• Risk and resilience theory explores how people respond to stress and demonstrate effective functioning (Bonanno et al., 2007; Chandra et al., 2010; Galea, 2014).

• Ecological theory examines the multiple interlocking social systems in which people interact over the life course (Bronfenbrenner, 1979).

• Systems theory explores relationships and interactions within and between social systems (Buckley, 1968; Von Bertalanffy, 1968).

• Narrative theory enables social workers to obtain clients’ or constituencies’ stories and to positively reframe critical life events (White, 2007).

The RESM: four phases

The RESM consists of four overlapping practice phases that are analogous to Greene’s (2015) practice competencies. The first phase is engagement or forming a relationship in the third space. The third space is a place in which people interact with one another face to face and use skilled dialogue and self-reflection to learn about others’ stories (Barrera & Corso, 2002). The second phase is assessment, or coconstructing a client or constituency narrative. The narrative or client story is a means of incorporating people’s lived experiences into the social work encounter to obtain client assessment data (Greene, 2015; Hallberg, 2001).

The third phase of the RESM is intervention or reconstructing the client or constituency narrative to effect change. The fourth phase is evaluation or determining how the client has used the helping process. Questions to ask include the following: Did the client perceive the practitioner as having knowledge and skills that the client could use? Did the social worker help the client perceive the practitioner as a peer collaborator or partner in the problem-solving effort (Solomon, 1976)? Is the client engaging in resilient behavioral outcomes, such as self-care and activism (Greene et al., in press)?

Defining resilience

In the early formation of the RESM, a broad literature review led to the collation of terms and assumptions translated from research on risk and resilience theory (Greene, 2012). Although terms still tend to remain vague and ill defined, definitions have been updated as the theory has evolved, and behavioral outcomes or markers of resiliency are better understood through the research findings that inform the theoretical concepts.

There has been a growing consensus among researchers that resilience should be defined as people’s ability to withstand and mitigate the stress of disruptive, adverse events (Chandra et al., 2010). Namely, resilience is demonstrated when people are faced with demanding situations and respond positively to them (Strumpfer, 2002). In other words, when people rise to environmental demands, overcome or reduce them, and maintain some level of effective functioning, they are considered to be resilient (Galea, 2014; Hjemdal et al., 2006).

The RESM: empirical roots

A historical review of the evolution of risk and resilience theory and the parallel construction of the RESM reveals the interconnection among research, theory, and practice. More than two decades ago, Fraser et al. (1999) suggested that “if we can understand what helps some people function well in the context of high adversity, we may be able to incorporate this knowledge into new practice strategies” (p. 136). The RESM, first introduced in the Journal of Human Behavior and the Social Environment in 2014, realizes this aim by providing a guide for social work practice with clients and constituencies who have faced and overcome adversity or high levels of stress or risk (Greene, 2014).

Early risk and resilience researchers sought to explain what appeared to be a differential developmental response to risk. Namely, researchers asked why some children better withstood higher levels of adversity than others in seemingly similar circumstances. For example, the seminal longitudinal studies of Werner and Smith (1982, 1992) examined how children faced high-risk situations such as child abuse and poverty and sought to explain what factors contributed to resilience. This groundbreaking research paved the way for developing programs that protected or shielded children from risk.

Other leading researchers, such as Rutter (1987) and Garmezy (1991), followed this research direction, focusing their questions on what factors promote competent functioning. Their research findings revealed protective factors that influence resilience at the individual, family, and institutional levels. These ideas about child development led to programs to support low-birth-rate babies and their mothers as well as school-based programs that promote resilience (Bernard, 1993; Masten & Coatsworth, 1998).

The psychiatrist Robert Lifton (Lifton, 1991, pp. 1993/1999) is another seminal theorist who first studied resilience by talking to survivors of the bombing of Hiroshima following World War II. During a visit to Japan, Lifton wanted to learn why despite experiencing such a severe event, survivors were remarkably poised to make a new future. He called this phenomenon the protean or resilient self. He later translated the idea that people can remain resilient even during times of uncertainty and extreme stress into his clinical practice.

Still another seminal resilience theorist was Leon Chestang (1972), a social work educator who brought his interest in combating racism to his research. Chestang’s views were prompted by one of his research studies, which involved interviews with 20 well-known African Americans in the arts. He found that the study participants’ narratives emphasized receiving unconditional love and support from their family and local community. He concluded that people can better overcome the adversity of discrimination and become resilient adults when their relationships and socialization involve the instillation of protective factors such as pride, self-respect, and hope for the future (see Miller & MacIntosh, 1999). The theoretical principles of Chestang and his colleagues drew attention to the need to infuse social work curriculum and practice with strategies that combat living in an unjust dual society (see Norton, 1978).

More recently, Michael Ungar (2011), a social work clinician and international researcher, created a research protocol that included exploring participants’ views about language and design in the very study about to be undertaken. Ungar argued that if the research questions were framed in a culturally sound manner, the findings would be more likely to reveal participants’ lived experiences. Ungar went on to propose that practitioners should focus on helping at-risk children learn to navigate environmental barriers to gain more effective functioning within their specific cultural context.

A Person–Environment (P-E) perspective: resilience in larger scale systems

The aforementioned scholars and multiple research efforts led to resilience being recognized as a process that goes well beyond individual traits (Richardson, 2002). Resilience is now understood as a multisystemic process within a cultural context (Masten, 2014; Ungar, 2011). Furthermore, ongoing research has underscored the fact that resilience needs to be understood as dynamic interactive processes that occur at the intersection between people and their environments (Van Breda, 2018).

The adoption of the P-E perspective brought about an interest in the resilience of larger scale social phenomena that requires the exploration of a system’s functional capacity and the collective contribution of its members. In other words, social workers need to frame their assessment process using a systems point of view. A systems point of view assumes that the whole is more than the sum of its parts and that social systems may be resilient in their own right (Buckley, 1968).

This human behavior precept requires further research but suggests a focus on the mutual influences of various systems in which clients and constituencies participate, such as families, schools, peer groups, work, neighborhoods, communities, and the larger society. One study that adopted this P-E approach to research and shaped the RESM as a multifaceted, interactional process was Forgiveness, Resiliency, and Survivorship Among Holocaust Survivors (Greene, 2010). Funded by the John Templeton Foundation, this quantitative study of 133 survivors of the Nazi Holocaust illuminated factors that permitted the survivors to make successful life transitions and resume effective functioning following the Holocaust (Greene, 2010). In essence, the study provided further understanding of the multisystemic nature of resilience.

Another study that explored resilience from a large-scale P-E perspective was Resilience and Healing Among Cambodian Survivors of the Khmer Rouge Regime (Greene, 2015). The study’s author analyzed survivor stories published in the Cambodian Tribunal Monitor and the Documentation Center of Cambodia Journal to determine what contributed to people’s resilience following the Khmer Rouge regime. She specifically asked why the 20 study participants who had lost family members during the 1975–1979 genocide of 1.7 million Cambodians maintained resilience despite experiencing severe hardships.

By critically evaluating study data, Greene (2010) concluded that the fact that survivors acted as civil parties and testified at the United Nations Cambodian Tribunal war trial helped them achieve a sense of peace. Greene went on to state that resilience outcomes were realized as participants asserted their family bonds through political activism. These accounts about life under the Khmer Rouge regime prompted the multisystemic approach to resiliency found in the RESM, which addresses forces from the individual to societal levels that influence resilient behavioral outcomes.

The RESM: potential contributions to evidence-based social work practice

A RESM human behavior perspective “identifies people’s sources of stress, their response to the stressor, and what may be needed to maintain some level of resilient functioning” (Greene et al., in press). Thus, it offers social workers research-informed principles to use throughout the social work helping process. For example, the model’s assessment guide comprises 10 research-based P-E dimensions that act as interview prompts. The prompts were derived from the literature on risk and resilience theory and can be used to map clients’ and constituencies’ sources of stress (White, 2007).

Summary and conclusion

The RESM is a research-informed approach to human behavior and practice derived from studies of risk and resilience theory. That is, many of the model elements such as definition of terms and assessment strategies were based on scientific inquiry. Therefore, the authors of this editorial contend that evidence-based social work practice strategies can be augmented with empirically supported theories and models of human behavior. For example, because living in a time and place that is uncertain can diminish resilience (Lifton, 1993/1999), the RESM practice approach encompasses the idea that social workers should take into consideration the consequences of the time and place in which the helping encounter has occurred.