On the Flip Side: Flipping the formula for progress in rehabilitation

In rehabilitation the formula for progress often starts by targeting one or a small set of skills. Treatment is structured to move that skill in a scaffolded or graded manner; where there is a gradual increase in difficulty and skill level. For example, a client can learn the basics of using a smartphone, then learn how to use the basics of a calendar app and lastly progress to the point of using all the features of the calendar app. Rehabilitation is filled with such examples of helping clients successfully progress on a domain-by-domain or skill-by-skill basis. The challenge with a narrow focus on one or more specific skills is the limited transferability to other skills. Are there strategies that are far-reaching in their impact? Absolutely, and quite a few at that! I posit that there is a place for reconceptualising the rehabilitation process for a sustainable and broader impact.

By tying happiness and well-being to goal-posts that continually move, we’re paradoxically reinforcing an impossibility

The formula for progress in rehabilitation starts with the premise that if a client works hard he’ll progress further and further. The more the client progresses the more his confidence grows, the happier he’ll be and his well-being will follow suit. The research is showing us that this formula is backwards. By tying happiness and well-being to goal-posts that continually move, just as you approach them, we’re paradoxically reinforcing an impossibility. We think we have to see persistent progress to feel good. We’ve got it backwards; our brains work in the opposite order. If you can raise a person’s level of positivity in the present performance improves. From creativity to energy levels to productivity in the workplace, performance levels are substantially and consistently increased. Under the umbrella of positive psychology there is burgeoning research that shows us that we can flip the formula for progress on its head. If we first develop skills for well-being and happiness and related skills, such as our attention, our performance and progress will increase across a myriad of domains.
The vehicles for positivity are numerous. There is mounting evidence in the literature illustrating the wide-ranging benefits of strategies and interventions designed to develop positivity. These strategies can thus serve as the foundation for well-being, success and progress in life and certainly in rehabilitation. Applying these strategies in rehabilitation can have immediate and long-term benefits. In the short-term an increase in progress will be seen when working on a skill-by skill basis. By their nature, positivity strategies are broad in their scope and thus carry sustainability for the long-term. Let’s review three areas of research that support the use of such strategies.

Based on his research and 12 years of experience at Harvard, Shawn Achor has shown that creating positive transformations can ripple into more successful outcomes throughout one’s life. Here are three strategies that the research has shown to lead to an increase in positivity. The first, ‘Writing down what you’re grateful for’. Writing down three new things you are grateful for each day into a journal will have lasting and significant effects on your optimism and success rates. Second, ‘Focus on the positive’. The strategy calls for writing for a couple of minutes a day describing one positive experience you’ve had over the past 24 hours. This strategy transforms the lens through which you view the world from a task-based thinker to a ‘meaning-based’ thinker which increases workplace happiness and productivity. The third, ‘Thank a colleague’. This strategy works just like it reads. Each day you write an email thanking or praising a member of your team.

We think we have to see persistent progress to feel good. We’ve got it backwards.

Our focus of attention, an overlooked and underrated asset, is the ‘Hidden Driver of Excellence’, argues Daniel Goleman, a psychologist and researcher. He shares that the practice of attention turns out to be a powerful tool to create positive change. The ability to stay focused on the task at hand and ignore distractions ranks among the most basic and most important skills in your cognitive toolbox. The more focused you are, the more successful you can be at whatever we do. Mindfulness is one of a number of strategies that serves to improve your focus. Mindfulness can be described as an active attention to notice that your mind has drifted, and a mental effort to end that reverie and revert back to the original course you were on. This cognitive exercise, if done with regularity and persistence, will make it easier to keep your focus where you need it to be.

Martin Seligman, the so-called father of Positive Psychology, is a world-renowned researcher. The goal of the positive psychology movement is to make people’s lives more fulfilling, rather than simply treating mental illness. He, along with his colleagues developed the Character Strengths and Virtues Handbook (CSV). The CSV identifies 6 classes of virtues (i.e. courage and temperance) which are further made up of 24 character strengths (i.e. persistence and gratitude). Seligman’s CSV research has led to the development of interventions and strategies that improve ‘character strengths’. The results are impressive. For example one study found that, “employees who used four or more of their signature strengths had more positive work experiences and work-as-a-calling than those who expressed less than four.” Another study concluded that, “across occupations, curiosity, zest, hope, gratitude, and spirituality are the Big 5 strengths associated with work satisfaction.”
Rehabilitation often needs to operate in narrow domains. Specific deficits need addressing and likewise specific skills need support for development. By flipping the formula around we can adapt our rehabilitation models to incorporate the positivity vehicles of well-being and success at the outset. Using positivity strategies leads to increased productivity and performance across the board. Framing rehabilitation in this manner serves to make progress in rehabilitation successful and sustainable.

Originally published in the Vocational Rehabilitation Association of Canada‘s magazine, Rehab Matters.

References
Achor, S. (2011). The happiness advantage: The seven principles of positive psychology that fuel success and performance at work. Random House.
Goleman, D. (2013). Focus: The Hidden Driver of Excellence. Bloomsbury Publishing.
Seligman, M. E. (2004). Character strengths and virtues: A handbook and classification (Vol. 1). Oxford University Press.

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