Objectives

This position paper aims to:

• Summarise the background and pragmatic rationale for DENT and its relationship to Intentional Peer Support in organisations and for individuals
• Give an overview of the DENT approach
• Define the terms within DENT and relate to the theoretical background
• Conclude with a vision for outcomes of DENT action research

 

Background and Pragmatic Rationale

Between them, the authors have a rich background of a combined 40 years of training, expertise, and practice in the fields of pedagogical psychology including; psychotherapy, counselling, coaching, peer support, and teaching, delivered across the public, corporate, and third sectors, up to CEO level in Corporate and Third Sector organisations. They have specialist interest and expertise in the areas of Leadership, Stress and Addiction.

Currently, they run various businesses, utilising the full range of their skills. One providing interim directors, executive coaching, and business consultancy for small to medium sized businesses; one providing personal and business coaching, training, and facilitating to those wishing to grow and better themselves; and a Community Interest Company serving the more vulnerable in our communities, with a passion for working with organisations to drive up the standards and quality of peer support provision within our communities.

Though, because DENT is grounded in Social Constructionist concepts, we see DENT as an essential and salient approach for leadership, organisational development and the development of communities of practice, this initial position paper is produced off the back of our work for the Department of Work and Pensions (DWP) in the UK and will reflect the benefits of the DENT approach within the field of peer therapeutic coaching, for improved mental and emotional health.

The background and rationale of the DENT approach would not be complete without emphasising that, despite their vast range of experience and skills, the authors predominantly see themselves as peer coaches, have trained in the field of peer support, and have developed a Diploma up to Master Coach level, underpinned by DENT, and which is discussed elsewhere.

 

DENT and Emotional and Mental Health (MH)

It is the ‘lived experience’ of the peer coach/leader (e.g. the authors have faced and successfully overcome life challenges) that has inspired the authors to ‘mind the gap’ both within therapeutic techniques, and within the way in which various services are provided. The DENT approach is therefore equally informed by therapeutic and coaching practice experience, lived experience of challenges and service provision, as well as academic theoretical knowledge and understanding.

The authors have an interest in capturing the practice they have evolved intuitively during their years of practice and distilling it, through research, into an approach that can be made useful to those they have a passion to serve. The outcome is always aimed towards beneficiaries and doing their bit to improve the quality of healthcare provision with the widest possible reach.

It seems like a timely decision to publish this work, during an era which has seen the past decade adopting more recovery focused and user led approaches within statutory and third sector organisations. In fact, ImROC had very ambitious aims back in 2008, to populate the public-sector health service workforce with 50% peer professional staff in the duration of their implementation of recovery-based services within the sector. (https://imroc.org/resources/implementing-recovery-new-framework-organisational-change/ )

The authors see DENT as taking the recovery approach a stage further, focusing its Purposeful Peer Initiative on the outcome, not just of recovery, but of Purposefulness and Purposeful Occupation for peers who learn the DENT techniques. This would include a clear focus on departmental goals in the organisational setting. Previous research by Emma Jaynes (Jaynes:2018) has shown that meaning and purpose in life is positively correlated with good quality of life, and so the authors adopt Purposefulness as the goal of DENT, leading to the individual becoming Adept in life (career, work and community) and personally fulfilled.

DENT overview

DENT takes a universal, pragmatic, world-centred approach to human development. World-centred for DENT means that individuals will learn how to better relate within themselves and outwards with their world. In doing this, it recognises that a totally introspected, self-bounded person is unlikely to meet their full potential. Similarly, a totally extrospected, unbounded person will come into conflict with the environment in which they need to relate and operate, and equally as unlikely to meet their full potential. The introspective and extrospective views need, to state it simply, be integrated.  Both views are likely to suffer from having unmet needs in different areas, that need attending to in order that they can both aim to self-actualise and, if they choose, transcend their own limits and serve usefully in some capacity.

With this world-centredness, DENT aims to support individual and social development through mediating and resolving the tensions of the person-in-the-world interface. These tensions are constantly changing, which means that the individual needs to become effective and efficient at adapting, if they are to relate with their world with calmness and consideration. DENT has coined this term and names it ‘Adeption’.

Adeption is the ability to constantly meld the person-in-the-world, with their environment, with ease. This interface of the person with their world, results in personal experience. Personal experience is a large part of the feedback the individual gets from negotiating mutuality in the person-in-the-world environment and then acting to meet those agreement.

Feedback provides learning and growth opportunities for personal and social development as the person reaches out towards their full potential alongside and with their peers. The way in which a person makes sense of, and consolidates, their learning, is through narrative. This might be through self-reflection, self-talk, dialogue, conversations, and feedback from, and to, other purposeful peers.

DENT is pragmatic to the extent that theory underpins a set of techniques that have been honed through practice and experience, as demonstrated in the introductory section of this paper. Techniques form the tools which individuals, through social groups, can utilise to support them towards meeting intentions, potential, purposeful occupation, and self-actualisation.

 

 

DENT terminology and theoretical placement

DENT occupies a Social Constructionist position with particular influence from Phenomenological and Discursive Psychologies. In summary, the Social Constructionist view shies away from essentialist limits pertaining to the notion that a person has a fixed identity, or an essence, that, at the core, never changes. Instead, identity is fluid (dynamic) and constantly changing and shifting in relation to our circumstances, others, the environment, and further. Once we accept that view, the potential for change becomes probable.

Social Constructionism, instead, holds the view that our identity is constructed from a limited range of discourses that are available to us in our culture. We choose a subject position which is culturally, socially, historically, politically, and geographically specific.  Social Constructionism tells me, for example, that a health challenge may be a part of my experience but my relationship with it and experience of it is in constant flux. I can change it and how I relate to it and I can even call it something else that I choose and take another perspective on it. Social Constructionism also acknowledges the power relations inherent in any relationship, be it with an organisation, a person, the culture, or an institution. This aspect will form a deeper part of the academic enquiry into the practical applications of DENT within Peer and Professional Peer relationships.

Dynamic

As already outlined, DENT recognises that everything in our world is in a constant state of flux. As such, as we grow and change, and, as everything and everyone in our environment changes as well, we must learn to continually re-negotiate our relationship with ourselves, others, and the wider environment. This means individuals must be adept at resolving the tensions, conflicts and frustrations that arise in socialising, by continually updating a sense of both inner and inter-relatedness, to maintain equilibrium in the face of the veracity and volatility of environmental change; to cope with uncertainty and ambiguity; and to behave congruently in mutuality with their social groups

Experiential

In the phenomenological sense, our experience is both subjective and intersubjective. Subjective, in the sense that only ‘I’ can experience ‘my’ encounter with myself, others, and the wider environment. In that sense ‘I’ am always alone. However, whilst it may seem paradoxical, our relatedness means that ‘I’ would not be the ‘me’ that I experience, had I not met ‘you’, or been ‘there’, or seen ‘that’, or done ‘that’ during my life. This is intersubjectivity.

In DENT, the experiential is expressed in the richness of the description of a lived experience. How it feels in ‘me’, to be ‘me’, today, as an embodied self, in my physical, emotional, psychological, social, and spiritual ‘reality’.

The experiential is something very different to narrative. The experiential is pre-interpretation. The narrative is a device I use to construct, using language or ‘talk’, my identity and place, or subject position, in the world.

Narrative

In the Discursive Psychological sense, all we have is language. Without talk, we cannot make meaning or sense out of our world. Language ‘does’ something, it is the tool we use to make sense of the experiential.

Discourse, in the broader sense, is how meaning is formed, expressed, and controlled in a culture.  It can be interrogated at the micro level, in our day to day conversations and dialogue, and the macro level, in the social, cultural, political, and historical landscape in which we find ourselves. When we create our subject position, we can only choose from a limited range of discourses.

In DENT, it is recognised that, using our talk, we actively and purposefully construct our experience, acknowledging that it is always contextual, in the broader sense, and power relations are inherent within it.

Narrative, in the DENT theory and techniques, becomes a means by which we understand the subject positions we currently inhabit, which we can then deconstruct and reconstruct, on purpose, to consciously fulfil our positive intentions for ourselves and our lives.

Anoni and Sociali

There is a concept that we must deal with in this theory. This is the sense of separateness we all have within ourselves, that part which, no matter how many friends we have, or how much one may feel connected in our communities, with all others, or with all things, is always alone. In DENT, we call this Anoni. The Anoni can be contrasted with the Sociali, which is the expectations placed on the individual to healthily fit in their various communities.

Within me, I have this uncertain, ambiguous quality that is indescribable. I know it, but I cannot name it and it can cause considerable frustration as I try to name it and communicate it to others. If I do name and describe it, I am using words that are socially constructed and understood. Those words are imperfect.

I have an observing self which can stand back and comment on how I feel and think about myself in a way that others might understand, but I can never quite get to the Anoni.

I can tell a story about Anoni which is healthy or unhealthy, and the frustration of not being able to describe it makes Anoni more intense and feel worse.

It is the peer coach’s job to help another to tell a healthy story about the Anoni and, to avoid the deep frustration of being able to bear the Anoni, the human must become purposeful, and to cope with the ambiguity of frustrations of the Anoni and yet still be an effective operant in the world, that is an effective Sociali.

Freedom comes about best when one is able to construct a healthy story which is aligned with the Inter-View; Self-View; and Life-View. In DENT Terms the three views need to be integrated. From this congruent alignment of beliefs and behaviour, comes a deep acceptance of the Anoni, and hence a reduction in its capacity to hinder and obstruct progress. When the Anoni is focused outwards on service, it is quietened and contented, we call this healthier version, the Social Anoni.

 

Combining the Phenomenological and the Discursive – the experiential and the narrative

In a very practical sense, if we can arrest the current narrative for a moment and tune into our current embodied experience, we create a pause. Within this pause we can get a sense of the current embodied state. The talk, at this juncture, comes from an intuitive and descriptive place of conveying what that current embodied state ‘is’ for me right now.

We describe the richness of our experience whilst remaining acutely aware of the way we are constructing it in our talk. What position we are taking, what our intention is, in short. What is it I am telling myself? What is it I want others to know? What is the function of the narrative I am currently telling?

What does my current telling of my story achieve for me? What purpose does it serve? If I want to change my life or my health, how does my narrative need to change?

It is here, with these types of questions that we can see how inextricably linked are our lives and our experiences with our narrative, or our ‘talk’ about it. Language ‘does’ something, it is an agent, we can only change something, with language. It is the most powerful vehicle for change.

From the place of pure experience, we can choose the path of the future narrative by purposefully, intentionally, and carefully constructing that path, through the coaching tree, using the Cycle of Adeption, towards the achievement of Adeptness, and a life of perpetual growth and purposefulness.

Vision, Research, and Conclusion

Vision

Our vision for DENT is an ambitious paradigm shift. Rather than a superfluous topic deemed interesting to study, we can see the overall pragmatic benefits of the DENT approach for improving (even remedying) social cohesion.

This can be achieved at a macro level when organisations; institutions; businesses; families; and the community take on board and pass on the DENT philosophy as underpinning their cultural ethos.

At the micro level, DENT improves and restores emotional and mental health; brings purposefulness to people’s lives by encouraging and supporting mutuality and service; builds good, solid, trusting relationships with self and others; and enables people to achieve that which they had never imagined possible.

Research

How do we know this? Currently, we have a large body of anecdotal evidence gathered. We are preparing to further our research in the following areas:

• The direct and indirect benefits of DENT based Intentional Peer Support (IPS) :

o   For Leadership

o   In businesses and Organisations

o   For Emotional and Mental Health

o   For gaining and retaining employment

• Investigating the extent to which modelling DENT IPS in community group settings impacts the health of the wider community

Further research interests include doing our bit to advance the ImRoc 10 key challenges (https://imroc.org/resources-supporting-the-10-key-challenges/ ) and realise a fully integrated mental health service where ‘peer’ professionals are the norm. This links in with our multiple level DENT based Peer Coaching Diploma aimed to provide career progression for those who wish to continue using their lived experience in their practice, beyond the lower NHS pay bands.

 Methodologies

We will use a blend of methodological approach in our research, including a survey based quantitative approach, qualitative methods including discursive and phenomenological approaches derived from semi-structured interviews and written feedback, and ethnographic research.

 

Conclusion

This paper has provided a brief outline and overview of the DENT approach for use within leadership, organisations and in support of individuals with emotional and MH challenges. It signals a move onwards from the traditional medical and recovery models, to a purposefulness model which is taken up and delivered by qualified peer professionals, thus enabling those once afflicted to live an adept and purposeful life, embodying and demonstrating DENT principles, whilst passing on their skills in the community and serving others.

DENT recognises the potential gulf between the ‘Anoni’ and the ‘Sociali’ and enables reconciliation of it by practicing and appropriating the DENT techniques as a way of life, leading to personal contentment and social adeption. DENT places itself within the field of Social Psychology. Melding phenomenological and discursive theoretical approaches.

The authors’ primary purpose is to be of service and leave a legacy of resilience behind them for our friends, families, communities, society, and the planet.

Together, in unity, we are stronger.

Emma Jaynes & Keith Abrahams

 

Spirituality, defined as possessing Spiritual Intelligence and having the capacity to demonstrate spiritual Values/Emotions (hope, gratitude, and compassion), contributes to a better quality of life for those who practice it, over those who do not practice Spirituality, even when individuals do not openly acknowledge Spiritual domain needs.

 

Abstract

This study aims to extend the research such as Dierendonnk (2012), Rowold (2011), and Fazilat-Pour (2016) which treats spirituality as an essential domain of life. It aims to investigate whether certain spiritual values and emotions such as Gratitude, Hope, Compassion, and possessing Spiritual Intelligence, is a predictor of good quality of life. Using five existing questionnaires: The World Health Organisation Brief Quality of Life questionnaire (WHOQOL Bref: 1996); The Santa Clara Brief Compassion Scale (2008); Hope Scale (1991); Gratitude Scale (2002); The Spiritual Intelligence Self-Report Inventory (Sisri-24: 2008), the data was collected via electronic survey. It was found that gratitude, hope, and the sub category of personal meaning production from the Spiritual Intelligence scale, were predictors of quality of life, but the further three sub categories, and compassion, were not. These results are in alignment with previous research and provide a firm foundation for further investigations towards defining a pragmatic spirituality which is accessible to all, regardless of individuals’ adherence to religious or spiritual doctrines.

 

Introduction

The scientific study of Spirituality has gained traction in the field of Psychology over the past 20 years (Emmons:2006). Most notably, the more specific fields of the Psychology of Religion and Positive Psychology are where the majority of this research resides. It seems that the most problematic issue is one of definition, and there is considerable inconsistency amongst the research in this respect which, according to Emmons, may account for the field’s slow progress and caution when approaching the topic of Spirituality (Emmons:2006).

Within the research a distinction is often made between Religion and Spirituality. The Oxford English Dictionary defines Religion as: ‘the belief in and worship of a personal God, or Gods; A particular system of faith and worship’. The Latin root is Religio which means obligation, bond, reverence. Spirituality is ‘the quality of being concerned with the human spirit or soul a opposed to material or physical things; the animating or vital principle of a person, from the Latin root Spiritus, meaning ‘breath’. (OED online)

Religion can be the means by which individuals express their spirituality. However, spirituality, it will be argued, is concerned more with human universal values and principles and the notion of a Pragmatic Spirituality will be explored.

Since the 1970s with the advent of the practical applications of the Biopsychosocial (BPS) model (Engels ref), it has become more commonplace within healthcare settings to take a more holistic view of an individual’s health to include the Physical, Social, Emotional, and Psychological domains. In the research on spirituality over the past 20 years, studies have begun to show that Spirituality is a domain in its own right (Rowold and Dierendonck) and should be considered distinct when looking into the causes of, and solutions to health challenges.

In their 2011 survey study, using the Spiritual Wellbeing Questionnaire, the Oxford Happiness Inventory and the SF-12 psychological wellbeing questionnaire, Rowold discovered that Spiritual well-being was distinct from mental, emotional and physical well-being. Their spirituality definition was split into four subscales of personal, communal, environmental, and transcendental. In partial support of their hypotheses, it was discovered that the personal (defined as having cohesive values, meaning, and purpose) was the strongest predictor of subsequent happiness, psychological well-being and lower levels of stress. Communal (meaning interpersonal connectedness) was a predictor or happiness, whereas the environmental and transcendental subscales had no significant impact. These latter scales will be discussed later on.

Dierendonck’s study (2012), using an experimental design, where two groups were asked to judge a survey completed by an imaginary person on their personal wellbeing, showed that spirituality was a distinct and essential human need in addition to the three essential basic psychological needs already posed by self-determination theory of relatedness, autonomy, and competence. This study focused on the extent to which Spiritual Wellbeing contributes to ‘the Good Life’, which was broken down into the two categories of Desirability, the perception that a person is living a life that others would find desirable; and Moral Goodness, the perception that a person demonstrates ethical and moral principles in their life.

This study showed that the Relatedness need was the most important with regards to both categories and confirmed that is was an essential need crossing cultural boundaries. Spirituality was also shown to positively influence both categories of the Good Life with particular reference to individuals being perceived as having strong inner resources, meaning and purpose in life.

Amirian and Fazilat-Pour (2016) extended this research by conducting a survey study which explored the relationship between Spiritual Intelligence and General Health and Happiness. They used King’s Spiritual Intelligence Questionnaire; Goldberg’s General Health Questionnaire; and The Oxford Happiness Inventory. Spiritual Intelligence was divided in to the four subscales of Critical Existential Thinking; Transcendental Awareness; Personal Meaning Production; and Conscious State Expansion. The study showed that people with higher over Spiritual Intelligence scores, rated more highly for happiness, and good general health. However, when broken down into the subscales, it was the Personal Meaning production which related most strongly and supported other research which shows that meaning in life both increases happiness and is preventive of mental health challenges such as depression and neuroticism (Mascaro and Rosen; 2006). Those who rated higher on Critical Existential Thinking, rated lower on General Health suggesting that the way we think about the universe or cosmos does not impact on health.

Generally speaking, the aforementioned studies focus predominantly on aspects of happiness. There is often a mixture of definitions of spirituality which combine some practical applications, such as meaning and purpose in life or values and ethics, with some arbitrary and more subjective concepts of connection with a divine power or integration with the cosmos or universe.

The current study focuses on Quality of Life as defined by the World Health Organisation’s (WHO) Brief Quality of Life questionnaire (WHOQOL-Bref) which focuses on the four domains of Physical Health, Social Life, Psychological Health and Environmental conditions. WHO have used the Physical, Social, and Psychological domains as their definition of health since 1948 (Huber:2011) and has been as yet unchanged.

The rationale for the current study is to contribute to the research which treats spirituality as an essential domain of life and to work towards a more robust definition of spirituality which can be seen as universal qualities that are accessible to all. Emmons (2006) has talked of emotions and values which can be considered spiritual, and worthy of research, therefore the current study focuses on compassion, hope, and gratitude, as well as spiritual intelligence (SI).

The researcher believes that individuals may well be practicing a ‘Pragmatic Spirituality’ in their daily lives without identifying themselves as such and a comparison will be made between those who do and do not consider themselves as ‘spiritual’ or having a spiritual belief. The research breaks down the SI categories as in Amirian and Fazilat-Pour’s research (2016), to show the extent to which the less tangible concepts of spirituality predict good quality of life. The researcher believes that where one is required to hold a belief in a particular God, entity or power outside of oneself, is where the potential positive effects of a spiritual way of life fall down, particularly in a Western secularised culture. This study aims to work towards a definition of a ‘Pragmatic Spirituality’ which is accessible to all, regardless of belief, and relies on universal qualities and values that can be developed by all.

The research questions are: Does Spirituality, defined as the capacity to demonstrate compassion, hope, gratitude, and spiritual intelligence, contribute to a better quality of life? And does it do so whether or not an individual considers themselves to be spiritual?

Hypothesis 1 : Spirituality, defined as the capacity to demonstrate hope, leads to a higher rating of quality of life, regardless of whether or not one considers themselves to be spiritual.

Hypothesis 2 : Spirituality, defined as the capacity to demonstrate gratitude, leads to a higher rating of quality of life, regardless of whether or not one considers themselves to be spiritual.

Hypothesis 3 : Spirituality, defined as the capacity to demonstrate compassion, leads to a higher rating of quality of life, regardless of whether or not one considers themselves to be spiritual.

Hypothesis 4 : Spirituality, defined as the capacity to demonstrate spiritual intelligence, leads to a higher rating of quality of life, regardless of whether or not one considers themselves to be spiritual.

 

Method

Participants

There were 158 participants who took part in the survey study. A random sampling method was used to recruit participants. However, participants were drawn from the researcher’s social media connections (Facebook, twitter, LinkedIn) and so it must be noted that there may have been some bias with regards to the characteristics and demographic of the population since they may have shared characteristics with the researcher. This may have been reduced slightly by the fact that those connections also shared with their own social media connections and that the social media settings were set to ‘public’, meaning that anyone using the platforms globally, could have participated.

The only criteria for inclusion was that participants had to be over the age of 18.

Procedure

The survey was designed in Qualtrics and an anonymous link was generated which was then shared on several social media platforms – Facebook, Twitter, LinkedIn. The survey was freely available on the web, publicly, to the global population and it was live for 4 days. It was advertised via the researcher’s personal Facebook timeline, groups, business pages, and friends’ timelines, who shared voluntarily. It was also advertised on Twitter and LinkedIn where it was also retweeted and shared several times. It was accompanied by a brief message outlining the nature of the research, explaining the anonymous nature of the link, and giving contact details for further information. It was also explained that the consent form and more detailed information could be found within the survey by clicking on the link. Consent was gained by a straightforward ‘Yes/No’ question at the beginning of the survey. The researcher’s supervisor, Dr Caroline Henderson gave ethical approval for the study.

No participants asked to be withdrawn from the study.

Measures

The survey was compiled by putting together 5 pre-existing surveys. These were: The World Health Organisation Brief Quality of Life questionnaire (WHOQOL Bref: 1996); The Santa Clara Brief Compassion Scale (2008) (α=0.90) ; Hope Scale (1991) (α= 0.74 to 0.84) ; Gratitude Scale (2002)(α= 0.82) ; The Spiritual Intelligence Self-Report Inventory (Sisri-24: 2008) (α=0.95).

A small selection of demographic questions were asked including: Age, Gender, Ethnicity, Marital Status, Education Level. The demographics were not used in the analysis of this study.

All of the questionnaires used a Lickert style scale. The gratitude and compassion surveys used a 7 point Lickert style scale, the hope survey used an 8 point Lickert style scale, and the WHOQOL Bref and Sisri-24 used a 5 point Lickert style scale. The Hope, Gratitude, Compassion, and Sisri-24 surveys used statements such as ‘I often have tender feelings towards people (strangers) when they seem to be in need’, ‘There are lots of ways around any problem’, ‘I have so much in life to be thankful for’, and ‘I am able to make decisions according to my purpose in life’.

With the compassion statements a number was chosen between 1 and 7, where 1 represented ‘Not at all true of me’ and 7 represented ‘Very true of me’. With the hope questionnaire, the answers were ‘Definitely False’, ‘Mostly False’, ‘Somewhat false’, ‘Slightly False’, ‘Slightly True’, ‘Somewhat True’, ‘Mostly True’, and ‘Definitely True’. With the Gratitude questionnaire, were the numbered answers ‘Strongly disagree’, ‘Disagree’, Slightly Disagree’, ‘Neutral’, ‘Slightly Agree’, ‘Agree’, Strongly Agree’.

The WHOQOL Bref asked questions such as ‘To what extent do you feel that physical pain prevents you from doing what you need to do?’ with answers ‘Not at all’, ‘A little’, ‘A moderate amount’, ‘Very much’, ‘An extreme amount’. Some questions were on a scale from ‘Very Dissatisfied’ to ‘Very Satisifed’. With the Sisir-24, each statement ranged from ‘Not at all true of me’ to ‘Completely true of me’.

 

Treatment of Data

Qualtrics software was used to collate the data and SPSS was used to analyse the data.

For the hope, gratitude, compassion, and sisri-24 questionnaires, the published scoring methods were used which was to sum the scores and then calculate the means. In the gratitude questionnaire, questions 2 and 6 were reverse scored. In the hope questionnaire, questions 3.5.7. and 11 were distractor questions and were removed before analysis. In the sisri-24 question 6 was reversed scored. The means of the sub categories of Critical Existential Thinking (CET), Transcendental Awareness (TA), Conscious State Expansion (CSE), and Personal Meaning Production (PMP)

In the WHOQOL Bref, the published method is to report all 4 domains separately. For this study the means from the 4 domains were calculated and then multiplied by 4 to give an overall mean, this meant that the number of regression analyses that needed running were fewer. Questions 3, 4, and 26 were reversed scored.

Multiple level regression analysis was calculated with QOL overall means as the dependent variable and Hope, Gratitude, Compassion, Spiritual Intelligence overall, Critical Existential Thinking, Personal Meaning Production, Transcendental Awareness, and Conscious State Expansion means as the Independent variables.

 

Results

The present study aimed to show the relationship between quality of life and spirituality as defined by hope, gratitude, compassion, and spiritual intelligence.

Table 1 indicates the means and standard deviations of the variables and subscales of the Spiritual Intelligence questionnaire. The mean of the question of whether a person considered themselves spiritual, yes or no, was calculated where the yes = 1 and the no = 4. This mean indicates that there were a greater number of individuals who answered yes to this question.

The variables are Quality of Life (α = 0.94), hope (α = 0.89), Gratitude (α = 0.84), Compassion (α = 0.83), Spiritual Intelligence Overall (α = 0.96), Conscious State Expansion (α = 0.91), Transcendental Awareness (α = 0.91), Personal Meaning Production (α = 0.88), and Critical Existential Thinking (α = 0.88).

N = the number of participants after the fields with missing data were removed.

 

Table 1

Variables	Mean	Standard Deviation	N
Quality of Life	14.51	2.61	143
Hope	47.62	9.77	143
Gratitude	34.6	6.29	143
Compassion	27.06	5.33	143
Spiritual Intelligence Overall	81.65	20.13	143
Conscious State Expansion	14.58	5.54	143
Transcendental Awareness	25.75	6.21	143
Personal Meaning Production	16.51	4.37	143
Critical Existential Thinking	24.8	6.42	143
Spiritual Yes/No	1.73	1.29	143

 

A multiple regression was carried out to investigate whether demonstrating hope, gratitude, compassion, and spiritual intelligence, broken down into subscales of conscious state expansion, transcendental awareness, personal meaning production, and critical existential thinking, could significantly predict participants’’ quality of life. The results of the regression indicated that the model explained 61.6 % of the variance and that the model was a significant predictor of quality of life, F(7,135) = 30.95; p = 0.000.

Whilst Hope (β = 0.116, p = 0.000), Gratitude (β = 0.146, p = 0.000), Personal Meaning Production (β = 0.139, p = 0.036) and compassion (β = -.063, p = 0.038) significantly contributed to the model, Spiritual Intelligence overall (β = -0.009, p = 0.352), Conscious State Expansion (β = -0.009, p = 0.848), Transcendental Awareness (β = -0.017, p = 0.751), and Critical Existential Thinking (β = -0.071, p = 0.105) did not.

The final predictive model was:

Quality of Life = 5.694 + (0.116*Hope) + (0.146*Gratitude) + (0.-0.63*Compassion) + (0.139*Personal Meaning Production) + (-0.009*Spiritual Intelligence) + (-0.009*Conscious State Expansion) + (-0.o17*Transcendental Awareness) + (-0.017*Critical Existential Thinking)

 

H1 the null hypothesis can be rejected as higher ratings on the hope questionnaire, leads to higher ratings of quality of life.

H2 the null hypothesis can be rejected as higher ratings on the gratitude questionnaire, leads to higher ratings of quality of life.

H3 the null hypothesis cannot be rejected as higher ratings on the compassion questionnaire, leads to lower ratings on quality of life.

H4 the null hypothesis can be partially rejected as only Personal Meaning Production subscale leads to higher ratings of quality of life.

 

After the initial analysis was carried out using the full data set, a further analysis was conducted on the data split into two for those who answered yes and no to the question ‘Do you consider or identify yourself as a spiritual person?’ From the means drawn from the full dataset, it was clear that there were a larger number of ‘yes’ answers and when split down, the numbers in each group were quite different from each other, therefore, the data in the ‘no’ set in particular must be approached with caution regarding the inferences made. However, the results were as follows:

Table 2 indicates the means and standard deviations of the variables including the subscales of the Spiritual Intelligence questionnaire for the ‘yes’ answers.

Table 2

 

Variables	Mean	Standard Deviation	N
Quality of Life	14.36	2.13	108
Hope	44.31	8.92	108
Gratitude	33.60	5.58	108
Compassion	26.63	5.32	108
Conscious State Expansion	9.68	4.37	108
Transcendental Awareness	20.06	4.66	108
Personal Meaning Production	13.86	3.20	108
Critical Existential Thinking	18.97	5.52	108

Table 3 indicates the means and standard deviations of the variables including the subscales of the Spiritual Intelligence questionnaire for the ‘no’ answers.

Table 3

Variables	Mean	Standard Deviation	N
Quality of Life	14.57	2.76	35
Hope	48.69	9.82	35
Gratitude	34.92	6.49	35
Compassion	27.20	5.36	35
Conscious State Expansion	16.17	4.93	35
Transcendental Awareness	27.60	5.50	35
Personal Meaning Production	17.37	4.36	35
Critical Existential Thinking	26.69	5.51	35

 

A multiple regression was carried out to investigate the extent to which demonstrating hope, gratitude, compassion, and spiritual intelligence, broken down into subscales of conscious state expansion, transcendental awareness, personal meaning production, and critical existential thinking, could significantly predict participants’ quality of life when they identified as ‘spiritual’. The results of the regression indicated that the model explained 64.1 % of the variance and that the model was a significant predictor of quality of life, F(7,100) = 25.509; p = 0.000.

Whilst Hope (β = 0.129, p = 0.000), Gratitude (β = 0.168, p = 0.000), and compassion (β = – 0.071, p = 0.055) significantly contributed to the model, Personal Meaning Production (β = 0.100, p = 0.189), Conscious State Expansion (β = -0.016, p = 0.782), Transcendental Awareness (β = -0.030, p = 0.648), and Critical Existential Thinking (β = -0.041, p = 0.438) did not.

A multiple regression was carried out to investigate the extent to which demonstrating hope, gratitude, compassion, and spiritual intelligence, broken down into subscales of conscious state expansion, transcendental awareness, personal meaning production, and critical existential thinking, could significantly predict participants’ quality of life when they did not identify as ‘spiritual’. The results of the regression indicated that the model explained 60.7 % of the variance and that the model was a significant predictor of quality of life, F(7,27) = 5.960; p = 0.000.

Whilst Critical Existential Thinking (β = -0.174, p = 0.034) and Personal Meaning Production (β = 0.362, p = 0.015) significantly contributed to the model, Hope (β = 0.054, p = 0.193), Gratitude (β = 0.008, p = 0.912), and compassion (β = – 0.020, p = 0.737) Conscious State Expansion (β = -0.031, p = 0.750), Transcendental Awareness (β = 0.095, p = 0.315), did not.

 

Tables 4, 5, and 6 show the strength of the correlation between the each of the variables and quality of life.

Table 4 – Correlation between all variables and quality of life, full dataset

Variables	r	Significance
Hope	0.700	0.000
Gratitude	0.639	0.000
Compassion	0.097	0.125
Conscious State Expansion	0.261	0.001
Transcendental Awareness	0.270	0.001
Personal Meaning Production	0.578	0.000
Critical Existential Thinking	0.091	0.141
Spiritual Intelligence Overall	0.310	0.000

 

The Full dataset showed that the strongest correlations with quality of life were found between hope, gratitude, and personal meaning production. The correlations were statistically significant. Spiritual Intelligence overall, Transcendental Awareness, and Conscious State Expansion has a weak correlation with quality of life and were statistically significant. Critical existential thinking and compassion did not have a significant correlation with quality of life.

 

Tables 5 – Correlation between variables and quality of life, ‘yes’ answers

Variables	r	Significance
Hope	0.730	0.000
Gratitude	0.686	0.000
Compassion	0.129	0.091
Conscious State Expansion	0.155	0.001
Transcendental Awareness	0.330	0.000
Personal Meaning Production	0.596	0.000
Critical Existential Thinking	0.307	0.054

 

The ‘yes’ dataset showed that the strongest correlations with quality of life were found between hope, gratitude, and personal meaning production. The correlations were statistically significant. Transcendental Awareness, Critical Existential Thinking, and Conscious State Expansion had a weak to moderate correlation with quality of life and were statistically significant. Compassion did not have a significant correlation with quality of life.

 

Table 6 – Correlation between variables and quality of life, ‘no’ answers

Variables	r	Significance
Hope	0.609	0.000
Gratitude	0.415	0.007
Compassion	-0.042	0.405
Conscious State Expansion	0.170	0.164
Transcendental Awareness	0.129	0.231
Personal Meaning Production	0.649	0.000
Critical Existential Thinking	-0.198	0.127

 

The ‘no’ dataset showed that the strongest correlations with quality of life were found between hope, gratitude, and personal meaning production. The correlations were statistically significant. Transcendental Awareness and Conscious State Expansion had a weak to moderate correlation with quality of life and were not statistically significant. Compassion and Critical Existential Thinking had a negative correlation with quality of life and did not have a significant correlation with quality of life. These results need to be treated with caution due to the low number of participants in the ‘No’ group.

 

Discussion

The results showed that spirituality, defined as the capacity to demonstrate hope, gratitude, and personal meaning production are positively correlated with quality of life, and this is consistent with the findings of researchers who have showed that spirituality is positively correlated with happiness and health.

The results also showed that some of the more arbitrary and difficult to describe areas of spirituality such as Transcendental Awareness, Conscious State Expansion, and Critical Existential Thinking were less positively correlated and, in some cases, were negatively correlated with quality of life. This would be consistent with the findings of Amirian and Fazilat-Pour (2016).

The results showed that compassion had very weak to no positive correlation with quality of life and, in the ‘no’ group were negatively correlated, and the findings were not statistically significant. This is surprising in that compassion is an attribute which is often regarded as desirable within religious groups and in particular, the Santa Clara Brief compassion scale was adapted from Fehr’s Compassionate Love scale (Fehr & Sprecher: 2005) which made an association with religious faith and compassion.

These results were consistent, whether or not a participant identified themselves as ‘spiritual’ and this is an important factor when working towards a formulation of a Pragmatic Spirituality that is accessible to all.

In an attempt to explain why the compassion results may have been so, it was considered by the current researcher that compassion could also be related to excessive giving of care and support to others. When this giving is unbalanced, it can lead to burnout and what is referred to in the literature as compassion fatigue (Durkin et al: 2013) This would suggest that it is not necessary for one to demonstrate compassion in order to have a good quality of life and, in some cases where compassionate giving is excessive, it might even lead to a reduced quality of life.

The current results support the findings of Rowold (2011) in that Personal Meaning Production correlated highly with quality of life in this study and in their study, the personal subscale (defined as having cohesive values, meaning, and purpose) correlated most highly with happiness. One could also associate the Rowold personal subscale with the values of gratitude and hope. However, in their study, the communal subscale (defined as interpersonal connectedness) was a predictor of happiness as well and gratitude could well be interpreted as being an interpersonal attribute when we are grateful for the contribution others make to our lives, for example.

In the same study, Rowold (2011) found that the environmental and transcendental subscales had no significant impact on happiness and that would relate to the current study’s findings in the spiritual intelligence subscales of transcendental awareness, conscious state expansion, and critical existential thinking which has very weak to negative correlation with quality of life.

As this study aims to work towards a definition of a ‘Pragmatic Spirituality’ one could begin to formulate a hypothesis about the necessity of certain of developing certain attributes which lead towards a greater quality of life. For example, if one is able to demonstrate that gratitude, hope, and meaning in life are essential requirements for good quality of life, one could begin to develop clinical interventions which aim to plug this gap.

Amirian and Fazilat- Pour also used the spiritual intelligence scale in their study (2016) and when the subscales were broken down, personal meaning production correlated most highly with general health and happiness. The current study supports these findings and again lends weight to the importance of having meaning in life for positive life outcomes.

 

In Direndonck’s (2012) study on the relationship between spiritual wellbeing and the good life, the self-determination basic needs of relatedness, autonomy, and competence were extended to include spirituality as a separate domain. It was then shown that spirituality had an impact on both categories of desirability and moral goodness with relationship to having meaning in life and a robust personal values system. This supports the current study’s claim that a Pragmatic Spirituality would consist of certain every day and familiar concepts that many people apply in their daily lives and that they may value as positive influencers on their quality of life.

Insofar as relatedness was found to be the most important need, this also supports the Rowold findings that the ‘communal’ subscale was an important predictor of happiness. One could link PMP and gratitude with the communal subscale, since having gratitude and meaning in life is often linked with the people in our lives we serve, care for, and appreciate. This might represent an area for more detailed study.

With further regards to the Amirian and Fazilat-Pour study into SI (ref), it was not a surprise to see that PMP in the current study was more highly correlated with QOL than the other three subscales, as this was reflected in their study in the correlation with happiness and health. This also bolsters the current researcher’s supposition that the pragmatic spiritual values are more important to health and wellbeing than some of the more arbitrary concepts which require prior clarification and a more academic appraisal of spiritual discourse of various kinds.

For example, in the sisri-24, the statements ‘I am able to enter a higher state of consciousness or awareness’ or ‘I am able to move freely between higher levels of consciousness or awareness’, or ‘Recognising the non-material aspects of life helps me feel centred’, would be unlikely to make sense to those who had not had access to certain religious or spiritual traditions or studies. Whereas the questions such as ‘I am able to define a purpose or reason for my life’, or ‘My ability to find meaning and purpose in life helps me adapt to stressful situations’, are accessible to anyone, regardless of their orientation or membership in spiritual groups.

In the full dataset analysis and even the group who answered ‘yes’ to the ‘yes/no’ question regarding spiritual identity, the correlation between the three sub categories of CSE, TA, and CET, and QOL, were much lower than PMP. This might point to a lack of understanding of the statements (in fact a couple of respondents did post a message to say they did not fully understand all of the questions), or it could demonstrate that good QOL is simply not reliant on being able to practice spirituality in this specific way.

The elements that are coming through from these pieces of research are reminiscent of Maslow’s hierarchy of needs (ref). Maslow’s model was largely theoretical, and self-determination theory has explored and confirmed the essential human needs of autonomy, competence, and relatedness, with the addition of spirituality as a distinct domain.

Maslow’s most commonly quoted hierarchy listed the five needs of : physiological and biological; safety; love and belonging; esteem, and self-actualisation. Later on, Maslow added cognitive; aesthetic; and transcendence (ref). The aesthetic, self-actualisation, and transcendence needs fall into the realms of spiritual needs where Maslow describes self-actualisation as referring to meaning and purpose, and transcendence as referring to service to others. The aesthetic will not be dealt with here. Maslow’s hierarchy fits with the idea of a Pragmatic Spirituality which considers meaning, purpose, service and the values of hope and gratitude as predictors of good quality of life.

Future research would be needed to investigate which other spiritual values (eg awe and forgiveness) could be considered important for good quality of life, happiness, and health. It would be interesting to extend the work on meaning and purpose, to discover what practical activities bring people meaning and purpose in life. For example, Emmons (2005) found that ‘spiritual striving’, or having spiritual goals, were enough on their own to provide meaning and purpose.

To extend the gratitude work, it would be useful also to investigate what it is that induces gratitude in people. Connectedness to others, or relatedness in SDT, has been looked on as a psychological element, but it may cross over to the spiritual and provide another essential element for pragmatic spirituality. It would be good to study this further as well.

Conclusion

The findings demonstrated that some elements of spirituality, gratitude, hope, and personal meaning production, predicted good quality of life. This was in the direction that was expected. These findings are helpful in moving towards defining a pragmatic spirituality which is accessible to all, regardless of whether or not they follow a particular religion or spiritual practice. It is the researcher’s intention that further investigation into a pragmatic spirituality will lend itself to the creation of useful therapeutic interventions which are aimed at the essential spiritual domain and equally weighted alongside the longer standing domains of the physical, social, mental, and emotional.

 

References

Amirian, M-E., & Fazilat-Pour, M., (2016) ‘Simple and Multivariate Relationships Between Spiritual Intelligence with General Health and Happiness’, Journal of Religious Health, Vol. 55, pp. 1275-1288

Dierendonck, D.V., (2012) ‘Spirituality as an Essential Determinant for the Good Life, Its Importance Relative to Self-Determinant Psychological Needs’, Journal of Happiness Studies, Vol 13, pp. 685-700

Durkin et al (2013) Wellbeing, compassion fatigue and burnout in APs

Mark Durkin, Joanne Smith, Michelle Powell, Jane Howarth, Jerome Carson

https://doi-org.libezproxy.open.ac.uk/10.12968/bjha.2013.7.9.456

Published Online: September 27, 2013

 

Emmons, R.A. (2005) ‘Striving for the sacred: Personal Goals, Life Meaning, and Religion’, Journal of Social Issues, Vol. 61. No. 4, 2005, pp. 731-745

Emmons, R.A. (2006) ‘Spirituality: Recent Progress’, in Csikszentmihalyi, M., & Csikszentmihalyi, I.S., (Eds), A Life Worth Living: Contributions to Positive Psychology Oxford: Oxford University Press

Sprecher, S., & Fehr, B. (2005). Compassionate love for close others and humanity. Journal of Social and Personal Relationships, 22, 629–651.

Huber, M. et al BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4163 (Published 26 July 2011) Cite this as: BMJ 2011;343:d4163 accessed 18^th May 2018

Maslow, A.H. (1971) The Farther Reaches of Human Nature, Penguin Compass: USA

Rowold, J., (2011) ‘Effects of Spiritual Well-Being on Subsequent Happiness, Psychological Well-Being, and Stress’, Journal of Religious Health, Vol. 50, pp. 950-963

Smith, B.W., Ortiz, A.J., Wiggins, K.T., Bernard, J.F., & Dalen, J., (2012) ‘Spirituality, Resilience, and Positive Emotions’, in Miller, L.J., (Ed) The Oxford Handbook of Psychology and Spirituality, Oxford: Oxford University Press

As a culture, we are inundated with messages from all around us about the importance of being ‘healthy’ and looking after our ‘wellbeing’. The media saturates us with information overload about, for example, what we should and shouldn’t be eating; the latest facts and figures about various illnesses; whether or not alcohol is a good or bad thing; and on and on …

Media campaigns are often designed to convince us to part with our hard earned cash to pay for expensive treatments, pills, potions and even cosmetic surgery, in order that we can skip to the front of the queue for  the next ‘miracle cure’ which promises us a quick and easy solution to our challenges.

Some campaigns are targeted to address the latest government agenda and societal issues, in order to reduce the financial burden on the public purse, caused by our ‘lifestyle’ related health problems.

Among the top 10 current public health issues of concern are: Diabetes; Obesity; Heart Disease; Cancer; Mental Ill Health and Substance Abuse. In amongst the list are those factors which the public health authorities want to focus on such as: physical health & nutrition; levels of physical activity; and reducing smoking, alcohol and recreational drug use. It is also acknowledged that environmental factors are implicated (ie our living conditions and peer group) and, I would argue, that stress is a major player (see Stress to Success).

Many of us hear about, and talk of, the need to lead a ‘healthy lifestyle’, but what do we mean by that, and how do we achieve it and attend to all its facets, when we lead such busy lives? Considering all the ‘noise’ about health, and the choices available to us, the seemingly enormous task of fitting in healthy habits can seem overwhelming, and so we put it off until another day. ‘I’ll start the diet on Monday’, ‘I’ll cut out alcohol after Christmas’, ‘I’ll join the gym and that’ll sort me out’. And then tomorrow never comes, dry January is over, and our gym passes go unused week after week.

So, what is different about yet another workshop on ‘Healthy Lifestyles’? The answer is, I believe, twofold – First, we believe in education, based on sound research that is stripped of the common health myths. We first need to understand, in very simple terms, what is required for ‘good enough’ health and to gently challenge any unhelpful beliefs or habits we may have developed or acquired about ‘health’.

Second, a calm and moderate approach to health is helpful. If we know we need to make some significant changes, extreme planning can be counter-productive. For example, we may be overweight, unfit, drink too much, and stressed. We may get to the point where we say ‘right that’s it, I start on Monday, I’m going to join the diet club, go to the gym every morning, and cut out alcohol completely’. We may begin with the best intentions and even with some success – however, come Thursday, as the weekend approaches, when we feel tired, busy and stressed, our enthusiasm and commitment begins to wane. We ‘fall off the wagon’, feel as if we have failed, and return with immediate effect, to our old and familiar ways.

The common adage that what we need is more willpower is wholly untrue. This is also backed up by research, which tells us that willpower uses a lot of our energy and resources, and runs out over a fairly short space of time. What we actually need, is forward planning and gradual, small changes over time, which eventually become automatic.

Some work around stress, Emotional Resilience (ER) and mindset may need to be done, (ER has been addressed here Emotional Resilience ) in order to ensure that we can both embark upon, and maintain, our commitment.

So, what does the Positive Ways Healthy Lifestyles programme cover? In addition to checking in with our Emotional Needs and Resources (Human Givens), we also look at sleep; nutrition; and exercise.

All elements of the programme are based on the latest psychological insights and research. With each element, we take a balanced approach including deconstructing some of the myths around sleep, nutrition and exercise.

For example, getting the right type of sleep is more important than the quantity of sleep we are getting. Lying awake worrying about the fact that we aren’t sleeping, is often a common challenge amongst insomniacs which perpetuates the issue so, shifting our beliefs around sleep, by educating ourselves about the research based facts, in the first instance, can be very helpful.

With eating, we are looking to make small changes, step by step, rather than embark upon a faddy ‘diet’ regime which feels inhibiting.  For example, if we eat frosted shredded wheats for breakfast, switching to plain shredded wheats may be a manageable step in the first instance.

Likewise, with exercise, if we have been completely sedentary for a long while, walking to the shops instead of taking the car may be a manageable initial step.

In short, what we are working towards is building in lifestyle improvements, bit by bit, so that they are sustainable over the long term and eventually we find we are living a ‘healthy lifestyle’.

All of the elements of the programme are delivered by qualified and experienced facilitators who are experts within their particular fields. Many of them have also had first-hand experience of some of the challenges which will be addressed, thus adding an even deeper dimension of understanding and identification with our clients.

If you would like more information on this programme or any of our work, please contact Emma Jaynes on: 07791 520388 or email at: emma@positiveways.co.uk.

Please visit www.positiveways.co.uk

Also http://www.counselling-directory.org.uk/counsellors/positive-ways

And http://www.lifecoach-directory.org.uk/lifecoaches/positive-ways

At Positive Ways, we understand that the emotional qualities and skills needed to be a successful leader are as important, if not more so, than the intellectual and technical competencies required to fulfil a role. In other words, in order to lead others successfully, we need to first successfully lead ourselves.

In business, it is a requisite that we continue our personal development in order to remain competent and current. However, this may be futile, at a fundamental level, if we do not also ensure that our personal development goes hand in hand. In the current context, developing our Emotional Intelligence (EI) and our Emotional Resilience (ER) are key components in ensuring our ability to lead.

We are human beings, and hence social animals, who need to interact with our environment and with other people in order to survive, thrive and, in this case, ensure our businesses perform. A good leader is both Emotionally Intelligent and Emotionally Resilient. At Positive Ways, we use the Emotional Resilience in Action model (ERA) and the Emotional Capital Report (ECR) to build these components.

The ECR has been designed for measuring our EI ( see Keith Abrahams’ article ). In the ECR, EI is grouped into 5 sections: Self-Awareness; Self-Management; Social Skills; Adaptability; Social Awareness – these are broken down into 10 sub-sections. Our ER (New ERA model ) can be measured anecdotally by our ability to bounce back and recover from setbacks quickly, and get our needs met in a calm and healthy way. In leading ourselves, it is important that we can take responsibility for ourselves and our situations; communicate in and develop healthy relationships in both our personal and professional lives.

The Positive Ways Leadership programme builds on the ERA model and incorporates the ECR, in order to first ensure we are leading ourselves successfully, and then that we have the EI needed to successfully lead others. Attendees gain an understanding of their own needs and how to deploy their resources in getting them met, they gain an insight into the EI competencies they need to develop, and they learn simple and practical tools and techniques which they can hone, to build both their ER and EI.

We find this approach equally beneficial in helping the individual to lead themselves, lead others (their staff, for example) and, in the service based professions, their clients. Our friends, family and colleagues benefit too, and the skills can be passed on to those around us either by direct teaching  or in ‘leading by example’.

For a full list of programmes and workshops and the next Leadership Programme, please visit : https://positiveways.co.uk/

We create a warm, positive relationship with our clients from which positive ways spring.

Positive Ways is a combination of equal support and gentle and suitable challenge.

Support means we provide comfort, encouragement, validation and serve as a foundation for you, keeping it place as you continue to grow.

Challenge means we will question, clarify and seek explanation of what limits or stops you from moving forward, which we will help you overcome.

We understand that each of us starts with a different capacity for resilience and coping. A careful emotional audit helps us assess your needs and capacity. The right mix of support and challenge will enable you to work and develop in the Positive Ways quadrant of ‘SUSTAINABLE GROWTH’.

Positive Ways will gentle nudge you out of:

1. Being STUCK – which is where apathy and inaction reside
2. SHYING AWAY – where the challenge feels too great
3. COLLUSION – where the view of the world is not properly questioned or fed back

This is because support without challenge does not encourage adult learning.  This is why positive ways puts its clients at the centre of the process, but provides some of the energy, direction and spare emotional and mental capacity that some clients, sometimes, think is missing from their world.

With support comes guidance and teaching, which leads to your ‘Emotional Resilience in Action’.