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SUBSTANCE ABUSE PREVENTION RESEARCH
Why study prevention research? Because prevention
theories assist us to identify how we can prevent problem
behavior from occurring - and that takes the guesswork out
of planning.
Prevention Theory
Theory is important. They are the guiding
principles that underlie your prevention approach. Theories
explain behavior and suggest ways to achieve behavior change.
They can explain the dynamics of behavior - why substance
abuse, violence or teen pregnancy occurs. Theories can explain
the processes for changing behavior and the effects of external
influences on behavior. They can help you identify the most
suitable target population, methods for accomplishing change,
and what should be monitored, measured and compared through
evaluation. Theory can help you answer all the "WHY?"
"WHAT?" and "HOW?" questions.
There are many different theories to consider.
Some theories deal with how and why individuals change their
behavior; other theories deal with how communities or systems
change. A good substance abuse prevention theory should:
• Identify the factors that predict
substance abuse;
• Explain the mechanisms through which they operate;
• Identify the internal and external variables that
influence these mechanisms, including cultural
factors;
• Predict points to interrupt the course leading to
substance abuse; and
• Specify the interventions to prevent the onset of
substance abuse.
An outline of four commonly used theories
in substance abuse prevention can be found at http://www.tanglewood.net/services/knowledgebase/84.htm.
This site provides a summary of the following theories:
• Cognitive-Affective
• Social Learning
• Conventional Commitment / Social Attachment
• Comprehensive
Risk and Protective Factor
Theory
For over 20 years, two researchers from the
University of Washington (J. David Hawkins, PhD and Richard
F. Catalano, PhD) have been examining what contributes to
or protects against a child's developing problem behaviors.
Through years of collecting and analyzing evidence, they have
found that there are conditions that contribute to, or safeguard
against, substance abuse and other problem behaviors. They
call these conditions risk and protective factors.
Hawkins and Catalano discovered that risk
and protective factors are associated with four problem behaviors:
substance abuse, violence, delinquency, teen pregnancy and
school drop-out. These risk and protective factors are organized
into the important areas - or domains - of a young person's
life: individual/peer; family; school; and community. To prevent
a problem from occurring, it is necessary to identify both
the factors that increase the likelihood of that problem developing,
and those factors that decrease that likelihood. It is important
to note that Hawkins' and Catalano's risk and protective factor
approach is the only theory about problem behaviors that is
proven to be predictive.
The risk and protective approach has some
similarities to the so-called medical model. Hawkins and Catalano
wanted to develop a theory that looked at problem behaviors
like doctors look at disease. Using the medical model, a doctor
can predict the likelihood that a problem will develop (e.g.,
a disease or disorder) based on the variables that exist within
a person and in his or her environment. If a problem develops,
the doctor will intervene to try and reduce the factors that
are causing the problem (e.g., through medication or surgery).
An example is heart disease.
Risk Factors: Each risk factor is associated
with more than one problem behavior. This is important because
it means that reducing risk factors is likely to have a positive
effect on more than one problem behavior. On the other hand,
not all risk factors are linked to every problem behavior
(for example, availability of drugs is linked to substance
abuse, but not to teen pregnancy).
Hawkins and Catalano make some generalizations
about risk factors:
• Risks exist in multiple domains,
so prevention efforts will be more effective
if they are comprehensive (effect change in several domains);
• The more risk factors that are present, the greater
the risk. While it may not be possible to address
every single risk factor that is present, reducing
the overall number can have a significant impact on future
problem behaviors.
• Risk factors show the same effect across different
races, cultures and classes.
• Risk factors can be buffered by protective factors.
Therefore, increasing the presence of protective
factors can have a positive affect on the problem
behavior you're trying to change.
Protective Factors: There are some
individual characteristics (such as gender or a resilient
temperament), that can protect kids from engaging in problem
behaviors - but the catch is that you really can't do anything
to change these characteristics - kids are either born with
them or not (e.g., it's a protective factor to be female).
Going back to the medical model, it's kind of like knowing
that someone has a history of heart disease in his or her
family. You can't do anything about it, but knowing about
the history can help you to take preventive action.
Bonding: The protective factors that
have been validated by Hawkins' and Catalano's research all
relate, fundamentally, to bonding. Bonding is the attachment,
commitment and belief that develop in children who are attached
to pro-social families, friends, school and community. According
to this theory, youth who are bonded in a positive way to
their peers, family, school and community, are less likely
to engage in negative behaviors.
Bonding will only take place, however, if
all three of the following conditions are present:
• Children must be given the opportunity
for involvement in productive, pro-social roles
in all four domains;
• They must be given the skills to be successfully
involved in those roles; and
• They must be given recognition and reinforcement
for their pro-social involvement
"Positive bonding makes up for many
other disadvantages caused by other risk factors or environmental
characteristics. Children who are attached to positive families,
friends, school, and community, and who are committed to
achieving the goals valued by these groups are less likely
to develop problems in adolescence. Studies of successful
children who live in high-risk neighborhoods or situations
indicate that strong bonds with a caregiver can keep children
from getting in trouble.
Children must be provided with opportunities
to contribute to their community, family, peers and school.
The challenge is to provide children with meaningful opportunities
that help them feel responsible and significant.
Children must be taught the skills necessary
to effectively take advantage of the opportunity they are
provided. If they don't have the necessary skills to be
successful, they experience frustration and/or failure.
Children must also be recognized and acknowledged for their
efforts. This gives them the incentive to contribute and
reinforces their skillful performance."
Source: "Developing
Healthy Communities: A Risk and Protective Factor Approach
to Preventing Alcohol and Other Drug Abuse," Developmental
Research and Program, Inc., 130 Nickerson, Suite 107, Seattle,
WA 98109, (800) 736-2630
Healthy Beliefs & Clear Standards:
Furthermore, the people and institutions to whom youth are bonded
need to express positive norms and standards for behavior, and
consistent consequences for not following these standards. Youth
are much more likely to follow the healthy beliefs and clear
standards of those people and institutions to which they are
bonded. If the bond doesn't exist, youth may ignore those messages,
or worse, do the opposite.
According to this theory, strategies and activities
that strengthen the bonds that tie children to families, schools
and communities by providing them with the opportunities and
the skills to participate successfully, and the rewards and
recognition for their effort, combined with strategies and
activities that reduce risk factors, will, together, move
children to the desired behavioral outcomes.
There are three criteria that Hawkins and
Catalano used before they would include a risk or protective
factor in their research-based list: (1) it had to be shown
to predict an increase or decrease in problem behavior; (2)
those predictions must have been proven true in multiple studies;
and (3) those predictions had to hold true over time, demonstrated
through the use of longitudinal studies.
Here is a table that shows Hawkins' and Catalano's
list of proven risk and protective factors by domain:
As mentioned above, only the risk and protective
factors shown in the above table have been demonstrated, through
the research, to predict the occurrence of problem behaviors
such as school drop-out, teen pregnancy, delinquency and substance
abuse. However, that doesn't mean that other risk and protective
factors don't exist - it simply means that those other potential
risk and protective factors don't have enough evaluated research
behind them to back them up.
You have probably heard the terms "risk
factor" and "protective factor" used before.
However, it's important to remember that these terms have
very specific definitions, according to Hawkins' and Catalano's
research. This can get confusing, because of the way the terms
"risk factor" and "protective factor"
are used every day in our work to mean lots of different things.
But, you have to remember that if you are going to adopt this
theory, you need to be very specific about the definitions
of these terms.
Developmental Assets Approach
Starting in 1989, the Search Institute began
its research on developmental assets. The Institute's framework
of 40 developmental assets is an outgrowth of their research
into what it takes to create the building blocks necessary
for youth to be healthy, caring, principled and productive.
The developmental assets theory is considered a "promising"
rather than proven approach, due to the fact that no independent
research has yet been published to indicate that implementing
asset-based approaches reduces or prevents substance abuse
or other problem behaviors.
The Institute's list of 40 developmental assets
necessary for healthy youth development are divided into "external"
and "internal" assets. External assets are those
that involve relationships and opportunities provided to young
people (e.g., support, empowerment, boundaries, expectations,
constructive use of time). Internal assets are those that
involve values and skills that young people develop to guide
themselves (e.g., commitment to learning, positive values,
social competencies and positive identity).
The Search Institute has developed a variety
of strategies intended to build assets in young people. All
of these strategies require that implementers have:
• An awareness of the framework;
• An assessment of the assets for each youth;
• An inventory of resources available to build assets;
and
• The ability to successfully implement and continue
the strategies.
Resiliency Approach
The resiliency approach evolved out of the
observation that many young people maintain the ability to
stay on a positive course despite troubled backgrounds. In
1986, Emmy Werner identified some of the characteristics of
those resilient youth:
• Optimistic outlook;
• Self-efficacy or competence;
• Self-discipline (ability to delay gratification and
control impulses);
• Problem-solving skills (e.g., think abstractly);
• Nurturing relationships.
Werner identified several environmental factors
that foster resiliency in youth, including:
• Younger mothers for boys, older
fathers for girls;
• Fewer than four children in the family;
• Steady employment for the mother, especially if she
was a single mother;
• Church attendance.
However, other researchers have come to different
conclusions about what makes for a resilient child, and the
final word is still not in. More research needs to be done
on resilience, especially across cultures. The resiliency
approach is also considered "promising" rather than
proven, due to the lack of published evaluation research on
the subject. No research currently exists to show, conclusively,
that increasing resilience leads to decreased substance abuse
or other problem behaviors.
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Meaningful opportunities
to contribute to the peer group