Innovations in Adolescent Substance Abuse Interventions (eBook)

Eric Wagner, Holly Waldron (Autoren)

eBook Download: PDF

2001 | 1. Auflage
406 Seiten
Elsevier Science (Verlag)
978-0-08-050877-1 (ISBN)

Infos

Innovations in Adolescent Substance Abuse Interventions focuses on developmentally appropriate approaches to the assessment, prevention, or treatment of substance use problems among adolescents. Organized into 16 chapters, this book begins with an assessment of adolescent substance use; theory, methods, and effectiveness of a drug abuse prevention approach; and problem behavior prevention programming for schools and community groups. Some chapters follow on the community-, family- and school-based interventions for adolescents with substance use problems. Other chapters explain psychopharmacological therapy; the assertive aftercare protocol for adolescent substance abusers; and twelve-step-based interventions for adolescents.

Inhalt

Front Cover 1
Innovations in Adolescent Substance Abuse Interventions 4
Copyright Page 5
Contents 6
Contributors 8
Preface 12
Chapter 1. Assessing Adolescent Substance Use 14
Chapter 2. Life Skills Training: Theory, Methods, and Effectiveness of a Drug Abuse Prevention Approach 44
Chapter 3. Reconnecting Youth to Prevent Drug Abuse, School Dropout and Suicidal Behaviors Among High-Risk Youth 64
Chapter 4. All Stars: Problem Behavior Prevention Programming for Schools and Community Groups 98
Chapter 5. Community-Based Intervention 122
Chapter 6. An Ecological Approach to Family Intervention for Adolescent Substance Use 140
Chapter 7. Motivational Interviewing for Alcohol-Involved Adolescents in the Emergency Room 156
Chapter 8. Facilitating Change for Adolescent Alcohol Problems: A Multiple Options Approach 182
Chapter 9. The Teen Intervention Project: A School-Based Intervention for Adolescents with Substance Use Problems 202
Chapter 10. Family Behavior Therapy 218
Chapter 11. Multidimensional Family Therapy for Adolescent Substance Abuse 242
Chapter 12. Cigarette Smoking Treatment for Substance-Abusing Adolescents 276
Chapter 13. Psychopharmacological Therapy 298
Chapter 14. The Assertive Aftercare Protocol for Adolescent Substance Abusers 326
Chapter 15. Twelve-Step-Based Interventions for Adolescents 346
Chapter 16. Substance Abuse Interventions with Latino Adolescents: A Cultural Framework 366
Index 392

Textauszug

Chapter 2

Life Skills Training: Theory, Methods, and Effectiveness of a Drug Abuse Prevention Approach

Gilbert J. Botvin; Kenneth W. Griffin*

Introduction

During adolescence, drug use generally progresses both in terms of the frequency and quantity of use as well as in the number of different drugs used (Millman & Botvin, 1992). For any single substance, the amount and frequency of use typically increase as youth transition from non-use to occasional use to more frequent use. There is also a progression in the type of drug or drugs used during this time period. For most youth, tobacco and alcohol are the first substances used, and some youth use inhalants early in the progression due to their wide availability. Later, a proportion of these youth begin to use marijuana, and some will eventually go on to use stimulants, opiates, hallucinogens, cocaine, and other illicit substances. It is now recognized that early experimentation with drugs increases the risk for drug abuse and other drug-related problems in later years. For this reason, adolescent drug abuse prevention programs should focus on preventing the early stages of drug involvement as a method of reducing drug abuse risk. For middle or junior high school students, prevention should involve attempting to prevent the initiation of drug use or the escalation to regular use, with a primary emphasis on the use of tobacco, alcohol, and marijuana.

Fortunately, research findings over the past two decades have provided a firm conceptual foundation for the development of effective approaches to drug abuse prevention. Much of this research has been conducted in school settings and has tested the impact of prevention programs designed to target the psychosocial factors associated with the initiation and early stages of drug use. The earliest of these psychosocial prevention studies focused on cigarette smoking, but more recent research has focused on the impact of drug abuse prevention programs on the use of a range of substances. Recent evaluation studies of psychosocial approaches to prevention have been larger, better designed and more sophisticated than in previous years, and this research has shown that drug abuse prevention approaches can be effective (reviewed in Botvin & Botvin, 1992; Goodstadt, 1986).

The goal of this chapter is to describe a drug abuse prevention intervention approach called Life Skills Training (LST), one of the most widely evaluated school-based prevention programs available. The theoretical basis for the LST program is described and the scientific evidence on the effectiveness of the program is reviewed, including data on the effectiveness of the program with different target populations. In addition, some future directions for prevention intervention research are discussed, particularly in terms of the dissemination of programs that have been proven to be effective.

Theoretical Background and Rationale

Etiology research has identified several important risk factors for adolescent drug use, as well as several protective factors that are important in countering the effects of these risks (Hawkins, Catalano & Miller, 1992). An integrated domain model of the most important factors contributing to drug-taking behavior is presented in Figure 1. These variables can be grouped into three broad categories or domains. The Background/historical domain consists of demographic factors (e.g., age, gender, social class), biological and cultural factors (e.g., temperament, acculturation, ethnic identity), and environmental influences (e.g., community disorganization, availability of drugs). The Social factors domain includes school factors (e.g., school climate, school bonding), family factors (e.g., family management practices, discipline, monitoring, parental drug use), media influences (e.g., television shows, movies, and advertising that promote drug use), and peer influences (e.g., friends’ drug use and pro-drug attitudes). The Personal factors domain includes cognitive expectancies (e.g., attitudes, beliefs, and normative expectations regarding drug use), personal competence skills (e.g., decision-making, self-control), social skills (e.g., communication skills, assertiveness), and a set of relevant psychological factors (e.g., self-efficacy, self-esteem, psychological wellbeing).

Figure 1 Integrated Domain Model of Drug Use Behavior.

A general model of drug use initiation that incorporates each of these key variable domains into an overall conceptual framework is shown in Figure 2. This theoretical framework contains key elements from the most prominent etiological theories of drug use, including social learning theory (Bandura, 1977) and problem behavior theory (Jessor & Jessor, 1977), as well as self-derogation (Kaplan, 1980), persuasive communications (McGuire, 1968), and peer cluster theories (Oetting & Beauvais, 1987). In this model, drug use is conceptualized as the result of a dynamic interaction of environmental and individual factors, in which peers, parents, and other social influences interact with individual psychosocial vulnerabilities to promote drug use. For example, some individuals may be primarily influenced to use drugs by media presentations that normalize or glamorize drug use, while others may be primarily influenced by family members or friends who use drugs or hold attitudes and beliefs supportive of drug use. These social influences are likely to have the strongest impact on those individuals with poor social and personal competence skills, and together these factors may lead to certain psychological vulnerabilities such as low self-esteem, social anxiety, and psychological distress. The more risk factors that an individual has, the greater the likelihood that he or she will become a drug user and/or abuser.

Figure 2 Hypothesized Model of Drug Use Initiation.

In addition to organizing key factors associated with drug use initiation, the hypothesized model in Figure 2 is useful for conceptualizing potential points of intervention for drug abuse prevention. For example, a prevention program that improves personal and social competence skills may have a beneficial impact on various psychological factors associated with reduced drug abuse risk. However, this type of model also has some inherent limitations. The model does not capture the dynamic and recursive nature of these mechanisms, nor does it contain an exhaustive list of etiologic factors.

Description of the Life Skills Training Program

The Life Skills Training (LST) program is an adolescent drug abuse prevention program that is typically provided in school classrooms. The LST program was designed to have a major impact on the individual-level Personal factors shown in Figure 1. The program is a primary prevention program that targets individuals who have not yet developed drug abuse problems, and this is accomplished by impacting on risk factors associated with the early stages of drug use. By intervening with a prevention program with younger populations (e.g., junior high school students), it is presumed that this ultimately will reduce the prevalence of drug abuse among these youth as they become older (e.g., seniors in high school). The LST approach is also a universal intervention designed for all individuals in a given setting, rather than a selective or targeted intervention designed only for individuals at “high risk.”

Program Overview

The LST prevention program consists of three major components. The first component is designed to teach students a set of general self-management skills, and the second focuses on general social skills. These two components are designed to enhance overall personal and social competence and to decrease motivations to use drugs and vulnerability to pro-drug social influences. The third component of LST includes information and skills that are specifically related to drug use, and these are included to promote drug resistance skills, antidrug attitudes, and antidrug norms. The LST program consists of 15 to 17 class periods (about 45 minutes each) and is intended for middle or junior high school students. In addition to the initial year of intervention in grade seven, the LST approach contains an additional two years of booster intervention designed to reinforce the material covered during the first year. This consists of ten booster sessions in grade eight and five in grade nine. For school districts with a middle school, the LST program can be implemented with students in grades six, seven, and eight. Below is a brief description of the major components of the LST program.

Program Components

Personal self-management skills

The personal skills component of the LST program is designed to impact on a broad array of self-management skills. To accomplish this, the personal skills component contains material to: (1) foster the development of decision-making and problem-solving (e.g., identifying problems, defining goals, generating alternative solutions, considering consequences); (2) teach skills for identifying, analyzing, and resisting media influences; (3) provide students with self-control skills for coping with anxiety (e.g., relaxation training) and anger/frustration (e.g., inhibiting impulsive reactions, reframing, using self-statements); and (4) provide students with the basic principles of personal behavior change and self-improvement...

Produkt-Details

• Erscheint lt. Verlag: 14.9.2001
• Sprache: englisch
• Themenwelt: Geisteswissenschaften ► Psychologie ► Allgemeine Psychologie
• Themenwelt: Geisteswissenschaften ► Psychologie ► Entwicklungspsychologie
• Themenwelt: Geisteswissenschaften ► Psychologie ► Klinische Psychologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Pharmakologie / Pharmakotherapie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Themenwelt: Medizin / Pharmazie ► Pharmazie
• Themenwelt: Sozialwissenschaften ► Soziologie
• Themenwelt: Technik
• ISBN-10: 0-08-050877-4 / 0080508774
• ISBN-13: 978-0-08-050877-1 / 9780080508771