Drug prevention focus should be on families

New programs target the root causes of drug use and other forms of delinquency.

By Rebecca A. Clay

Conventional programs designed to prevent drug use among young people just don't work, says psychologist Karol Kumpfer, PhD, director of the Center for Substance Abuse Prevention (CSAP) at the U.S. Substance Abuse and Mental Health Services Administration, an agency of the U.S. Public Health Service.

Most programs merely provide children with information about the dangers of substance abuse, Kumpfer explains. That's not enough. What's needed, she argues, are programs that attack the root causes of substance abuse. And that means programs that strengthen families, she says.

"Scare tactics are not enough," says Kumpfer. "Giving kids information about the negative consequences of using drugs is helpful, but you also have to help parents become more effective parents."

Now Kumpfer is working to share that vision. Before coming to work at CASP and with support from the U.S. Office of Juvenile Justice and Delinquency Prevention, she and a colleague culled 50 proven models from a database of a thousand prevention programs based on family strengthening. CSAP plans to spend $10 million to help at least 100 communities adopt these research-based programs.

Exemplary programs

When Kumpfer first suggested bringing children and parents together in substance-abuse prevention programs 20 years ago, the idea was considered revolutionary.

Called the Strengthening Families Program, the project she went on to develop at the University of Utah teaches parents better parenting skills and teaches young children problem-solving and other skills. Then it brings families together in therapeutic play sessions and weekly meetings to enhance family functioning. The goal is to give children the skills they need to reject substance abuse and other forms of delinquency.

The result? Significant reductions in problem behaviors, poor parenting and family dysfunction--all risk factors for substance abuse, teen pregnancy, violence and other problems down the line. Although Kumpfer's original program targeted the 6- to 10-year-old children of substance-abusing parents, its positive results have been replicated a dozen times with other populations.

Striking results

Another of the "exemplary" programs on Kumpfer's list was adapted from the Strengthening Families Program and is aimed at families without existing substance-abuse problems. Designed by Virginia Magaard, PhD, and evaluated by Richard Lee Spoth, PhD, and colleagues at Iowa State University's Institute for Social and Behavioral Research, the intervention builds skills associated with reduced substance abuse and other forms of conduct problems.

During seven two-hour sessions, parents and their 10 to 14-year-olds attend separate skill-building groups and then assemble for supervised family activities such as role-playing or joint problem-solving. The children's sessions focus on such topics as goal-setting, stress management, communication, responsibility and resistance to peer pressure. Meanwhile, their parents learn how to express affection, set rules and encourage good behavior. Four booster sessions during the six months to a year after the program ends help reinforce the lessons.

Preliminary results have been striking, says Spoth, who directs Project Family, a series of studies evaluating various skills building programs and methods for increasing participation in them.

Take the project's study of 33 middle schools, for example. Children in the families that received the intervention waited longer to use tobacco, alcohol and marijuana than the children in the control group's families, says Spoth, explaining that "delayed initiation" of alcohol reduces the chances of alcohol dependence and substance abuse later in life.

Four years after the study began, the experimental group had a 35 percent relative reduction in lifetime use of cigarettes, a 40 percent relative reduction in being drunk and a 56 percent relative reduction in lifetime use of marijuana, compared to the control group. Even intervention-group members who did start smoking or drinking did so less frequently than their control-group peers.

The program doesn't just target substance abuse. At the two-year follow-up, the researchers found a significant reduction in conduct problems and school-related problems such as truancy, a significant reduction in affiliation with antisocial peers and a significant increase in positive interactions between parents and their children.

"Imagine a line representing the control group's level of problem behavior and a line representing the intervention group's level of problem behavior," says Spoth. "What we're seeing is an increasing divergence over time. That reinforces the idea that developmentally well-timed skills building interventions--even when they're fairly brief--can effectively change the trajectory of problem behaviors."

More than education

Myrna B. Shure, PhD, is another psychologist who has developed a prevention program that harnesses families' energy.

Her "Raising a Thinking Child: I Can Problem Solve" program helps parents help their 4- to 7-year-olds think for themselves. In the first part of the program, children play games that teach them a problem-solving vocabulary. In the second part, they learn how to listen, consider the consequences of their behavior, develop alternatives and identify their own and others' feelings. In the third part, they solve hypothetical problems. Throughout the 10- to 12-week program, parents do exercises that teach them how to engage their children in problem-solving.

The program prevents and reduces behaviors that longitudinal research has shown predict substance abuse and other problems in adolescence, says Shure, a professor in the department of clinical and health psychology at MCP/Hahnemann University in Philadelphia. Children in the 100-plus families who have participated in her studies have shown less antisocial behavior, withdrawal and inability to make friends and more of the skills children need to resist peer pressure and make better decisions.

"Programs that lecture to kids about the dangers of drugs, unsafe sex and guns don't work," says Shure. "You have to teach kids how to think, not what to think."

For more information, visit the University of Utah's Strengthening America's Families web site at http://www.strengtheningfamilies.org.
Rebecca A. Clay is a writer in Washington, D.C.



Read our privacy statement and Terms of Use

Cover Page for this Issue

PsychNET®
© 1999 American Psychological Association

APA Home Page . Search . Site Map