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High school isn't too late for prevention programming

July 16, 2015
by Julia Brown, Associate Editor
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Teen substance use can be reduced by 52% with prevention programming, and all age groups in adolescence can benefit, according to a new study published in the World Journal of Preventive Medicine. The study’s lead author, Gilbert J. Botvin, PhD, professor emeritus of Cornell University's Weill Medical College and developer of the LifeSkills Training program for middle school and high school students, says that up until now, it has been very difficult to identify effective substance abuse prevention programs, and that most of the focus has been primarily on the beginning of the adolescent period, with middle or junior high school populations.

“The general thinking is that the earlier you start, the better prevention, and to a large extent that stands to be true. But what’s important about this study, however, is that it shows that high school isn’t too late,” he says.

For youths who didn’t get an effective substance use prevention program in grade school, a universal program such as LifeSkills Training—one that’s not targeted for kids with problems, but rather for the whole student population—could prevent teens from starting drugs or moving to an increased level of severity in terms of drug use, Botvin says. The study focuses on young people who were using one or more drugs on a daily basis, and the LifeSkills Training program was able to cut that daily substance use in half.

“This tells us that with a universal prevention program in high schools, it’s possible to make a substantial difference, and it can be done with an approach that’s been identified to be effective with younger populations like middle school kids,” Botvin says. “A very similar approach can be applied in a way that’s developmentally or age appropriate to the older population using images, examples, and so forth in the intervention. It’s really a major breakthrough in prevention.”

LifeSkills Training is a straightforward, school-based intervention that can be conducted by high school teachers with relatively little specialized training. In fact, only a single-day training workshop is required, and additional support is provided in the form of curriculum materials and student workbooks. Botvin adds that the purpose of LifeSkills Training is to give teens the tools to cope with challenging life situations.

“The training provides opportunities within class for kids to learn and practice a whole set of general life skills that aim to enhance overall confidence and reduce internal motivation to engage in substance use, while also giving them the skills to resist social pressures or influences from friends or family,” he says. “This has tremendous public health potential because it can be done inexpensively.”

The potential of the programming extends past cutting the amount of substance use, also reducing health and other problems associated with substance abuse, Botvin adds.

The importance of life skills

Life skills aren’t traditionally taught in an organized, formalized way, but rather assumed that they’ll be learned organically on the path to adulthood, Botvin says. Meanwhile, teens at high risk from substance use are typically those who have the greatest deficit in terms of coping skills.

“We teach them how to cope with stress and anxiety, how to make informed decisions and general social skills in order to meet new people, develop healthy relationships, manage conflicts and avoid misunderstandings,” he says.

For that reason, LifeSkills Training is different in approach from traditional, often ineffective drug abuse prevention programming such as D.A.R.E., for example, which and emphasized the dangers of drugs. Instead, Botvin says, LifeSkills programming approaches the topic in a much more positive way that embraces youth development.

“With this approach applied to younger age groups like middle school kids, we found that the prevention program still had a lasting impact—not only until the end of high school, but in at least one study the beginning of young adulthood, or early 20s,” he says. “So this kind of positive success-oriented approach is really important.”

Moving forward

When asked what comes next, Botvin says awareness must be increased across the field in order to encourage schools to look closely at what programming they currently have and determine whether or not it’s effective. “That’s the biggest challenge, trying to translate what we’ve learned in research into action and encourage teachers around the country to implement more effective programs,” he says.

Botvin says he’d like to replicate the study with a larger population and do a longer-term follow-up; he’s also interested in examining the impact of middle school training in addition to high school training for added exposure. He adds that the same research could also be applied to sexual violence prevention in both high school and college populations. “There’s quite a bit on the drawing board of things that are important problems facing teens that are natural extensions of this kind of research,” Botvin says

While it’s important to treat addictions and help people successfully transition into recovery, he suggests that clinicians take note of this study and try to incorporate the enhancement of personal and social competence among their patients to give them a set of positive life skills. For example, he says, using cognitive-behavioral therapy (CBT) techniques. “When working with high school kids, especially, the combination of typical treatment modalities and prevention techniques is needed.”