Children on The Brink:
Youths at Risk of Drug Abuse
Volume 12, Number 3
Specialized High School Prevention Programs Target At-Risk Adolescents
By Robert Mathias, NIDA NOTES Staff Writer
Adolescents on their way to dropping out of school and abusing drugs can be diverted toward healthier,more successful lives, according to NIDA-supported researchers. By using interventions designed specifically to address the personal and social factors that place some high school students at risk
of drug abuse, schools can reduce these young people's drug use and other unhealthy behaviors, these researchers say.
One such drug abuse prevention program under way in the Seattle area has improved academic performance and reduced drug involvement among high school students whose poor academic records and behavioral problems indicate they
are at high risk of dropping out of school and abusing drugs. Another drug abuse prevention program in California is showing promising early results in reducing and preventing serious drug use among students in continuation schools. Continuation schools are alternative public schools where students with behavioral and other problems can complete their high school education.
"Our ethnographic studies show that kids who are at high risk of dropping out of school and abusing drugs are more isolated and depressed and have more problems with anger," says Dr. Leona Eggert of the University of Washington in Seattle. "They are disconnected from school and family and are loosely connected with negative peers," she says. Additional assessments indicate that many of these youths also have suicidal behaviors or thoughts, Dr. Eggert says. Universal drug abuse prevention programs that are aimed at all youths in a school are usually inadequate to meet the special needs and problems of these youths, she states.
Dr. Eggert and her colleagues have developed a high school-based drug abuse prevention intervention that is designed for students in the 9th through 12th grades who are skipping classes, doing poorly academically, and in danger of dropping out of school and abusing drugs. The program, called Reconnecting Youth, works to reattach at-risk youths to their schools, their families, and positive peer groups. The program also teaches them social and personal skills they can use to better manage their emotions and deal with their problems without resorting to drug use.
Reconnecting Youth's core element is a one-semester daily Personal Growth Class that is incorporated into the youths' regular class schedule. The class is led by a teacher who fosters the development of a mutually supportive peer group that encourages positive behaviors. The group encourages acceptance, respect, understanding for others, and a willingness to help other classmates solve their problems constructively. The class also focuses on enhancing the youths' self-esteem; improving their decision-making and communications skills; and improving their ability to manage stress, anger, and depression. The ultimate goals of the program are decreased drug use and increased school performance and emotional well-being.
Studies conducted among multiethnic populations of at-risk boys and girls in Seattle area high schools show that, compared to at-risk youths who did not receive the intervention, youths in the Reconnecting Youth program have increased academic performance and decreased drug involvement. The program also improves at-risk youths' ties to their schools and teachers and increases their self-esteem and social support. The program is equally effective with boys and girls but appears to have more of an effect on reducing girls' attachment to friends who skip school and use drugs. Determining the ramifications of this apparent gender difference requires more detailed analysis, which Dr. Eggert plans to do in future studies.
The latest version of the Reconnecting Youth program includes additional classroom and school components that address the needs of the substantial portion of these youths who also are at risk for suicide. The program has been shown to decrease depression, anger and aggression, stress, and suicidal thoughts and behaviors among these youths.
Project Toward No Drug Abuse
Adolescents completing their education in continuation or alternative public high schools are another group at high risk for drug abuse. In California, youths are transferred from regular schools to continuation high schools because of negative behaviors such as drug use, truancy, and fighting with schoolmates, explains Dr. Steven Sussman of the University of Southern California. These students report much higher levels of drug and alcohol use than do students in traditional schools, he says. Research by Dr. Sussman and others indicates that about 36 percent of continuation high school students report weekly marijuana use compared to 9 percent of high school students in traditional schools. About 25 percent of continuation high school students in California also say they smoke marijuana daily, Dr. Sussman says.
Preventing drug abuse among these youths presents many difficulties, he says. First, drug abuse prevention programs that have worked with general populations of younger adolescents in junior high and middle school are less likely to be effective with these older, at-risk high school students. Second, students in continuation high schools present a complex mix of behavioral and social problems and come into daily contact with many other students who use drugs and have a favorable attitude toward drug use. Finally, many of these youths already have used, or currently are using, a variety of drugs.
To meet the needs of this at-risk population, Dr. Sussman has been developing a specialized school-based curriculum for continuation high school youths that forms the core of a program called Project Toward No Drug Abuse. To develop the curriculum, he relied heavily on extensive testing and the feedback
of continuation high school youths themselves. This research sought to ensure that the curriculum would be acceptable and relevant to these youths, tailored to counteract their specific reasons for drug use, and practical for continuation high schools to implement.
The resulting curriculum consists of motivational activities, social
skills training, and decision-making components. These components are delivered in nine classroom sessions over the course of three weeks to
all students in the continuation high school by health educators trained by project staff. The program uses a variety of interactive teaching strategies such as role playing and self-scoring questionnaires to motivate students in the class against drug use, provide them with the skills they need to change their negative behaviors, and guide them toward decisions to not use drugs.
"What we're doing in the nine lessons is trying to find motivators for change that are personally relevant for these high-risk youths," says Dr. Sussman. For example, in one session, the students are encouraged to resist succumbing to negative stereotypes of continuation high school students as "losers" who abuse drugs and have no goals in life. In fact, continuation high school students say they have goals like anyone else, such as getting a job or attending college, Dr. Sussman says. Therefore, another session demonstrates how drug abuse can destroy their health and limit their ability to achieve their goals. "Basically, we are getting them to be more internally and externally consistent so their behavior matches what they think of themselves and what they want," he says.
The curriculum for Project Toward No Drugs is currently being tested among a multiethnic group of more than 1,500 boys and girls in 21 continuation high schools in southern California. An initial analysis conducted 1 year after the conclusion of the class indicates that the program has had significant preventive effects on drug and alcohol use, Dr. Sussman reports. Because the program was developed with feedback from boys and girls from a number of ethnic groups, there were no significant differences in effect by gender or ethnicity, he says.
Eggert, L.L. Psychosocial approaches in prevention science: Facing the challenge with high-risk youth. Communicating Nursing Research 29(4):73-85, 1996.
Eggert, L.L.; Nicholas, L.J.; and Owen, L.M. Reconnecting Youth: A peer group approach to building life skills. Bloomington, IN: National Educational Service, 1995.
Eggert, L.L.; Thompson, E.A.; Herting, J.R.; and Nicholas, L.J. Reducing suicide potential among high-risk youth: Tests of a school-based prevention program. Suicide and Life-Threatening Behavior 25(2):276-296, 1995.
Eggert, L.L.; Thompson, E.A.; Herting, J.R.; Nicholas, L.J.; and Dicker, B.G. Preventing adolescent drug abuse and high school dropout through an intensive school-based social network development program. American Journal of Health Promotion 8(3):202-215, 1994.
Sussman, S. Development of a school-based drug abuse prevention curriculum for high-risk youths. Journal of Psychoactive Drugs 28(2):169-182, 1996.
Sussman, S.; Simon, T.R.; Dent, C.W.; Stacy, A.W.; Galaif, E.R.; Moss, M.A.; Craig, S.; and Johnson, C.A. Immediate impact of thirty-two drug abuse prevention activities among students at continuation high schools. Substance Use and Misuse 32(3):265-281, 1997.
For more information:
- About Reconnecting Youth, contact Psychosocial and Community Health Department, Box 357263, University of Washington School of Nursing, Seattle, WA 98195-7263, (206) 543-9455.
- About Project Toward No Drug Abuse, contact Institute for Health Promotion and Disease Prevention Research, University of Southern California, 1540 Alcazar St., CHP 207, Los Angeles, CA 90033, (213) 342-2589.
From NIDA NOTES, May/June 1997
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