1. CHAPTER 13: Prevention Substance Abuse Counseling: Theory and Practice
Fifth Edition
Patricia Stevens
Robert L. Smith
Prepared by:
Dr. Susan Rose, University of the Cumberlands

2. Overview of Chapter Types of Prevention Prevention: A Brief History
Comprehensive Prevention
Community Prevention
Risk and Protective Factors
Life Skills Training (LST): Effectiveness of a Comprehensive Prevention Approach
Steps to an Effective Prevention Program
Implications for Counseling

3. Types of Prevention Primary Health Model of Prevention
Primary: Use – Development
Goal: To prevent or delay the beginning of use
Secondary: Misuse/Abuse – Psychological Dependence
Goal: To help novice or experienced users discontinue or limit their use
Tertiary: Addiction – Dependence
Goal: Same as relapse and relapse prevention

4. Types of Prevention
IOM (Institute of Medicine) Classification Scheme for Prevention Planning
Universal Level: targeted to the general population
Selective Level: targeted to the at-risk populations
Indicated Level: targeted to persons or groups who already show problems as a result of ATOD use and who require intervention to halt or ameliorate these difficulties
Comprehensive Delivery of Programs and Services: the current accepted prevention paradigm

5. Prevention: A Brief History
Knowledge-Attitudes-Behavior (KAB) Model (1960’s – 1970’s)
Presentations were supplemented by an array of scary antidrug films, dire warnings of possible consequences, stereotyping of users, overstatements about the “likely” addiction that would follow from experimentation, and moralizing about the destructive lifestyle
Based on fear, zeal and moralistic attitude, not scientific knowledge
Unproductive and potentially counterproductive

6. Prevention: A Brief History
1970’s – 1980’s Approaches
Affective education: Helping students identify and express their feelings; Helping them feel valued and accepted; building self-esteem
Values Clarification: Assisting students in decision-making skills
Teaching Alternatives: Relaxation, Meditation, Exercise, Involvement with the arts, etc.
Development of Personal and Social Skills: Problem-solving, Self-Management, and Leadership Skills
Recognition of Peer Pressure and Methods of Resistance

7. Prevention: A Brief History
Project D.A.R.E. (Began in 1983)
Normative Education (1980’s): Environmental approach that can be incorporated into a wider, more comprehensive strategy of ATOD prevention
Aspects of Environmental or Ecological perspective
Norms: perceived rules of behavior or values that influence a person’s attitudes and actions.
In preventative terms, Norms set limits or establish guidelines that are the background or framework for ATOD use/abuse
Embedded systems offering reciprocal causality: Individuals are influenced by families, which, in turn, are influenced by social networks, and vice versa.

8. Prevention: A Brief History
Proactive Prevention Model
Incorporates strategies of earlier models
Primary Prevention: Providing services to prevent abuse among non-users
Secondary Prevention: Reducing the likelihood that at-risk individuals will develop problems
Tertiary Prevention: helping abusers into recovery
Distinguished from previous approaches by its two main components:
Emphasizing the importance of providing accurate information about communities and normative environments
Focusing on healthy, positive attitudes and behaviors of community members

9. Comprehensive Prevention
Attempts to address multiple levels of intervention and multiple populations.
Takes into account the variety of factors that may be involved in the problem and the available theories for addressing these factors, integrating multiple strategies in a collaborative effort.
Incorporates a view of the wider environment and ecology within which the problem resides
Considers diversity
Is developmentally appropriate
Attends to the effects and consequences of ATOD abuse
Presumes that prevention is a long-term effort

10. Community Prevention CASASTART
CASA: Children at Risk, from the National Center on Addiction and Substance Abuse at Columbia University
START: Striving Together to Achieve Rewarding Tomorrows
Components of Program
Case Management
Family Services
Educational Services
After-school and Summer Activities
Mentoring
Incentives
Community policing and enhanced enforcement
Juvenile Justice Intervention

11. Risk and Protective Factors
Table 13.1 (Pages )
An ATOD prevention model utilizing risk and protective factors should encompass:
The agent
The individual
The environment

12. Life Skills Training (LST)
Effectiveness of a Comprehensive Prevention Approach (
Most widely researched and evaluated prevention programs with children and youth
It is a primary prevention, school-based, universal classroom program that addresses a number of critical prevention components in an integrated way
Basic Structure
Geared toward middle school students
Consists of class periods of approximately 45 minutes each in the first year
“Booster” sessions: 10 in the second year and 5 in the third year

13. Life Skills Training (LST)
Effectiveness of a Comprehensive Prevention Approach cont.
Components
General Self-management Skills: Problem-solving, Decision-making, Critical Thinking, Coping Strategies
General Social Skills: Effective Communication, Developing Healthy Friendships
Information/Skills that specifically address drugs and their use: Awareness of social influences to use, normative education tactics

14. Steps to an Effective Prevention Program
Planning must be conducted and/or affirmed by a representative group of stakeholders
Community Collaboration is recommended
Address Core Questions
Table 13.2, Page 352

15. Steps to an Effective Prevention Program
Effective prevention planning begins with:
Needs clarification
Assessment
Development of goals and measurable objectives supported by consistent evaluation procedures

16. Implications for Counseling
The Advocacy Role includes involvement in collaborating with different stakeholders in devising and promoting prevention strategies.
Counselors must have the knowledge base and skills necessary for prevention work.