2. 2 Emerging Issues: Substance Abuse Prevention Across the Lifespan Julie Stevens, MPS, LCDC, ACPS SAMHSA’s Center for the Application of Prevention Technologies Southwest Resource Team June 5, 2012 Little Rock, AR

3. 3 Learning Objectives Discuss the importance of a lifespan focus to effective prevention practice Discuss theories of human development as they relate to life transitions Apply prevention theories to prevention practice across the lifespan Identify additional available resources that relate to prevention across the lifespan

4. 4 Substance abuse prevention across the lifespan is a NEW approach to many states and communities. A New Concept

5. 5 Lifespan Approach – Where Are We Now?

6. 6 Prevention and Silos Mental Health Prevention Programming Criminal Justice Others? Education

7. 7 Why Should Prevention Be Focused Across the Lifespan?

8. Continuum of Care: A Guide to Prevention Across the Lifespan Case Identification Standard Treatment Long-term Treatment After-care and Rehabilitation Indicated Selective Universal Promotion Prevention Promotion Treatment Maintenance Promotion

9. 9 Overview of Risk and Protective Factor Theory Risk factors may predict substance abuse Protective factors can buffer risk factors. Factors occur in multiple context. Factors have a cumulative effect.

10. Risk and Protection Across the Lifespan Brain Development Social Development Changing Web of Influence

11. 11 Most research has been applied to school-age children Little research has been done on other age groups Logical risk and protective factor theory “leaps” have been made from youth to adults, but there is a need for more research Limitations of Current Risk and Protective Factor Research

12. 12 Small Group Discussion Participant handout p. 7

13. 13 Risk/Protective Factors….How Does It All Fit? Where? With Whom?

14. 14 Brain Development: Opportunities for Risk and Protection Prenatal and Childhood: “The Wiring Up” Adolescence: “The Age of Reasoning” Adulthood and Beyond: “Plasticity”

15. 15 Brain Development: “Use it or Lose it” Pruning eliminates weak or unused synapses (connections) in the brain From 3 to 10 years, the formation of connections and elimination of unused connections are balanced.

16. 16 Brain Development: “Use it or Lose it” In adolescence the pruning exceeds the formation. Throughout the lifespan experiences help determine which synapses grow and which ones die.

17. 17 Small Group Discussion Participant handout p. 8

18. 18 Social Development: Opportunities for Risk and Protection Identifies needs and developmental tasks that are associated with each age group. Explains that chronological age may not be the same as developmental age.

19. 19 Social Development: Opportunities for Risk and Protection Identifies transition periods throughout human development. Explains the need for developmentally appropriate prevention materials and techniques.

20. 20 Thinking about Social Development: Time Machine Activity Participant handout p. 10

21. 21 Social Development Where Do We Intervene? Transition Period Death of a Parent New Job Adolescence

22. 22 Importance of Transition Periods “Transitions in life represent a time of potential transformation in self-definition and interpersonal relationships, which may in turn have a long-term impact on psychological well-being”. Individual - internal Ecological - external

23. 23 Erik Erikson: Examining Transitions in Social Development Erickson looked at individuals and divided their lives into stages that require resolution of a basic conflict to achieve the next level of development.

24. 24 Erikson's Stages and Substance Abuse Discomfort Drug Use Temporary Relief of Discomfort Discomfort Returns Conflict

25. 25 Applying Erikson's Stages to Prevention Practice For childhood (ages 7-12), the primary conflict to resolve is one of industry vs. inferiority. To assess prevention needs for this stage we look at: Possible stressful tasks created by this conflict that may lead to substance abuse Risk and protective factors that may relieve or aggravate those stressful tasks

26. 26 Effective Prevention Practice Transition Education and intervention BEFORE the transition

27. 27 Applying Erikson's Stages to Prevention Practice Participant handout p. 11-13

28. 28 Web of Influence: Social Ecological Model (similar to Urie Bronfenbrenner bioecological development model) Individual Family/ Relationship Community Society

29. 29 Perspectives on the Web of Influence "Of the many cues that influence behavior, at any point in time, none is more common than the actions of others" (Albert Bandura,1986)

30. 30 Individual Family / Relationship Community Society Web of Influence for Young, Middle & Older Adults Involvement should include a collaboration with churches, schools, community organizations and workplace.

31. 31 Suggested Strategies for Intervening Interventions in different age groups should focus on the abilities, problems, and web of influence of that age group and can target audiences that are: Universal Selected Indicated

32. 32 Bringing It All Together Participant handout p. 18

33. 33 Future of Prevention and Next Steps