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CONTENTS

vii Preface

Chapter 1
1 Adolescent Development: Risk, Vulnerability, and Resilience
Carol P. Kaplan

Chapter 2
22 Prevention Programs Reviewed: What Works?
Elaine Norman, Sandra Turner, Sharyn J. Zunz, and
Kathy Stillson

Chapter 3
47 School Climate and Community Norm Change
Sharyn J. Zunz

Chapter 4
73 New Directions: Looking at Psychological Dimensions in
Resiliency Enhancement
Elaine Norman

Chapter 5
95 Building on Strengths: Risk and Resiliency in the Family,
School, and Community
Sandra Turner

Chapter 6
113 Resilience in African American Adolescents: Issues
Pertinent to Alcohol and Other Substance Use
Saundra Murray Nettles
 Chapter 7
131 Did We Make a Difference?: Techniques and Process in
Program Evaluation
Michael Phillips

Chapter 8
157 Funding Substance Abuse Prevention Programs for Youth
Roslyn H. Chernesky

193 Index
PREFACE

There is an almost universal consensus that we as adult individuals,

as communities, and as a nation, should attempt to prevent our
youngsters from using alcohol, tobacco, and other drugs such as
marijuana, cocaine, and heroin. We, the adults, use these substances
in abundance-especially the legal ones, alcohol and tobacco. Our
youngsters fmd them readily available, and they know that they offer
a number of satisfactions. They know, for example, that substance
use has the potential to relieve feelings of inadequacy and other
psychological pains that naturally occur with adolescence and that use
offers an opportunity to express opposition to authority, to afftrm
solidarity with peers, and to appear "grown up" (Jessor, 1985).
Why then, if we use substances to such a large extent and if we
know they offer certain satisfactions, do we wish to prevent our
youngsters from partaking? The answer is obvious. As a culture we
are deluged with evidence of the harmful effects of alcohol, tobacco,
and other illicit drugs. We know that important risk factors for
regrettable, sometimes tragic, accidents and for health problems in
later life have their roots in youthful incautious substance use (Public
Health Service, 1995a). We wish to protect our children from lung
cancer, heart disease, cirrhosis of the liver, drunk driving accidents,
and addiction.
Recognizing this we have made the use of alcohol, tobacco, and
other drugs illegal before adulthood. We wish to prevent our
children from beginning to use these substances until they are adults-
older, more mature, and better able to make reasoned decisions.
Teen-agers do use substances in much larger numbers than we
are comfortable with. In 1992, according to the National Household
Survey on Drug Abuse (Public Health Service, 1995b), four out of
every ten adolescents aged twelve to seventeen reported having used
alcohol at least once in their life, one out of every three reported
having used tobacco, and one out of every six reported having used
an illicit drug (mainly marijuana). These figures have been dropping
significantly since 1979. The 1979 figures are stunning in comparison
to the 1992 figures we just noted. In that earlier year, seven of ten
youngsters of that age reported having used alcohol, more than five
in ten reported ever using tobacco, and one in three reported ever
using another illicit substance. As the nation became more health
conscious a steady downward trend in substance use among youth
seems to have occurred (see table below).

Percent of 12- to 17-year-olds reporting ever using substance

In 1979 In 1985 In 1992
Alcohol.................. 70.3% 55.4% 39.3%
Tobacco................. 54.1% 45.3% 33.7%
Other illicit drugs 34.3% 29.7% 16.5%

Source: (Public Health Service, 1995b).

The 1992 numbers are still quite high and there is evidence that
a definitely discernable rise in use among youngsters has been
occurring since 1992 (Swan, 1995).
In the past decade and a half considerable public resources have
been devoted to the development and testing of school and
community-based programs designed to prevent substance use and
abuse among adolescents. At the present time three-quarters of the
school districts in the United States have anti-smoking programs, and
nearly two-thirds have alcohol and other drug programs as part of
their curriculum (Public Health Service, 1995a). Some such programs
have been proven to be effective prevention tools, while others have
not.
For three and a half years, from 1990 to 1994, a team of
researchers and clinical practitioners from Fordham University's
Graduate School of Social Service, with funding from the New York
State Office of Alcohol and Substance Abuse Services, worked to
review the literature published in the past two decades pertaining to
the content and outcomes of adolescent substance abuse prevention
programs which had been fielded during that twenty-year period.
The results were presented to over a thousand substance abuse
prevention specialists in a series of seminars throughout New York
State. Included were prevention specialists in schools and social

viii PREFACE
agencies, junior high and high school teachers, social workers, and
school administrators.
The magnitude of the appreciation voiced by the attendees for the
material in the seminars led to the development of this book.
All of those present were working in the field, in schools and
community agencies, attempting to accomplish adolescent substance
abuse prevention. Most didn't have up-to-date information on the
most effective strategies. They didn't know how to obtain
curriculums related to those strategies nor how to get training in
using them. They had little formal information on the adolescent
developmental issues that might affect substance use. Few were
aware of the new trends in program development such as resiliency
enhancement. Even fewer were equipped to do research evaluations
of their programs. Most were eager to know about funding sources
to help them develop new or expand existing programs.
In order to answer those concerns, interests, and needs this book
was developed. It is intended as compendium of materials to help
adolescent substance abuse prevention specialists develop, improve,
evaluate, and fund prevention programs.
The first chapter in the book presents a clinician's view of the
developmental issues faced by adolescents that potentially affect
substance use. Carol P. Kaplan notes in "Adolescent Development:
Risk, Vulnerability, and Resilience," that adolescence is a period of
both vibrant growth and vulnerability and risk. The vitality and
emotions of adolescence can at times be misunderstood as
pathological, while some seriously disturbed behavior can be
misinterpreted as normal. The article helps us to understand the
nature of normal adolescence and the indicators of disturbance.
Knowledge of both are essential in our effort to help teen-agers avoid
substance abuse.
In order to choose productive prevention programs for teenagers,
it is important to know what has already been tried and found
effective as well as what has proved not to be useful. In the second
chapter, "Prevention Programs Reviewed: What Works?," Elaine
Norman, Sandra Turner, Sharyn J. Zunz, and Kathy Stillson review
the curriculum-based adolescent substance abuse prevention
strategies developed in the past two decades, their theoretical
underpinnings, and the outcomes of their research evaluations. The
chapter describes the components of successful curriculum-based
prevention programs and includes information on how to locate the
program coordinators in order to obtain curriculum materials and

ix
training in their use.
Prevention efforts that are not curriculum based have also
contributed to the reduction of substance use among adolescents.
These include efforts to change school climate and community norms.
That is the subject of chapter three by Sharyn J. Zunz. Extensive
public health efforts to change community norms have been fielded.
The most well known, those concerning tobacco consumption and
driving while intoxicated, have had positive results nationwide as have
attempts by some schools and community agencies to change their
organizational climate and policies to help impart non-substance use
norms to students. The chapter describes a number of these efforts
in detail and includes a synthesis of useful suggestions for developing
such programs for adolescents.
In recent years the field of adolescent substance abuse prevention
has been undergoing a paradigm shift. Instead of focusing upon
reduction of risk, vulnerability, and pathology the spotlight has turned
to enhancement of strengths and resiliency. Chapters four, five, and
six deal with this topic. They outline the personal, family, school, and
community factors that, according to the research literature, enhance
sustained competent functioning even in the presence of major life
stressors. These chapters describe programs that utilize this material
in their prevention efforts.
In "New Directions: Looking at Psychological Dimensions in
Resiliency Enhancement," Elaine Norman reviews the theoretical
underpinnings of the resiliency concept and synopsizes the research
literature related to the psychological factors that make up, and
enhance, resiliency. In "Building on Strengths: Risk and Resiliency
in the Family, School, and Community," Sandra Turner does the same
for family, school, and community resiliency factors.
Few evaluated prevention programs have targeted minority
youngsters. There has also been a paucity of publications specifically
related to the strengths of minority group adolescents, and the ways
such strengths can be, and are, mobilized to prevent substance abuse.
Saundra Murray Nettles, in "Resilience in African American
Adolescents: Issues Pertinent to Alcohol and Other Substance Use,"
examines current misconceptions of African American adolescents'
use of alcohol, tobacco, and other drugs; reviews risk and protective
factors making for greater vulnerability or greater resiliency; and
describes models of meaning, culture, and context relevant to
resiliency enhancement prevention programming for African
American youth.

x PREFACE
 Whatever substance abuse prevention program we implement we
want to know if, and to what extent, it achieves its intended goals.
Most funding agencies wish to know this too. Michael Phillips in
"Did We Make a Difference?: Techniques and Process in Program
Evaluation" leads us through all the steps one must undertake when
evaluating a prevention program. From the original goal setting to
the fmal report writing he details each stage of the research endeavor
to follow in order to measure how well the program works.
Finally, conducting and evaluating adolescent substance abuse
prevention programs is expensive. Although as a society we have
given lip service to the need for prevention, public health and
substance abuse professionals have constantly had to struggle to
obtain fmancial support for prevention activities. From the onset of
public funding in the area of substance abuse, the lion's share of
governmental monies have been earmarked for law enforcement and
interception of illegal drug supplies. Most of the small remaining
share has been funneled into much needed addiction treatment
programs, leaving very little for prevention efforts. In these days of
shrinking resources, obtaining funding for prevention activities from
outside sources has become a genuine art. In "Funding Substance
Abuse Prevention Programs for Youth," Roslyn H. Chernesky
discusses funding opportunities from foundations and from federal
agencies and she gives detailed information on the grantmaking
process and proposal writing.
This volume contains the most recent knowledge available in the
field. The hope is that it will prove helpful as we work to assist our
youth in their effort to be, and to remain, substance free.

Elaine Norman

Professor
Fordham University at
Lincoln Center
Graduate School of Social
Service

xi
REFERENCES

Jessor, R. (1985). Bridging etiology and prevention in drug abuse

research. N.l.DA.-Research Monograph Series, 56, 257-268.

Public Health Service. (1995a). Healthy People 2000: National Health

Promotion and Disease Prevention Objectives. U.S. Dept. of
Health and Human Services. DHHS Pub. No. (PHS) 91-50213.

Public Health Service. (1995b). National Household Survey on Drng

Abuse: Main Findings 1992. U.S. Dept. of Health and Human
Services, SAMHSA, Office of Applied Studies. DHHS Pub. No.
(SMA) 94-3012.

Swan, H. (March/April1995). Marijuana and other drug use among

teens continues to rise. NIDA Notes. U.S. Public Health Service.
(NIH Pub No. 95-3478), 8-9.

xii PREFACE
CHAPTER 1

Adolescent Development: Risk, Vulnerability, and

Resilience
Carol P. Kaplan

INTRODUCTION

Adolescence as a developmental phase contains certain features that

can be regarded as universal. It is an eventful time with
opportunities for vibrant growth as well as vulnerability and risk.
Interwoven with the universal characteristics of adolescence are
various constitutional factors and experiences which may influence the
adolescent towards either developmental progress or dysfunction.
For example, trauma and victimization, as well as social stressors
such as poverty and racial discrimination, may place young people at
risk (Turner et al., 1994; Garmezy, 1991; Dornbusch et al., 1991;
Arnold, 1990; Gibbs et al., 1989; Rutter, 1987; Myers and King, 1983).
Drawing upon established theories as well as more recent
research findings, the following chapter presents an overview of some
of the ways in which we understand normal adolescent development
as well as risk, vulnerability, and resilience. The chapter will examine
developmental processes beginning in early childhood, and review a
number of specillc problems of adolescence. Substance abuse
frequently accompanies both developmental dysfunction and specillc
disorders of adolescence, so the chapter will highlight the relationship
between these issues and adolescent substance abuse in an
ecosystemic framework.

NORMAL ADOLESCENT DEVELOPMENT AND

VULNERABILITY

Early Childhood
Infancy and early childhood impact subsequent development
greatly. Along with basic nourishment and care, children require the
opportunity for attachment, or bonding, with at least one significant
nurturing adult as well as continuity of care, consistency, love, and
appropriate discipline. When any of these ingredients are absent or
when young children are malnourished, neglected, abused, or denied
the opportunity to bond because of the loss of significant caretakers,
detrimental effects upon personality development and competent
functioning can be expected, sometimes profound and lifelong ones
(Bowlby, 1973; 1980; 1982; Spitz, 1965; Mahler et al. 1975). Many
adolescents who become seriously dysfunctional or delinquent have
early histories of extreme loss, deprivation, or abuse (A. Freud, 1967;
Eisen, 1972; Winnicott, 1973; Marohn et al., 1982; Mishoe, 1986;
Goodman, 1988.)

Latency
Developmentally, early childhood is followed by the period
traditionally known as latency, roughly ages 6 to 11. Because of the
great importance of early childhood events, the significance of latency
is not always appreciated. According to Sarnoff (1976), latency is a
period of relative calm, pliability, and educability. The "average
expectable environment" provides nurturing, stability, and structure
and protects children from inappropriate aggression and sexual
overstimulation. In such an environment they attend school and learn
academic skills, while playing musical instruments, joining teams,
pursuing hobbies, making friends, and in general, achieving a sense
of their own capabilities and increasing their sphere of mastery (a
process that would have begun during early childhood.) Thus
strengthened by this period of growth, children are better able to
withstand the pressures of the next phase of development:
adolescence.
Children who have not been able to gain skills and mastery during
latency, e.g. because of learning disabilities, a chaotic or destructive
home environment, or emotional problems, will find adjustment
during adolescence much more difficult (Meeks and Bernet, 1990).
Unfortunately, many children in our society are at risk for substance
abuse, school dropout, pregnancy, and delinquency in their teen years.
Without adequate adult supervision or family supports, or in
communities devastated by poverty, neglect, and violence, they are
deprived of opportunities for learning and mastery. Some experts
recommend school-based support services for latency-age children in
order to prevent dysfunction then and during adolescence.

2 ADOLESCENT DEVELOPMENT
 Adolescence
The period between childhood and adulthood, which begins with
the physical changes of puberty and may have a variety of different
end points, has now come to be recognized as a distinct
developmental phase in all cultures (Schlegel and Barry, 1991).
Adolescence brings changes in the physical, psychological, cognitive,
and social spheres of an individual's life. However, there is great
variability among individuals, and chronological age does not
necessarily correspond to physical or emotional age.

Physical Changes
Growth may occur unevenly or in spurts, differentially for boys
and girls and for different individuals. Adolescence also brings the
development of reproductive capacity and secondary sexual
characteristics. Girls and boys whose bodies are changing frequently
become self-conscious and self-involved. Sexuality becomes an
important issue. Hormonal changes and fluctuations may lead to
moodiness, although this is not inevitable (Brooks-Gunn, 1991).
Early maturing girls and late maturing boys seem to have special
problems.

Psychological Changes
The developmental ego psychological approach to adolescence of
such writers as Anna Freud (1958), Erikson (1950, 1968), Laufer
(1966), and Kaplan (1984) describes the normal adolescent
developmental process as a "psychosocial moratorium," with a
normative identity crisis and a period of mourning and depression,
during which the young person makes a final emotional separation
from parents and bids farewell to childhood. This has been called
the "second separation-individuation process" (Bios, 1%2, 1979). The
young person fmally experiences himself or herself as separate from,
and eventually makes a life apart from, the parental family. Acting
out and experimentation are normal and even desirable, according to
this theory. The optimal result will be intimacy with a partner and
the development of a separate identity. Ideally, the young person will
establish himself or herself in the world of work based upon
individual interests, skills, and abilities to the extent that society
provides adequate opportunities for employment and self-
development.
In contrast to the view that adolescence inevitably is tumultuous,
some writers have maintained that it need not be so (Offer, 1987).

3
While the individual (and the family) may be challenged to cope with
new realities, most are able to do so. However, even those who view
normal adolescence as a period of generally successful coping agree
that the most stormy stage for young people is likely to be early
adolescence-around ages 12 to 14-roughly the period of junior high
school. This age group must manage often dramatic physical and
emotional changes, including hormonal ones, within a school context
with less structure than primary school provided (Miller, 1983;
Peterson et al., 1991).
In addition, for young teenagers the desire for increased
independence from parents comes at a time when the capacities to
manage such independence are not firmly in place-a fact usually
recognized by the parents and on some level by the teen as well.
Irritability, emotional lability, even tantrums, may appear in this
phase and then dissipate as the adolescent becomes increasingly able
to cope with more independence and the challenges of high school.
Clearly, during these years families will experience stress and must
draw upon their adaptive abilities. If, however, parents either
overreact to the young teenager and fail to establish a dialogue or do
not set appropriate limits, the undesirable behavior patterns may
become ftxed (Offer, 1969; Miller, 1983.)
Virtually all writers on adolescence agree on the importance of
the peer group. The adolescent draws close to peers just at the time
when he or she confronts the fact that parents are neither perfect nor
omnipotent. The peer group provides the support required during
this stage of normative disillusionment and aids the teen in the tasks
of separation from the parents and establishment of a new identity.
Especially during the early adolescent period, young people, in their
desire for acceptance, are inclined to follow the peer group in every
detail of behavior and style, while at the same time they appear to be
rejecting parental (and sometimes societal) values (Miller, 1983).
Obviously, therefore, the characteristics of the peer group now
assume tremendous importance. Some of the classic research and
writing on adolescence grew out of society's concerns about "juvenile
delinquency," often defmed as antisocial behavior by adolescents in
groups (Aichhorn, 1963). Indeed, antisocial, underachieving, or
substance abusing peers may impact very negatively upon an
adolescent's trajectory towards adulthood, especially if childhood
developmental accomplishments have been tenuous or deficient.
Obviously, therefore, communities in which violence and substance
abuse are prevalent will tend to produce more antisocial adolescents.

4 ADOLESCENT DEVELOPMENT
 Paradoxically, adolescents continue to need adult attention,
support, and guidance, even as they sometimes seem to be rejecting
the adults in their life, and even as school structure (as well as some
family structures) tends to mitigate against stable relationships with
adults (Miller, 1983; Schlegel and Barry, 1991). If adults fail to
recognize the fact that adolescents continue to need their guidance
and support and ignore or reject the rebellious young person,
negative consequences may result. Adolescents flourish in an
atmosphere of dialogue and discussion (Hauser et al., 1991), which
the parents may be unable to provide if they are overwhelmed or
inadequate to the task of parenting.

Cognitive Changes
Adolescence marks the beginning of the capacity for abstract
reasoning (Piaget, 1967; Flavell, 1%3). For the first time, most young
people become able to understand philosophical and ideological
issues in their full complexity and to appreciate concepts like "the
future" more realistically. Yet because of their new ability to think
abstractly, adolescents come to see and understand problems which
they did not previously perceive as such, especially in areas like future
work opportunities (or the lack of them), values, and the complexity
of interpersonal relationships. Thus, this very capacity for abstract
thinking can create new difficulties and new challenges for coping, as
the "world of what matters" (Larson and Asmussen, 1991) is
expanded. The following are some examples:
1. With friends and members of the opposite sex, who are now so
important, such issues as loyalty, trust, and betrayal arise for the ftrst
time and are capable of causing negative as well as positive emotions.
The young person will need to call upon all of his or her resources
to cope with these intense feelings.
2. As abstract reasoning allows youngsters to project themselves
into the future, an opportunity is provided for some adolescents to
change course and take a more positive direction. As following
chapters note, a sense of self-efficacy and optimism as well as at least
one positive relationship with a caring adult in the family, school,
and/or the community are among the ingredients associated with
resiliency and positive outcomes. In their absence, despair and
dysfunction may result (Zunz et al., 1993).
3. In conjunction with the capacity for abstract reasoning, and an
increased ability to experience the complexity of relationships, the
adolescent may be both more empathic and more aware of ambiguity

5
than was the case in childhood. In the long run, this may lead to
growth. In the short run, however, the individual may actually feel
more vulnerable. In fact, as Norman indicates in chapter four, some
research shows that a high degree of empathy may prove detrimental
to teens in high stress situations.

Social Changes
From the sociological point of view, adolescence is a period of
social role learning and restructuring (Schlegel and Barry, 1991). For
the first time, the youngster possesses real power of independent
action. In order to understand these issues, particularly as they
impact upon risk and vulnerability in adolescence, a systemic,
ecological point of view is extremely useful for the following reasons.
1. It is in the peer group that adolescents can rehearse the social
activities and behaviors of adulthood (Schlegel and Barry, 1991). As
noted above, however, certain peer groups may foster antisocial roles,
leading to increased vulnerability.
2. The cognitive changes of adolescence pave the way for this
learning of new social roles. Optimally they are fostered in the
secondary school environment, in which adequate support is provided
not only for cognitive development but for constructive social role
learning as well. However, in some communities school may become
the place where violence and negative social roles are rehearsed.
3. Society must foster and promote appropriate social role
learning by providing opportunities for future productive work. Only
if such opportunities are available do adolescents have an incentive
to defer immediate gratification in preparation for a rewarding future.
At least half of U.S. youth do not go to college, and many fail to
graduate from high school (Petersen et al., 1991). Too many teens,
especially those who are poor, see opportunities in life on the street
as more attractive and financially rewarding than those in the
legitimate job market. The question for many of these young people
is not how to make it but whether to even try and make it (Inclan
and Herron, 1989).
4. The structure of our society leads to gender specific
vulnerabilities. For example, girls in adolescence may be more
vulnerable to depression (Petersen et al., 1991) and to declining
academic motivation (Gilligan et al., 1990), while boys may respond
to stress during this period with increased acting out. Too, for girls,
early puberty may produce stress, while it rarely does so for boys
(Brooks-Gunn, 1991).

6 ADOLESCENT DEVELOPMENT
 5. For those young people inadequately equipped during latency
with the academic skills that will prepare them for productive work,
adolescence may be the last opportunity for remediation. Here again,
schools may not provide such remediation appropriately, and the
teenager who feels like a failure may even drop out, thus foreclosing
constructive options for the future.
6. It would appear that the very transitions of adolescence can
cause stress for some youngsters, especially if they occur in the
context of other developmental events. For example, some research
suggests that young people who enter puberty at the same time that
they begin junior high school may have more problems than those
whose physical development occurs later-multiple changes occurring
simultaneously can produce vulnerability and risk (Simmons et al.,
1987).
7. Normative adolescence may look different for young people
from different social backgrounds and social classes. For example,
it has been pointed out that while for the middle class white
adolescent in our society increasing physical and psychological
separation from the family and involvement with peers can be
considered appropriate and healthy, the situation is different for many
Puerto Rican teens. A well-differentiated and functional adolescent
in a poor Puerto Rican family, for instance, may take on great
responsibility for the family unit, including the parents; while the
lack of such family responsibilities and expectations tends to be
associated with psychosocial dysfunction and even antisocial behavior
(lnclan and Herron, 1989). This idea correlates with the fmding of
researchers that resilient adolescents from high-risk environments
tend to have family responsibilities (Werner and Smith, 1992).
Thus, from the ecosystemic point of view, it is clear that the
developments in the different spheres cited above are not really
separable when we view adolescence as a period of potential risk and
vulnerability as well as one of new opportunities for coping and
resilience. Rather, the physical, emotional, cognitive, and social
developments of adolescence all mesh with each other. The early
years of life, as well as constitutional and environmental factors,
provide the foundation for later relationships and overall functioning.
Then, in adolescence, the world of relationships is transformed by the
introduction of intimacy, and also by the increased possibilities for
thinking about the complexity of relationships. As the adolescent
considers the future and his or her role in life, influences from the
family, school, community, and society at large will be crucial.