Classroom challenge

Much progress has been made in the last 30 years in developing and testing effective prevention policies, programs and practices in relation to mental, emotional and behavioral problems in young people. Many produce benefits to individuals and society that far exceed their costs.

Yet, in the allocation of resources, effective prevention strategies are often overlooked in favour of strategies to cope with the ‘downstream consequences’ of disorder. And such methods are sustained through an existing infrastructure that provides funding, access and workforce training.

In response to this challenge, a new generation of community coalition-based approaches has emerged with a dual focus on community development and mobilizing, along with scientific evidence around what works for that community.

The best-known examples are both from the US: Communities that Care (CTC) and PROSPER (Promoting School-community-university Partnerships to Enhance Resilience). Recent evaluations of each have demonstrated their effectiveness in reducing behavioral problems.

Given their success, it is important to understand what skills are needed by individuals to implement them successfully. Both CTC and PROSPER require a community coordinator, often seen as critical to the success of the programs, to facilitate the coalition’s work. So, what does this role involve?

David Hawkins and his team from the University of Washington set out the skills and capacities needed in the person fulfilling this role. These include:

• community-mobilizing skills to activate and organize diverse stakeholders;
• an understanding of prevention science;
• an ability to collect, analyze and present epidemiological data;
• group facilitation skills to build consensus around priorities and actions;
• knowledge of universal and targeted effective prevention programs, policies and practices;
• knowledge of the various systems agencies and organizations that affect youths and could be activated for prevention programming;
• skills to facilitate the integration of programs and policies into systems;
• appreciation of the importance of fidelity, and an ability to manage systems for monitoring that;
• process and outcome evaluation skills;
• an ability to communicate program costs and benefits; and
• an ability to identify and secure resources to support and sustain their work.

This is a formidable list and, unsurprisingly, it is difficult to find candidates who possess all of these skills.

The response, according to the authors, should be to train a new generation of prevention practitioners. And, they argue, social work is well-placed to take the lead in meeting this challenge. It has, for instance, a long track record of prevention work and a tradition of preparing students to consider the environmental predictors of health and behavior problems. Social workers are also usually exposed to a variety of agencies and systems. Casework and community organizing activities place a premium on focusing on solutions.

But can social work education seize the opportunity? Drawing on their experience at the University of Washington, Hawkins and his colleagues outline how it can.

Undergraduate students should be taught to use scientific principles to inform their practice decisions, and develop knowledge which informs practice and critical thinking skills. Together, these will make students more aware of the value of prevention.

Courses should also teach students that many significant social problems can be prevented before they occur, and help them learn how to read scientific reports and evaluate evidence. Lecturers should reframe student expectations of social work roles to include prevention, and teach them the skills to monitor implementation fidelity.

Social work students need exposure to epidemiological and longitudinal studies that identify risk and protective factors which can predict undesirable outcomes. In practice classes they need to learn “micro-practice skills” such as engaging stakeholders and assessing resources, building consensus and reaching the so-called “hard to reach”.

Building on these foundations, universities might offer advanced practice courses as electives that could be taken to complete a degree. Examples might include the principles of cost-benefit analysis, applying theories of organization change, how to secure resources, and how to use a risk and protective factor profile to select programs which can address identified needs.

Hawkins, J. D., Shapiro, V. B. & Fagan, A. A. (2010) ‘Disseminating effective community prevention practices: opportunities for social work education’, Research on Social Work Practice 20 (5), 518-527.