New findings by researchers at Iowa State University have strengthened the argument for offering adolescents school-based life skills training to combat the risks of substance misuse.

The work by Richard Spoth and colleagues at the Partnerships in Prevention Science Institute also suggests that combining two proven programs – one school-based, the other family-centered – can add up to a doubly powerful preventative measure.

Developed by Gil Botvin at the Institute for Prevention Research, Cornell University, Life-skills Training (LST) is a population-wide program designed for children between the ages of eight and 14. Impressive trial results have earned it “Model Program” accreditation by Blueprints for Violence Prevention.

LST uses a cognitive-behavioral therapy framework to get children to think for themselves, to be confident in their own abilities and cope with pressure from peers and the media. It also aims to help them to communicate effectively, to avoid misunderstandings and to be assertive when faced with tough decisions. [See also: Who needs drugs when you can binge on life skills?]

Richard Spoth wanted to establish whether such light-handed interventions might offer children with relatively severe problems such as prescription drug misuse long-term benefits – also what might be the effect of reinforcing LST with his Iowa center’s own Strengthening Families program (ISFP).

Spoth reports in the July edition of the journal Addiction on experiments in public schools in the predominantly rural US midwest involving over 2,100 young people. Some received only LST, some both programs, others neither.

He found that on its own LST had a significant long-term impact on prescription drug use – but the results for the combined intervention were better still. In both cases the benefits were detectable as long as five and a half years afterwards.

Before the new findings were published it was known that LST had the potential to reduce smoking rates by three-fifths and alcohol use by a quarter. And because LST focuses on the causes of substance misuse it was known to have wider benefits, for example in relation to young people's self-esteem.

The net result is that LST is able to claim more general official recognition than any other US drug prevention program. The National Institute on Drug Abuse, the US Department of Education, the American Psychological Association, the National Centers for Disease Control and the Center for Substance Abuse Prevention have all confirmed its value.

ISFP, the second ingredient Spoth trialled, also carries Blueprints model program accreditation. Developed at Iowa State for children between the ages of ten and fourteen, it has been shown to reduce problem behaviors and substance misuse by helping to make parent-child relationships warmer and more supportive.

Groups of parents meet once a week for two hours usually in community settings. Led by teachers, church ministers, mental health workers or social workers, the sessions encourage parents to develop consistent and age-appropriate monitoring and supervision of their children. The program also builds children’s capacity to resist peer pressure and manage conflict.

The two-hourly sessions continue for seven weeks and are usually followed up by several booster sessions within six months to a year of receiving the program.

Young people who attend the program have been shown to experience significantly lower rates of alcohol, tobacco, and marijuana use compared to those who do not attend.

Reference
Spoth R, Trudeau L, Shin C, Redmond, C (2008) “Long-term effects of universal preventive interventions on prescription drug misuse”, Addiction, 103, July, pp1160-1168.