Helping Adolescents at Risk: Prevention of Multiple Problem Behaviors

This is a rigorous scholarly text dedicated to a very real social problem, and it does try to identify successful and unsuccessful community and state-wide attempts to prevent or reduce youth problems. It doesn’t pretend to be a self-help book or parenting manual, or indeed a profound philosophical or political analysis.

Rating: 4

Helping Adolescents at Risk: Prevention of Multiple Problem Behaviors

By , 2004. ISBN 1572309733. The Guilford Press. 318 pages.

My interest in this book was triggered by three main factors. First, I am the father of two young men. Second, it is very well publicised in the media that young people have many problems that seem perennial, ‘fashionable’ and stubborn, and frustrating for parents, teachers and policy-makers. Third, I have recently been teaching communication and counselling skills on a Youth Work course. Returning to the first point, I have only to mention any problem with my own sons and colleagues immediately tell me their similar problems (mainly concerning young males), and when asking students to talk about some of their personal issues for classroom demonstration purposes, the subject of parenting stress is very commonly brought up.

The authors, all American, have a mixture of psychology and biology backgrounds, with other transdisciplinary inputs. The book is concerned with helping to formulate preventive social policy for adolescents. By ‘at risk’ is meant all those adolescents risking their health, freedom and future by smoking, drug and alcohol use, pregnancy and disease, and anti-social behaviour including stealing and assault. By ‘multiproblem youth’ the authors mean something like ‘deviance-prone youth’. It is acknowledged here that ‘influences on the development of the multiproblem youth begin while the child is still in the womb’ (p. 2). Low birthweight and perinatal complications are known predictors of later problems. Genetic, hormonal, educational, peer, parenting, economic and media contributors factors are all analysed. Bullying has about a 10% incidence in American schools, with all its later consequences. Unsurprisingly, lower socioeconomic status raises the likelihood of multiple problems. The research appears inconclusive regarding weapons control, but some projects (e.g. the Saving Lives Project in Massachusetts) have been found to reduce drink-related fatal car crashes among adolescents. (Figures are produced that confirm the high incidence of involvement with drink and drugs by the age of 17.) Somewhat surprisingly, some job training schemes and boot camps actually seemed to increase offending rather than helping.

The book is about ‘prevention science’ and community psychology, and on the one hand makes it appear that Americans take very seriously their youth’s problems. Great concern is shown for empirically supported interventions, or what we tend to call in the UK evidence-based practice. On the other hand, as one reads on to discover that ‘the average cost of problems per youth during 1998 was about $12,300…or 84,000 young lives’ it becomes evident that the costing of and research into young people’s (socially or developmentally disruptive) problems is probably ahead of any in-depth understanding and humanitarian addressing of adolescents’ problems in their own terms. This is not a criticism of the book or its authors but an indictment of the attitude of mass societies in today’s global capitalist civilisation. On one view, children’s welfare has been made increasingly secondary in importance to economic activity (busy, working parents; pressurised schools; examination-obsession leading to much stress and many ‘failures’; treating young people as media-manipulated apprentice consumers). See, for example, Barber’s Consumed: How Markets Corrupt Children, Infantilize Adults and Swallow Citizens Whole. I am sceptical that any prevention science, ultimately always funded by conservative governments, can ever penetrate the perennial problem of youth disaffection and problem behaviour. Who is willing even to consider the possibility that the needs of young people, at their biologically most energetic and vulnerable, may simply be at odds with a treadmill, business-as-usual society?

British readers will be very familiar with slightly shifting media representations of young people as drinking too much (particularly, currently, young women), of young British females as being among the most likely to experience early unwanted pregnancies; and of the high risks of both suicide and violence among young men. As I write, a great deal of government agonising is going into the reclassification of cannabis on the basis of an increase in psychotic casualties. While there are some cultural variations, this American text does identify similar problems to our own. The authors admit that their concentration has not been on the so-called internalising disorders of depression, anxiety, low self-esteem, eating disorders, suicidal risk and so on, because it was outside their remit. It may seem strange too that the parenting, educational and social interventions recommended here largely exclude counselling or similar psychological, one-to-one interventions. But this not so strange when we remember that in the UK provision of counselling in schools and for vulnerable adolescents is extremely patchy, apart from those relatively lucky to be in further and higher education; heavy-duty psychiatric or probation interventions are of course available when things have already gone very wrong for adolescents who are imploding in their rooms or exploding on the streets. There is, however, some focus on multidimensional family therapy and groupwork in the youth sector in this book.

In its own terms this is a rigorous scholarly text dedicated to a very real social problem, and it does try to identify successful and unsuccessful community and state-wide attempts to prevent or reduce youth problems. It doesn’t pretend to be a self-help book or parenting manual, or indeed a profound philosophical or political analysis. In its own terms, then, it must be considered an excellent book of its kind. Although some case study material is included, the voices of adolescents themselves are not included. The plight of those who internalise rather than act out is tacitly put aside. No mention is made of projects like Fred Newman’s Marxist-inspired social therapy with at-risk young black people. Indeed, analyses of differences of race and gender are curiously muted here. Such approaches to social problems mirror those in the UK that produce pseudo-pragmatic, pseudo-scientific (‘evidence-based’) and pseudo-economically contained policies and deliverable packages.

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