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Success of Ecologically-Based Interventions: Success of Ecologically-Based Interventions:

Implications for Optimizing Developmental Implications for Optimizing Developmental Outcomes for Boys and Young MenOutcomes for Boys and Young Men

Cindy Schaeffer, Ph.D.Associate Professor, Family Services Research Center

Dept. of Psychiatry and Behavioral SciencesMedical University of South Carolina

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Mismatch between Developmental Research and Most Interventions for Youth

Consider the wisdom of many of our common interventions for youth/boys:

• Individual approaches (individual therapy, etc.) when youth have multiple ecological influences

• Group interventions (group therapy, etc.) which tend to cluster youth with problems together

• “Boot camps,” alternative schools, psychiatric hospitals, detention centers, etc. see above, plus isolation from well-functioning / prosocial /

mainstream youth• Mentors and counselors

contrived relationships rather than naturally occurring, sustainable relationships

• Midnight basketball Monitoring youth directly instead of supporting caregivers in

doing so

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The Mismatch, continued

Consider the wisdom of the structure and policies of many of our interventions:

• Delivered in clinics/professional offices Rarely where young people actually live

• Delivered by professionals strangers rather than family/community members

• Delivered mostly by women when many of our young people in need are boys and young men

• Suspend/expel/kick-out when constructive use of time is so critical

• One size fits all when every youth/boy is unique

Most existing interventions and policies meet the needs of the professionals that run them, not the youth they serve

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Mismatched Interventions May Cause Harm

Not basing interventions on developmental science (and other social science) can be dangerous:

• Universal drug prevention and teenage pregnancy prevention programs (Werch & Owen, 2002)

• Scared Straight (Petrocino, Turpin-Petrocino, & Buehler, 2005)

• Group-based treatments for conduct disorder / delinquency (Dodge, Dishion, & Lansford, 2006)

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Ecological Approaches Hold More Promise

• Blueprints for Violence Prevention (2007)

• Surgeon General Report on Youth Violence (2001)

• Surgeon General Report on Mental Health (1999)– “Families are essential partners in the

delivery of mental health services for children and adolescents.”

• OJJDP Model Programs Guide (2007)

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What makes an intervention “Ecological?” Key Assumptions of Such Models:

• Youth naturally exist within many systems: family, extended family, school, peer group, neighborhood, church, etc.

• These systems, not the professionals, are the key to youth success– Caregivers are the primary agents of change

• Caregivers need support from the broader ecology in order to meet the demands of parenting

• Interactions between systems (e.g., caregiver & school personnel) are just as important to target as are interactions within systems (e.g., parent-child interactions)

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What makes an intervention “Ecological?” Key Assumptions of Such Models (cont’d):

• Youth and systemic strengths always exist, and these are the best levers for creating positive changes

• All systems need to act responsibly, not just the youth

• Interventions need to be developmentally appropriate – youth’s developmental level and needs are central

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Ecological Interventions:

• Are delivered within the ecology itself – in homes, schools, and neighborhoods

• As much as possible, are delivered by natural ecology members (e.g., caregivers, teachers, other youth), not professionals

• Adhere to guiding principles but are highly individualized

• Are designed to promote generalization and sustainability after the intervention ends

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Examples of Ecological Interventions: Universal (prevention for all youth)

• Good Behavior Game (GBG; Barrish, Saunders, & Wolf, 1969)– Classrooms, by teachers

• Promoting Alternative Thinking Strategies (PATHS; Greenberg, Kusche, & Mihalic, 1998)– Classrooms, by teachers with caregiver support at

home• Positive Behavior, Interventions and Supports

(PBIS; Sugai & Horner, 2002)– Entire school, by all school personnel with caregiver

involvement• Family Check-Up (Dishion & Kavanagh, 2003)

– School guidance department, by teachers and caregivers

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Examples of Ecological Interventions: Selected (prevention for youth showing early risk)

• Nurse-Family Partnership (Olds et al., 1998)

– Homes, by caregivers• School Transitional Environment Program

(STEP; Felner & Adan, 1988)

– Schools, by homeroom teachers• Linking the Interests of Families and

Teachers (LIFT; Reid & Eddy, 2002)

– Schools and homes, by teachers and caregivers• FAST Track (Conduct Problems Prevention Research Group;

1996)

– Schools and homes, by teachers, tutors, and caregivers

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Examples of Ecological Interventions: Indicated (interventions for youth showing problems)

• Functional Family Therapy (FFT; Alexander et al., 1998)

– Homes, by caregivers• Multisystemic Therapy (MST; Henggeler et al., 1998)

– Homes, schools, and neighborhoods; caregivers working with other ecology members

• Multidimensional Treatment Foster Care (MTFC; Chamberlain & Mihalac, 1998)

– Homes, schools, and neighborhoods; foster parents working with caregivers and other ecology members

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What does all this have to do with boys?

• Ecologically-based models for juvenile offending: positive outcomes are not moderated by gender (e.g., Schaeffer & Borduin, 2005)

• Recent review of evidence-based psychosocial treatments: these treatments are equally effective for boys and girls across ethnic groups (Huey & Polo, 2008)

• When gender effects for evidence-based / ecological interventions have been found, outcomes tend to favor boys (e.g., Good Behavior Game; Petras et al., 2008)

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Why do ecological approaches work with boys?

• Tend to address a comprehensive array of risk factors• Promote classroom environments that support boys

– Attention and peer support in ways other than aggressive acting out

– Individualized academic enhancement (when needed)– Caregiver advocacy for specific school needs– Caregiver reinforcement of school success

• Promote home environments that support boys– Positive parenting practices (e.g., monitoring, supervision,

warmth)– Engagement of male ecology members (e.g., uncles, absentee

fathers, grandfathers) – natural and sustainable “mentors” and role models

– Incorporate family’s expectations and goals for men in the family

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Why do ecological approaches work with boys?(cont’d)

• Break ties to deviant peer groups, and promote ties to prosocial peer groups

• Require responsible behavior on the parts of all parties – inherent fairness and justice of this approach is appealing to adolescents

• Helping caregivers helps youth - boys care about relationships too

**Individualized ecologically-based interventions ARE gender-responsive (and culturally sensitive; Huey & Polo, 2008)**

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Gaps: Need for the Development and Testing of New Ecological Interventions in Several Domains

• More ecologically-based peer group interventions in more settings (i.e., that go beyond classroom/school interactions)

• Comprehensive interventions to promote high school graduation and achievement that involve family-school linkage, especially for older youth

• Vocational interventions for emerging adults

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Recommendations for Helping Boys: Mental Health / Positive Development Interventions

• When choosing interventions for boys, choose evidence-based and ecological models whenever possible

• Inform, disseminate, and assist communities with how to implement evidence-based ecological models in real-world settings

• Develop and test (randomized trials) new ecological interventions

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Recommendations for Helping Boys: Mental Health / Positive Development Interventions

• Participatory action research (Chesler, 1991): partnerships between research institutions and communities for testing and refining good “organic” ideas

• Approach new questions that arise for boys from an ecological framework – THINKING and DOING ecologically

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Recommendations for Helping Boys: Broader Policies and Emphases

• Policies that support natural ecology members, especially caregivers, in their interactions with youth

• Policies that support youths’ positive use of free time in ecologically-valid and sustainable ways, and made BROADLY available to youth

• Promote an ecological way of thinking about youth needs in all sectors pertaining to youth

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Send questions or request more information (references, etc.) from Dr. Schaeffer at:

schaeffc@musc.edu or (410) 970-6451