Preventing Childhood Disorders, Substance Abuse, and Delinquency

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Edited by: Ray DeV. Peters & Robert J. McMahon

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  • Banff International Behavioral Science Series

    SERIES EDITORS

    Kenneth D. Craig, University of British Columbia

    Keith S. Dobson, University of Calgary

    Robert J. McMahon, University of Washington

    Ray DeV. Peters, Queen's University

    Volumes in the Banff International Behavioral Science Series take the behavioral science perspective on important basic and applied challenges that confront practitioners working in the fields of the social, psychological, and health services. The editors invite leading investigators and practitioners to contribute because of their expertise on emergent issues and topics. Contributions to the volumes integrate information on themes and key issues relating to current research and professional practice. The chapters reflect the authors’ personal, critical analysis of the topics, the current scientific and professional literature, and discussions and deliberations with other experts and practitioners. It is our intention to have this continuing series of publications provide an “expressive” early indicator of the developing nature and composition of the behavioral sciences and scientific applications to human problems and issues. The volumes should appeal to practitioners, scientists, and students interested in the interface between professional practice and research advances.

    Volumes in This Series:

    • Anxiety and Depression in Adults and Children Edited by Kenneth D. Craig and Keith S. Dobson
    • Advances in Cognitive-Behavioral Therapy Edited by Keith S. Dobson and Kenneth D. Craig
    • Preventing Childhood Disorders, Substance Abuse, and Delinquency Edited by Ray DeV. Peters and Robert J. McMahon

    Copyright

    View Copyright Page

    Dedication

    This volume is dedicated to the memory of our deceased parents

    Paul D. and Pauline H. Peters and Robert J. McMahon, Jr.

    Preface

    The chapters in this volume are the work of a collection of experienced scientist-practitioners in the field of childhood disorders, substance abuse, and delinquency. The central theme of the volume is prevention and early intervention approaches to dealing with these important social problems.

    A long tradition of research in the behavioral and social sciences exists describing myriad etiological factors that contribute to the manifestation of childhood and adolescent problems. Also, there exists an extensive literature concerning a variety of treatment approaches to child and adolescent psychological and social problems, and much exciting work in this area continues, particularly in the context of developing empirically validated treatments (see, for example, Weisz, 1996; Weisz, Weiss, Han, Granger, & Morton, 1995). However, despite whatever successes these treatment interventions may have with seriously disordered children, there is a growing recognition that there are simply not enough individuals trained in these procedures to make a significant impact on the prevalence of these disorders (e.g., Albee, 1982; Offord, 1987; Peters, 1988).

    Consequently, there has been increased interest in the past decade in approaches to these major social and emotional disorders in children that are designed to prevent the onset of disorder or to deal with problematic behaviors when they first appear. This volume presents theories and practices of leading-edge prevention and early intervention programs with children from birth through adolescence.

    Following an introductory overview chapter by Coie, the volume is organized in a developmental or chronological fashion with the first chapters describing interventions with very young children and their families. Subsequent chapters address issues and interventions with elementary school children, “transition” or preadolescent children, and finally, adolescents. Although the volume is organized around the age of the focal children, there is also a strong emphasis on involving parents, schools, and the community in most of the intervention programs.

    The volume represents a collection of current prevention and early intervention approaches selected to be of interest to academics, other researchers, and students in the behavioral sciences as well as to those involved in direct intervention with children and adults, such as social workers, clinical psychologists, psychiatrists, and other mental health professionals. Finally, given the timely nature of the topic, the volume should be of substantial interest to policymakers at the state or provincial and national levels who are searching for more effective and efficient large-scale intervention approaches to dealing with social and behavioral problems in children and adolescents.

    A major issue running throughout the volume, and indeed, throughout the field itself, is the definition of different approaches to prevention. Historically, the concept of prevention has developed from the fields of disease, public health, and epidemiology. The first attempt to identify different categories of prevention activities appeared in a working group report of the Commission on Chronic Illness (1957), which proposed a distinction between primary prevention, which is practiced prior to the biological origin of the disease, and secondary prevention, which is practiced after the disease can be recognized but before it has caused suffering and disability. Somewhat later, a third class of prevention activities was proposed by Leavell and Clark (1965)—namely, tertiary prevention, which is practiced after suffering or disability from the disease is being experienced with the goal of preventing further deterioration.

    In a chapter on prevention in child and adolescent psychiatry, Graham (1994) has commented,

    By convention, three types of preventive activity are recognized (Henderson, 1988). Primary prevention involves intervention that reduces the incidence of disorder. Secondary prevention comprises treatment that reduces the duration of the disorder, and tertiary prevention covers rehabilitative activity that reduces the disability arising from an established disorder. (p. 815, italics added)

    This tripartite division of prevention activities has been criticized by several writers. Gordon (1983) argues that it does not distinguish between preventive interventions that have different epidemiologic justifications and require different strategies for optimal use. He claims that the classification scheme is an artifact of the earlier mechanistic conceptions of health and disease that do not apply easily to more complex, multifactorial causal models of physical disease and mental disorders.

    Bower (1987) suggests that secondary and tertiary prevention constitute contradictions in terms, because they do not represent prevention per se but various forms of treatment and rehabilitation. He argues that only primary prevention should be called prevention.

    A similar point is made by Peters (1990), who argues that the term prevention should be reserved for those interventions that attempt to reduce the incidence or onset of a problem, disorder, or disease in individuals who do not show any sign of the disorder in question and suggests that the term early intervention replace secondary prevention, and treatment/rehabilitation replace tertiary prevention.

    Finally, Gordon (1983) has proposed a further division of prevention or primary prevention interventions into three categories: universal preventive interventions, and two types of targeted preventive interventions. Universal (or populationwide) preventive strategies are designed to reach all individuals of a particular age in a specified area or setting (for example, all 0- to 2-year-old children in a particular community or all children attending a particular primary school). Selective preventive interventions are one form of targeted strategies and are implemented with individuals who are considered to be at risk for developing a particular disease or disorder based on specified biological, psychological, or social factors external to the targeted individuals. Examples include children living in families on social assistance and children of drug-abusing or divorced parents. Indicated preventive interventions are a second type of targeted strategies designed to reach individuals considered to be at risk for a particular disorder by virtue of specified current characteristics of the individuals themselves, so-called internal factors, such as low-birth-weight babies or children experiencing peer relationship difficulties.

    A recent publication on the prevention of mental disorders by the Institute of Medicine (IOM, 1994) advocates the adoption of a modification of Gordon's distinction between the three types of universal and targeted prevention strategies. All three types of preventive interventions are represented in the current volume, in addition to promotion strategies such as those discussed by Peters (1988, 1990). Also, discussions of advantages and disadvantages of each of these intervention approaches appear throughout the volume.

    In the opening chapter, Coie introduces a conceptual framework of prevention in the context of violence and antisocial behavior. In a discussion of some of the most important considerations in designing preventive interventions for violent and antisocial behavior, Coie argues against a universal or populationwide strategy in favor of a targeted approach that attempts to select participants on the basis of identified risk factors. Coie notes that there is some recognition of the difficulty in distinguishing between primary and secondary prevention with children who are at high risk for problems such as antisocial behavior. He claims that those children who are at risk for later violence or antisocial behavior are those who show some form of antisocial behavior at school entry. He thus advocates an indicated strategy of prevention. This emphasis on preventing later serious antisocial behavior by working with young children who are identified as currently showing less serious antisocial behavior underscores the definitional conundrum that continues to plague the field of prevention.

    Coie is one of the members of the Conduct Problems Prevention Research Group (CPPRG), which is currently funded by the National Institute of Mental Health and the Center for Substance Abuse Prevention to implement a multisite trial of a prevention program for antisocial children, known as the Fast Track Program. The details of this project are presented in later chapters, but in his opening chapter, Coie describes the developmental model that the CPPRG has employed in planning and implementing their intervention strategies with antisocial children beginning at the entry to elementary school. The model elegantly encapsulates a broad range of factors that have been identified in previous research as contributing to the development of antisocial behavior in children beginning as young as 2 to 3 years of age through to the expression of delinquency in adolescence.

    In Chapter 2, Peters and Russell describe a type of universal prevention initiative titled the Better Beginnings, Better Futures Project. The project has three major goals: (a) to prevent serious social, emotional, behavioral, physical, and cognitive problems in young children; (b) to promote the social, emotional, behavioral, physical, and cognitive development of these children; and (c) to enhance the abilities of socioeconomically disadvantaged families and communities to provide for their children.

    The focus is on children to the age of 8 years old, living in socioeconomically disadvantaged communities and neighborhoods in Ontario. These communities are being funded to provide services tailored to local circumstances for 4 years of implementation. The children, families, and demonstration communities will be followed until the children reach their mid-20s to see if this type of early childhood education and family support model has made a difference in life span development and community development for children, families, and high-risk neighborhoods.

    In many ways, this model in unique because it focuses on child, family, and community factors. In the Better Beginnings, Better Futures Project, the neighborhood or community is considered to be high risk. All children and families living within a designated neighborhood or community are eligible to take part in any of the programs; that is, the intervention is universal but within a high-risk community. The purpose of the project is to strengthen children and their families as well as the local community itself. In this sense, the project is designed to foster three aspects of human development: child development, family development, and community development.

    One of the most salient differences between the Better Beginnings Project and other models is the requirement for meaningful, significant parent and community leader involvement in decision making. During the first year of local development, this characteristic of the model came to mean that the Steering Committee and each major subcommittee of the local project needed to have a membership of at least 50% parents or other community residents. It became equally clear that although the requirement for 50% local representation was important, what really made this level of participation possible was the transfer of real decision-making power to these committees. The participants on these committees wrote the job descriptions, delegated the hiring committees, decided salary levels, and decided the amount of funding to go to each component of the model (e.g., child care, home visiting, community safety). The transfer of this level of control and responsibility to parents and other community members has the potential of empowering community residents who, individually and collectively, may have felt little control over their lives and the lives of their children.

    In the third chapter, Pizzolongo describes the Comprehensive Child Development Program (CCDP), an innovative effort put forth by the Administration on Children, Youth and Families (ACYF) and established by Congress in 1988. CCDP is based on an extensive history of research and programmatic efforts in early-intervention programs for young children and their families who are part of the low-income population of the United States. These programs, of which CCDP is now a part, have focused on alleviating the pressing problems faced by low-income families, including inadequate housing, health care and nutrition, family breakup, teenage pregnancy, lack of positive role models and growth experiences for children, and poor educational attainment and employment prospects. These problems often lead to crime or welfare dependency. This chapter provides information on the history and program features of the CCDP as well as an overview of early intervention studies and other programs that attempt to enhance the strengths of low-income families and their children and diminish the problems that they face.

    In Chapter 4, Bierman, Greenberg, and the CPPRG provide a description of part of the Fast Track Program, which is based on the developmental model described earlier by Coie. Fast Track is a multisite demonstration project involved in the development, implementation, and evaluation of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. Seven integrated components make up the program. This chapter focuses on three components: (a) a universal prevention curriculum used by teachers, (b) a targeted social skill training group program, and (c) a peer-pairing program, all designed to build social skills and enhance positive peer relationships. The chapter begins with an overview of the social skill deficits associated with conduct disorders and targeted in Fast Track.

    The content and structure of the social skill training components used in the Fast Track Program are then described. The ways in which the Fast Track social skill training programs attempt to address the needs of children with conduct problems and the interpersonal contexts in which their social skills are developing are elaborated. Across both the universal (classroom-based) and targeted (high-risk group-based) levels of intervention, the procedures used to promote competencies in six social skill domains are described. These domains include (a) social participation, (b) prosocial behavior, (c) communication skills, (d) self-control, (e) regulating oneself in rule-based interactions, and (f) social problem-solving skills. In the last section of the chapter, special issues in the implementation of social skill training programs with children who exhibit multiple conduct problems are discussed.

    The chapter by McMahon, Slough, and the CPPRG is a continuation of the description of the Fast Track Program, emphasizing the three program components that focus on the family context: (a) parent groups, (b) parentchild relationship enhancement, and (c) home visiting. The parent group component focuses on four specific content areas: (a) the development of positive family-school relationships, (b) parental self-control (i.e., anger control), (c) the development of reasonable and appropriate expectations for the child, and (d) parenting skills to increase positive parent-child interaction and decrease the occurrence of acting-out behaviors. Prior to focusing on parenting skills, parents learn how to maintain their self-control when faced with frustrating child behavior and to develop expectations for their children's behavior that are realistic and appropriate for their children's developmental level. These skills are viewed as necessary to the learning and mastery of various parenting skills to facilitate positive parent-child interactions and to decrease inappropriate child behaviors.

    At the conclusion of each parent group, the parents and children meet together for parent-child sharing time. The primary goal is to foster positive parent-child relationships through the promotion of positive interchanges between parents and children. A variety of cooperative activities, games, crafts, and joint reading activities are employed. A second goal of this component is to provide an opportunity for parents to practice the new skills that they learned in the parent group with their children with supervision and support from Fast Track staff.

    The home-visiting component of Fast Track is intended to serve a variety of functions. First, it provides an opportunity for the development of a positive relationship between the Fast Track staff member and the family members. Second, the home visits provide yet another opportunity to promote the generalization of parenting skills to the natural environment. Third, the home visits can promote effective parental support for the children's school adjustment through the encouragement and support of parent-child reading activities, parental monitoring and assistance with the child's homework assignments, and discussion regarding effective parent-teacher communication and teamwork to assist the child in meeting his or her academic and social goals. Fourth, the home visits provide an opportunity to promote parental problem-solving and coping skills concerning the stressors that affect many of these families. The ultimate goal is to foster parental feelings of empowerment and efficacy and to decrease the risk of fostering dependency on Fast Track staff. The chapter concludes with a discussion of implementation issues that have arisen in the course of developing and applying the family-focused program components.

    The chapter by Lochman and Wells begins with an overview of developmentally oriented preventive intervention projects. The importance of a clear conceptual model for the intervention is stressed. This model can include an understanding based on current empirical work of the risk factors that predict later disorder and of the mediating and moderating factors that influence how the projected trajectory for the disorder manifests itself. One central model describing the occurrence and development of aggressive behavior is a social-cognitive or social information-processing model. This model has been derived from research over the past 15 years that has documented that aggressive children are hyperattentive to hostile social cues, have hostile attributional biases, have social problem-solving deficits involving a relative lack of verbal assertion and compromise solutions, and expect that aggressive behavior will have relatively positive outcomes for them.

    Based on this model of social-cognitive difficulties, an intervention known as the Anger Coping program was developed. This program focuses on aggressive children's difficulties in social perspective taking, awareness of arousal, use of self-instructional inhibiting abilities, and social problem solving. This preventive intervention is school based and consists of 18 weekly group sessions. A series of four programmatic outcome studies has found that in comparison to untreated or comparison treatment conditions, children who have participated in the Anger Coping program have reductions in independently observed off-task behavior, reductions in parent- or teacher-rated aggression, and improvements in self-esteem in the month after treatment.

    Lochman and Wells’ current work on the Coping Power program is an extension of the Anger Coping program that is longer in duration and that incorporates the family as well. The child and parent components of this more comprehensive intervention are described. The chapter concludes with a discussion of implementation issues with teachers, peers, and family members.

    Cunningham begins Chapter 7 by reviewing the research literature that indicates that externalizing or Disruptive Behavior Disorders (Attention-deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder) are among the most prevalent, persistent, and vexing of the early childhood problems referred to children's mental health centers. Although these disorders reflect the complex interplay of genetic factors, parental psychopathology, marital interactions, family functioning, peer relationships, educational experiences, and larger socioeconomic variables, parenting is almost universally considered to play a mediating role in either their emergence, maintenance, or longer-term developmental course. Parent training programs designed to teach more effective child management strategies have emerged as an important component in more comprehensive prevention and intervention programs for this population.

    In this chapter, Cunningham describes the design and evaluation of the Community Parent Education (COPE) program's large group, neighborhood-based parent training courses. To increase the availability of parent training, this program shifted from individual or small-group programs to courses capable of accommodating from 25 to 35 participants. To increase accessibility and improve use among high-risk families, courses are advertised widely, scheduled at day and evening times, conducted at conveniently located neighborhood schools and community centers, and equipped with an on-site volunteer child care service. To enable large groups of parents to participate actively in the problem-solving discussions, modeling exercises, and role-playing activities that represent the critical skill-building components of individual programs, much of the work of the course is accomplished in five-member subgroups, in which parents review the successful application of new strategies to problems at home, rehearse new skills, and formulate homework goals.

    Recently completed trials comparing large, community-based courses with more clinic-based individual programs suggest that, in addition to a substantial improvement in cost-effectiveness, large groups improved use among socioeconomically disadvantaged parents, immigrants, and families of children with more severe problems. Parents participating in larger groups reported greater reduction in child management problems, better maintenance of gains at 6-month follow-ups, and better problem-solving skills.

    In Chapter 8, Prinz and Miller continue the discussion of parent training and family involvement in interventions for children at risk for conduct disorder. These authors claim that despite moderate success rates with childhood antisocial behavior, the greatest stumbling block for family-based interventions has been insufficient engagement of parents. Indications of inadequate engagement include sporadic attendance, missed appointments (both canceled and uncanceled), tardiness to sessions, failure to complete “homework” assignments, limited or counterproductive involvement in sessions, and ultimately, premature dropout.

    Four major domains have been identified as having a strong impact on parental engagement: (a) the therapeutic process, (b) personal constructs, (c) intervention characteristics, and (d) situational demands and constraints. Prinz and Miller describe ways of addressing each of these four domains to foster more successful parental engagement. They conclude by observing that intervention research on parental engagement is important but is not without its share of major challenges. In a free society, people have a right to choose not to participate, even to their own or their children's detriment. Furthermore, the collection of attrition data, or even the expectation of attrition, is not always compatible with the aims of community programs or grant-funding agencies. Nonetheless, progress in the evolution of interventions for childhood conduct problems depends in part on researchers themselves staying engaged in the tackling of problems associated with parental engagement and attrition.

    In Chapter 9, Dishion, Andrews, Kavanagh, and Soberman begin by noting that problem behavior in children is highly situational, ebbing and flowing as a function of context and development. Thus, it is unlikely that a single course of intervention will likely result in a permanent solution. They suggest that a dental model of prevention may be helpful as a guiding metaphor for preventing child and adolescent problem behavior. Just as preventive interventions for tooth decay are needed throughout the life span, preventive interventions are needed throughout childhood (ages 0 to 18). Like a dental model, intervention is necessarily individualized and may consist of both treatment and prevention, depending on the vulnerabilities and protective factors at each stage of development.

    The Adolescent Transitions Program (ATP) is an evolving menu of intervention and assessment resources that was conceptualized under such a framework. ATP is intended as an intervention for high-risk youth, formulated on the basis of a social interactional model for the development of antisocial behavior in childhood and problem behavior in adolescence. There are two basic intervention targets: the parents (parent focus) and the young adolescents (teen focus). Group interventions with the parents seek to improve parent family management skills; interventions with the youth aim at developing self-regulation of problem behavior. The two curricula are designed to parallel each other, and skill development exercises frequently include parent-child activities.

    Dishion and colleagues conclude their chapter by noting that problem behavior has stability across development and within context. Knowledge of early antisocial antecedents, long-term sequelae, and negative outcomes provides a guidance in the preventive procedures necessary for young adolescents and their parents. Dishion and colleagues propose that regular checkups provide a nonstigmatizing mechanism for assessing levels of “decay” and gathering the necessary resources across contexts to prevent further deterioration and eventual loss of these youth to our society.

    Significant progress has been made over the past decade in developing effective strategies for preventing substance abuse among adolescents. No one has contributed more to this research knowledge than Botvin. In Chapter 10, Botvin presents a conceptual model that incorporates what is known about causes and developmental progressions of drug abuse. He then describes a cognitive-behavioral prevention approach based on this model called Life Skills Training, which was developed to (a) affect drug-related expectancies, (b) teach skills for resisting social influences to use drugs, and (c) promote the development of general personal self-management and social skills. The Life Skills Training program consists of 15 class periods of roughly 45 minutes each. The background and rationale for the Life Skills Training approach to drug abuse prevention is discussed, intervention materials are described, and the research studies testing its efficacy are summarized. This is a universal or primary prevention intervention that has been tested on several different populations of adolescents in school settings.

    In Chapter 11, Kumpfer, Molgaard, and Spoth review the research on family risk and protective factors that influence delinquency and drug abuse in youth, identify principles of effective family intervention models, and describe promising family-focused intervention models for use with special populations. This is followed by a description of the theoretical underpinnings, development, implementation process and results of various forms of the Strengthening Families Program. This is a family-focused, selective prevention intervention that has been tailored for special populations at high risk for substance abuse and delinquency, such as children of substance abusers, children being removed from the home because of child abuse and neglect, and low-income rural and urban parents of different ethnic groups. The chapter concludes with a presentation of research methods and a summary of several outcome studies evaluating the effectiveness of the Strengthening Families program.

    In Chapter 12, Tremblay, Mâsse, Pagani, and Vitaro describe the long-term outcomes of a group of adolescents who had been involved in a longitudinal-experimental study aimed at understanding the development of aggressive kindergarten boys in Montreal and also to test the effectiveness of an early intervention strategy. The emphasis in the chapter is on the early intervention program that was designed to attenuate early aggressive behavior and to prevent later delinquency involvement. The program was planned in the early 1980s when parent training and child social skills training were proposed as alternative approaches to the treatment of aggressive early elementary school-age children and early adolescents. These two intervention components were carried out with a group of highly aggressive, low-socioeconomic-status boys for a period of 2 years while they were between the ages of 7 and 9. These boys have now been followed for 6 years after program termination to the age of 15, along with two control groups of aggressive boys. The results indicated significant long-term impacts of the intervention program on a variety of adolescent behaviors, including gang membership, substance abuse, self-reported delinquency, and police arrests of self and friends. The chapter concludes with a discussion of the successes and limitations of this early intervention approach to aggressive behavior and suggestions for improvement in future program planning.

    In Chapter 13, Spoth and Redmond cite the recent report on the prevention of mental disorders by the IOM (1994) as providing a framework for preventive intervention research that can be productively applied to rural populations. The preventive intervention research cycle presented by the IOM articulates several phases of research. The application of the prevention intervention research cycle to rural populations described in this chapter follows the same sequence as the phases. Consistent with the problem identification and knowledge base review phases of the prevention intervention research cycle, the chapter begins with a review of the need for prevention research targeting rural families (Phase 1) and a brief summary of family-related etiological factors, including recent rural family research conducted at their center (Phase 2). An overview of project procedures and rural implementation strategies is then given (Phases 3 and 4). Finally, the chapter illustrates studies used during Phases 3 and 4 to examine rural family characteristics influencing response to project recruitment strategies and to project interventions.

    In the concluding chapter, Offord presents a critical review of this volume and the field of prevention of childhood mental disorders in general. His review examines the quality of research designs, the multicomponent nature of many preventive interventions, type of evaluation measures, and the adequacy of replication. The parallel between these criteria of judging quality and those employed by the American Psychological Association's Division 12 Task Force on Promotion and Dissemination of Psychological Procedures (1995) is examined.

    Following the review of existing prevention efforts, Offord identifies a number of outstanding issues that need to be addressed: (a) issues in developmental epidemiology concerning risk factors, (b) the advantages and disadvantages of universal versus targeted prevention programs, (c) the role of descriptive versus experimental epidemiology, and (d) issues of program dissemination and maintenance, including cost, feasibility, whether or not a program is imposed, and reliance on exceptional people. These issues represent important challenges for the field of prevention in the coming years.

    References
    Albee, G.W. (1982). Preventing psychopathology and promoting human potential. American Psychologist, 37, 1043–1050. http://dx.doi.org/10.1037/0003-066X.37.9.1043
    Bower, E.M. (1987). Prevention: A word whose time has come. American Journal of Orthopsychiatry, 57, 4–5. http://dx.doi.org/10.1111/j.1939-0025.1987.tb03501.x
    Commission on Chronic Illness. (1957). Chronic illness in the United States (Vol. 1; published for the Commonwealth Fund). Cambridge, MA: Harvard University Press.
    Gordon, R.S. (1983). An operational classification of disease prevention. Public Health Reports, 98, 107–109.
    Graham, P. (1994). Prevention. In M.Rutter, E.Taylor, & L.Hersov (Eds.), Child and adolescent psychiatry (
    3rd ed.
    , pp. 815–828). Oxford, UK: Blackwell Scientific Publications.
    Institute of Medicine. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.
    Leavell, H.R., & Clark, E.G. (1965). Preventive medicine for a doctor in his community: An epidemiological approach (
    3rd ed.
    ). New York: McGraw-Hill.
    Offord, D.R. (1987). Prevention of behavioral and emotional disorders in children. Journal of Child Psychology and Psychiatry, 25, 9–20.
    Peters, R.DeV. (1988). Mental health promotion in children and adolescents: An emerging role for psychology. Canadian Journal of Behavioural Science, 20, 389–401. http://dx.doi.org/10.1037/h0079941
    Peters, R.DeV. (1990). Adolescent mental health promotion: Policy and practice. In R.J.McMahon & R.DeV.Peters (Eds.), Behavior disorders of adolescence: Research, intervention, and policy in clinical and school settings (pp. 207–223). New York: Plenum.
    Task Force on Promotion and Dissemination of Psychological Procedures. (1995). Training on and dissemination of empirically validated psychological treatments. The Clinical Psychologist, 48, 3–23.
    Weisz, J.R. (1996, March). Empirically validated treatments for children and adolescents: Criteria, problems and prospects. Paper presented at the 28th Banff International Conference on Behavioural Science, Banff, AB.
    Weisz, S.R., Weiss, B., Han, S., Granger, D.A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117, 450–468. http://dx.doi.org/10.1037/0033-2909.117.3.450

    The Banff Conferences on Behavioural Science

    This volume is one of a continuing series of publications sponsored by the Banff International Conferences on Behavioural Science. We are pleased to join Sage Publications in bringing this series to an audience of practitioners, investigators, and students. The publications arise from conferences held each spring since 1969 in Banff, Alberta, Canada, with papers representing the product of deliberations on themes and key issues. The conferences serve the purpose of bringing together outstanding behavioral scientists and professionals in a forum where they can present and discuss data related to emergent issues and topics. As a continuing event, the Banff International Conferences have served as an expressive “early indicator” of the developing nature and composition of the behavioral sciences and scientific applications to human problems and issues.

    Because distance, schedules, and restricted audience preclude wide attendance at the conferences, the resulting publications have equal status with the conferences proper. Presenters at each Banff Conference are required to write a chapter specifically for the forthcoming book, separate from their presentation and discussion at the conference itself. Consequently, this volume is not a set of conference proceedings. Rather, it is an integrated volume of chapters contributed by leading researchers and practitioners who have had the unique opportunity of spending several days together presenting and discussing ideas prior to preparing their chapters.

    Our “conference of colleagues” format provides for formal and informal interactions among all participants through invited addresses, workshops, poster presentations, and conversation hours. When combined with sightseeing expeditions, cross-country and downhill skiing, and other recreations in the spectacular Canadian Rockies, the conferences have generated great enthusiasm and satisfaction among participants. The Banff Centre, our venue for the conferences for many years, has contributed immeasurably to the success of these meetings through its very comfortable accommodation, dining, and conference facilities. The following documents conference themes over the past 28 years.

    1969 I

    • Ideal Mental Health Services

    1970 II

    • Services and Programs for Exceptional Children and Youth

    1971 III

    • Implementing Behavioural Programs for Schools and Clinics

    1972 IV

    • Behaviour Change: Methodology, Concepts, and Practice

    1973 V

    • Evaluation of Behavioural Programs in Community, Residential, and School Settings

    1974 VI

    • Behaviour Modification and Families and Behavioural Approaches to Parenting

    1975 VII

    • The Behavioural Management of Anxiety, Depression, and Pain

    1976 VIII

    • Behavioural Self-Management Strategies, Techniques, and Outcomes

    1977 IX

    • Behavioural Systems for the Developmentally Disabled
      • School and Family Environments
      • Institutional, Clinical, and Community Environments

    1978 X

    • Behavioural Medicine: Changing Health Lifestyles

    1979 XI

    • Violent Behaviour: Social Learning Approaches to Prediction, Management, and Treatment

    1980 XII

    • Adherence, Compliance, and Generalization in Behavioural Medicine

    1981 XIII

    • Essentials of Behavioural Treatments for Families

    1982 XIV

    • Advances in Clinical Behaviour Therapy

    1983 XV

    • Childhood Disorders: Behavioural-Developmental Approaches

    1984 XVI

    • Education in “1984”

    1985 XVII

    • Social Learning and Systems Approaches to Marriage and the Family

    1986 XVIII

    • Health Enhancement, Disease Prevention, and Early Intervention: Biobehavioural Perspectives

    1987 XIX

    • Early Intervention in the Coming Decade

    1988 XX

    • Behaviour Disorders of Adolescence: Research, Intervention, and Policy in Clinical and School Settings

    1989 XXI

    • Psychology, Sport, and Health Promotion

    1990 XXII

    • Aggression and Violence Throughout the Lifespan

    1991 XXIII

    • Addictive Behaviours Across the Lifespan: Prevention, Treatment, and Policy Issues

    1992 XXIV

    • State of the Art in Cognitive-Behaviour Therapy

    1993 XXV

    • Anxiety and Depression in Adults and Children

    1994 XXVI

    • Prevention and Early Intervention: Child Disorders, Substance Abuse, and Delinquency

    1995 XXVII

    • Child Abuse: New Directions in Prevention and Treatment Across the Lifespan

    1996 XXVIII

    • Best Practice: Developing and Promoting Empirically Validated Interventions

    We would especially like to thank Philomene Kocher for her diligence in preparing the manuscript for publication and Valerie Angus for her secretarial services. Also, we would like to acknowledge the expert guidance and support that we received from C. Terry Hendrix, Jim Nageotte, Nancy Hale, and Vicki Baker at Sage Publications. It has been a pleasure working with them. While preparing this volume, Ray Peters was on the faculty of Queen's University and Bob McMahon was on the faculty of the University of Washington. The assistance and support of these institutions is gratefully acknowledged.

    RayDeV.Peters
    RobertJ.McMahon
  • About the Editors

    Ray DeV. Peters, Ph.D., is Professor of Psychology at Queen's University in Kingston, Ontario, and is research director of the Better Beginnings, Better Futures Project, a large, multisite longitudinal study in Ontario on the prevention of mental health problems in young children from birth to 7 years of age. He was a visiting scientist with the Oregon Social Learning Center in 1979–1980 and with the Mental Health Division of the World Health Organization in Geneva, Switzerland, in 1986–1987. His primary research interests are in the areas of children's mental health and development psychology. Since 1982, he has served on the executive committee of the Banff International Conference on Behavioral Science.

    Robert J. McMahon, Ph.D., is currently Professor and Director of the Child Clinical Psychology Program in the Department of Psychology at the University of Washington. His primary research and clinical interests concern the assessment, treatment, and prevention of conduct disorders in children. He is a principal investigator on the Fast Track project, a large, multisite collaborative study on the prevention of serious conduct problems in school-aged children. His primary responsibilities on that project concern the development and implementation of the family-based intervention components. He is also a principal investigator on the Early Parenting Project, a longitudinal study examining the development of children of adolescent mothers from infancy into elementary school. He is the author (with Rex Forehand) of Helping the Noncompliant Child: A Clinician's Guide to Parent Training and of a number of scientific articles, chapters, and reviews. He has also coedited (with Ray Peters and others) several volumes emanating from the Banff International Conferences on Behavioural Science.

    About the Contributors

    David W. Andrews, Ph.D., is Research Associate at the Oregon Social Learning Center. He has authored numerous articles on the influence of families and friends on both healthy and problematic development through childhood and adolescence. He served as Head of the Department of Human Development and Family Sciences at Oregon State University, where he received honors as a Distinguished Professor and Fulbright Scholar. Upon completion of a National Institute of Mental Health Postdoctoral Fellowship, he joined the Oregon Social Learning Center staff in developing and evaluating programs for high-risk adolescents. His recent publications include coauthored articles in Child Development, the Journal of Personality and Social Psychology, the Journal of Consulting and Clinical Psychology, and Developmental Psychology.

    Karen L. Bierman, Ph.D., is Professor of Psychology at the Pennsylvania State University. Her research has focused on the exploration of factors that affect the development of adaptive peer relations, social competence, and behavioral adjustment in middle childhood and on the design and evaluation of remedial and preventive interventions for at-risk children. Previous intervention studies have been published in Child Development and the Journal of Consulting and Clinical Psychology. She is principal investigator of the rural Pennsylvania site of the Fast Track project.

    Gilbert J. Botvin received his Ph.D. from Columbia University in 1977 with training in both developmental and clinical psychology. After graduate school, he spent 3 years at the American Health Foundation, first as a staff psychologist and later as Director of Child Health Behavior Research. He is currently Professor of Psychology at Cornell University Medical College with a joint appointment in the Department of Public Health and the Department of Psychiatry. He is also the director of Cornell's Institute for Prevention Research and director of the New York Hospital-Cornell Medical Center Smoking Cessation Service, where he has been involved in the treatment of addictive behavior. He has conducted research in child and adolescent development, adolescent health behavior, and behavioral approaches to chronic disease risk reduction and is internationally known for his groundbreaking work in tobacco, alcohol, and drug abuse prevention. He has authored or coauthored more than 115 scientific papers and chapters and presented more than 100 papers at national and international conferences. He has served as a consultant to a number of state and federal agencies in the United States, including the National Cancer Institute and the National Institute on Drug Abuse.

    John D. Coie, Ph.D., is a Professor of Psychology at Duke University, where he has been director of the clinical training program. He received his Ph.D. in psychology from the University of California at Berkeley. He has been the recipient of an ADAMHA Senior Research Scientist Award since 1990 and has chaired the NIMH Review Committee on Child and Adolescent Risk and Prevention Research. The primary focus of his research is on identifying early risk factors for adolescent involvement in violence and antisocial behavior. He currently directs a longitudinal study of youth from age 8 to young adulthood. He is codirector of a major comprehensive program for early prevention with children who are at high risk for adolescent violence. The Fast Track project is a four-site consortium funded by NIMH since 1990. This program addresses family, school, and child competence needs across the period of elementary school and early middle school. His recent publications deal with child aggression and peer relations, with developmental models of adolescent dysfunction and antisocial behavior, and with peer group processes that either protect against or increase the likelihood of delinquency. He has coauthored Peer Rejection in Childhood with Steven Asher.

    Charles E. Cunningham, Ph.D., is a Professor of Psychiatry in the Faculty of Health Sciences at McMaster University and an affiliate member of the Centre for the Studies of Children at Risk, in Hamilton, Ontario. He has been involved in research on both pharmacological and behavioral interventions and has a special interest in models that increase the availability and cost efficacy of services for children with disruptive behavior disorders. He is currently involved in the development and evaluation of large-group, community-based parenting programs and student-mediated conflict resolution programs. He directs Chedoke-McMaster Hospital's Community Parent Education (COPE) Program, which provides parenting courses for families of children with disruptive behavior disorders. He is a member of the editorial board of the ADHD Report and the Chair of the National Professional Advisory Board of CHADD Canada. He is a principal investigator or coinvestigator on grants from the Ontario Mental Health Foundation, the Medical Research Council, and the Ministry of Education. He holds a Senior Research Fellowship from the Ontario Mental Health Foundation. Recent publications are coauthored articles in the Journal of Consulting and Clinical Psychology and the Journal of Child Psychology and Psychiatry.

    Thomas J. Dishion, Ph.D., is Research Scientist at the Oregon Social Learning Center, an Adjunct Behavioral Scientist at the Oregon Research Institute, and an Associate Professor of Counseling Psychology at the University of Oregon. He is collaborating in basic research on interpersonal processes underlying the influence of peers on adolescent problem behavior. In addition, he is principal investigator on a project funded by the National Institute on Drug Abuse to evaluate preventive intervention strategies with high-risk youth. He has recently coauthored three books on theory, intervention, and assessment with child and adolescent problem behavior and a book for parents of preschool children, in addition to research publications in the Journal of Consulting and Clinical Psychology, Development and Psychopathology, Child Development, and Developmental Psychology.

    Mark T. Greenberg, Ph.D., is Professor of Psychology at the University of Washington. He is coauthor of several books, including Promoting Social and Emotional Development in Deaf Children: The PATHS Project (1993), The PATHS Curriculum (1995), and Attachment in the Preschool Years: Theory, Research and Intervention (1990). He is one of the principal investigators of the Fast Track project and is the director of the PATHS Curriculum project (both funded by the National Institute of Mental Health). His primary interest is in the prevention of childhood psychopathology (in normal and challenged populations) through interventions that promote healthy emotion regulation and social competence.

    Kate Kavanagh, Ph.D., is Developmental Psychologist and Research Associate at the Oregon Social Learning Center. She has worked with hundreds of parents, teens, and children during her 17 years at the center. This direct service has contributed to her work in the study of family variables predictive of child and adolescent adjustment problems, the development of family and school-based intervention and prevention programs, and the training of community professionals in assessment and intervention techniques. She has created video and print intervention materials for family populations, including working parents of preschoolers and elementary school children, families with at-risk and delinquent youth, and families of kindergartners at risk for conduct disorders. Currently, her research is focused on conduct disorders in females and the development of gender-sensitive intervention and assessment materials. Two recent publications have addressed cross-gender influences of parents and teachers in the identification, prediction, and remediation of problem behaviors in early adolescence.

    Karol L. Kumpfer, Ph.D., is a psychologist with more than 20 years experience in alcohol and drug abuse treatment and prevention research. She is Associate Professor of Health Education at the University of Utah where she has conducted federally funded research for NIDA, NIAAA, NIMH, CSAP, DOE, FIPSE, and OJJDP on family, school, and community approaches to drug prevention. A frequent conference speaker, she is coauthor (with Ezekoye and Bukoski) of Childhood and Chemical Abuse: Prevention and Intervention, as well as journal articles and monographs. She has developed several family skills training programs, including a 14-session Strengthening Families Program with DeMarsh and Child, focusing on elementary-age children, and the Strengthening Families Program II with Molgaard, focusing on fifth to eighth graders. She is currently involved in research on applications of the Strengthening Families Program for different ethnic youth and their families. Recently, she completed a national search for the best family programs in the country for the Office of Juvenile Justice and Delinquency Prevention. She is an evaluation specialist, who was CO-PI on the CSAP National Evaluation of the High Risk Youth Demonstration Program and consultant on the Pregnant and Post Partum Drug Abusing Women and Infant Grantee Program. She is currently the evaluator for several CSAP-HRY and CYAP grants. She has published an evaluation book, Measurements in Prevention, on measurement instruments for prevention program evaluators.

    John E. Lochman received his Ph.D. from the University of Connecticut. He is an Associate Professor in the Department of Psychiatry at Duke University Medical Center and an Associate Professor in the Department of Psychology: Social and Health Sciences at Duke University. He is on the editorial board for the Journal of Consulting and Clinical Psychologyand a Fellow in the American Psychological Association. He has authored research papers and chapters on cognitive-behavioral assessment and intervention with aggressive children, on the social-cognitive dysfunctions of aggressive children and their parents, on the later adolescent adjustment of children identified as aggressive in elementary school, and on preventive interventions for conduct disorder and substance use. Recent journal articles have appeared in the Journal of Consulting and Clinical Psychology, the Journal of the American Academy of Child and Adolescent Psychiatry, Developmental Psychology, the Journal of Abnormal Child Psychology, and Development and Psychopathology. His research work has been funded by grants from the National Institute on Drug Abuse and the National Institute of Mental Health.

    Louise C. Masse, Ph.D., is Assistant Professor of Behavioral Sciences at the University of Texas-Houston School of Public Health. She received her doctorate from the University of Ottawa in Measurement and Evaluation. Her background also includes a B.Sc. and M.Sc. in exercise sciences. She was a postdoctoral fellow of the Research Unit on Children's Psychosocial Maladjustment at the University of Montreal. Her research interests are in measurement and evaluation, juvenile delinquency, and violence. Her interests lie in assessing delinquency and violence, with a focus on understanding the psychosocial determinants of these behaviors. Her other research interests are in the area of physical activity and are related to the validation of instruments measuring physical activity and understanding the psychosocial determinants of physical activity.

    Gloria E. Miller received her Ph.D. from the University of Wisconsin—Madison and is currently Professor of Psychology at the University of South Carolina. She is a Fellow of the Division of School and Educational Psychology in the American Psychological Association. Her research interests lie in the prevention of severe conduct disorders in children, with a particular emphasis on understanding the parental and child self-regulatory processes that contribute to antisocial outcomes. Her most recent work focuses on intervention enhancements that lead to increased engagement, compliance, and subsequent behavioral improvements in children and families. In collaboration with Ron Prinz, this work has been funded by two consecutive grants from the National Institute of Mental Health. She has coedited Cognitive Strategy Research (1989), and her most recent publications have appeared in Psychological Bulletin, the Journal of Consulting and Clinical Psychology, and the Journal of Clinical Child Psychology.

    Virginia Molgaard is Associate Professor in the Department of Human Development and Family Studies at Iowa State University where she received her Ph.D. in Family Environment. She has served as State Family Life Specialist for the past 11 years for the Cooperative Extension Service. In that role she has developed curricula on topics such as building self esteem in youth and families, dealing effectively with stress, balancing work and family, and building strong families. In addition, she is presently serving as a research scientist at the Social and Behavioral Research Center for Rural Health at Iowa State University where she has served as a liaison to the extension system, developing news media releases for the public, and providing research updates for staff. In her research role, she has been involved through PROJECT FAMILY in a National Institute of Mental Health-funded project to test a preventive intervention for families, designed to reduce the risk of adolescent substance abuse and other behavior problems. In addition, she has developed a model, presented at a recent workshop sponsored by the NIMH, for involving the extension service in large-scaled intervention research projects.

    David R. Offord is a child psychiatrist with major interests in epidemiology and prevention. He is Professor of Psychiatry at McMaster University and head of the Division of Child Psychiatry, research director of the Chedoke Child and Family Center. He has been director of the Child Epidemiology Unit since its inception in 1980. He is also director of the newly formed Centre for Studies of Children at Risk, which focuses on policy issues, scientific research, and training. He is a National Health Scientist and a member of the Premier's Council on Health, Well-Being, and Social Justice. He has played a leading role in the Ontario Child Health Study and the follow-up. The major goal of the initial cross-sectional study, carried out in 1983, was to obtain unbiased precise estimates of the prevalence of emotional and behavioral problems, physical health problems, and substance use among Ontario children 4 to 16 years of age. The follow-up study carried out in 1987 focused on issues of outcome, prognosis, and risk. He was principal investigator on a community intervention project in a public housing complex in Ottawa that focused on providing a first-rate nonschool skill development program for all children, 5 to 15 years of age, in the complex. The model employed in this successful demonstration project is now being replicated in two locations in Ontario. He is director of the State-of-the-Child Research Unit funded by the Laidlaw Foundation, in which the major goal is to determine what data should be collected on a regular basis on children and youth in Ontario to inform and evaluate policy. Furthermore, he has completed pilot work on two Native reserves in the area of children's health, particularly mental health, and he is the coprincipal investigator of the Tri-Ministry Project, a 6-year study aimed at determining whether adjustment problems can be prevented in children from kindergarten to Grade 3 by a combination of parent training, classwide social skills training, and academic support. In addition, he has published widely in the scientific literature.

    Linda Pagani, Ph.D., is Assistant Professor Research Associate (School of Psycho-Education) and Research Associate (Research Unit on Children's Psycho-Social Maladjustment) at the University of Montreal. Her current research, which is mostly prospective in nature, focuses on the influence of family processes (marital transitions, poverty, parent-child relationships, child rearing) on children's development (academic performance and sociobehavioral adjustment). She is currently involved with several longitudinal projects, including the Montreal Longitudinal-Experimental Study of Boys and the Quebec Longitudinal Study. Some recent publications include authored and coauthored articles in the American Journal of Orthopsychiatry, the American Journal of Family Therapy, the Journal of Consulting and Clinical Psychology, and the Journal of Divorce and Remarriage.

    Peter J. Pizzolongo is Research Associate at CSR, Incorporated, in Washington, D.C. Primarily, he serves as Assistant Director for Management Support for the Comprehensive Child Development Program (CCDP). The CCDP, a federally funded project of the U.S. Department of Health and Human Services, is a community-based family support and education demonstration project begun in 1988. It is designed to encourage intensive, comprehensive, integrated, and continuous services for low-income families and their children to promote economic and social self-sufficiency among participating adults and to enhance children's physical, socioemotional, and intellectual development. As management support coordinator, he oversees the monitoring of and training and technical assistance to 34 CCDP projects nationwide. Previously, he served as project director for the Head Start Home-Based Support Services Project and for the U.S. Public Health Services's HIV/AIDS Training Institute for Public Health Professionals, as the child development associate representative coordinator for the Council on Early Childhood Professional Recognition, as a child care resource and referral agency director, as a Head Start state training officer, and as a Head Start and day care center administrator and caregiver. He is coauthor of Caring for Preschool Children, the U.S. Department of Defense's Child Caregiver Training Program, HIV/AIDS Training Curriculum for Public Health Professionals, Responding to Children Under Stress, The Head Start Home Visitor Handbook, Living and Teaching Nutrition Curriculum, and other publications.

    Ronald J. Prinz obtained his B.A. at the University of California at Berkeley and received his Ph.D. from the State University of New York at Stony Brook. He is currently Carolina Research Professor in Psychology at the University of South Carolina. He has published several edited books and more than 50 research articles pertaining to problems encountered by children and families. He coedits the Advances in Clinical Child Psychology series with Thomas Ollendick. He is a Fellow of the American Psychological Association, an elected member of the Board of Directors in the Association for Advancement of Behavior Therapy, and on the editorial boards for the Journal of Clinical Child Psychology and the Journal of Abnormal Child Psychology. His research interests lie in the areas of prevention and treatment of childhood aggression and related sequlae.

    Cleve Redmond, Ph.D., is Research Scientist at the Social and Behavioral Research Center for Rural Health at Iowa State University. His current research interests include the examination of factors influencing the recruitment and retention of families into preventive interventions designed to prevent teen problem behaviors, as well as the factors influencing the efficacy of such preventive interventions. His research is being conducted as part of Project Family, a series of studies evaluating factors that affect parent motivation to enhance parenting skills and the efficacy of family skills-focused interventions for the prevention of juvenile substance abuse and conduct problems (funded by the National Institute on Drug Abuse, the National Institute of Mental Health, and the Center for Substance Abuse Prevention). Among his recent publications are coauthored articles in the Journal of Marriage and Family, the Journal of Family Psychology, and Health Education Research.

    Carol Crill Russell is Senior Research and Policy Adviser for Children's Services, Ministry of Community and Social Services, in Ontario. She monitors population based and intervention research on healthy child development funded by the ministry. The key research projects are the Ontario Child Health Study, a multiphase epidemiological study of children's mental health; the Better Beginnings, Better Futures Project, an investigation of an ecological prevention model currently demonstrated in seven disadvantaged urban neighborhoods and five First Nations; the Helping Children Adjust Project, an early intervention project in more than 50 primary schools; and a multisite investigation of intensive family preservation in child welfare. She is also working with an advisory group to design a system to identify, evaluate, and disseminate information on effective services for children in greatest need or at greatest risk. She is the past chair of the Family System Working Group for the Provincial Substance Abuse Strategy, a member of the Inter-Ministry Committee on Crime Prevention, and a member of the Expert Advisory Group for the National Longitudinal Survey of Children. She holds a B.A. in psychology, an M.S. in sociology, and an M.S.W. and Ph.D. in social work and sociology.

    Nancy M. Slough, Ph.D., is Research Scientist in the Department of Psychology at the University of Washington. She is currently the Research Director and Clinical Supervisor at the Seattle site for the Fast Track Program, a national multisite collaborative study on the prevention of conduct problems in school-aged children. Her primary research and clinical interest is the prevention of conduct disorders in children with a focus on improved parenting skills and the parent-child relationship. Her other research interests include the development and assessment of attachment and peer relationships in school-aged children. Her most recent publication appeared in New Directions for Child Development.

    Lawrence H. Soberman, Ph.D., is former Project Director for the Adolescent Transitions Program. He specializes in the assessment of and educational programming for high-risk and special education students. He has developed screening techniques for the identification of problem behavior during adolescence and was instrumental in formalizing the curriculum components of the Adolescent Transitions Program prevention trial. He is continuing to implement innovative strategies for improving learning environments in public schools.

    Richard Spoth, Ph.D., is Research Scientist and Project Director for Prevention Programming and Research at the Social and Behavioral Research Center for Rural Health. Following his tenure as clinical director of a hospital-based service where he developed and evaluated preventive behavioral health programs, he obtained a grant to support the establishment of the Social and Behavioral Research Center for Rural Health with colleagues at Iowa State University in the late 1980s. His interest in interdisciplinary research led to further collaborative activity directed toward the organization of the Iowa Consortium on Substance Abuse Research and Evaluation, a consortium of universities and state agencies; he now serves on its executive committee and internal advisory board. Currently, his primary research interests include prevention of substance abuse and other adolescent adjustment problems in rural families and communities, strategies for enhancing recruitment for and retention in preventive interventions, and needs assessments for prevention services. He directs Project Family, a series of studies of factors influencing parent motivation to enhance parenting skills and investigations of the efficacy of family skills-focused interventions in the prevention of juvenile substance abuse and conduct problems (funded by the National Institute on Drug Abuse, the National Institute of Mental Health, and the Center for Substance Abuse Prevention). Recent lead-authored publications in family-focused journals such as the Journal of Marriage and the Family and the Journal of Family Psychology reflect his current research focus. Additionally, he is serving on federally sponsored expert and technical review panels addressing issues in rural and family-focused prevention research.

    Richard E. Tremblay, Ph.D., is Professor of Psychiatry and Psychology at the University of Montreal. He is director of the Research Unit on Children's Psychosocial Maladjustment, an interuniversity research center created by Laval University, McGill University, and the University of Montreal. He is also a member of the Canadian Institute for Advanced Research's program on Human Development. Over the past 14 years, he has been conducting two large longitudinal studies of kindergarten children to understand the development of children's psychopathologies. Recent publications from this research program can be found in the Archives of General Psychiatry, Child Development, the Journal of Abnormal Psychology, the Journal of Abnormal Child Psychology, the Journal of the American Academy of Child Psychiatry, the Journal of Child Psychology and Psychiatry, and the Journal of Consulting and Clinical Psychology.

    Frank Vitaro, Ph.D., is Professor (School of Psycho-Education) and Senior Investigator (Research Unit on Children's Psycho-Social Maladjustment) at the University of Montreal. His interests lie in (a) the early prediction and prevention of aggressive behavior, substance use, and delinquency in relation to peer group and peer dyadic processes and (b) the “spontaneous” modification of developmental trajectories in children at risk due to individual characteristics (e.g., aggressiveness) and environmental characteristics (e.g., familial or school-related variables). He is currently engaged in several collaborative longitudinal studies, some of which have lasted over a decade. Experimental preventive trials are included in some of these studies as a manipulative strategy to test causal relationships between process variables and outcomes. Some of his recent publications as first author or coauthor include articles in the Journal of Abnormal Child Psychology, the Journal of Child Psychology and Psychiatry, the Journal of Clinical Child Psychology, Child Development, Development and Psychopathology, Archives of General Psychiatry, and the Journal of Consulting and Clinical Psychology.

    Karen C. Wells, Ph.D., is currently Associate Professor of Medical Psychology and Director of the Family Studies Program and Clinic at Duke University Medical Center. She completed her internship in clinical psychology at Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, and has been on the faculties of the Departments of Psychiatry at the University of Pittsburgh School of Medicine and George Washington University School of Medicine. She has authored and coauthored numerous papers on family processes and parent training intervention for children and adolescents with disruptive behavior disorders. She is currently conducting studies on parent and family prevention and intervention for Attention Deficit Hyperactivity Disorder, adolescent substance abuse, and adolescent depression.


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