# Presentation: 350340

## Success of Ecologically-Based Interventions: Implications for Optimizing Developmental Outcomes for Boys and Young Men 

- Cindy Schaeffer, Ph.D.
- Associate Professor, Family Services Research Center
- Dept. of Psychiatry and Behavioral Sciences
- Medical University of South Carolina

## 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

## 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*

## 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)

## 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)

## 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)

## 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

## 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

## 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

## 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

## 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

## 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)

## 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

## 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**)***

## 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

## 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

## 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

## 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

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

- _[schaeffc@musc.edu](mailto:schaeffc@musc.edu)__ or (410) 970-6451_