Author: Bret Orton

LifeSkills Training (LST) is a three-year universal substance abuse and violence prevention program designed to be implemented with middle/junior high school students. LST consists of 15 core sessions in Level 1, 10 booster sessions in Level 2, and 5 booster sessions in Level 3. Additional violence prevention lessons also are available for each level (3, 2, and 2 sessions). Units are taught sequentially and delivered primarily by classroom teachers. LST provides students with training in personal self-management, social skills, and resistance skills specifically related to drug use. Skills are taught using instruction, demonstration, feedback, reinforcement, and practice.

Certified trainers provide site-based training, and ongoing technical assistance and Training of Trainer (TOT) workshops also are available. Program materials include a teacher’s manual and consumable student guides for each level, stress management CD, and smoking and biofeedback DVD. Each unit in the curriculum has a specific major goal, measurable student objectives, lesson information and key concepts, identified teaching techniques, classroom activities, and suggested enrichment techniques. Additional resources available on the LST website include unit quizzes, lesson support slides, fidelity checklists, program evaluation tools (pre-and post-test), and activities and self-checks designed for students.

The numerous evaluations of Life Skills Training (LST) cover multiple outcomes and follow-up periods. Early studies focused on tobacco use, followed by studies focused on alcohol and marijuana use, polydrug use, and illicit drug use other than marijuana. More recent studies examined the effectiveness of LST on HIV/AIDS risk behaviors, risky driving, and violence and delinquency. Studies testing LST have not only demonstrated short-term effects on tobacco, alcohol, marijuana use and violence, but also provide evidence of its long-term effectiveness on illicit drug use, with several studies providing 5-6 year follow-up data, and one study providing 10-year follow-up data with reductions in HIV risk behaviors. Additionally, across several studies the intervention group showed significantly greater improvement than the control group in life skills knowledge, substance use knowledge, and perceived adult substance use, both at short-term and longer-term follow-ups.

Research indicates that LST is generalizable to a variety of ethnic groups, and has been proven effective with White, middle-class, suburban and rural youth, as well as economically-disadvantaged urban minority (African American and Hispanic/Latino) youth. In terms of cost-benefit analysis, Washington State Institute for Public Policy (May 2017) reports $17.25 in measured benefits per $1 spent in implementing LST.

Read the Program Fact Sheet

Return to Blueprints Bulletin Issue 6. April 2018.

Project Northland is a six-year intervention delivered over seven academic years from middle to high school, but a shortened, 3-year version may also be used in grades 6, 7, and 8. Its grade-specific components include classroom curricula, peer leadership, youth-driven extra-curricular activities, parent involvement programs, and community activism. By intervening on multiple levels, Project Northland strives to teach students skills to effectively negotiate social influences to drink, while at the same time directly modifying the social environment of youth (i.e., peers, parents, school, and community).

Phase I provides programming for 6th, 7th, and 8th graders. Each of the three years of programming has a specific theme and incorporates individual, parent, peer, and community participation. The students receive skills training in communicating with their parents about alcohol (6th grade), dealing with peer influence and normative expectations about alcohol (7th grade), and understanding methods that bring about community-level changes in alcohol-related programs and policies (8th grade).

Phase II of the program is designed to help maintain the effects through high school. Intervention strategies include community organizing, parent education, youth development, media, and school curriculum. The five intervention strategies are designed to increase community efficacy to enact changes in policies and practices related to high school students’ alcohol use.

The main evaluation of Project Northland began with a 7-year study of six counties and 24 school districts in northeast Minnesota. School districts (and adjoining communities) were randomized to an intervention or reference condition. Students (2,351) in grade 6 at the baseline assessment in fall 2001 were followed through grade 12 in spring 1998.

Students in the intervention drank significantly less than control students at the end of 8th grade. Students in the intervention group who were never-drinkers at the beginning of sixth grade not only drank significantly less than students in the control group but also had lower onset rates, and they also smoked fewer cigarettes and used less marijuana at the end of the eighth grade. Students in the intervention schools were significantly less likely to increase their Tendency to Use Alcohol and binge drinking, and marginally less likely to increase past month alcohol use during grades 11 and 12.

Project Northland returns $4.51 for every dollar invested.

Read the Program Fact Sheet

Return to Blueprints Bulletin Issue 7. July 2018.

A juvenile sex offender treatment program to reduce criminal and antisocial behavior, especially problem sexual behavior, by providing intensive family therapy services in the youth’s natural environment over a 5- to 7-month period.

Multisystemic Therapy (MST) is an intensive family- and community-based treatment that addresses the multiple causes of serious antisocial behavior across key systems within which youth are embedded (family, peers, school, and neighborhood). Multisystemic Therapy-Problem Sexual Behavior (MST-PSB) is guided by the same principles and uses many of the same evidence-based techniques as in MST for nonsexual offenders but focuses on aspects of the youth’s ecology that are functionally related to the problem sexual behavior. At the family level, MST interventions often aim to (a) reduce caregiver and youth denial about the sexual offenses, (b) remove barriers to effective parenting, (c) enhance parenting knowledge, and (d) promote affection and communication among family members. Moreover, conjoint work with family members and other appropriate persons in the youth’s social ecology (e.g., teachers, extended family) is essential in the development of plans for risk reduction, relapse prevention, and victim safety. At the peer level, interventions often target youth social skill and problem-solving deficits to promote the development of friendships and age-appropriate sexual experiences. Peer relations interventions are conducted by the youth’s caregivers, with the guidance of the therapist, and often consist of active support and encouragement of relationship skills and associations with non-problem peers, as well as substantive discouragement of associations with deviant peers (e.g., applying significant sanctions). Likewise, under the guidance of the therapist, the caregivers often develop strategies to monitor and promote the youth’s school performance; interventions in this domain typically focus on establishing improved communication between caregivers and teachers and on restructuring after-school hours to promote academic efforts.

MST-PSB is individualized for each family. Families are provided family therapy while youth are provided individual therapy, and services are delivered over a period of 5-7 months. Therapists have 3-5 families on their caseloads, and rotating members of the team are available to respond to crises 24 hours a day, 7 days a week.

Blueprints has certified three studies evaluating MST-PSB (Borduin et al., 1990, 2009; Letourneau et al., 2009). The first study was a pilot conducted in Columbia, Missouri (Borduin et al., 1990) in which 16 adolescents arrested for sexual offenses were randomized to either MST-PSB or individual therapy control conditions. Recidivism data were collected at an approximately 3-year follow-up. The second Blueprints-certified study was also conducted in Columbia, Missouri (Borduin et al., 2009) and compared the efficacy of MST-PSB versus usual community services (UCS), the latter consisting of cognitive-behavioral group and individual treatment. A total of 48 youth and their families were randomly assigned to MST-PSB (n = 24) and UCS (n = 24). Data were gathered at baseline and posttest, and assessments using police and court records of juvenile and adult criminal activity were conducted an average of 8.9 years after treatment had been completed so that adult arrest data on every youth could be collected. The third Blueprints-certified study was a randomized control trial conducted in Chicago, Illinois (Letourneau et al., 2009) with a sample of 127 participants referred by the Cook County State’s Attorney’s Office after having been charged with a sexual offense. The assessments with each youth and caregiver occurred within 72 hours of recruitment into the study, and at 6, 12, and 18 months post-recruitment.

Results from Borduin et al. (1990) showed that fewer subjects in the MST-PSB condition had been rearrested for sexual crimes (12.5% vs. 75%), as well as nonsexual crimes (25% vs. 50%). The frequency of sexual rearrests was significantly lower in the MST-PSB condition than in the control condition (0.12 vs. 1.62). The number of rearrests was also lower in the MST-PSB group than control group for nonsexual offenses (0.62 vs. 2.25). Significant outcomes were found for 17 of the 18 outcome measures in Borduin et al. (2009), including improved caregiver and youth psychiatric symptoms; family functioning; and youth behavioral problems, peer relations, grades in school, criminal behavior, and sexual reoffending. Letourneau et al. (2009) found that the treatment group improved significantly more than the control group on 8 of 11 outcomes tested: youth-reported deviant sexual interest, youth-reported sexual risk, caregiver-reported deviant sexual interest, caregiver-reported sexual risk, delinquency, substance abuse, youth-reported externalizing, and out-of-home placement.

In terms of cost-benefit analysis, Washington State Institute for Public Policy (December 2018) reports $1.60 in measured benefits per $1 spent in implementing MST-PSB.

Read the Program Fact Sheet

Return to Blueprints Bulletin Issue 9. May 2019.

A family-based intervention to promote protection against, and reduce risk for, behavior problems, illicit drug use, alcohol use, cigarette use, and unsafe sexual behavior in Hispanic youth and adolescents.

Familias Unidas™ is a multilevel family-based intervention designed to prevent substance use and sexual risk behavior in Hispanic adolescents. The program is influenced by culturally specific models developed for Hispanic populations in the United States, and is delivered primarily through multi-parent groups, which aim to develop effective parenting skills. The multi-parent groups, led by a trained facilitator, meet in 8-9 weekly two-hour sessions for the duration of the intervention. Each group has 12 to 15 parents, with at least one parent from each participating family. Sessions include problem posing and participatory exercises. Group discussions aim to increase parents’ understanding of their role in protecting their adolescent from harmful and risky behaviors and to facilitate parental investment. The program also includes 4 to 10 one-hour family visits in which parents are encouraged to apply the newly learned parenting skills while interacting with their adolescent.

Familias Unidas™ also involves meetings of parents with school personnel, including the school counselor and teachers, to connect parents to their adolescent’s school world. Family activities involving the parents, the adolescent, and his or her peers and their parents allow parents to connect to their adolescent’s peer network and practice monitoring skills.

Facilitators must be Spanish-speaking and bicultural, with a minimum of a bachelor’s degree in psychology and 3 years of clinical experience, or a master’s degree and 1 year of clinical experience.

Familias Unidas™ has been evaluated in seven randomized controlled studies. The study which qualified for Blueprints certification (Pantin et al., 2009) randomly assigned 213 8th grade students at-risk for problem behaviors in three Florida middle schools to treatment or control. Control families received three referrals to agencies in their catchment area that serve youth with behavior problems. Assessments were completed at baseline and at 6, 18, and 30 months post-baseline.

Familias Unidas™ resulted in a lower rate of increase in substance use, compared to controls, from pretest to 30-month posttest (15% to 25% vs. 13% to 34%). Additionally, family functioning improved in the treatment group compared to the control group and parents reported a smaller percentage of treatment youth displaying externalizing behaviors. There were no significant differences for engaging in sexual intercourse, although sexually active youth in the intervention reported a significantly increased level of condom use from 6 months to 30 months postbaseline, compared to controls.

Blueprints-Certified Citations
Pantin, H., Prado, G., Lopez, B., Huang, S., Tapia, M. I., Schwartz, S. J., … Branchini, J. (2009). A randomized controlled trial of Familias Unidas for Hispanic adolescents with behavior problems. Psychosomatic Medicine, 71, 987-985.

Read the Program Fact Sheet

Return to Blueprints Bulletin Issue 9. May 2019.

Maryland Ignition Interlock License Restriction is a statewide license restriction program for drivers with multiple alcohol-related traffic offenses that is designed to reduce alcohol-impaired driving recidivism. The use of ignition interlock license restrictions requires those with previous alcohol-related driving offenses to pass a breath analyzer test of blood alcohol levels before starting a vehicle. The program further requires that drivers who are applying for reinstatement of their driving licenses install the ignition interlock system in their vehicle and continue to use it for two years before they are eligible for reinstatement.

The ignition interlock device requires a potential driver to blow into a breath alcohol sensor connected to the vehicle’s ignition system before the vehicle’s engine will start. An on-board computer analyzes the alcohol concentration of the driver’s breath and compares it to a set point, usually .02 grams per deciliter. If the alcohol concentration is above the set point or the driver does not provide a breath sample, the interlock prevents the vehicle engine from starting. Ignition interlocks are comprised of four basic elements: 1) A breath alcohol sensor installed in the passenger compartment of a vehicle and connected to a control unit in the engine compartment that allows the engine to start only upon an acceptable breath test; 2) A tamper-proof system for mounting the control unit in the engine compartment; 3) A data-recording system that logs breath test results, tests compliance, and collects other state-mandated data; and 4) A retest system which, after the engine has started, requires the driver to provide additional breath samples (generally every 10 to 15 minutes) to ensure that the driver remains alcohol-free. Several minutes are provided for the driver to exit traffic and move to a safe location for retesting.

The qualifying studies for Blueprints were Beck et al. (1999) and Rauch et al. (2011), which conducted evaluations of the program in the state of Maryland by randomly assigning 1, 387 and 1,927 drivers to treatment or control groups, respectively. Beck et al. (1999) reported that drivers with the ignition interlock system were significantly less likely to recidivate in the year in which they had the system installed as compared to the control group, and this benefit was maintained in the following year after system removal. Results for Rauch et al. (2011) showed that drivers with two years of interlock installation, relative to controls, had a lower hazard of committing an alcohol-related offense with sustained effects two years following the intervention period.

Citations
Beck, K. H., Rauch, W. J., Baker, E. A., & Williams, A. F. (1999). Effects of ignition interlock license restrictions on drivers with multiple alcohol offenses: A randomized trial in Maryland. American Journal of Public Health, 89, 1696-1700.

Rauch, W. J., Ahlin, E. M., Zador, P. L., Howard, J. M., & Duncan, G. D. (2011). Effects of administrative ignition interlock license restrictions on drivers with multiple alcohol offenses. Journal of Experimental Criminology, 7,127-148.

Read the Program Fact Sheet

Return to Blueprints Bulletin Issue 8. December 2018.