An Ounce of Prevention: A Model for Working with Couples At-Risk for Battering

Literature on preventing spousal battering before it starts is virtually non-existent. This article describes a prevention of abuse program that targets couples at-risk for battering. At-risk couples and the process of engaging them in couples counseling are described. The prevention model is based on a Bowenian approach that focuses on partner differentiation and reducing emotionality and promoting rational thinking. It is assumed that increasing differentiation decreases the risk of spousal battering. The various techniques used to facilitate differentiation are presented as well as a case example illustrating a successful prevention of abuse experience.     

A conceptual review of discipline in the schools: A consultation service model

Although discipline has been identified consistently as the major problem in U.S. education, few conceptual models are available to guide the analysis of discipline problems and to integrate the consultation and preventive mental health perspectives. A model is presented that integrates a consultation problem-solving process (involving problem identification, problem analysis, intervention, and evaluation) with the preventive mental health levels (i.e., primary, secondary, and tertiary preventions). These perspective interface because discipline-related problems can occur and be resolved at all three prevention levels, although most are addressed only at the tertiary level. A review of the relevant literature is presented with each component of the model, and pragmatic applications are suggested to facilitate both problem-solving and consultation. Although the tertiary prevention level is emphasized, consultants are reminded that secondary and primary prevention programs are potentially more cost-effective and efficacious.     

Prevention,the appropriate target of infant psychotherapy

The aim of this paper is to evaluate the case for preventive interventions in infancy aimed at the reduction of childhood psychopathology. The paper considers the terminology of prevention and the case for prevention in infancy. It is argued that increased knowledge concerning the developmental pathways involved in many psychological disorders opens the door to prevention initiatives. An overview of recent prevention trials is provided and the implications from treatment evaluation studies are explored. The case for prevention of conduct disorders is taken as an illustration of the potential for interventions in infancy. A developmental model of conduct disorder implicates a vicious cycle of parent–child interactions, a process that may arguably be preempted by early intervention. Three modalities are considered in detail: (a) early parent training; (b) the enhancement of attachment security; and (c) the facilitation of the development of reflective function. Studies in each of these areas are reviewed. The paper concludes that increased emphasis on the prevention aspect of infant mental health interventions is justified and desirable. © 1998 Michigan Association for Infant Mental Health     

The precaution adoption process

This article presents a critique of current models of preventive behavior. It discusses a variety of factors that are usually overlooked-including the appearance of costs and benefits over time, the role of cues to action, the problem of competing life demands, and the ways that actual decision behavior differs from the rational ideal implicit in expectancy-value and utility theories. Such considerations suggest that the adoption of new precautions should be viewed as a dynamic process with many determinants. The framework of a model that is able to accommodate these additional factors is described. This alternative model portrays the precaution adoption process as an orderly sequence of qualitatively different cognitive stages. Data illustrating a few of the suggestions made in the article are presented, and implications for prevention programs are discussed.     

Collaborative Consultant: A New Role for Counselors Serving At-Risk Youths

School and community counselors have important roles in developing and implementing mental health programs for youths and families. Counselors who are working with the more complex issues of at-risk youths can enhance implementation of prevention programs by altering their roles to function within a collaborative consultation model. This model represents a new paradigm in that counselors interdependently and collaboratively partner with people previously considered their “consultees.” Such collaboration can result in more comprehensive and integrated programs, and it can prevent fragmentation and duplication of efforts. Collaborative consultation is described and contrasted with more traditional consultation models, and a 5-stage implementation process is presented. Personal and systemic factors that support the collaborative process are examined.     

心理预防概念的更新及其对实践的指导意义

继Caplan的“公共卫生预防模型”之后,Gordon提出另一个综合性预防模型;美国国家科学院医学研究所绘制了“心理健康干预光谱”; 美国国家研究所和国家科学院医学院则进一步将“心理健康促进”正式纳入心理预防概念。“心理健康促进”是针对消极被动的传统预防而提出的积极主动的预防。心理预防概念的发展与更新,特别是将“心理健康促进”纳入心理预防体系,要求树立预防的全局观念,提高预防的针对性,将消极心理预防与积极心理健康促进结合起来。     

Embedding prevention services within systems of care: Strengthening the nexus for children

System-of-care models that offer a continuum of integrated mental health services for children are being widely implemented in local communities. Preventive services, arising from the theoretically grounded prevention sciences, are an important but neglected component of this model. Studies of the use of mental health services by children are reviewed, and an integrative model is proposed to incorporate prevention services as a component of the child mental health service system. Construction of the prevention sciences has followed a linear phase model that has advantages and disadvantages for bridging prevention sciences and services research. As prevention science progresses into broader field tests of its effectiveness, studies of child services can be informative, especially in advancing the applicability and dissemination of research findings. Future directions are outlined to strengthen the nexus between services research and prevention science, and to construct a new genre of prevention services research.     

牙髓病治疗过程的历史回顾与哲学思考

牙髓病的发生原因遵循多因素的模式,牙髓病的治疗方案的研究历程顺应该病发生原因研究进程和认识,在牙髓病治疗过程中体现了技术更新的跃进方式更新和渐进形式更新,说明一项新技术替代原有技术,实现了旧质向新质的转换,而疾病的防治需要科学的策略和措施.     

Entwicklungsbezogene Pr?vention von Gewalt und Kriminalit?t

This article provides an overview of concepts and empirical evaluations of developmental prevention of delinquency, violence and other forms of antisocial behavior in childhood and youth. At first basic terms and arguments are discussed; then a selection of family, child school and community-oriented programs are briefly presented. There follows an integrative evaluation of the field that is mainly based on systematic reviews and meta-analyses. An integrative model shows that preventive effects depend on many characteristics of the programs, contexts, participants and evaluation methods. In total effect sizes are positive and small but show practical relevance. There is a strong need for more well controlled outcome evaluations with long-term follow-up and more process evaluations of implementation and quality assurance. Future research and practice should be integrated within a long-term and cross-departmental prevention policy.     

The Prevention of Suicidal Behaviors: An Overview

The authors discuss the development of the concept of prevention as it has evolved from the public health and mental health fields. Concepts of epidemiology, treatment, and community mental health are defined in terms of their contributions to the evolution of prevention thinking. Four models of prevention are presented and critiqued: the public health model, the operational model, the antecedent conditions model, and the injury control model. Essential ingredients for implementing effective preventive interventions are presented, as well as examples of practical preventive interventions.     

Protecting Our Daughters: Intersection of Race, Class and Gender in African American Mothers’ Socialization of Their Daughters’ Heterosexuality

Using a framework of intersectionality and Black feminist thought, this paper provides a conceptual exploration of the socialization process among African American mothers and daughters, with special attention given to the ways in which African American girls become aware of their mother’s attitudes and beliefs concerning romantic relationships. Edmondson Bell, E. L., Nkomo, S. M. (1998). Journal of Comparative Family Studies, 29, 285–295 labeled this process armoring. I propose a model of sexual risk for low income African American girls in which the armoring process serves as the focal point. I then provide a conceptual discussion, comparing my proposed model to current social cognitive models in its ability to comprehensively explain the correlates and predictors of sexual behavior among this population. Implications concerning sexual risk prevention efforts are also discussed.     

Community-Based Research in India: A Case Example of International and Transdisciplinary Collaboration

While there has been a trend toward greater disciplinary collaboration over the last several decades, the emergence of the HIV pandemic has required that disciplines work more closely and creatively to generate the multiple and innovative approaches necessary to meet the demands for effective prevention and treatment. This paper describes the nature of collaborative relationships among U.S. and Indian anthropologists, psychologists, demographers, epidemiologists, physicians and representatives of other fields and sectors in conducting a large scale, multi-year HIV/STD prevention project directed toward married men in urban poor communities in Mumbai (Bombay), India. The project has challenged members of the participating disciplines to develop a transdisciplinary conceptual model, to test the model with community-based formative research and to utilize the results in the development and implementation of a multi-level (community, provider and patient) intervention. The paper describes the interaction among disciplines and international sectors in the conceptualization, methodology and community-based action components of the project. In addition, it examines both the inhibiting and facilitating factors that are a part of the collaborative process. The paper concludes with implications for future transdisciplinary partnerships.     

A multiple case study approach to work stress prevention in Europe

Work stress has become a major issue among European employees. The current practice of its prevention seems disappointing, as work stress prevention programmes are predominantly reactive and biased to the individual. The lack of organization-level intervention studies is a barrier to progress in reducing work-related stress. In addition to the “true experimental approach”, multiple case studies may provide an adequate research strategy for addressing the potential impact of stress interventions in organizations. The study aim was to obtain more knowledge with respect to evidence-based work stress prevention in Europe, by focusing on both content (cause-effect relationships) and process (“how”). Therefore it was decided: (1) to collect from each European Union member state a work stress intervention study; (2) to analyse each of these cases as to content and process factors; and (3) to systematically compare these studies in a step-by-step approach. Through a network approach, 11 cases were identified. Nine projects received an acceptable methodological standard and were included in this study. Evaluation of these cases reveals that stress prevention is no “one time event”, nor merely a technical process. It is concluded that “true prevention” (i.e., preventive measures that are based on an adequate diagnosis identifying risk factors and risk groups, which theoretically and logically fit in with the problems, and which are introduced and implemented in a proper way) may be beneficial to both the employee and the organization.     

A music-based HIV prevention intervention for urban adolescents

OBJECTIVE: This research examines the process of conducting and evaluating a music-based HIV prevention intervention among urban adolescents, and is informed by the information, motivation, behavioral skills (IMB) model. DESIGN: Musically talented opinion leaders were recruited to write, record, and distribute HIV prevention themed music to their peers to increase HIV prevention motivation, behavioral skills, and behaviors. In this 3-month field experiment, participants were 306 students enrolled in health classes at each of three large multiracial urban high schools (one treatment school; two control schools). MAIN OUTCOME MEASURES: Measures of HIV prevention information, motivation, behavioral skills, and behaviors, both pre- and postintervention. RESULTS AND CONCLUSION: Results indicate that the intervention influenced several aspects of HIV prevention motivation, behavioral skills, and condom use and HIV testing behaviors. This research demonstrates that the incorporation of music into HIV prevention interventions for adolescents has the potential to be effective.     

Dream appreciation group: A model of stress prevention for medical students

This paper describes a pilot study in stress prevention for medical students, utilizing Montegue Ullman's process in a dream appreciation group. Relevant literature on the use of dreams in a group is reviewed. In this model, group dynamics and interaction are not analyzed, rather the dream holds center stage. The technique of working with dreams in a group is described, and selected vignettes are presented to document the process. This study suggests that in the presence of a supportive group atmosphere, unconscious conflicts can be alleviated or resolved so as to enhance medical students' evolving personal and professional identity.This paper is based on a presentation at the thirty-first winter meeting of the American Academy of Psychoanalysis, Scottsdale, Arizona, December 11, 1987.     

The Place of Suicide Prevention in the Spectrum of Intervention: Definitions of Critical Terms and Constructs

The authors trace the evolution of prevention models and conceptual foundations for the prevention of disorders starting with the public health/medical model and concluding with the contemporary model recently proposed by the Institute of Medicine of the National Academy of Sciences. They compare and contrast the contributions of each model toward the theoretical reduction of suicide in the general population. Risk and protective factors as they relate to suicidal behaviors are identified. The paper explores conceptual frameworks used to understand population-level risk factors and moves toward a discussion of how to target individuals at risk for suicidal behaviors. First-order and second-order targets of change in prevention efforts are defined and examples provided.     

Prevention of child sexual abuse. Myth or reality

Programs to prevent child sexual abuse have proliferated as a result of increased public awareness and professional documentation of its incidence. We describe the content and format of these prevention programs in general and examine selected programs for effectiveness. Although there is limited evidence for an increase in knowledge for program participants, most evaluations suffer from basic design problems and present few results indicative of either primary prevention or detection. Overall, we argue that self-protection against sexual abuse is a very complex process for any child and that few, if any, prevention programs are comprehensive enough to have a meaningful impact on this process. Finally, we discuss several untested assumptions that guide these programs. We conclude that it is unclear whether prevention programs are working or even that they are more beneficial than harmful.     

Mediational screening as a model for prevention research

Examined here is Pillow, Sandler, Braver, Wolchik, and Gersten's (this issue) strategy for screening prevention trial participants. The reviewer concludes that their selection strategy should increase the statistical power of prevention outcome studies, increase intervention cost effectiveness, and help to prevent their possible iatrogenic effects. Also, their model points up inadequacies in the longitudinal data on which most prevention strategies are based, and their model could well serve as a template for future research.     

Place of Strength: Indigenous Artists and Indigenous Knowledge is Prevention Science

The Place of Strength (PoS) project represents an effort to Indigenize program evaluation with Indigenous communities by melding art with prevention science. We propose that Native artists as evaluators: (a) opens avenues of communication for Indigenous perspectives; (b) provides opportunities to capture spiritual, relational, and emotional impacts of prevention programming; and (c) maintains Indigenous processes, language, and values at the center of knowledge production. The New Mexico Tribal Prevention Project (NMTPP) funded seven Southwestern tribes to develop substance abuse prevention programs. In response to their expressed negative experiences with evaluation of prevention strategies, NMTPP piloted PoS. PoS shifted systematic knowledge paradigms to Tribal thought, values, and perspectives embodied in art. Art exists in Native communities as a way of documenting lifeways and historical experiences through various cultural forms. We share the process of collaborating with Native artists to document the impact of substance abuse prevention initiatives through their art within a community context. We offer concepts derived from this project as a community psychology model for re‐conceptualizing evaluation utilizing Indigenous knowledge.