The Resilience Model of Substance Abuse Prevention

Many teens, although living in high-risk environments, seem to possess personal resilience that helps them avoid alcohol, tobacco, and other drug problems.  The resilience model suggests we can prevent teen substance abuse by increasing their protective factors and reducing their risk factors.  Protective factors, along with risk factors, need to be more widely publicized for the use of parents, gatekeepers, and prevention planners. While many of the factors listed below are the result of external forces that are difficult or impossible to control, the factors that can be changed may increase the resilience of teens that are at high risk for problems with alcohol, tobacco, or other drugs.

Protective Factors

One current challenge to the prevention field is to identify protective factors and determine how they can be instilled in all teens, but especially in teens living in high-risk environments. The following is a checklist of teen protective factors:

• Child Personality Characteristics
  • Affectionate/endearing
  • Easy temperament
  • Autonomous
  • Adaptable and flexible
  • Positive outlook
  • Healthy expectations
  • Self-efficacy
  • Self-discipline
  • Internal locus of control
  • Problem-solving skills
  • Socially adept
  • Tolerance of people and situations
• Child Constitutional Strengths
  • Adequate early sensory motor and language development
  • High intelligence
  • Physically robust
  • No emotional or temperamental impairments
• Community Environment
  • Middle or upper class pleasant neighborhood
  • Low unemployment
  • Adequate housing
  • Low prevalence of neighborhood crime
  • Good school
  • School that promotes learning, participation, and responsibility
  • High-quality health care
  • Easy access to adequate social services
  • Flexible social service providers who put clients' needs first
• Family Environment
  • Adequate family income
  • Structured and nurturing family
  • Parents promote learning
  • Fewer than four children in family
  • Two or more years between the birth of each child
  • Few chronic stressful life events
  • Multi-generational kinship network
  • Non-kin support network, e.g., supportive role models, dependable substitute child care
  • Warm, close personal relationship with parent(s) and/or other adult(s)
  • Little marital conflict
  • Family stability and cohesiveness
  • Plenty of attention during first year of life
  • Sibling as caretaker/confidante
  • Clear behavior guidelines

If the high-risk environment is the family itself, for instance if children are growing up in an alcoholic or drug abusing family, studies suggest that they have a better chance of growing into healthy adulthood if they: 

• Can learn to do one thing well that is valued by themselves, their friends, and their community;
• Are required to be helpful as they grow up;
• Are able to ask for help for themselves;
• Are able to elicit positive responses from others in their environment;
• Are able to distance themselves from their dysfunctional families so that the family is not their sole frame of reference;
• Are able to bond with some socially valued, positive entity, such as the family, school, community groups, or church;
• Are able to interact with a (perceived to be) caring adult who provides consistent caring responses.

Risk Factors

Risk factors are characteristics that occur statistically more often for those who develop alcohol, tobacco, and other drug problems, either as adolescents or as adults. It is important to recognize that risk factors are only indicators for the potential of problem occurrence. While they can be helpful in identifying children who are vulnerable to developing alcohol, tobacco, or other drug problems, they are not necessarily predicative for an individual child. Children growing up under adverse conditions often mature into healthy, well-functioning adults. In addition, the use of risk factors to label children poses its own risk. Consequently, there is increasing attention on those factors that seem to protect children from developing alcohol, tobacco, or other drug problems.  Recent research identifies the following individual, family, and social/cultural risk factors:

• Constitution of the Child
  • Child of an alcohol, tobacco, or other drug abuser
  • Less than 2 years between the child and its older/younger siblings
  • Birth defects, including possible neurological and neurochemical dysfunctions
  • Neuropsychological vulnerabilities
  • Physically disabled
  • Physical or mental health problems
  • Learning disability
• Early Behavior Problems
  • Aggressiveness combined with shyness
  • Aggressiveness
  • Decreased social inhibition
  • Emotional problems
  • Inability to express feelings appropriately
  • Hypersensitivity
  • Inability to cope with stress
  • Problems with relationships
  • Cognitive problems
  • Low self-esteem
  • Difficult temperament
  • Personality characteristics of ego under-control, rapid tempo, inability to delay gratification, overreacting
• Adolescent Problems
  • School failure and dropout
  • At risk of dropping out
  • Delinquency
  • Violent acts
  • Gateway drug use (tobacco, alcohol, marijuana)
  • Other drug use and abuse
  • Early unprotected sexual activity
  • Teenage pregnancy/teen parenthood
  • Unemployed or underemployed
  • At risk of being unemployed
  • Mental health problems
  • Suicidal
• Negative Adolescent Behavior and Experiences
  • Lack of bonding to society (family, school, and community)
  • Rebelliousness and nonconformity
  • Resistance to authority
  • Strong need for independence
  • Cultural alienation
  • Fragile ego
  • Feelings of failure
  • Present versus future orientation
  • Hopelessness
  • Lack of self-confidence
  • Low self-esteem
  • Inability to form positive close relationships
  • Vulnerability to negative peer pressure
• Family Environment
  • Alcohol, tobacco, and other drug dependency of parent(s)
  • Parental abuse and neglect of children
  • Antisocial, sexually deviant, or mentally ill parents
  • High levels of family stress, including financial strain
  • Large, overcrowded family
  • Unemployed or underemployed parents
  • Parents with little education
  • Socially isolated parents
  • Single female parent without family/other support
  • Family instability
  • High level of marital and family conflict and/or family violence
  • Parental absenteeism due to separation, divorce, or death
  • Lack of family rituals
  • Inadequate parenting and low parent/child contact
  • Frequent family moves
• Community Environment
  • Poverty
  • Living in an economically depressed area with:
    • high unemployment
    • inadequate housing
    • high prevalence of crime
    • high prevalence of illegal drug use
  • Minority status involving:
    • racial discrimination
    • culture devalued in American society
    • differing generational levels of assimilation
    • cultural and language barriers to getting adequate health care and other social services
    • low educational levels
    • low achievement expectations from society

There are no simple solutions for helping teens at high risk for developing alcohol, tobacco, or other drug problems. Reducing risk factors and fostering resiliency are part of a comprehensive approach to prevention, and are consistent with a public health approach to reducing problems.   

References

Breaking New Ground for Teen at Risk: Program Summaries. CSAP Technical Report 1 (1990) BK163

Hawkins, J.D., Lishner, D.M.; and Catalano, R.F. "Childhood Predictors and the Prevention of Adolescent Substance Abuse." In Etiology of Drug Abuse: Implications for Prevention. NIDA Research Monograph 56. A Research Analysis and Utilization System Review Report, 1985

Using Community-Wide Collaboration to Foster Resiliency in Kids. A Conceptual Framework. Portland, OR: Northwest Regional Educational Laboratory (1993)

Teen at High Risk for Substance Abuse (1990) BKD06