Building Bridges Across the Spectrum:
How Prevention Connects with Addiction
Treatment
FACILITATED BY:
JANE GOBLE-CLARK
CENTER FOR
PREVENTION SERVICES
Agenda
 Hour 1
- Welcome and Introductions
- What is Prevention?
- Prevention Strategies
 BREAK
 Hour 2
- Prevention 101 continued
- Shared Skills: Collaboration
- Experiential learning
 BREAK
 Hour 3
- Shared Skills: Cultural Competency
- Experiential learning
Introductions
WELCOME !
1.
Facilitator and Agency background
2.
Audience -- Why is this topic important and relevant to the
work you do?
What will we accomplish today?
 Discussion of how prevention spans and is relevant to addiction
treatment
 Discussion of the differences between collaboration and
compromise and how to use that to find unity in the diversity of
professions
 Discussion of cultural competency as a professional tool and as a
bridge between the fields of prevention and treatment
 Create new networking opportunities and provide links
 Q&A
Norms for Today’s Training
 Start and end on TIME
 Ask for clarification
 Each person is a resource to the whole group
 Be respectful of each other’s opinions and expertise
 HAVE FUN!!!
 What else?
Group Activity
Circle of Friends
- Please form two circles with your classmates
- Create a smaller circle of people to be the inner loop
- Create a larger circle of people to be the outer loop
- People in inner and outer circles face each other (like a
dance!)
- The facilitator will give quick Q & A, then
- Each group moves to their left after specified time
- Finishes when everyone has met each other!
Common Prevention Quotes
 “An apple a day keeps the doctor away.”
 “An ounce of prevention is worth a pound of cure.”
 “Prevention is better than cure.”
 “A stitch in time saves nine.”
CSAP’s Definition of Prevention
 “Prevention is a proactive process. It empowers,
individuals, and systems to meet the challenges of
life events and transitions by creating and
reinforcing conditions that promote healthy
behaviors and lifestyles.”
- William Lofquist,
CSAP - Center for Substace Abuse Prevention
NCSAPPB’s Definition of Prevention

“Substance Abuse Prevention is the reduction,
delay, or avoidance of alcohol and other drug use.
Prevention promotes positive environments and
individual strengths that contribute to personal
health and well-being over an entire life span.
Effective prevention strategies encourage
individuals, families, and communities to take part
in assessing and changing their lifestyle and
environments.”
NCSAPPB - North Carolina Substance Abuse Professional Practice Board
Who Does Prevention?
Grandparents
Parents
Preventionists
Youth
Teachers
Counselors
Treatment Providers
Aunts/Uncles
You
Me
Community Members
EVERYONE!!
Why Provide Prevention Services?
“Drug use is not a national problem…it is a
series of local epidemics.”
~
“Prevention is not about one program or
activity…it is about making it part of the ground
water—the way communities do business.”
The Continuum of Care
Different levels of prevention are distinguished by the level of risk
of disorder/distress in various populations groups targeted.
Types of Prevention on the Continuum
 Individual / Familial
 Indicated
 Selective
 Environmental
 Universal
IOM Prevention Components
Universal Prevention:

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Addresses the entire population
Aim is to prevent/delay use of ATOD. Deters onset by
providing individuals with information/skills
Selected Prevention:


Targets subsets of the population considered at risk by
virtue of their membership in a particular segment of the
population
Key Selected Prevention targets the entire subgroup
regardless of the degree of risk of any individuals in the
group
Indicated Prevention:

Targets individuals who are exhibiting early signs or
consequences of ATOD use.
IOM - Institute of Medicine
Prevention Domains
► Individual/Peer
► Family
► School
► Community
Substance abuse and mental illness are complex problems that develops in
response to multiple influences.
Each domain presents an opportunity for preventive action.
Individual/Peer/Family = Individual-level strategies
School/Community/Society = Environmental strategies
Prevention Domains
 Individual
Experiential Learning:
 Family
 Peer
 School
 Community
 Society
Circle of Support
-Begin with one person in the middle
-Add additional members to the
activity
-How does this exercise answer the
question below?
Why target each of these areas?
The Community Wheel
CSAP’s Prevention Strategies
 Information Dissemination
 Prevention Education
 Alternatives
 Problem Identification & Referral
 Community Based Processes
 Environmental Approaches
What are some examples of these strategies?
Strategies: Information Dissemination
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Media Campaigns
Brochures
Videos
Radio and Television
Public Service
Announcements
Lectures
Health Fairs
Resource Directories
Clearinghouses and other
information centers
One Time Talks
Got Questions?
Call Drug Line
704-375-DRUG (3784)
All calls are anonymous and confidential
Strategies: Prevention Education
 Classroom and Small
Group Sessions
 Parenting and Family
Management Classes
 Peer Lead and Peer
Helper Programs
 Education Programs
for Youth Groups
 Groups for Children of
Substance Abusers
Strategies: Alternatives
 Mentoring Programs
 Drug Free Social and
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Recreational Activities
- Ex. SAAM Family
Festival
Community Service
Activities
Drug Free Dances and
Parties
Youth and Adult
Leadership Activities
Community Drop-in
Centers
Strategies: Problem Identification and Referral
 Driving-while-
intoxicated Education
Programs
 Employee Assistance
Programs
 Student Assistance
Programs
Strategies: Community Based Approaches
 Building Interagency
Collaboration
 Training Community
Members/Agencies in
Substance Use Education
and Prevention
 Conducting Systematic
Planning
 Supporting Community
Team-Building
Piedmont Area Substance Abuse
Provider Association
Substance Abuse Training Series
Hosted by: PASAPA and PBH
8:30 AM - 12:00 PM
Environmental Approaches
 Community laws that prohibit
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alcohol and tobacco
advertisements in close
proximity to schools
The establishment and review
of school drug policies
Technical assistance to
communities to help them
maximize law enforcement
efforts to govern the availability
and distribution of drugs
Community policies regarding
access to alcohol and tobacco
products
Community laws that increase
punishments for DUIs
BREAK
Experiential Learning
Planning A Community Center
Rules:
- Each person gets to make one line on the board
- No conversation allowed
- Complete the plan
- The group processes the shared work
Public Health Model
 Individual Prevention:
Focuses on trying to
change the host
 Environmental
Prevention: Focuses on
trying to change the
agent and the
environment
Why Plant the Seed of Prevention?
 Those who consume alcohol before the age of 15 are
5 times more likely to have an alcohol problem later
in life.
 Youth drug use is associated with suicide, violence,
unwanted pregnancies, school failure, delinquency,
and transmission of sexually transmitted infections
The Role of Prevention
To create communities in which people have a quality
life:
 Healthy environments at work & in school
 Supportive communities and neighborhoods
 Connected to families and friends
 Alcohol, tobacco, and other drug-free lifestyles
 Addiction and crime-free individuals and
communities
The Roots of Prevention
 1950s

Scare Tactics
 1960s

Scare Tactics and Information
 1970s

Drug Education and Alternatives to Drug Use
 1970s-1980s

Education, Alternatives, and Trainings
 1980s-1990s

Parent, School, and Community Partnerships
 1990s

Use of Evidence-based “Model Programs”
 2000s

Strategic Prevention Framework and focus
on cultural competency and sustainability
New Growth
 Strategic Prevention Framework
 Assessment,
Capacity, Planning,
Implementation, Evaluation, Sustainability,
and Cultural Competence
 Risk and Protective Factors
 Community,
School, Family, and
Peer/Individual
SAMHSA’s
Strategic Prevention Framework Steps
Assessment
Profile population
needs, resources, and
readiness to address
needs and gaps
Evaluation
Monitor, evaluate,
sustain, and improve
or replace those that
fail
Sustainability &
Cultural Competence
Implement evidencebased prevention
programs and
activities
Implementation
Capacity
Mobilize and/or build
capacity to address needs
Develop a
Comprehensive
Strategic Plan
Planning
SPF: A shared framework
Benefits of the Strategic Prevention
Framework:
 Creates an objective community profile
 Identifies how to effectively and
efficiently use resources
 Assists in the selection and
implementation of effective strategies
 Unifies the power of individual citizens
and institutions
 Create a comprehensive plan in which
everyone in the community has a stake
 Holds community institutions
accountable
Risk & Protection Approach
 In past century, doctors have discovered factors
that:
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Put people at risk for such things as heart disease and
diabetes.
Protect people from such conditions
 This Risk and Protective Factor approach follows
the same model for prevention for our
communities’ children
Risk Factors
are listed to
the left.
What are
some
Protective
Factors?
Risk & Protection Approach
A Simple Premise
What are Risk Factors?
 Conditions or situations that increase the likelihood that
a child will develop one or more health and/or behavior
problems in adolescence.
What are Protective Factors?
 Conditions or situations which decrease the likelihood of
future behavior problems.
Where are they found?
 In four domains
Community, School, Family, Peer/individual
Prevention:
Where We Are Now
 Prevention planning is strategic
 Based on risk and protective factors
 Prevention movements, rather than individual
programs
 Strategies are evidence-based
 Addresses the whole community culture
 “Prevention is Health Reform”
Science-Based Prevention Programs
 Identified and or substantiated through an expert
consensus or analytical process using commonly
agreed on criteria
 National Registry of Effective Practices and
Programs (NREPP) www.nrepp.samhsa.gov
 Why is science-based important?
Past and Present Prevention
Prevention Services
 Prevention Agencies or Programs
 Centers for Prevention Resources
 Prevention Policy Alliance
 TRU
 Specialty Contracts
 Youth Suicide Prevention
 Methamphetamine Prevention Initiative
Prevention Services
 Safe and Drug Free Schools and Communities
 Fetal Alcohol Spectrum Disorders Prevention
 Underage Drinking Prevention
 Early Interventions
 Bullying Prevention
 Violence Prevention
 Suicide Prevention
 Juvenile Crime Prevention
Community Prevention
 24/7
 Social Host
 Youth Leadership
 Community Policing
 Alcohol Compliance Checks
 Tobacco Reward/Reminder Visits
 Responsible Beverage Sales and Service
Prevention Outcomes
 Youth Drug Survey
 Tracks
trends in use and abuse
 Covers 40 years
 2010 data is most recent
 Synar
 Decrease
in sales of tobacco to
minors from 48.3% to 8.2%
Things to Remember about Prevention
 It is a process, it doesn’t
happen overnight
 Environmental prevention
is more effective than an Individual
approach
 It spans SA, MH and DD
What Can You Do?
 Call your local prevention service providers
 Become active in your local coalitions
 Call your school board members, city officials and
state officials asking them to support prevention
initiatives
 Talk to your children, grandchildren, niece, and
nephews
 Be active in your community and in children’s lives
 Raise awareness in your own profession
 Share resources with clients
BREAK
Crossing the Bridge
 Relationship-building
 Collaboration vs. Compromise
 Cultural Competency
Strategies for Relationship-building
Experiential Learning: The Head-band Activity
Volunteers Needed!
You won’t look as “stylish” as this guy. . . but you will
have fun!
Strategies for Relationship-building
The Head-band Activity: DISCUSSION
 What observations do you have about the actions
and behaviors in the role play?
 How does this scenario exemplify the process of
creating collaborations?
 Other questions?
Strategies for Relationship-Building
 Active listening
 Ask questions
 Be open to suggestions
 Willingness to learn new perspectives without
judgment
 Respect
 Focused body language or tone of voice
 Authentic desire for collaboration
Ugli Orange Case
(10 minutes)
 Pair up
 Negotiate and make the
best deal you can
 Choose carefully how
much information you
will reveal
Collaborative vs. Compromise
“Let’s meet both our
needs and interests.”
“Let’s split the
difference.”
Problem solving attitude
50/50 solutions
Sharing information
Nobody fully gets what
they want
Mutual satisfaction &
investment of time
Blaming and resentment
Principled Negotiation
 People: Separate the people from the problem
 Interests: Focus on interests not positions
 Options: Generate a variety of possibilities before
deciding what to do
 Criteria: Result based on a fair standard,
independent of either side
Seize the Day:
Recognizing and Maximizing an Opportunity to Collaborate
 Relationship between
individuals
 Willingness to
acknowledge historical/
cultural/organizational
back-stories
 Willingness to create a
new story
 Trust that everyone’s best
interest will be
represented
Q&A
Resources
 Substance Abuse and Mental Health Services
Administration – www.samhsa.gov/prevention
 National Institute on Drug Abuse – www.drugabuse.gov
 Foundation for a Drug Free World -
www.drugfreeworld.org
 National Multicultural Institute – http://www.nmci.org/
 Teaching Tolerance- http://www.tolerance.org/
Contact Information
Jane Goble-Clark, Executive Director
goble-clark@preventionservices.org
Office: 704.375.3784
Web: www.preventionservices.org