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Losing Generations: Adolescents in High-Risk Settings (1993)

Chapter: 10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES

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Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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10
Good Practice: Community-Based Interventions and Services

As detailed throughout this report, many of the major institutions, or settings, in which adolescents are growing up are unable to provide the guidance and support young people need for positive development. Policies that might change high-risk settings into ones that promote adolescent development have been neglected, and existing policies often diminish the viability of families and neighborhoods. The urgent need for increased support of the major settings of adolescent life as well as very basic changes within these institutions has been argued throughout the report. The primary institutions that serve youth—health, schools, employment, training—are crucial and we must begin with helping them respond more effectively to contemporary adolescent needs. Effective responses will involve pushing the boundaries of these systems, encouraging collaboration between them and reducing the number of adolescents whose specialized problems cannot be met through primary institutions.

Even if categorical systems become more effective, however, some adolescents will continue to experience problems that transcend the response capacities of primary institutions. For these adolescents and their families, specialized service programs may fill the gaps or compensate for failures in major life settings (Schorr et al., 1991). This chapter reviews the experience of service programs that attempt to meet the needs of adolescents experiencing complex, often health-or life-compromising problems. Information

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

for the chapter was developed through a special symposium held in New York City and attended by the directors of adolescent programs that are thought to be particularly successful in turning around the lives of young people who are caught in a web of failure. The panel also heard from a number of adolescents served by the programs. This chapter summarizes what was learned at the symposium as well as through our review of the growing literature on this subject.

There are numerous examples of locally designed and operated programs through which communities are beginning to address the risks that face many of America's adolescents. Many local efforts aim at supporting families and strengthening communities. The commonality among such efforts is that they seek to enable and empower parents and community residents to increase their capabilities to nurture young people. Communities have also implemented a range of innovative initiatives in response to the risks that often arise from service systems themselves. The innovative strategies, and the experiences of the local practitioners that created them, may provide models for national programs and policies in the years ahead. They certainly offer a rich lode of examples that should be drawn upon by primary systems as they evolve in response to current needs. All of the examples of "good practice" exhibit a number of common characteristics. First and foremost, their services for adolescents are comprehensive: the programs transcend categorical labels, organizations, and funding sources to bring together a coherent package of service to young people. Whether programs are offered in a single site or through interagency collaboration, the goal is to provide services that ensure that the emotional, recreational, academic, and vocational needs of adolescents are explicitly addressed. Comprehensiveness also means that these programs provide adolescents from high-risk settings with the developmental opportunities that are too often missing in their lives.

This chapter describes innovative programs in three broad categories: (1) strengthening families and communities; (2) improving institutional services; and (3) comprehensive service for adolescent development. We use the label "good practice" to identify those programs and interventions that have strong research and theoretical justification. Such judgments should also be supported by evaluation research, but few of the programs have been rigorously evaluated. In other cases, new evaluation methodologies must be developed that adequately assess the quality and outcomes

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

of multipurpose programs or comprehensive service systems (see Chapter 11).

STRENGTHENING FAMILIES AND NEIGHBORHOODS

Assisting adolescents requires attention to the settings—families and neighborhoods—that they experience on a daily basis. In good practice initiatives, community residents—both adults and, increasingly, adolescents—are viewed as integral resources who can contribute substantially to the change process. That is, good practice programs focus on the conditions for change—engagement and empowerment—rather than the problems per se of families, neighborhoods, and young people. They provide participants with legitimate opportunities to contribute in ways that are directly relevant to their concerns and interests.

Supporting Parents

If parents are not supported, they have a diminished capacity to support their children (Bronfenbrenner, 1978). In response to the conditions described in Chapters 3 and 4, many communities have implemented family support programs directed toward low-income parents. Such parents not only suffer from economic hardship, but also face additional challenges arising from the lack of personal networks—friends, coworkers, and extended family members—that contributes directly to emotional distress and continued isolation from the labor market (Cochran, 1990). Family support programs vary tremendously, but one common feature is an attempt to "extend" families by helping parents form both functional and emotional attachments to other parents. Most programs also have educational components, aimed at enhancing parenting skills, and many have training components to help parents enter, or progress within, the labor market.

Traditionally, family support programs focused on parent education, as in the case of Head Start, with the goal of teaching parents effective caregiving skills. Over time, the goals broadened to include a range of activities and strategies, the development of personal networks, and peer supports for childrearing and employment. Evaluation research indicates the potential strengths of family support programs: when programs are well implemented, they are found to enhance the emotional well-being of parents, broaden their social networks, and facilitate child development (Cochran, 1990; Kagan et al., 1987; Weiss, 1987).

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

There are an estimated 2,000 family support programs across the country, most of which are implemented by nonprofit organizations (Zigler and Black, 1989). Unfortunately, only a small minority provide family support for parents with adolescent children, especially those in high school, and these programs tend to be taught in class-like settings and aimed at middle-class families. Some of the more innovative programs not only focus on imparting caregiving skills, but also help parents cope with stress in their lives—such as fear for children's well-being—and difficulties in funding appropriate services for their children. Such programs help parents develop personal networks through which parents can help solve problems of guidance, monitoring, and communication (Small, 1990).

The increasing number of parents unable to care for their children has overwhelmed the child welfare system (see Chapter 9). Absent economic supports and employment training (which are often unavailable), a number of "family preservation" or "home-builder" programs seek to prevent the placement of children in foster care or other supervised settings. Typically, a trained case manager provides a family with intense short-term counseling and parent education, arranging for a broader spectrum of child welfare, health, and mental health services as needed. Evaluations of family preservation programs remain open to multiple interpretations, and their effectiveness is disputed. Some studies suggest that the program works better with families with young children, rather than families with adolescents (Rossi, 1991; Farrow, 1987).

Interagency collaboration is often necessary to provide comprehensive service to families and their children. In Ventura County, California, for example, a project seeks to strengthen families' ability to manage and to care for adolescents with behavioral and emotional disorders by linking schools and agencies that provide mental health services—welfare, juvenile justice, and health. Staff and funding are integrated across agencies to support the program, and case management ensures continuity of care. Evaluation indicates that the project decreased rates of out-of-home placement and facilitated earlier return of adolescents to their home and school when placement did occur: since 1985, out-of-county juvenile justice and social services placements have been reduced by 46 percent in Ventura County (U.S. Office of Technology Assessment, 1991).

Teenage mothers are often poor and lack the knowledge, skills, and social support needed to be good parents. Further, they commonly lack the education, training, and connections to employment

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

that would enable them to obtain jobs and become self-sufficient. One result is the high proportion of welfare dependency among adolescent mothers discussed in Chapter 2. Exemplary programs directed toward teenage mothers are therefore unusually comprehensive—seeking to impart the parenting skills discussed above, but also to assist the mothers over the numerous hurdles standing between them and self-sufficiency, such as job training, child care, and transportation. Some family resource centers—for example, those operated by Friends of the Family (Commission on Chapter 1, 1992)—have had some success in providing essential services in a single site and offering referrals for services that cannot be provided. Two exemplary programs—project Redirection and New Chance—have been successful in the complex task of arranging necessary services.

Project Redirection operated at 11 sites, delivering services to very low-income teenagers who were either pregnant or parents of young children. It linked participants with existing educational and support services in the community and also provided direct services, including parenting workshops, peer group support sessions, counseling, and mentoring. In a 5-year follow-up, Project Redirection participants had better outcomes than a comparison group on measures of weekly wages, welfare recipiency, and parenting skills. In addition, their children showed better cognitive skills and fewer behavioral problems. Nonetheless, disadvantage was still prevalent: fewer than one-half of the participants had completed high school, only one-third were working full time, and one-half were receiving Aid to Families with Dependent Children (AFDC) (Polit et al., 1985).

Building on the Project Redirection experience, New Chance offers similar services to highly disadvantaged young mothers. Rather than using a ''brokered service" or "case management" model, New Chance provides the majority of services in a program setting, with an emphasis on direct services to children in a developmental day care setting. Although studies of project effects are not yet available, lessons have been learned regarding the implementation of family support programs. For example, while the parenting programs are relatively easy to put into place, the implementation of employment and training and family planning components is more difficult. Participant absenteeism remains a significant problem, requiring extensive outreach with highly skilled staff (Quint et al., 1991).

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

Mobilizing Neighborhoods

Other local initiatives aim not to strengthen specific families, but instead, to rebuild and strengthen neighborhoods. This approach is based on historical evidence indicating that sustained change occurs most readily when local residents invest themselves and their resources in the effort (Cochran, 1990; McKnight and Kretzman, 1992; Davies, 1991).

Successful neighborhood mobilization has occurred through at least four mechanisms: (1) community organizing and development, (2) collaboration in service delivery, (3) the implementation of community-based programs, and (4) the involvement of families in school governance and instruction. Fundamental to each strategy is the importance of building on existing resources and engaging the people—adult and adolescent residents—typically excluded from such efforts.

Community organizing and development initiatives run the gamut from simple networking and coalition building to resource leveraging. The common focus is an effort to realign the political, financial, and institutional forces in neighborhoods. In the most distressed neighborhoods, there is often a need for residents to coordinate traditional grassroots organizing with larger initiatives in the form of community development corporations (CDCs). CDCs, often organized and funded by public-private collaborations, provide service not currently supported by government. For example, a CDC might undertake a housing rehabilitation program that renovates existing housing stock, which it then rents to citizens. Another housing program might seek to turn the program into a community-based effort that requires potential homeowners to participate in the renovation program in many ways, from management to remodeling (Leavitt and Saegert, 1989; Rivlin, 1991).

CDCs often seek to enhance the beauty and safety of neighborhoods as a strategy for retaining residents and businesses. In one area of New York City, for example, the Grand Central Partnership supplements municipal services with a 50-percent security force, a 40-person sanitation force, and an extensive program for homeless persons. Another partnership has renovated a major park in Manhattan, providing a place for adults and young people to relax and play in safety. Other CDC programs broaden the array of services available to parents through the provision of family support and education, child care, and after-school programs (Edelman and Radin, 1991; Leinberger, 1992).

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

Increasingly, programs for young people are also seen as an integral part of community organizing and development efforts. The rationale is two-sided: on one side, youth are viewed as a threat to the viability of housing and community cohesion; on the other side, young people are untapped resources for positive change and can often make irreplaceable contributions to their own neighborhoods. For these reasons, some CDCs operate day care, after-school tutoring programs, child-family activities, recreational programs, employment and training programs, and counseling (Sullivan and DeGiovanni, 1991).

The provision of services through collaboration between federal, state, and community-based entities is another method of neighborhood mobilization. Programs of the U.S. Office of Economic Opportunity were developed on this model. One barrier is that government agencies are hesitant to share authority with neighborhood residents, who are too often viewed only as prospective clients. Nonetheless, collaboration has long been the mechanism for delivering employment and training services, and in recent years similar programs have successfully delivered youth-oriented services traditionally provided by the police, justice system, social services, and health and mental health agencies (Spergel, 1976; Sauber, 1983; Eisenhower Foundation, 1990).

Collaborative or jointly organized services can offer tangible benefits not easily accomplished through more traditional modes. However, successful implementation demands concrete knowledge of the neighborhoods in which programs operate, including resource availability, past history and present conditions, income mix, and cultural norms and beliefs. Consequently, using neighborhood residents as professional staff and as members of governing bodies better ensures that the problems defined and the solutions offered are consistent with local conditions. Collaboration also appears to enhance the attachment of the involved adults to the neighborhood, and in some studies services have been provided more efficiently and with improved client outcomes (Camino, 1992; Cochran, 1990; Suttles, 1972).

It must be remembered, however, that the most beneficial effect of community initiatives is likely to be on the individuals involved in the effort. The tangible, but modest, achievements of CDCs benefit a small number of people and are easily overwhelmed by the major structural changes in neighborhoods as discussed in Chapter 4. We know far too little about the ecology of urban change—why certain neighborhoods implode into disorganization and disintegration while others do not.

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

As a response to the unsuccessful efforts of the juvenile justice system in decreasing crime and hostility, many community organizations have become directly involved in providing services to offenders. Often, community and justice system collaborations focus on juvenile restitution programs, in which young people are ordered by the court to pay restitution to their victims or to engage in community service to pay back the neighborhood. While these programs have benefits for young people and crime victims, their potential may be even greater as a vehicle for mobilizing neighborhoods.

In the Juvenile Justice Alliance in Oregon, government officials and community organizations have created a model for services to all young people. The restitution program, for instance, has led to coalitions between business and labor organizations, trained a large cadre of paid and volunteer staff, and developed ties to organizations not traditionally associated with juvenile justice or youth service, such as forestry, fish and game, and wildlife groups (Bazemore, 1988). Other interventions have focused on providing new opportunities for young people, mediating with schools and law enforcement agencies to change policies, and developing job and community service programs. On the whole, programs that emphasize advocacy and institutional mediation appear to be more effective than approaches based on mobilizing residents to provide traditional educational and social services (Fagan, 1987).

Community-based youth programs are often implemented to fill the void in adolescents' lives that results from extremely stressed families and to provide developmental experiences typically offered by schools, health programs, or employment training agencies. Such programs play a key role in development by giving young people a sense of membership, a chance to develop supportive relationships with a range of adults and peers, and an opportunity to develop functional and interpersonal skills necessary for healthy adolescent development (Pittman and Wright, 1991). Not surprisingly, community-based youth programs have been found to be an integral factor contributing to resiliency and positive self-identities among young people (Werner and Smith, 1982; Heath and Mclaughlin, 1991).

Viewed as neighborhood institutions, these diverse organizations—ranging in size from volunteer-run organizations to multimillion-dollar entities—can collectively provide young people with a critical array of opportunities and services, as well as a place to form interpersonal relations with adults and peers. Because community-based services typically make little or no distinction between

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

clients that are served, they are able to implement programs that remove stigmatizing distinctions like "undeserving" or "high risk." Often staffed by neighborhood residents and volunteers, these programs have sought to fill the gaps by providing services not extensively supported by government and not readily available elsewhere: group counseling, life-skills training, family counseling, substance abuse education, and supportive services for abused children (Sauber, 1983; Pittman and Cahill, 1992; Independent Sector, 1992; Littell and Wynn, 1989; Wynn et al., 1987). They can also serve as protective institutions that promote adolescent development and prevent entry into the child welfare and criminal justice systems (Bronfenbrenner, 1979; Garbarino, 1985; Pittman and Wright, 1991). Neighborhoods can also be directly strengthened through the contributions of young people. Community action youth programs demonstrate the value of using local residents in the effort to rebuild neighborhoods. In El Puente, for example, they have initiated a recycling program, formed an advocacy/action group ("The Toxic Avengers") to oppose the concentrations of toxic wastes in their neighborhood, established an AIDS education drama group, and conducted a measles immunization campaign. At YouthBuild, participants have organized a construction company that renovates city-owned buildings and are developing a local child care center. In other programs that employ youth service, youth are conducting community needs assessments, renovating housing, serving as tutors, and providing service to elders, to list only a few examples (Nathan and Kielsmeir, 1991; Quinn, 1992).

The school building is an integral part of all communities. Not only is it the setting in which the majority of young people spend each day, but ideally, it is also a place where parents, other neighborhood adults, and service providers can form personal relationships and collaborate in the change process. Hence, changing schools can help strengthen neighborhoods. Furthermore, the active involvement of parents can help to transform the culture of the school itself (Lightfoot, 1975; Davies, 1991). Family involvement in all phases of schooling—from governance to the instructional process—provides direct mechanisms of parent empowerment.

Several recent initiatives seek to engage parents and school staff in a collaborative efforts:

  • The social development model creates organizational structures whereby stakeholders (students, parents, teachers) meet on a regular basis to make decisions regarding the climate of schools,

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

with an emphasis on ensuring that the academic and social needs of all students are explicitly addressed in all school activities (Comer, 1988).

  • In the accelerated schools model, school stakeholders collaborate in creating school structures and instruction consistent with "new" school norms, with an emphasis on reflection, trust, risk taking, and communication (Levin, 1987).

  • The schools reaching out model emphasizes experimentation and "participatory inquiry" among stakeholders, aimed at identifying the major barriers to quality education in schools, and developing consensus and plans to address priority issues (Davies, 1991).

Moreover, family involvement has direct benefits for students. Program evaluations consistently find that such involvement enhances the academic achievement of students, particularly when parents take an active role as classroom tutors or engage in structured home-based instruction that is complementary to, and reinforces, classroom instruction (Epstein, 1991a; Swap, 1990; Eastman, 1988).

Regardless of the type of involvement, schools must confront the fact that low-income and minority parents are often isolated from and distrustful of schools. In part, this lack of involvement is because it is difficult for parents to arrange for child care for younger children or time off from work. But it also stems from the structure of schools: teachers are granted little time to work with parents and are given little training to learn how to engage parents. It is also due in part to explicit and implicit messages from the school that parents are not welcome (Lightfoot, 1975; Lareau, 1989; McLaughlin and Shields, 1987; Slaughter and Schneider, 1986; Boutte, 1992).

Yet for each of these barriers, many communities and school districts have implemented programs with demonstrated effectiveness. A fundamental ingredient for success is that schools must create opportunities for partnership—teachers need time for collaboration, and principals need to instill an organizational ethos that encourages the development of sustained relationships. For example, studies of Chapter 1 and Head Start have shown that teachers and parents will engage in governance activities if they are given genuine opportunities to participate in key decision-making forums. Studies of home-school partnership consistently demonstrate that parents will become involved if teachers expect participation and provide parents with sufficient interpersonal and

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

technical support (Epstein, 1991b; Zeldin, 1990; Krasnow, 1991; Swap, 1990).

IMPROVING INSTITUTIONAL SERVICES

In this section we highlight some good practice initiatives—in the areas of health, education, and employment training—that seek to replace current institutional practice with alternatives better suited to the developmental needs of adolescents.

New Settings for Health Services

The U.S. health system, built around and financially sustained by the treatment of pathology and physical disorders, provides strong incentives for service to be provided in traditional settings, such as hospitals and physician offices. But these settings are not well suited to the provision of comprehensive health services and are often inaccessible for low-income adolescents and their families. A number of communities have attempted to fill this gap by developing alternative school-and community-based centers—some are linked to and supported by hospitals, others are freestanding.

There are only about 400 school-linked health programs in the country, which serve less than 1 percent of all adolescents. School-linked health centers convey a number of benefits. They are readily accessible and provide a confidential setting in a familiar environment, and they integrate health and education to promote preventive interventions. Sports and health examinations and immunizations are often the most frequently offered services. School-linked health centers rarely provide contraception or refer pregnant teenagers for abortions; reviewers often note that the weakest components of school-based adolescent health centers are their family planning programs (Kirby and Waszak, 1989; Dryfoos, 1988; Levy and Shepardson, 1992).

Research indicates that the centers reach a large percentage of the student population in the schools where they are located and that they identify significant numbers of untreated or unrecognized health conditions. Some centers have demonstrated positive effects in delivering preventive services with measurable outcomes, such as reduction in pregnancy rates, delay in onset of sexual activity, increased contraceptive use, and improved school attendance (Dryfoos, 1990; Packard Foundation, 1992).

The heaviest demand on school-linked health services is for individual counseling to address adolescent depression, stress, and

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

substance use. However, the lack of insurance coverage for these conditions means that most centers can only provide crisis intervention and short-term treatment. In response, some schools are forming collaborative programs with local family support and mental health services to provide counseling and early intervention services to students, both self-referrals and those identified by teachers. Because the centers value confidentiality and are easily accessible, they are able to provide preventive services to many young people who would otherwise not have them (Lorian et al., 1984; Orr, 1987; Millstein, 1988; G. Reynolds, 1991, personal communication; A. Shirley, 1992, personal communication).

Community-based multiservice centers (e.g., drop-in centers, life options centers, community clinics) provide access to both in-school and out-of-school young people. Community centers are accessible to dropouts and are not subject to school regulations, but they are not linked to a primary institutional base. They are able to consolidate and link services, however, and they often use an array of creative strategies to make services attractive, relevant, and developmentally appropriate for youth. At the highly regarded New York City programs, The Hub and The Door, for example, health services are supplemented with peer-based interventions and supports, mentoring, and classes in the arts, life skills, and job and career training.

The greatest strength of community-based centers is their emphasis on outreach. The most vulnerable teenagers are often isolated, living either on their own or in dysfunctional family settings. Such youths are unlikely to engage the health system, through either a school or community clinic; street-based outreach is the most effective means for reaching them. However, this strategy for adolescents from high-risk settings requires aggressive outreach by talented providers who know and are trusted in the community; see, for example, Joseph (1992) on outreach programs for adolescents at risk for HIV infection (also, K. Hein, 1991, personal communication). For example, midnight basketball leagues in New York appear to be effective settings for conducting outreach to populations at risk for health problems (M. Cahill, 1992, personal communication). Regardless of the setting in which service is provided, however, five strategies appear most effective in ensuring accessibility and outreach (H. Spivak, 1992, personal communication):

  1. modifying hours of operation to include service after school and in the evening;

  2. locating services in settings familiar to youth;

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×
  1. having a culturally diverse staff;

  2. developing collaborative outreach and service provision efforts between health institutions and other settings, such as courts and police, public housing corporations, youth centers, recreation programs, and schools; and

  3. consolidating services into comprehensive, multiservice environments.

New Academic Approaches

Perhaps the most important step in fostering adolescent development and achievement is the improvement of education. Beginning with A Nation at Risk (National Commission on Excellence in Education, 1983), there has been a stream of highly negative assessments of the education system. Schools have responded by broadening the range of programs that they offer. Indeed, the education system is becoming the dominant setting for preventive health services, as well as for substance abuse prevention, sex education, and violence prevention programs. The call for greater emphasis on basic skills has led to broader requirements for courses in math, reading, and science. Increasingly, schools are integrating "work-readiness" components into their curriculums. Many schools have also sought to improve accountability and performance from principals, teachers, students, and parents: for example, schools are beginning to implement policies of school-based management, parent choice, and common curriculums as mechanisms for accountability and vehicles for change.

Changes in policy are important only if they contribute to more effective school and classroom environments in which students are strongly motivated to work hard at challenging learning tasks. As yet, there has been relatively little national attention to issues of school organization and instruction, although these are clearly critical to schools' effectiveness. Research shows that fundamental instructional practices—ability grouping (tracking), grade retention, Chapter 1 programs, categorical dropout prevention programs—create many disadvantages for low-achieving students and have not been effective in improving academic achievement among such students.

Some school districts are implementing alternatives to these practices, many of which have empirical support, and others that are justified by research on student learning and motivation. The common denominator is an effort to provide quality programming for low-as well as high-achieving students. Specifically, explicit

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

efforts are made to ensure low achievers are afforded the caring teachers, energetic instruction, and high expectations for success that have traditionally been principally offered to higher achieving students. In so doing, they create a positive setting for learning and growth.

In some schools, rigid forms of tracking have been replaced with a mix of heterogeneous and "accelerated" classes that provide extra assistance from the school's most accomplished teachers. One example is for ability grouping in only one or two subjects, with the rest of the student's program occurring in heterogeneous classes. Instead of attempting to fine-tune track assignments into the most homogeneous groupings, other schools use broadband groupings that separate only the students at the extremes of ability (Oakes and Lipton, 1992; Newmann and Thompson, 1987; Cohen, 1986).

Because being retained in grade is one of the most stressful experiences for students, with clear negative effects on subsequent achievement, some schools have implemented alternatives to traditional grade retention practices. Other models allow students to advance in grade level while concurrently taking "bridging classes" and receiving extra help to make up deficiencies (Goodlad and Anderson, 1987; Slavin, 1990; Braddock and McPartland, 1992).

Chapter 1 and dropout prevention programs are the traditional means for providing extra assistance to the most needy students. However, they are often de facto lower tracks for students who have been retained. There are alternative strategies that do not require tracking and that have been found to produce less grade retention and higher achievement. For example, some schools form interdisciplinary teacher teams that allow scheduled time with small groups of "remedial" students. Other schools use peer tutoring or direct tutoring by teachers during scheduled periods (MacIver and Epstein, 1991; Lloyd, 1978; Kelly et al., 1964; Madden et al., 1991; Hedin, 1987; Cohen et al., 1982).

Other models provide extra assistance through methods that allow students to remain in their regular classrooms. Some programs use instructional strategies that allow all students to learn common course contents; others use multiple textbooks and instructional methods to accommodate different learning styles (Epstein and Salinas, 1991; The Civic Achievement Award Program, n.d.; Levin, 1987). Less frequently, students are given options as to the type of extra assistance they receive, a strategy that appears to be successful in enhancing the student's motivation to engage in the learning process (Treisman, 1985; Ascher, 1991).

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

Finally, some schools are replacing traditional Chapter 1 ''pullout" programs and dropout prevention programs with initiatives that seek to avoid labeling and further isolating low-achieving students by instead implementing schoolwide programming for the benefit of all students. The most promising programs directly address student motivation by complementing traditional instructional strategies with more diverse pedogogies, including experiential and cooperative learning. Explicit efforts are made to ensure that instruction is directly relevant to students' interests and concerns (LeTendre, 1991; Massachusetts Advocacy Center and Center for Early Adolescence, 1988).

A positive school climate—one in which students feel "membership" in their schools and in which they perceive that teachers care about them as individuals—is considered a prerequisite for student engagement in either academic or vocational learning. The large size of many high schools is seen as a strong institutional barrier to a positive school climate. In large schools, teachers are most likely to form close supervisory relations with only the most accomplished students, while others (most often minority students and low achievers) remain isolated from ongoing adult attention (McPartland, 1990, 1991; Bryk et al., 1990; Powell et al., 1985).

Available evidence indicates that low-achieving students are most likely to prosper in smaller schools. Accordingly, some districts have created alternative schools and schools-within-schools to make schools feel smaller. Alternative schools, which are usually much smaller and more student oriented than the typical comprehensive high school, have been found to be effective with many students who would otherwise have dropped out (Wehlage et al., 1989; Gold and Mann, 1984; Glatthorn, 1975; Garbarino, 1980). The Bronx Regional High School (New York) provides one of the most inspiring examples of success, educating a student body composed exclusively of students with serious behavior problems and a record of academic failure. The success of the program is built on respecting the students, challenging them to succeed, and providing the individual level of attention that they need. The success of Job Corps and of vocational academies is attributed, in part, to the fact that academic instruction is provided in smaller, independent learning centers (Mangum, 1987; Dayton et al., 1992).

Other schools have implemented alternatives to departmentalized staffing as a strategy for making a school smaller and more personal, and approach that may be especially effective for minority

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

students. There is some evidence that achievement may be fostered by specialist teachers, but other research indicates that student motivation may be so tightly tied to relations with teachers that they actually have greater achievement and improved social behavior with fewer teachers (Bryk and Driscoll, 1988; Becker, 1987; Massachusetts Advocacy Center and Center for Early Adolescence, 1988; Gottfriedson and Daiger, 1979; Wehlage et al., 1989). Most schools seek to find a balance. Some schools use only two or three different teachers covering all subjects for each student, a strategy seen especially valuable in helping young people succeed in the difficult school transitions—from elementary school into middle school and from middle school into high school. The more common strategy is to implement programs of interdisciplinary team teaching. Teams of four teachers covering each of the major subjects share the same four classrooms of students, with regularly scheduled team time to address individual student needs and with each adult team member having special responsibilities for a homeroom subgroup, including providing students with extra help.

Vocational Education and Employment and Training Programs

As discussed in Chapter 7, the United States does not have well-articulated school-to-work transition programs for adolescents who do not enter college, enter technical training programs, or join the armed services—in other words, for a majority of the young people leaving high school each year. One consequence is that many adolescents move into the labor market without adequate training or experience. Many experts believe that more uniform and integrated school-to-work transition systems are needed (Hahn, 1991; Nothdurft, 1990; Hamilton, 1990). In the absence of national policy support and guidance, many schools and communities have begun to develop alternatives to existing vocational education and employment and training programs, and in doing so, have begun to create their own systems.

Most students in vocational programs and Job Training Partnership Act (JTPA) programs have few opportunities to test their skills on the job. Employers have limited opportunities to work with prospective employees. In response to this lack of connection, the most innovative local initiatives in vocational education are designed for employers to provide supervised work experience to young people. In some models, complementary academic instruction is provided by the school.

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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In cooperative education programs, there are agreements between a school and a cooperating employer. In general, both schools and employers offer close supervision to students and ensure that the student engages in relevant classroom instruction and meaningful work experiences. Cooperative education programs have been shown to enhance high school graduation rates and the postsecondary education enrollment. And, of all vocational programs, participants in cooperative education are most likely to gain permanent employment in an area for which they were trained (U.S. General Accounting Office, 1991; Hamilton, 1990).

Apprenticeship models are another strategy for integrating work experience with academic instruction. During the late 1970s, the U.S. Department of Labor funded eight school-to-apprenticeship programs, some of which continue to operate. These programs are similar to cooperative education: the primary difference is that students in the apprenticeship programs are primarily engaged in the building trades, with the expectation that they become registered apprentices at the completion of their schooling. Interpretations of evaluations range from positive to "spotty" (U.S. General Accounting Office, 1991; CSR, Inc., 1981; Siedenberg, 1989).

More recently, a small number of school-based apprenticeship programs have been implemented. Their fundamental characteristic is that progressive instruction is provided for a minimum of 3 years. In general, schools release students for about one-half day to engage in their apprenticeship; they also provide opportunities to students to relate their work experience to their academic classes, for example, by assigning special projects. These programs differ from traditional apprenticeship programs in that they are not concentrated in the building trades, and students are not necessarily expected to take full-time work at the completion of the apprenticeship. After graduation, students are given several options, including full-time work, contingent on good performance, and opportunities to enter postsecondary education while continuing the apprenticeship (Hamilton and Hamilton, 1992a; Hoyt, 1990, 1991; Lerman and Pouncy, 1990; Hamilton et al., 1991).

In lieu of providing young people with structured work experience, many schools have opted for modifying instructional approaches, with particular emphasis on improving vocational education. Some efforts aim to integrate academic and vocational instruction by incorporating academic concepts into vocational programs or by coordinating the academic and vocational curriculum so that students are provided with complementary instruction

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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in both settings. Either way, many models are currently being implemented.

In recent years, curriculums have been designed that seek to foster work-oriented competencies in the context of academic course offerings (U.S. Department of Labor, 1992). The goal is to deemphasize essays, book reports, and research papers in favor of brochures, memorandum, advertising copy, and planning documents, while at the same time, providing a traditional liberal arts education that focuses on general competencies and an appreciation of learning through exposure to course content that is often independent of explicit occupational purposes (Grubb, 1992; Nothdurft, 1989). Alternatively, other schools are beginning to consider vocational education as an alternate route for academic instruction. In some programs, for example, students learn academic concepts through problem-solving activities: geometry can be taught as part of a curriculum on carpentry; physics and reading can be taught through curriculums on automotive repair or plumbing (Brandt, 1992).

A fundamental barrier to these initiatives is that they often require schoolwide changes not only in the vocational curriculum, but in the academic curriculum as well, and such reforms are often poorly implemented (Grubb et al., 1991; Rosenstock, 1991). There are few systematic evaluations, but some research indicates that the most successful programs concentrate resources in a single setting, such as a specialized high school or a regional vocational center, that allows educators to provide integrated and progressive learning experiences to young people—similar to the approach used in core academic courses (Goodlad, 1984; Wirt, 1991; Hamilton, 1990; Bishop, 1989). For example, secondary school "vocational academies" are one of the few models of vocational education that consistently has positive outcomes in terms of increasing graduation rates, enrollment in postsecondary education, and earnings. Organized as schools-within-schools, staffing for these academies often consists of three academic teachers and one vocational teacher who stay with cohorts of students for 2 or 3 years. They focus on a specific field (e.g., health, electronics, business), building field-specific vocational courses around a core of academic courses (Grubb, 1992; Hayward et al., 1988; Dayton et al., 1992).

Many of the themes reflected in good practice in vocational education have been adopted by recent initiatives in employment and training programs. There is an emerging consensus that academic instruction is necessary to supplement traditional occupational training and job placement services. And while basic education

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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currently constitutes only a small component of JTPA programs, recent demonstrations reverse this emphasis: for example, in JOBSTART, each participant is required to take at least 200 hours of basic skills remediation. In the Summer Training and Education Program (STEP), participants hold half-time jobs, with the rest of the day spent in basic skills remediation (Public/Private Ventures, 1987a; Cave and Doolittle, 1991; see also Chapter 7). Experience in these innovative programs suggests that a range of services is necessary for positive results. For example, some evidence supports the combination of early work experience with job training, the inclusion of remedial education in the array of services, and the combination of self-directed job search strategies and job placement programs. The program with the strongest positive effects—Job Corps—provides basic skills training, work experience, occupational training, and job placement services (Bailis, 1991; Carnevale, 1991; Hahn, 1991; Grant Foundation, 1988; U.S. General Accounting Office, 1991; Public/Private Venture, 1987b). Because participants are at high risk for dropping out of school or not sustaining participation in employment and training programs, for example, outreach and case management are essential components. Employment programs that incorporate counseling, peer group supports, and mentoring components are increasing. The actual quality and mix of such services vary widely, however, and often they remain secondary or are offered only on a referral basis. To be effective, programs need to view them as essential components, of a level of importance comparable to the core employment services that are traditionally provided (Public/Private Ventures, 1987c). Although the need for comprehensiveness has been well understood since the 1960s, such programs have high front-end costs, and resources have rarely been available to support them. As a result, the overwhelming majority of programs have been narrowly focused.

Finally, the stigma attached to employment and training graduates has led other programs to take actions to inform potential employers about the skills and motivation of participants. Other approaches include "job portfolio" program components that provide graduates with a "credential" listing their special strengths, accomplishments, skills, and references; such programs have had promising effects (Charner, 1988; Stemmer et al., 1992). Career Beginnings provides participants with instruction in self-directed job search strategies; so does Jobs for America's Graduates, in which staff help participants secure their first jobs and then provide

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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ongoing case management assistance to help them retain those jobs (Cave and Quint, 1990; Jobs for America's Graduates, 1989).

KEY ELEMENTS OF COMPREHENSIVE SERVICE

Researchers and practitioners agree that adolescents (as well as families) in high-risk settings require comprehensive services, but there is less agreement regarding the most useful conceptualization of comprehensive services. In general, however, "comprehensive" highlights the emerging consensus that rather than offering a single type of service or adopting a single categorical program goal (e.g., substance abuse prevention, school retention, family counseling), programs should offer a range of services and have multiple goals. (Indeed, almost all of the programs cited in this chapter are comprehensive.) This perspective reflects the well-documented finding that adolescents who engage in one type of problem behavior often concurrently engage in others. It suggests that, to the extent possible, all needed services should be offered in a single site or at least under a single administrative structure. Not all comprehensive programs, however, are implemented within single sites by single agencies. More recently, some programs are comprehensive by virtue of integrating program components provided by different service entities. Regardless of the structure, the goal of comprehensive service delivery systems is to transcend categorical labels, organizations, and funding sources to bring together an appropriate package of service that is easily accessible to young people and their families.

Current national policies are not supportive of comprehensive service: almost all federal and state funding is allocated by "problem" to designated agencies responsible for designated services (Dryfoos, 1990). In the absence of policy support, an increasing number of communities have taken the initiative, sometimes supported by public and private funds, to implement comprehensive programs. Schools are often the settings for comprehensive services because almost all children use them, at least initially. Other sites are also being used successfully, including housing projects and community centers. "Second-chance" employment demonstrations, school-linked health and mental clinics, family resource centers, street-based clinics, community-based youth development programs, and the Cities in Schools models are just a few illustrations of comprehensive programs. These initiatives have had documented success in increasing the accessibility and use of available services by adolescents from high-risk settings, but there is a paucity

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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of evaluation research that identifies the outcomes of that use.

In this section, we highlight four cross-cutting program strategies that appear particularly important for adolescents from high-risk settings—independent of institutional setting: (1) sustained adult support, nurturance, and guidance; (2) opportunities to become involved in the community through structured community learning and service experiences; (3) opportunities to engage in structured experiences, including cooperative activities with peers, aimed at learning how to cope productively with the stress and pressures emanating from high-risk settings; and (4) demonstrations of respect and trust from adults, by having choice and "voice" within programs, and by learning about and experiencing different cultures and traditions.

Sustained Adult Support

Perhaps the most serious risk facing adolescents in high-risk settings is isolation from the nurturance, safety, and guidance that comes from sustained relationships with adults. Parents are the best source of support, but for many adolescents, parents are not positively involved in their lives. In some cases, parents are absent or abusive. In many more cases, parents strive to be good parents, but lack the capacity or opportunity to be so. In response, mentoring and case management are becoming an essential element of most programs; additional services are needed for adolescents in transition from the foster care system.

Mentors, in the traditional sense of the term, are adults, typically unrelated volunteers, who assume quasi-parental roles as advisers, teachers, friends, and role models for young people. Mentors are often expected to be confidants and advocates and, in some programs, to develop collaborative relations with parents and school staff. The empirical foundation for mentoring programs stems from the literature on resiliency, which indicates that a key factor in successful adolescent development is the presence of a sustained and nurturing relationship with adults (Garmezy, 1987; Rutter, 1987). Evaluation data are scarce, however, primarily because most research has examined the effects of mentoring within the context of other program services (see below).

Most recently, mentoring programs have been used as a vehicle for preventing teenage pregnancy and delinquency and as a means for addressing isolation in high-poverty neighborhoods. Young males from poor families are a particular focus, because they are

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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less likely to maintain sustained participation in pregnancy prevention and employment programs. Other mentoring programs seek to reduce the isolation of young people from the labor market by matching older adolescents with community adults who hold positions of authority in business and government (Mincy and Weiner, 1990; Dryfoos, 1990; Children's Defense Fund, 1988; Mentoring International, 1989).

It is questionable if mentoring programs can replicate the parent-adolescent relationship, and few programs have that expectation. However, mentoring relationships with young people can be effective if they extend over time and if mentors themselves have clear goals, adequate training, and adequate support from the sponsoring organization. These requirements create a dilemma: as the number of young people who need mentors increases, the demands on mentors to be "full-service providers" makes it increasingly difficult to enlist volunteers. Because of this dilemma, perhaps the primary goal of "freestanding" mentoring programs should be to help young people build competencies. Other positive outcomes—such as trust and close affiliation—are likely to surface as a result of the skill-building process (Hamilton and Hamilton, 1992b; Roche, 1979).

Even under the best of circumstances, it is difficult for parents to connect their children with necessary educational and service programs. In other cases, parental involvement may not be appropriate or desired by adolescents who must arrange services on their own. In response, many programs have found it necessary to implement extensive case management services.

Most often, case managers (also known as counselors, advocates, or mentors) work directly with adolescents to arrange service delivery. In most community-based youth development programs, such as The Door and El Puente, young people are given a primary counselor or mentor immediately on entering the program. Some schools have found that the traditional school counselors fail to meet the needs of at-risk youth and so are institutionalizing alternative methods of providing youth with close personal relationships. At the South Brooklyn Alternative School, for example, every staff member is assigned as a "counselor-advocate" for specific students (Pittman and Cahill, 1992).

The use of case managers is well established in programs for teenage mothers, for whom there is a need for interagency coordination and flexibility. In the Teenage Pregnancy and Parenting Project (TAPP) model, for example, the counselors are not tied to any particular service delivery system, but help link clients with

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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a broad array of programs, including school, social, nutritional, employment, obstetrical, public health services, and infant day care. The counselors, primarily social workers, also provide counseling and conduct follow-up to ensure that clients received services. In comparison with national and local norms, TAPP clients had fewer repeat pregnancies, stayed in school for a longer period after delivery, and had fewer low-birthweight babies. Clients who maintained consistent contact with their counselors generally had the most positive outcomes (Brindis et al., 1987). Another program, the Adolescent Pregnancy and Dropout Prevention Model, has reported an 88 percent school retention rate among teenage mothers served in the program. Success appears in part to be due to the case managers, who meet with teenage mothers on a regular basis to inform them about academic alternatives, help them identify job interests, and arrange for tutoring and home teaching (Earle, 1989).

Other programs rely on case management as an integral strategy to prevent entry into the justice and foster care systems. The Adolescent Diversion Project (ADP), for example, focuses on youth who have already committed delinquent acts but have not yet been formally adjudicated. The ADP is designed to develop empowerment skills in young people and their parents by building on the personal strengths existing within their families. The instrument for change is an extensively trained family worker (university student or community volunteer) who spends 3 hours per week with the assigned youth for 4-5 months. Evaluation results showed less recidivism among ADP participants than among other delinquent adolescents (Davidson and Redner, 1988).

The effectiveness of case management depends on case managers who can work across service domains. Whether directed at parents or at-risk youth, case management is a difficult and labor-intensive service. Because of the heavy demands on their time, case managers in all programs report that caseload size is a major barrier to performance. For those who work across agencies, confidentiality of information is often a problem. Finally, case managers must confront the lack of available services: adequate child care, housing, and employment opportunities remain limited, despite the best efforts of case managers (Brindis et al., 1987; Quint et al., 1991).

Adolescents in foster care face special barriers to making a successful transition into young adulthood. All have experienced the effects of severely troubled families, and many have spent their childhoods in many homes. They often need sustained emotional

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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relationships with adults, as well as counseling or mental health services. The availability of an individual who provides continuous care and attention to the adolescent for an extended period of time is especially crucial as part of planning "discharge" from foster care.

Ideally, discharge planning, a process that engages the adolescent and all guardians as full participants, should begin well before age 18, both to ensure that adolescents develop necessary skills and to arrange necessary support services. In the most comprehensive models, child welfare agency staff serve as case managers who coordinate with government agencies and community-based youth programs to ensure the availability of counseling, recreational, and competency-building services, and often to arrange transitional housing as well (Merry, 1987; Spergel and Hartnett, 1990).

Community Learning and Service

One of the realities of daily life for adolescents from high-risk settings is impoverished neighborhoods—neighborhoods that lack recreational and employment opportunities, safety, and many role models of successful adults. Such adolescents often develop feelings of alienation and hopelessness; they do not develop feelings of caring or attachment to their neighborhoods. In response to this situation, many programs have begun to incorporate community learning and service into their array of services.

Empirical and evaluation research supports this approach. A broad body of literature indicates that community participation—in the form of community service, internships, and experiential learning—has measurable effects on young people in terms of preventing problems and in promoting competencies and achievements. For example, there is evidence that community learning and service programs enhance attachments to neighborhoods. That is, in well-designed programs, young people have been found to develop a greater interest in local issues and a perceived competence that they can bring about change (Hamilton and Zeldin, 1987; National Task Force on Citizenship Education, 1977; Calabrese and Shumer, 1986; Newmann, 1975).

Community learning and service can also be considered an alternative pedagogy to assist young people to develop a range of competencies. For example, planned community experiences have been found to promote gains in basic academic skills (Agnew, 1982; McKensey and White, 1982; Hamilton and Zeldin, 1987;

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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Rutter and Newmann, 1989). Other studies indicate that youth with structured community experiences and service show greater increases in problem-solving skills, personal and social responsibility, and earnings, and in accepting attitudes toward those different from themselves (Conrad and Hedin, 1982a,b; Hamilton, 1980; Hamilton and Fenzel, 1988; Bucknam and Brand, 1983).

Developing Emotional Strengths and Life Skills

Young people from high-risk settings often need special services to confront the emotional pain and feelings of hopelessness that can interfere with positive development. Some community programs are implementing interventions that facilitate collaborative peer group relations so that young people can learn from, and support, each other. Other programs are providing structured opportunities for young people to practice and develop the social, decision-making, and life skills necessary to succeed in high-risk settings.

An emerging body of research indicates that various forms of peer counseling and instruction, when conducted with adult guidance, can serve as supports for coping with the influences of high-risk settings. For example, the Teen Outreach program combines volunteer community service with after-school group counseling sessions to help young people confront the stress in their lives. A 3-year evaluation indicated that Teen Outreach participants had fewer pregnancies and were less likely to drop out of school or get suspended than a comparable group of students. Benefits were greatest for those at greatest risk and were related to the number of volunteer hours worked and attendance at the counseling meetings (Philliber et al., 1988). In the Teen Choice program, social workers staff three components: small groups, individual counseling and referral, and classroom dialogues. This approach has also had success in increasing contraceptive use among young people (Stern, 1988).

The power of peer counseling and group discussion have also been demonstrated in the use of high school curriculums on substance abuse and violence prevention. An analysis of drug prevention programs found that, of five approaches examined, peer programs were the most effective on all outcome measures, especially on indices of actual drug use (Tobler, 1986). In violence prevention programs, staff seek to create a process by which young people discuss and analyze violent behavior and identify and practice alternative behaviors to deal with their anger. Simulations

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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and group feedback allow participants to respond to their peers regarding their behavior. Preliminary studies are encouraging, particularly with respect to young people with the highest number of risk factors (Spivak et al., 1989; Education Development Center, 1989).

Similarly, cooperative learning is being used to transform classrooms into settings in which students collaborate to achieve learning goals. Data generally support this approach, which is used extensively in elementary grades and often in middle grades. It is ironic that cooperative learning is not widely adopted in high schools, where student responsiveness to peer group pressures is even stronger than at younger ages (Johnson and Johnson, 1987; Slavin, 1990; Braddock and McPartland, 1992).

Most programs for at-risk youth focus on preventing problem behaviors; less attention has focused on building the emotional strengths of young people. This approach has led to prevention programs that try to scare young people, ask them to ''just say no," or disseminate didactic information. But studies consistently find that these traditional strategies of problem prevention (of substance abuse, sexual activity, violence) have little or no positive impact, especially when they constitute the primary program intervention, and they may even stimulate further acting out (Dryfoos, 1991; Falco, 1988; Hayes, 1987).

The history of failure among prevention programs has led some service providers to develop alternative strategies. There is an emerging body of research indicating that programs that try to strengthen adolescents' coping, decision-making, and assertive skills lead to better outcomes. These programs—grouped under the label of "social and life-skills training"—help adolescents to identify and resist the social pressures that encourage problem behaviors. The most successful programs have taken a progressive approach, first teaching adolescents strategies to address general life dilemmas and then focusing on coping with the specific pressures to use drugs or engage in sexual activity. Most programs develop activities to promote responsible behavior as a step toward future abstinence. Other models shown to be effective are peer taught, use older adolescents or young adults as role models, include media analysis, and make counseling available for those with special needs (Tobler, 1986; Hansen et al., 1988; Stringham and Weitzman, 1988).

Social and life-skills training programs share many features of current "social competence promotion" or "mental health promotion" programs. In general, the programs that demonstrate positive

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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outcomes seek to help adolescents develop an overall sense of well-being, flexibility in dealing with stress, and a repertoire of behavioral skills needed to solve both interpersonal problems and problems of daily living. Most of these programs are integrated into school curriculums, and involve between 8 and 20 sessions conducted by teachers with special training. The programs combine informational and experiential activities, complemented by group discussion and counseling. Early evaluations indicate that these programs are successful in improving adolescents' impulse control and self-identity, ability to understand the perspective of others, ability to solve problems, and school performance (Elias et al., 1986; Weissberg et al., 1988; Felner and Felner, 1989).

Demonstrating Trust and Respect for Adolescents

Explicit in good practice models is the recognition that young people, like all people, need to feel a sense of comfort and need to be offered a sense of autonomy in order to profit from program teachings and experiences. For this reason, many community programs seek to design programs that encompass principles of trust and respect for young people. Consistent demonstrations of caring and high expectations for young people are a prerequisite. Many programs are also providing young people with choice and "voice" regarding program operation, and, in response to the racial and ethnic diversity of adolescents, many practitioners incorporate cultural traditions and values into programs.

Choice and "Voice" for Adolescents

Personal attachments to institutions and engagement in program activities occur most readily when participation is voluntary or when individuals have options about how and when to participate (Newmann, 1981). Many school-linked health centers, for example, attribute their effectiveness to the fact that participation is voluntary, discussions are confidential, and young people are encouraged to bring friends along for support. Few youth development programs have enrollment requirements, so young people can immediately participate in activities. Adolescents are given choices about participation in the activities: a "drop in, test things out" approach is essential to effective programming. The almost universal use of small groups, flexible grouping practices, symbols of membership (uniforms, T-shirts), and clear structures (regular meetings, codes of conduct) reflects an organizational and

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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programmatic recognition of the importance of group membership. Not surprisingly, adolescents in high-risk settings are most likely to identify community-based youth programs as their major source of institutional attachment (Pittman and Cahill, 1992; Heath and McLaughlin, 1991).

Youth development programs also use their institutional advantage to allow young people to participate in program decision making. In many programs, adolescents are given the responsibility of developing, implementing, and enforcing rules regarding drugs, violence, and conduct. Similarly, most community-based youth programs provide opportunities and expect adolescents to take responsibility for themselves and for others. For example, in The City, Inc., an alternative school and youth program, participants decide how to address problems when their peers break established rules (Pittman and Cahill, 1992). In the Youth Action Program (which provides job training and education for young people from poor neighborhoods), the youths participate in every level of program governance, from staffing and budget decisions to program and policy initiatives. Similarly, in a program sponsored by the Kalamazoo Youth United Way, participants conduct needs assessments, raise money for youth programming, and then decide how and where to expend the money (The Union Institute, 1991).

It is more difficult to promote institutional membership in schools, since attendance is mandatory. Nonetheless, evidence suggests that teachers can form personal relationships with students—a prerequisite for membership—if students spend sustained time with teachers on an individual basis or in small groups and if they engage together in such activities as recreation, counseling, and the study of more than one subject (Bidwell, 1970; Newmann, 1981). Choices can also be provided to students within the confines of schools. In some schools, adolescents choose whether to engage in cooperative or independent learning in certain classes, with the provision that they engage in both during a given week. Students in need of remedial instruction show improved outcomes when offered choices among a range of high-quality special assistance programs (Treisman, 1985; Ascher, 1991). In other schools, students vote on how to spend extracurricular funds or participate in working groups to decide the content of school assemblies. Schools can expect student assistance in tasks such as tutoring, media work, meal preparation, fundraising, and plant maintenance (Wynne, 1980).

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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Issues of Race, Ethnicity, and Culture

Racial and ethnic discrimination is a continuing reality in the United States: discriminatory practices, and responses to them, affect the development of young people from racial and ethnic minority populations. And although members of such populations share most of the values and orientations of the dominant social groups, important cultural differences also exist, which not only influence the nature of personal interactions with those in the dominant culture, but equally important, influence the ways in which parents and their adolescent children view the world, including social institutions (Gibbs and Huang, 1989; Batts, 1988). In response, many programs try to develop strategies for addressing the complex issues of discrimination, race, ethnicity, and culture. The most fundamental commonality of such programs is that they do not attempt to adopt a "color-blind" view of young people, which essentially denies that race and ethnicity are deeply rooted aspects of individual identity. On the contrary, good practice requires explicit attention to race, ethnicity, and culture, not as add-on program dimensions, but through strategies that are embedded within all aspects of the program (Camino, 1992; Comer, 1989; Pine and Hilliard, 1990).

Most practitioners see the recognition of racial and ethnic differences, as well as the promotion of open dialogue and expression regarding differences, as necessary prerequisites to instilling mutual respect among youth. For example, the SEED (Students Educating Each Other about Discrimination) project, which is being designed and targeted for implementation in Ann Arbor, Michigan, uses group discussion to train high school students to serve as role models and change agents who challenge racism (Polakow-Suransky and Ulaby, 1990). In other programs, understanding of multicultural differences emanates from shared experiences in purposeful activities. Pursuit of common goals among cross-ethnic peers has been documented as instrumental in reducing negative stereotypes and prejudices (Slavin, 1991). Such activities can also help to forge meaningful bonds between adults and young people. In one multicultural training program for youth workers in Montgomery County, Maryland, youth and adults were grouped cross-racially and cross-ethnically. Evaluations indicate that the experiences provided a good basis for building rapport (Washington School Anti-Racism/Anti-Oppression Training Group, 1991).

Multicultural competence, cooperation, and problem solving can also be promoted by curriculums that incorporate elements of

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
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various cultural and ethnic histories and traditions. For example, one program engaged Puerto Rican children and teenagers in New York City in telling and responding to stories about Puerto Rican heroes and heroines who negotiated tough situations in order to achieve success; an evaluation showed that participants enhanced their repertoire of positive coping skills (Costantino et al., 1988). Programs based on cultural pride stimulate the development of solid racial and ethnic identities, which serve as focal points from which to develop firm cross-ethnic relationships (Rosenthal, 1987; Wigginton, 1991). Some schools have incorporated multicultural referents throughout the curriculum, instead of relegating information on minorities to separate chapters, courses, or months.

Attention to race and ethnicity requires caring and sensitive staff. Although it is important to have minority staff in decision-making positions in all programs, membership in a racial or ethnic minority does not in and of itself guarantee cultural competence. Therefore, most programs that address issues of race and ethnicity ensure that all staff receive multicultural training. Training—if implemented over time, and not as a "one-time" initiative—has been found to have positive outcomes, such as increased knowledge about cultural differences and similarities, fewer stereotypic assumptions about minority adolescents and their families, improved cross-cultural interactions, and greater client satisfaction (Pederson, 1988; Lefley, 1989; Pine and Hilliard, 1990; Viadero, 1990; Ascher, 1991).

CONCLUSIONS

This chapter has highlighted "good practice" programs to help adolescents in high-risk settings—interventions that have strong research and theoretical justifications. However, such initiatives are not and should not be seen as substitutes for improving the basic institutions of adolescent life. The key to providing for adolescent needs is an approach based on the ideal of comprehensive services. In most instances this will mean pushing primary institutions to expand their horizons and build bridges, e.g., between schools and health care systems. Good practice programs have demonstrated the advantages of changing the institutional service settings that adolescents experience on a daily basis and redesigning programs to have multiple goals and a range of interventions. In pursuing these objectives, service providers must overcome formidable obstacles in the form of narrowly defined

Suggested Citation:"10 GOOD PRACTICE: COMMUNITY-BASED INTERVENTIONS AND SERVICES." National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Washington, DC: The National Academies Press. doi: 10.17226/2113.
×

categorical program funding streams that place rigid and arbitrary restrictions on grantee programs.

Adolescents from high-risk settings need a comprehensive set of developmental opportunities and experiences that, too often, are not an integral part of their lives. That is, adolescents need opportunities to confront and address the difficult realities existing in their lives. They need opportunities to form sustained and positive relationships with adults and peers. They need opportunities to succeed and to be rewarded for success. They need opportunities to contribute, to feel in control, and to demonstrate competencies. In brief, young people need a comprehensive array of services that are empowering and that provide legitimate opportunities to develop and use their interpersonal, academic, and vocational skills. We recognize that there are limitations in relying on research, theory, and expert consensus without the additional insight gained from program evaluations. These issues are addressed in greater detail in Chapter 11. At the same time, studies clearly document the significant risks existing within current institutions and programs. Furthermore, there is sufficient accumulated knowledge to eliminate or reduce these risks by designing alternative models. At a minimum, implementation of best practice models would better ensure that institutional programs "do no harm" to adolescents. In a more optimistic light, it is likely that the programs highlighted in this chapter offer models that will aid the reform of primary settings as well as demonstrating effective interventions for adolescents whose experiences place them in extreme jeopardy.

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At least 7 million young Americans—fully one-quarter of adolescents 10 to 17 years old—may be at risk of failing to achieve productive adult lives. They use drugs, engage in unprotected sex, drop out of school, and sometimes commit crimes, effectively closing the door to their own futures. And the costs to society are enormous: school and social services are overwhelmed, and our nation faces the future with a diminished citizenry.

This penetrating book argues that the problems of troubled youth cannot be separated from the settings in which those youths live—settings that have deteriorated significantly in the past two decades. A distinguished panel examines what works and what does not in the effort to support and nurture adolescents and offers models for successful programs.

This volume presents an eye-opening look at what millions of the nation's youths confront every day of their lives, addressing:

  • How the decline in economic security for young working parents affects their children's life chances.
  • How dramatic changes in household structure and the possibilities of family and community violence threaten adolescents' development.
  • How the decline of neighborhoods robs children of a safe environment.
  • How adolescents' health needs go unmet in the current system.

Losing Generations turns the spotlight on those institutions youths need—the health care system, schools, the criminal justice, and the child welfare and foster home systems—and how they are functioning.

Difficult issues are addressed with study results and insightful analyses: access of poor youths to health insurance coverage, inequities in school funding, how child welfare agencies provide for adolescents in their care, and the high percentage of young black men in the criminal justice system.

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