Prevention of drug abuse by promoting mental health among school students
Conceptual framework for a project on prevention of drug abuse
Implementation of the project
Evaluation of the programme for students
Evaluation of the programme for teachers
Author: C. GAZMURI-PLAZA,, C. LANGDON-PIZA, R. FLORENZANO-URZUA
Pages: 107 to 112
Creation Date: 1985/01/01
School of Medicine, University of Chile, Santiago, Chile
An approach to the prevention of drug abuse among adolescents by promoting mental health was implemented in a study carried out in 1983 in the schools of La Reina, a district of the metropolitan region of Santiago, Chile. A series of workshops, organized for the training of students and teachers, focused on the acquisition of communication abilities, the resolution of day-to-day conflicts and the improvement of self-esteem. The workshop training was intended to enable the trainees to replicate the knowledge and experience gained with their fellow classmates and teachers. The evaluation, carried out by means of a questionnaire administered at the beginning and at the end of the training programme, showed positive results among students and teachers, but better results were obtained among the teachers.
The increasing abuse of psychoactive substances among youth is a cause of great concern. A considerable number of studies carried out in Chile have shown evidence of the abuse of psychoactive substances, such as alcohol, tobacco, cannabis and volatile solvents, among children and adolescents [ l] - [ 5] ; the problems of such abuse have prompted the national authorities to set up various preventive, treatment and rehabilitation programmes, which are described elsewhere [ 6] - [ 8] . Primary prevention of drug abuse includes dissuasive approaches focusing on the dangers of drug abuse and other informational and educational approaches [ 9] , as well as approaches which promote the development of mental health among young people, under the assumption that young people who have psycho-social problems run a greater risk of becoming involved with drugs.
Since 1981 the authors have been involved in developing programmes for the primary prevention of drug abuse among youth in Chile. Some of these programmes have already been described elsewhere [ 8] . Among the main tasks of a young person undergoing a series of rapid psycho-social changes during adolescence is to develop a proper identity and independence. An adolescent makes efforts to prove his identity and self-esteem, to develop his physical image and to achieve communication with others and integration into a peer group. While striving to achieve these goals, an adolescent is normally confronted with conflicts which he may resolve in a constructive manner or by resorting to maladjusted behaviour. The latter often involves the use of psychoactive substances, by which the adolescent attempts to resolve his day-to-day conflicts.
It should also be mentioned that adults, being identification models for young people, often present themselves as users of psychoactive substances, such as alcohol and tobacco, and this makes it more difficult for an adolescent to develop the right attitudes towards drug use. Attempts by the adolescent to identify with his peer group and to become part of it may lead to involvement with psychoactive substances. Thus, drug use may attract the attention of the adolescent in his or her attempts to resolve the conflicts arising in the course of day-to-day living. Drug abuse becomes a symptom of the adolescent's maladjusted approach to the social environment and the attempt to achieve personal autonomy. The adolescent often feels various forms of social pressure, which usually involve parents, friends, school, communication media and religion. With this in mind, the appropriate educational intervention should enable an adolescent to Cope with such social pressure in a constructive manner.
Within this conceptual framework, the authors have developed a specific educational strategy for a project which attempts to promote drug abuse prevention through a mental health approach among school students of La Rein, a district of the metropolitan region of Santiago [ 10] . The project was implemented during the second half of 1983. The project was to help students achieve the following aims :
To improve interpersonal communication abilities and to promote their relations with parents, friends and teachers ;
To develop their identity and self-esteem in order to enable them to cope with their day-to-day problems ;
To learn about using recreation and free time as a healthy alternative to the use of psychoactive drugs ;
To become capable of sharing with their class-mates their newly acquired knowledge and healthy attitudes towards psychoactive drugs ;
To develop the capacity of making responsible personal decisions about drug use.
The project was first carried out with a group of 100 students : 50 in the ninth, tenth and eleventh classes of two high schools and 50 in the eighth class of seven primary schools. The students were trained in eight workshops, each lasting three hours. On completion of the training, each student repeated a workshop with his or her classmates ; this programme reached an additional 400 students.
In addition, 26 teachers of the La Reina school system were trained, which included 11 primary school and high school directors, 11 teachers in charge of orientation and 4 teachers from the Department of Education. The teachers were trained in five workshops, each lasting four hours. On completion of training, the teachers conducted workshops in their schools, reaching an additional 1 10 teachers.
The project continued during 1984 and, in addition to students and teachers, included 22 parents who, upon completion of their training, were expected to use the same methods to conduct 10 training workshops for 200 parents in eight primary schools and two high schools. Since the educational strategy employed in this project has already been described in detail elsewhere [ 10] , this article focuses on the evaluation of the results of this programme.
To evaluate the results obtained in the programme for students, a questionnaire was designed that would measure their ability to Communicate, their self-image, alcohol use and other related variables. The questionnaire was administered at the beginning of the programme in 1983 to 100 students involved in the workshop training (pre-test survey) and was again administered in the same year on completion of the training (post-test survey). The post-test survey reached only 56 students because some students were involved in their final school examinations, which coincided with the date of the survey, and others, hesitating to believe that the survey was anonymous, did not take part in it. Of the 56 respondents, 48.2 per cent were males and 51 .8 per cent females ; 53.5 per cent were in grade 8 and 46.5 per cent in grades 9, 10 and 11 . The age of the respondents ranged from 12 to 18 years. The majority (69.7 per cent) lived in families with 5 to 8 members, while only 19.6 per cent of the respondents lived in smaller and 10.7 per cent in larger families.
A comparison of the results obtained in the pre-test and post-test surveys showed that there was considerable improvement in communication abilities : 23.3 per cent of the respondents in the post-test survey scored very high on communication skills, while none of the respondents performed so well in the pre-test survey. In addition, 39.3 per cent of the respondents in the pre-test survey reported poor communication skills, whereas the post-test survey indicated that only 17.8 per cent were in this category. Females achieved higher scores than males ; also, high school students scored higher than primary school students.
With regard to the self-image of the respondents, there seemed to be no significant differences between pre-test and post-test surveys. Females recorded lower scores in self-image in both surveys. High school students achieved lower scores in the pre-test survey than primary school students, but this difference disappeared in the post-test survey.
There were no significant differences with regard to attitudes towards alcohol Consumption between the pre-test and post-test surveys, but the percentage of those who recorded high scores in knowledge of addictive alcohol use increased from 3.6 per cent in the pre-test survey to 17.9 per cent in the post-test survey. The number of reported non-drinkers increased from 33.9 per cent in the pre-test survey to 39.3 per cent in the post-test survey, but in the same period the number of excessive drinkers increased from 10.8 to 23.2 per cent.
The post-test qualitative analysis showed that the workshops helped students to know themselves better; to learn to value themselves ; "to become more of a person" ; to accept their weaknesses and to analyze their problems. They also stated that the training helped them to interact more positively with adults and to improve their relationships with their parents. The students also stated that the training helped them to understand better the risk involved in alcoholism and drug addiction and to use their spare time in a healthy way. Shy and insecure adolescents showed a higher level of progress because they learned to participate more openly in public and to make new acquaintances. The adolescents felt more secure and trustful and had more open and comprehensive attitudes after the workshops. They found that the experience was positive for their personal growth.
A questionnaire was designed to evaluate the results obtained in the programme for teachers. The questionnaire included variables on communication ability, self-image, and the resolution of conflicts between father and son. It was administered at the beginning of the workshop programme in 1983 to the 26 teachers involved (in the pre-test survey), and it was again administered to 22 teachers at the end of the training programme (in the post-test survey).
Most of the respondents were females (81 .8 per cent), middle-aged, married, with two to four children and with more than 16 years of teaching experience.
A comparison of the results obtained in the pre-test and post-test surveys showed that the teachers made significant improvements in their ability to Communicate, their self-image and in their ability to resolve a father-son Conflict. In the post-test survey, 27.3 per cent of the respondents had very good scores and 50.0 per cent good scores in communication skills compared with the zero result obtained for each of these two categories in the pre-test survey. The percentage of teachers who demonstrated a very good knowledge of communication skills increased from 22.7 per cent in the pretest to 68.2 per cent in the post-test survey. Similar results were obtained for other variables : the percentage of the teachers who performed very well on the self-image part increased from 27.3 per cent in the pre-test to 50.0 per cent in the post-test survey, whereas the percentage of the respondents who demonstrated a very good ability to resolve a conflict between father and son increased from 45.5 per cent in the pre-test to 72.7 per cent in the post-test survey.
The teachers' qualitative analysis showed that the workshops helped them to become more open to other persons, to accept themselves and others better, to Communicate with sincerity and to express their feelings more easily. The teachers said that they were able to establish relationships which were more sincere and spontaneous, thus setting aside their defensive selfimage, their authoritarian style and their predominantly intellectual communication. They also stated that as a result of the workshops they improved their trust and comprehension of others as well as their personal and family relationships. With regard to their children, they were more inclined to hear and understand them. They reduced their expectations of others and learned to pay attention to their internal processes. The teachers felt that the training helped them to recognize experience as one of personal growth and development.
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