http://www.healthscout.com/news/1/521817/main.html"Experts: 'Get Tough' Programs Don't Curb Youth Violence
One-on-one therapy best at preventing delinquency, studies find
By E.J. Mundell
HealthDay Reporter
FRIDAY, Oct. 15 (HealthDayNews) -- Highly publicized anti-violence programs like Scared Straight, D.A.R.E., and boot camp-type interventions won't change troubled kids' violent behaviors and may even encourage them, according to a new report from a U.S. government panel of experts.
"These programs can cost money and yet not produce any outcome the community wants -- and there's also the possibility that the programs might actually harm some youth and the community," said panel chairman Dr. Robert C. Johnson, director of Adolescent and Young Adult Medicine at the University of Medicine and Dentistry of New Jersey.
He and other panelists spoke to reporters at a press conference held Friday in Washington, D.C.
In their State-of-the-Science Conference Statement, experts from the panel -- convened and supported by the National Institutes of Health -- noted that rates of youth violence in the United States remain high, despite declining from a peak in the mid-1990s.
In their deliberations, the panelists sifted through data from trials going back to 1990 on the causes and prevention of youth violence. They found that anti-violence programs involving "scare tactics" or bullying by adults simply don't work.
"Many of these programs take the child out of the family," explained panelist Dr. Leon Eisenberg, a professor of social medicine and psychiatry at Harvard Medical School. "And whatever they may do or not do for the child while he's in the institutional setting, [they] leave him completely adrift when the treatment is over. Some of these programs are, frankly, quite dreadful."
Johnson agreed. In fact, these "tough-love," group-oriented efforts "often exacerbate problems, by grouping young people with delinquent tendencies together, where the more sophisticated instruct the more naive" in destructive behaviors, he said.
Often, Eisenberg said, parents see boot-camp type programs as a quick fix for problems that have much more complex roots.
"It [temporarily] gets rid of the problem. You don't see it every day, and you assuage your guilt by paying money for it -- you think you're doing something for your child," he said.
Unfortunately, that may not be the case, since studies show no benefit to these types of initiatives in curbing bad juvenile behavior, according to the experts.
Fortunately, safer, more effective violence-prevention programs exist. Studies suggest that long-term, one-on-one or family-oriented therapy does seem to work in turning kids' lives around, the panel found.
Panelist Richard Lempert, a professor of law and sociology at the University of Michigan, said it's easy to think "nothing works," but many models do. "Working with individuals to increase skills and competencies, sometimes in school settings, sometimes in homes, sometimes in families -- that seems to be promising," he said.
Looking over the data, the experts noticed common threads between programs that worked and those that didn't. Effective programs -- such as one-on-one behavioral therapy or family interventions -- tended to involve long-term treatment, lasting a year or longer, and were targeted at specific stages in child development. They were also most often delivered outside of institutions such as juvenile detention centers.
On the other hand, programs that didn't work also shared certain features, such as gathering troubled kids together in large groups, using poorly trained and under-supervised staff, and emphasizing scare tactics, boot-camp-type environments, or browbeating by stern adults.
Johnson said much more research needs to be done to figure out exactly which interventions work best at keeping troubled teens from violence. Right now, the panel is urging the creation of a national, population-based Adolescent Violence Registry to better track youth violence trends, as well as research focused on how communities can best spend their money to keep youth violence at bay.
Simply locking violent juvenile offenders away may help society feel safer, but studies suggest it does not serve as a deterrent to others, the experts noted.
"Simply put, the practice of transferring juveniles to adult jurisdictional systems can be counterproductive," Johnson said, "resulting in greater violence among incarcerated youth."
According to Johnson, youth violence is most often rooted in the family, and that's where the real solutions may lie. "If parents make sure to communicate on a constant basis with their children, and if they model the appropriate behavior to their kids, that's going to be a very important support throughout childhood," he said.
More information
For a close look at the study, head to the NIH Consensus Development Program (consensus.nih.gov ).
SOURCES: Robert C. Johnson, M.D., panel and conference chairman, National Institutes of Health State-of-the-Science Conference, professor of pediatrics and professor of psychiatry, and director, Adolescent and Young Adult Medicine, University of Medicine and Dentistry of New Jersey, Newark; Leon Eisenberg, Ph.D., professor emeritus of social medicine and psychiatry, Harvard Medical School, Boston; Richard Lempert, Ph.D., professor of law and sociology, University of Michigan, Ann Arbor, and director, division of social and economic sciences, National Science Foundation, Arlington, Va.; Oct. 15, 2004, National Institutes of Health State-of-the-Science Conference Statement "
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Last updated 10/15/2004.
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