JOURNAL OF ADOLESCENT HEALTH 1991;123588-590
Adolescents at Risk Conference: overview ELI GINZBERG,
Ph.D.
‘Ibis introduction has a number of interrelated objectives and goals: to provide a road map of what we know about adolescents at risk, what we don’t know about them, and how we can best dill the lacunae in our knowledge; to determine the extent to which the American people are using the knowledge they have to reduce the ravages of adolescents’ malfunctioning; and to pinpoint the many different groups that should redouble their efforts to reduce and eliminate the great individual and societal losses thag stem from the dysfunctional behavior of adolescfznts. The papers that follow deal sequentially with the following critical themes: the conceptual frameworks that provide the best understanding of the dynamics of adolescent risk behavior; what is known about the causative factors supporting teenage vio-
lence, sexual behavior (including risk of acquired immrPnod&ie~~cy syndrome [AIDS]), and alcohol and drug -.lbuse;and the guidelines to be followedand by who-in seeking to reduce and eliminate the large individual and societal costs that flow from adolescents who are so unsettled and upset that they are unable to make the transition from adolescence to young adulthood without special assistance and
support. By way of stage setting it may be helpful to inform
the reader of the scale and scope of the problems subsumed under the descriptive title “adolescents at risk.” The papers that follow relate to a population or’a?pproximately 7 million young people who are at serious risk of not being able to negotiate without special assistance the transition from adolescence to ~~---
Fnntt the Eisdawm Centerfir the Consematinn ofHuman &sauces, Columbia University, New York. ilddms reprint tapests to: Eli Ginsberg, Ph.D., The Eisenhawr cadcr@ * Gmset~~tion ofHumanResources, Columbia University. 2880 %mdq, 4th Floor, New York, NY 10027. Mwfuscri;rt acceptd September 1991. 58s 10!54439MU$3.50
fibfished by ~~vh
young adulthood. This means that a high proportion are likely to be consigned to a peripheral role in adult society, at best margin&y involved in performing their roles as workers, parents, and citizens. To make matters worse, many will never reach their midtwenties, for they will have become the victims of homicide or will have taken their own lives, or they wili be headed for premature death as a consequence of having contracted human immunodeficiency (HIV) infection or having become a drug addict. Clearly, the subject of adolescents at risk should be high on the nation’s agenda for study and action. But the incontrovertible fact is that the subject, al-
though of concern to a small number of researchers, has surely not been at the center of public policy. The explanation for this paradox is embedded in the complexity of conceptualizing the processes of adolescent risk behaviors and the related complexities of modifying the critical societal institutions that must be altered if the adverse behaviors are to be prevented or reduced. To complicate matters, most adolescents reared in intact Eamilies with reasonable
income, housing, schooling, and social status are able to make the transition from childhood to adulthood without encountering life-threatening pressychological and social forces in the shaping of adolescent behavior, and distinguish between younger and older adolescents, where the former are at risk of engaging in dysfunctional behaviors and the latter are already engaged in such behaviors. The next group of papers focuses on a number of high-risk behaviors, including violence; early sexual intercourse, including exposure to AIDS; and alcohol and drug use. One important point that emerges IS the fact that violence in inner-city poverty areas is approaching epidemic proportions, with homicide the single leading cause of death for young Black maies. Since the causes of this epidemic are not well understood.. successful interventions must be directed to deepening the knowledge base while reducing access to handguns and providing adolescents with modes of conflict resoiution other than that of resorting to violence. Since adolescents, by virtue of their biological development, ate capable of sexual activity, and since the age of first intercourse has been dropping, all sexually active adolescents are at risk not because they engagc isr sexual intercourse but because they don’t do so “safely.” Many fail to use contraceptive devices and find themselves pregnant or suffering from a sexually transmitted disease, including possibly AlDS for small but growing numbers. TlLere are several challenges to the search for constructive ways to respond to the complications of adolescent sexuality. The first is to recognize that although it may prove possible to encourage young adolescents to delay having sexual intercourse for a few yam, there is Iittle pvospect of further delay for most of them. Large numbers of parents and organizations have been unwilling to acknowledge the reality which pleciuderi constructive actions aimed at making adolescent sexual behavior less risky by expanded and improved interventions. When it comes to adolescents’ use of alcohol and drugs, the assessment of risk factors is complicated by the fact that experimentation with one or the other or both is “normal” behavior. For a significant minority the experimentation progresses to addiction with serious and often lethal consequences. We need more knawledgc about how to differentiate between the experimenters and those who are becoming more deeply involved in substance abus?: we need improved education and training of physicians and other health care personnel so they be-
come sensitive to the importance of preventive and therapeutic interventions: and we need muchexpanded treatment programs aimed at detoxificatidn of those who have become addicted. The two concluding papers are focused on programs and policies. The first presents an evaluation of diverse, multiagency, c,nmmunity programs that attempt to change high-risk behaviors among adolescents by prevention, therapy, and rehabilitation. There is IIO single institution in our society that is capable of providing the range of services needed by adolescents at risk, but the school probably offers the best positioned community resource on which to center comprehensive multiagency efforts. In the concluding paper we are reminded of some important, often neglactecl truths that should be central to all policy discussions and actions. Among them is the probalsili’q that most adolcs;tints reared in intact, loving an6 caring f?miiies who are brought up in decent neighborhi;r& will face and surmount the turmoils of adolescencca without special difficulty or danger. It is not possible or desirable to remo;Ie all challenges and dangers from the adolescent’s environment because chsllenges increase coping skikic and provide the assurance that comes with meeting challenges successfully. Adolescents reared in deprived circumstances often lack the personal skills and access to the opportunities that would enable them to achieve the basic goals of adulthood-to obtain a regular job and earn an income that would enable them to marry and have a family. Ours is a society that looks to the ~11c1~arfamily to assume and discharge the multiple responsibilities of transforming the infant into child and later into the adolescent, so that he or she can perform cffectivcly as an adult. Unfortunately, contemporary American soci@y has an increasing number of dysfunctional families that are unable to meet this primary responsibility. To COL+:ic& matters, our society has been slow to initiate suppor Gq/c,programs that would bolster families at risk so that tilt aduhs would be better able to carry out their parenting responsibilities. Many families live in poverty because of our society’s unwillingness to provide for the basic income needs of people who cannot work or who are unabie to earn enough from their work. We have an educational system that is poorly serving many children and young people from disadvant:iged families because of its inability to provide them with the basic knowledge and skilis that they need to obtain and hold a regular job. In fact, sizable numbers of young people find their school-
589
5?0
ELI GINZBERG
ing so unattractivaa that they drop out before they have acquired the minimum competencies for successful adulthood. A further complication arises from the fact that the U.S. economy, despite its generally good record of job creation, still does not provide sufficient work opportunities for all who need and want to work. The poorly educated high school drop-outs, particularly from minority groups, are likely to find themselves at the end of the job queue. There is a wide array of governmental and private sector programs that are directed to helping families and young people at risk. Their effectiveness is greatly reduced, however, because each operates
JOURNAL OF ADOLESCENT HEALTH Vol. 12, No. 8
within a narrowly defined orbit which fails to address the complexity of the problems of the adolescent or his or her family. A major challenge is to improve the coordination among those preventive and remedial programs, increase the resources available to them, and evaluate their effectiveness. To help families and young people at risk, more societal efforts need to be directed to assuring that the basic institutions on which society dependsthe family, the school, and the world of work-are strengthened so that every person will be better able to cope successfully with the challenges that he or she encounters in moving from childhood to adulthood.
Adolescents at Risk Conference: overview ELI GINZBERG,
Ph.D.
‘Ibis introduction has a number of interrelated objectives and goals: to provide a road map of what we know about adolescents at risk, what we don’t know about them, and how we can best dill the lacunae in our knowledge; to determine the extent to which the American people are using the knowledge they have to reduce the ravages of adolescents’ malfunctioning; and to pinpoint the many different groups that should redouble their efforts to reduce and eliminate the great individual and societal losses thag stem from the dysfunctional behavior of adolescfznts. The papers that follow deal sequentially with the following critical themes: the conceptual frameworks that provide the best understanding of the dynamics of adolescent risk behavior; what is known about the causative factors supporting teenage vio-
lence, sexual behavior (including risk of acquired immrPnod&ie~~cy syndrome [AIDS]), and alcohol and drug -.lbuse;and the guidelines to be followedand by who-in seeking to reduce and eliminate the large individual and societal costs that flow from adolescents who are so unsettled and upset that they are unable to make the transition from adolescence to young adulthood without special assistance and
support. By way of stage setting it may be helpful to inform
the reader of the scale and scope of the problems subsumed under the descriptive title “adolescents at risk.” The papers that follow relate to a population or’a?pproximately 7 million young people who are at serious risk of not being able to negotiate without special assistance the transition from adolescence to ~~---
Fnntt the Eisdawm Centerfir the Consematinn ofHuman &sauces, Columbia University, New York. ilddms reprint tapests to: Eli Ginsberg, Ph.D., The Eisenhawr cadcr@ * Gmset~~tion ofHumanResources, Columbia University. 2880 %mdq, 4th Floor, New York, NY 10027. Mwfuscri;rt acceptd September 1991. 58s 10!54439MU$3.50
fibfished by ~~vh
young adulthood. This means that a high proportion are likely to be consigned to a peripheral role in adult society, at best margin&y involved in performing their roles as workers, parents, and citizens. To make matters worse, many will never reach their midtwenties, for they will have become the victims of homicide or will have taken their own lives, or they wili be headed for premature death as a consequence of having contracted human immunodeficiency (HIV) infection or having become a drug addict. Clearly, the subject of adolescents at risk should be high on the nation’s agenda for study and action. But the incontrovertible fact is that the subject, al-
though of concern to a small number of researchers, has surely not been at the center of public policy. The explanation for this paradox is embedded in the complexity of conceptualizing the processes of adolescent risk behaviors and the related complexities of modifying the critical societal institutions that must be altered if the adverse behaviors are to be prevented or reduced. To complicate matters, most adolescents reared in intact Eamilies with reasonable
income, housing, schooling, and social status are able to make the transition from childhood to adulthood without encountering life-threatening pressychological and social forces in the shaping of adolescent behavior, and distinguish between younger and older adolescents, where the former are at risk of engaging in dysfunctional behaviors and the latter are already engaged in such behaviors. The next group of papers focuses on a number of high-risk behaviors, including violence; early sexual intercourse, including exposure to AIDS; and alcohol and drug use. One important point that emerges IS the fact that violence in inner-city poverty areas is approaching epidemic proportions, with homicide the single leading cause of death for young Black maies. Since the causes of this epidemic are not well understood.. successful interventions must be directed to deepening the knowledge base while reducing access to handguns and providing adolescents with modes of conflict resoiution other than that of resorting to violence. Since adolescents, by virtue of their biological development, ate capable of sexual activity, and since the age of first intercourse has been dropping, all sexually active adolescents are at risk not because they engagc isr sexual intercourse but because they don’t do so “safely.” Many fail to use contraceptive devices and find themselves pregnant or suffering from a sexually transmitted disease, including possibly AlDS for small but growing numbers. TlLere are several challenges to the search for constructive ways to respond to the complications of adolescent sexuality. The first is to recognize that although it may prove possible to encourage young adolescents to delay having sexual intercourse for a few yam, there is Iittle pvospect of further delay for most of them. Large numbers of parents and organizations have been unwilling to acknowledge the reality which pleciuderi constructive actions aimed at making adolescent sexual behavior less risky by expanded and improved interventions. When it comes to adolescents’ use of alcohol and drugs, the assessment of risk factors is complicated by the fact that experimentation with one or the other or both is “normal” behavior. For a significant minority the experimentation progresses to addiction with serious and often lethal consequences. We need more knawledgc about how to differentiate between the experimenters and those who are becoming more deeply involved in substance abus?: we need improved education and training of physicians and other health care personnel so they be-
come sensitive to the importance of preventive and therapeutic interventions: and we need muchexpanded treatment programs aimed at detoxificatidn of those who have become addicted. The two concluding papers are focused on programs and policies. The first presents an evaluation of diverse, multiagency, c,nmmunity programs that attempt to change high-risk behaviors among adolescents by prevention, therapy, and rehabilitation. There is IIO single institution in our society that is capable of providing the range of services needed by adolescents at risk, but the school probably offers the best positioned community resource on which to center comprehensive multiagency efforts. In the concluding paper we are reminded of some important, often neglactecl truths that should be central to all policy discussions and actions. Among them is the probalsili’q that most adolcs;tints reared in intact, loving an6 caring f?miiies who are brought up in decent neighborhi;r& will face and surmount the turmoils of adolescencca without special difficulty or danger. It is not possible or desirable to remo;Ie all challenges and dangers from the adolescent’s environment because chsllenges increase coping skikic and provide the assurance that comes with meeting challenges successfully. Adolescents reared in deprived circumstances often lack the personal skills and access to the opportunities that would enable them to achieve the basic goals of adulthood-to obtain a regular job and earn an income that would enable them to marry and have a family. Ours is a society that looks to the ~11c1~arfamily to assume and discharge the multiple responsibilities of transforming the infant into child and later into the adolescent, so that he or she can perform cffectivcly as an adult. Unfortunately, contemporary American soci@y has an increasing number of dysfunctional families that are unable to meet this primary responsibility. To COL+:ic& matters, our society has been slow to initiate suppor Gq/c,programs that would bolster families at risk so that tilt aduhs would be better able to carry out their parenting responsibilities. Many families live in poverty because of our society’s unwillingness to provide for the basic income needs of people who cannot work or who are unabie to earn enough from their work. We have an educational system that is poorly serving many children and young people from disadvant:iged families because of its inability to provide them with the basic knowledge and skilis that they need to obtain and hold a regular job. In fact, sizable numbers of young people find their school-
589
5?0
ELI GINZBERG
ing so unattractivaa that they drop out before they have acquired the minimum competencies for successful adulthood. A further complication arises from the fact that the U.S. economy, despite its generally good record of job creation, still does not provide sufficient work opportunities for all who need and want to work. The poorly educated high school drop-outs, particularly from minority groups, are likely to find themselves at the end of the job queue. There is a wide array of governmental and private sector programs that are directed to helping families and young people at risk. Their effectiveness is greatly reduced, however, because each operates
JOURNAL OF ADOLESCENT HEALTH Vol. 12, No. 8
within a narrowly defined orbit which fails to address the complexity of the problems of the adolescent or his or her family. A major challenge is to improve the coordination among those preventive and remedial programs, increase the resources available to them, and evaluate their effectiveness. To help families and young people at risk, more societal efforts need to be directed to assuring that the basic institutions on which society dependsthe family, the school, and the world of work-are strengthened so that every person will be better able to cope successfully with the challenges that he or she encounters in moving from childhood to adulthood.
