The Journal of Primary Prevention, Vot 16, No. L 1995

Primary Prevention as Health and Social Competence Promotion Maurice J. Elias 1

Primary prevention continues to be shackled by an implicit "magic bullet" perspective and an inoculationist mentality. The proliferation of short-ten'n, uncoordinated programs co-exists with data showing that large segments of our teenage-and-younger population are exposed to conditions that are likely to harm their psychosocial growth. The status of primary prevention in the schools is shown pictorials as a jumbled confusion. A n argument is made that coordination of interventions, centered around the goal of promotion of health and social competence, is necessary to achieve more successful primary prevention. Skills comprising social competence as life skills for adaptation to diverse environments are outlined. A representation of schools with programming organized by a shared prevention~promotion skills~set of strategies is provided. Primary prevention is discussed as emergent from the promotion of health and social competence; the latter are ends in themselves, reflecting children's inalienable, developmental "rights". Persons concerned with primary preveniion--and therefore with the education and the socialization of children--are called upon to examine their efforts and determine the extent to which they are addressing focal skills and doing so in a coherent, developmental, and cross-culturally sensitive manner, accompanied by the commitment of resources, time, and focused professional development activity guided by the tenets of knowledge in the primary prevention field. KEY WORDS: primary prevention; prevention; social competence; life skills; adaptation; school intervention; at-risk youth; social problem solving; social decision making; children's

rights; social policy.

If children are to experience healthy relationships and occupy meaningful and productive roles in society as adults, they must he competent at communicating and

ICorrespondence should be addressed to Maurice J. Elias,Ph.D., Department of Psychology, Rutgers University,Livingston Campus, New Brunswick, NJ 08903.

O 1995HumanSciencesPress, Inc.

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Elias working cooperatively with others. They need to be able to express their own opinions and beliefs, to understand and appreciate the perspective of others who differ from them in background, needs, or experiences, and to become skilled at reasoned disagreement, negotiation, and compromise as methods of solving problems when their own needs or interests conflict with those of others. Indeed, in the face of decreasing resources and increasing global interdependence, it can be argued that such qualifies are essential to our survival. The question, then, is not whether we mast enhance children's social competencies, but rather how to accomplish this goal (Banistich, Elias, & Branden-Multer, 1992, p. 231).

The question of how to enhance children's competencies is central to the field of primary prevention. From my perspective, which has been informed by involvement in school-based social competence promotion programs in over half the states in the U.S., as well as several other countries, and a recent study of the implementation of prevention programs, I believe that primary prevention is a widely misunderstood concept and that the consequences of this misunderstanding surround us in our professional and personal lives. Primary prevention continues to be associated with notions of discrete causality of specific forms of psychopathology and with discrete, time-limited efforts that can act with surgical efficiency to eliminate the noxious factors that lead to maladjustment (cf. Duncan, 1994). It would appear as if advocates of primary prevention have continued work to do regarding communication of the importance of promoting health and competence. Many researchers, theorists, and those working in the contexts of schools, mental health centers, and policy making positions stiff appear to be discovering the case for behavior as contextual in nature and biopsychosocial at its essence (DuPanl & Eckert, 1994; Gresham, 1994; Sehinke, 1994). A corollary, that lasting change takes time and emerges from trusting relationships, which themselves take time to nurture, also seems far from universally understood. Primary prevention has the potential to be a most exciting field that can make a genuine and substantial difference in the mental health and social and emotional functioning of individuals in many communities. For this to happen, the shackles of individual deficit-oriented thinking about health must be sawed through completely. The consequences of maintaining an implicit "magic buffet" perspective and an inoculationist mentality can be seen in widespread public support--and considerable financial resources--devoted to such efforts as "Just Say No" to drugs, to 17 week-long programs such as D.A.R.E. that are expected by some to be adequate to prevent alcohol and other drug abuse after being given in the fifth grade (Goodstadt, 1986; Leukefeld & Clayton, 1994) and short-term suicide prevention interventions in the schools (Garland & Zigler, 1993). Ironically, the proliferation of such programs co-exists with a dramatic deterioration in the state of our children today.

Health and Social Competence Promotion

Certainly, there are data showing that large segments of our teenageand-younger population are exposed to conditions that are likely to harm their psychosocial growth. Family disruptions seem to head everyone's list, both because of the specific turmoil caused by the process of separation and divorce and the harsh realities faced by upwards of 8 million "latchkey' children and the over one-half million teenagers who have become parents each year since 1982. These children--and their children--face significant risks of alcohol and other drug abuse and a variety of behavioral and emotional problems that may lead them to mental health services or into the correctional system (Carnegie Council on Adolescent Development, 1989; Institute of Medicine, 1993; London, 1987; National Research Council, 1993, Weissberg & Elias, 1993; William T Grant Commission on Work, Family, & Citizenship, 1988). The numbers, however, do not reveal several important facets of the problem. The cyclic nature of what happens to children must be recognized and accompanied by a determination to intervene effectively. Children who "come through the system" do so with scars, even if they have not had difficulties "severe" enough to lead them to societal helping or rehabilitative agents. They are impaired in their ability to form and sustain relationships, to parent, to become stable, productive members of the workforce, and to participate as planful, forward thinking members of a democracy. Professionals, overwhelmed by demands for their services, have adopted a threshold that allows far too many children to "slip through the cracks." The often-verbalized notion that it is also "the parents' responsibility," while true, implies that parents can act as a form of safety net for their children. Unfortunately, the safety net is itself riddled with holes and frayed strings. Levels of parental stress, psychopathology, substance abuse, and violence, especially in context of poverty, are increasing, with devastating effects on children (Association for Children of New Jersey, 1993; National Research Council, 1993). Even motivated parents often are so engaged in attempting to survive by meeting only visible and pressing demands that they cannot do for their children what they would like from a primary preventive or health promotion perspective. Not until members of these families hit the net and fall through do they seem to be able to command attention to their plight and obtain needed resources (Hechinger, 1992; National Research Council, 1993; Schorr, 1988).

THE URGENT NEED FOR ACTION It is difficult to mount an argument that, for minority and impoverished children and adolescents, enough has been done, the right things have been

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done, or that there is any more time to wait. Significant reports have been issued which reflect the growing sense of urgency: "A Nation at Risk" (National Commission on Excellence in Education, 1983); "Turning Points" (Carnegie Council on Adolescent Development, 1989); "Before It's Too Late" (Center for Early Adolescence, 1988); "The Urban Superintendents' Call to Action" (Office of Educational Research and Improvement, 1987); "Within Our Reach" (Schorr, 1988); "The Forgotten Half" (William T Grant Commission on Work, Family, & Citizenship, 1988), "Beyond Rhetoric" (National Commission on Children, 1991); "Violence and Youth" (APA Commission on Violence and Youth, 1992), "Fateful Choices" (Hechinger, 1992), "Losing Generations" (National Research Council Panel on High Risk Youth, 1993), and "Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research," the long-awaited "state of the field" report by a distinguished panel convened by the Institute of Medicine (1993). Each report goes beyond decrying the present trends and offers feasible solutions toward which efforts can be initiated in the present. Perhaps what also is needed is a tangible "feel" for the reasons impelling action.

A STUDY OF IMPLEMENTATION OF SCHOOL-BASED PREVENTION PROGRAMS Out of a deep concern that what children are receiving in the schools in the name of prevention--and, most often, primary prevention--might not be adequate, Peter Gager, Mary Hancock, and I undertook a study of prevention programs actually implemented in the state of New Jersey (Elias, Gager, & Hancock, 1993; Gager & Elias, under review; Gager, Hancock & Elias, 1992). We felt that rhetoric concerning the prevention of violence, substance abuse, AIDS, drop-out, and related problems faced by our youth must be replaced by an examination of available data and documented experience with school-based prevention programs. This is especially important as we embark on what looks to be a growing emphasis on "Safe Schools" and related violence prevention interventions. We undertook a survey of every New Jersey school district concerning the implementation of substance abuse prevention and related programs over the past 5 years. What seems to work best in various districts? According to those who carry out programs, what accounts for their long-term success and failure? The following can be identified as our central findings: 9 there are significant gaps in the prevention/health and social competence promotion efforts children receive in the schools; if New Jersey is any indicator, significant gaps exist at various grade levels,

Health and Social Competence Promotion

including Grades 7 and 8 and grade 10, where much mandated "health" time is consumed by Driver's Education programming; 9 most health promotion and problem prevention programming received by students in the schools consists of "home grown" efforts, created by local school curriculum committees; unfortunately, validated program~ rarely are the raw material for such efforts. Even when programs with validation evidence supporting their use were actually carried out, these were found to have been both successfully and unsuccessfully implemented in New Jersey school districts. This suggests strongly that factors in the design and delivery of primary prevention and health and social competence promotion efforts as services (Weissberg & Elias, 1993) are critical to determining the success of school-based efforts; 9 there is a paucity of material available for special education students and other "at risk" learners; the predominant expectation is that, if they are mainstreamed, they will have to "adapt" to the existing materials or that they are excluded from receiving preventive programming; ff they are not mainstreamed, the nature of service delivery to them is such that special education children are presumed to be "beyond" prevention; 9 there is decreasingly less effort to provide coordination of instruction across types of prevention programs, respectively, within grade levels, across grade levels within school buildings, across elementary, middle school and high school settings within districts, and across school districts within geographically proximate areas. Note that New Jersey is a leader among the states in mandates for health education, family life education, alcohol, drug, tobacco, and steroid use prevention and HIV/AIDS prevention, violence prevention, and child assault prevention. Each of these tends to be treated as discrete entities requiring separate efforts at "prevention." If the situation in New Jersey is better than average and what is being provided to children is, even at this stage of evolution of prevention theory and practice, substandard, this must be faced realistically. I believe that we will not make substantial progress until we acknowledge that the problems facing our youth are too serious to be subjected to any half-hearted, vaguely conceived, conveniently brief, inadequately funded, or poorly monitored interventions. Implementation of short-term, band-aid, cosmetic solutions even indirectly under the rubric of primary prevention erodes our credibility and makes the work of those who advocate the necessity of long-term, collaborative, carefully monitored efforts much more difficult. Yet, this is the state of the art today.

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Our responsibilities to children in the area of life skills is every bit as important as our responsibilities to build their academic skills. The two must go hand in hand if children are to grow up in safety and come to be adults, and leaders, of schools, families, agencies, and communities charaeterized by caring more than conflict, and excellence more than mediocrity. And these possibilities must extend equally to all students, regardless of where they live, their culture of origin, their gender, or specific handicaps they might have.

A CONCEPTUAL FRAMEWORK FOR PRIMARY PREVENTION AS HEALTH AND SOCIAL COMPETENCE PROMOTION Among many facets of the problem that must be addressed, I will focus on one: the proliferation of uncoordinated school-based programs. The predominance of discrete programs and the lack of coordination is partially depicted in Figure 1. Note that in the model of services as currently configured, each individual student implicitly is regarded as the source for integrating various and often divergent program inputs. When thinking about special education, at-risk, disaffected and other special needs students, Ryan's notion of "blaming the victim" comes to mind, as we are relying on those with greatest need and difficulty to take responsibility for putting together that which is presented to them--if, indeed, it is presented to them. It can be useful to step back for a moment and look, from a "taskanalytic perspective," at what many children are experiencing as they work their way through our school-based primary prevention system.

Coping with Confusion Mirman, Swartz, and Barell (1988) have identified some of the experiences of "at risk" children in the schools. They sit in the classroom and have difficulty making cognitive connections across subject areas and between classroom learning and their lives outside the school; they do not feel skilled at many academic tasks; their learning goals are set for them and they neither identify with them or understand their immediate or broad purposes; they often are directed in how to learn, and it is not always in ways which are best suited for them; they have a difficult time taking advantage of any extracurricular offerings. Children are "at risk" to the extent to which they fit this profde, regardless of their cultural or socioeconomic background.

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___=%~_ PREVENTION PROGRAMS WITHOUT A COMMON FRAMEWORK

Fig. 1

Figure 1 contains a representation of a school and its programs. As one can see, there are many different specialized areas now addressed by programs or curricula; many of these are, individually, excellent. A number of sources have identified prevention programs that have shown themselves to be of value in many of the areas listed in Figure 1 (Institute of Medicine, 1993; National Research Council, 1993; Price, Cowen, Lotion, & RamosMeKay, 1988; Zins & Forman, 1988). But what happens when they are combined in the course of the school day? Over the course of a year? Over the course of 3 years? From preschool through grade 12? The answer also is implied in the representation: a jumbled confusion. Certainly, there are students who are capable enough to integrate the diverse elements of each program into some coherent whole; and certainly, there are school districts that place a high value on curricular integration. But Figure 1 portrays a predominant situation. A Paradox with a Lit Fuse

The paradox of expecting the afflicted to rise up and make themselves heard is not without precedent. All of the disturbing facts noted earlier about the state of children and youth today fall disproportionately worse on members of ethnic and cultural minorities, particularly to the extent to which they are impoverished and lack education (Gibbs, Huang, & Associates, 1989; Hechinger, 1992; London, 1987; National Research Council, 1993; William T. Grant Commission on Work, Family, & Citizenship, 1988).

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In our society, this refers most prominently to poor citizens of African American and Latino ethnic and cultural heritage. But the disaffection of the urban underclass can be found in middle and upper class adolescents in white America. They experience confusion about their identities, their future social roles, and the amount to which they will have to work to carve out their dreams (Irwin, 1987). Much of this confusion is stirred by the power of our media, particularly television, in shaping both our images and our thought processes. In a public television series on the media, Bill Moyers showed how children are identifying more with "images" and less with close adults; these images are conveyed by the mass media and picked up and reinforced within peer groups. Television portrays life as a fast-paced succession of images to be bought, sold, copied, and moved around; images of consumption, physical attractiveness, and power seem to be most prominent (Perry, Kelder, & Komro, 1993). Where are the images that portray health, work, learning, sustained effort, and thoughtfulness? And how will they become salient in a mass media culture with a relatively short attention span? The lit fuse can be seen in the alienation of children (and, sadly, many parents) from schooling and learning. School failure and dropout are themselves images--images of generations of children who do not see school as a bridge to their future. However, there is no doubt that the cycle potentiated by school disaffection is insidious and harmful and will greatly increase the gaps among youth in our society and in our society'S ability to reach its econ o m i c - a n d social--potential (Center for Early Adolescence, 1988; Hechinger, 1992; Kantor, 1994; Srebnik & Elias, 1993; W'dliam T Grant Commission on Work, Family, & Citizenship, 1988). The lit fuse also is reflected in the difficulty that various sectors of our society--notably business and governm e n t - a r e experiencing in filling the roles they have to offer. For the sake of our collective future, children need to be guided by positive images and possess the skills needed to actualize and participate in the roles those images describe. Therefore, one partial solution to this difficulty is a level of consensus on what constitutes "social competence" and can serve as the core set of skills that ALL students should possess and that should be coordinated across various educational units. In this way, current and future generations of children can be helped to function as healthy, productive, and satisfied members of society.

THE ROLE OF PRIMARY PREVENTION AND THE SCHOOLS The continuing undercurrent of emphasis on basic academic skills is probably driven more by economic and workplace forces--both domestic

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and international--than by a genuine concern with the well-being of our nation's children and youth. For if the latter were the case, compelling statements about the inextricable bond linking personal, social, affective, and cognitive development would be more in the forefront. Arguments have been made that "Placing an overlay of strong academic demands on the current educational climate is likely to result in few increases in learning and instead exacerbate current stress-related problems and lead to further alienation among our student population" (Elias, 1989, pp. 393-394). There have been calls for placing "character education" as part of schooling to help counter the mass media imagery and restore to children and adolescents a sense of focus, stability, and history; this, in turn, would allow them to see that competitive, individualistic capitalism is not the only metaphor with which to understand the business world--or family life (Banlnrind, 1987; Gilligan, 1987; Lickona, 1991; London, 1987). Finally, specific visions of schools as engaging places of learning and growth have been articulated, and in specific terms (e.g., Carnegie Council on Adolescent Development, 1989; Center for Early Adolescence, 1988; Educational Leadership, volume 46, No. 5 [entire]). It is necessary to explicate "pathways toward accomplishment" for all students in school, perhaps by borrowing from special education and having an "IEP" (individualized educational program) for all students in which a segment is devoted to a long-term perspective on how the child is being prepared for one or more adult roles (Elias, 1989). Such considerations multiply in importance as our schools become more culturally diverse and have to address non-college and college youth with equal seriousness (Gibbs et al., 1989; National Research Council, 1993; William T Grant Commission on Work, Family, & Citizenship, 1988). Part of the solution involves intervention at both the person and environment levels (Elias, 1987, 1989). Specifically, children require the confidence, competencies, and chances to feel that they can learn and work successfully toward a positive future, to feel invested in learning what the programs are conveying, and to have the skills to learn from the various programs and carry their learnings into their everyday lives. However, there is a responsibility in the environment to provide practice and reinforcement opportunities and integration and coordination to the various helping efforts, thereby reducing the confusion individual students experience. Mirman et al.'s (1988) prescription for at-risk children is appropriate for all children: "We believe that by teaching at-risk children to think carefully and independently through decisions and problems, we will help them see that they have choices, that they have some control over their lives... The extent to which at-risk students are afforded opportunities to engage in collaborative prob-

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lem solving may determine whether or not they become less disaffected with the school" (pp. 138-9,145). Empowerment and engagement relate to choice and control; these, in turn, relate to a basic sense of confidence and to the social competence skill.~ needed to interact effectively in the school, family and neighborhood (Srebnik & Elias, 1993). These considerations fall at the intersection of what should be standard school concerns and what would be advocated in the name of primary prevention; indeed, the gap between primary prevention and proper socialization of health and social competence is, at best, minuscule. Working from a consensual core of social and health r tencies can be a significant step toward the goals of primary prevention as a public health policy and a humanitarian concern. To better define the competencies in question, it will be valuable to consider briefly what is meant by "social competence" and its relevance for all students.

SOCIAL COMPETENCE AS LIFE S g l L I ~ FOR ADAPTATION TO DIVERSE ENVIRONMENTS Anyone attempting to discuss the topic of social competence would be well advised to read Burton White's (1988) treatment of the area. He believes that such discussions must be delimited and pragmatic. First, he notes that "social competence should address factors that differ from intelligence and language or, at the very least, do not overlap with them any more than is necessary" (p. 34). He then reviews the efforts of the federal Office of Child Development, the RAND Corporation, and the Educational Testing Service to develop a definition of social competence during the late 1960's and early 1970's. A "panel of experts" generated a list of 29 component areas, ranging from "fine motor dexterity to general knowledge to quantitative and relational concepts to appropriate regulation of antisocial behavior" (White, 1988, pp. 36-37). He describes as "far fetched" the idea that functioning programs could be developed to implement all the facets of the definition. Waters and Sroufe (1983), essentially agreeing with White, urge that greater attention be paid to key processes relating to social interaction and their development over time and under different environmental conditions. A first step in following their suggestion is to determine the extent to which there is a consensus with regard to the attributes of a socially competent individual. Evidence from a variety of sources suggests a high level of agreement concerning the domains that reflect social competence (Commission on the Prevention of Mental-Emotional Disabilities, 1986; Consortium on the School-Based Promotion of Social Competence, 1994; Lickona, 1991;

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Westchester County Social Competence in the Schools "l~sk Force, 1990). Socially competent children, at least as defined in mainstream American culture, are those who: 9 possess a positive sense of serf-worth; 9 feel capable as they interact with others and take on new developmental tasks and challenges; 9 behave ethically and act responsibly toward others; 9 appreciate the benefits of a multiracial society and respect the values of others; 9 are skilled in interpersonal encounters and communication, get along with others, and develop long-term interpersonal relationships; 9 develop sound work habits, motivation, and values; 9 engage in health-enhancing and health protective behaviors; 9 are motivated to become productive citizens by serving as positive, contributing members of their peer group, family, school, and community; and 9 avoid engaging in behavior that may lead to negative consequences such as substance abuse, unwanted teen pregnancy, AIDS, social isolation, serious physical injury, school dropout, depression, suicide, unemployment, or criminal prosecution. Given the realities in Figure 1, attaining even this deceptively brief set of outcomes is a major challenge. Nevertheless, wise change agents such as Sarason (1978, 1982), Weick (1984) and Cowen (1980) have argued that a coordinated, determined set of "baby steps" toward programmatic goals pursued by diligent, persistent, committed individuals will lead to a series of local "small wins" that ultimately will fuel momentum toward widespread and lasting change. They urge that those concerned with children and schools define manageable, practical segments of the ecological landscape as the focus for research, intervention, and policy. To do so, a simplification strategy is called for. Two elements of such a strategy in the area of social competence promotion are a cross-cultural, pan-historic perspective and a long-term adaptation perspective.

A Cross-Cultural, Pan-Historic Perspective. Jacob Bronowski, in his master work, "The Ascent of Man" (1971), traced the evolution of humanity and civilization from the origins of life to the present era. Among his observations and reflections, he identified certain "defining qualities" of human beings, or certain core "skills" that allow the

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potent/al for human survival and advancement. These qualifies include the ability to think of several ways to reach a goal; forethought, analysis, and planning; the documentation of attempts to solve problems (via artistic and linguistic forms); and the ability to reco,tmize and use feelings as information for guiding decision making, problem solving, and action. Bronowski's perspective allowed him to recognize that homo sapiens survived and thrived because of their (our) capacity to exercise the abilities needed to master the challenges and realities of social and physical environments. But not all homo sapiens subgroups exercised their competencies--including their social competencies--equally. Across subgroups--which we now refer to as cultural and ethnic variations--assorted norms and differences reflect the range of conditions to which humans could--and did--adapt. No less significant is the record of adaptational failures and the importance of documenting and learning from them. The consensus on the attributes of socially competent children reflects the need to view competence in a way that befits the increasing complexity of our society. Bronowski has attempted to define those enduring skills that have allowed social groups to participate in the "ascent" most vigorously. More recent and equally useful perspectives are found in the emerging constructs of "practical intelligence" or "multiple intelligences" (Eisner, Sternberg, Levin, & Gardner, 1994; Sternberg & Wagner, 1986) and interpersonal-cognitive or social problem solving and decision making (Elias, 1993; Elias & Clabby, 1992; Spivack & Shure, 1988; Weissberg, Jackson, & Shriver, 1993). From this perspective, social structure and social roles require different types of abilities that are needed and valued. Mercer, Gomez-Palacio, and Padilla (1986) point out that social competence is linked to social roles. They identify several roles as present across cultures: family, community, peer, school, nonacademic school, earner/consumer, and self-maintenance. Skill domains that cut across these roles include verbal-linguistic and mathematical-quantitative abilities, but also spatial, musical, kinesthetic-athletic, interpersonal, and intrapersonal abilities. From Bronowski's perspective, the "ascent of humanity" is the trajectory forged by humans exercising their basic social competencies to adapt to new and varied environmental circumstances, as well as by humans recognizing environments sufficiently noxious to warrant avoiding, changing, or entering only with extensive preparation. What Bronowski and other philosophers, historians, and chroniclers of human progress help do is to unhinge, decouple, and otherwise differentiate social competence and adjustment. One can be socially competent--possess or even display the key "human" qualities noted earlier--but not be seen as adjusted. Conversely, one can be viewed as very well adjusted and yet show significant deficiencies in social competence.

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From a cross-cultural perspective, the skills that comprise social competence would go beyond cultural variation and instead would be identified with shared features at the level of humanity. Adjustment, on the other hand, is inextricably bound to cultural, historical, and situational norms and expectations. Some school-related examples include a passive, shy, compliant, dependent child who may be viewed by teachers as adequately adj u s t e d - h e or she causes little trouble, gets things done in school, etc.--but may have deficiencies in social competence. Another example is a child who is creative, thoughtful, planful, insightful, and tuned into his or her own feelings and those of others, but is seen by teachers and peers as poorly adjusted. More complex is the example of an inner-city teenager who turns to drug selling for his or her livelihood; such a child could be seen as adjusted or as lacking in social competence. The application of a primary prevention construct in these contexts is not always as clear as an application of a health and social competence promotion construct.

A Long-Term Adaptation Perspective The cross-cultural, pan-historic perspective attempts to focus both on characteristics of individuals and characteristics of environments. The longterm perspective focuses more on individuals. It represents an extension and further explication of Bronowski's set of basic human skills. Rutter (1987) reviewed adaptation difficulties and the specific socialization factors which seemed to assist children and adolescents in overcoming those difficulties. He concluded that there is a set of "mechanisms" which serve a protective function to individuals even when they are in circumstances that most would find to be harmful. These mechanisms combine with the skills in Bronowski, processes defined by Waters and Sroufe (1983), Dodge and Associates (1986), Ford (1982), emerging work in the field of practical intelligence (Gardner, 1991; Sternberg, Okagaki, & Jackson, 1990), affect (Elias, 1990a), and a long tradition of findings in preventive mental health (Commission on the Prevention of Mental-Emotional Disabilities, 1986; Elias & Clabby, 1992; Hawkins, Catalano, & Associates, 1992; Price et al., 1988) to suggest what Elias (1990b) refers to as an outline of "protective factors." These factors, portrayed in q~ble 1, can be thought of as a core set of skills which comprise the social competencies necessary for long-term human adaptation. They encompass several areas: self-control and selfregulation, self-efficacy expectancies, skills for prosocial group participation and interaction, skills to promote social decision making and problem solving, and skills to extend and enrich one's social networks and social aware-

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lg Table 1. Protective Factors/Social Competencias for Long-Term Adaptation

To What Extent is the Child: 1. able to articulate goals of his or her actions. 2. able to think of more than one way to reach a goal. 3. able to plan a sequence of goal-directed actions. 4. able to realistically anticipate consequences of, and potential obstacles to, actions. 5. able to express a positive sense of self-efficacy (a sense of "I can" and a general optimism about the outcomes of his or her personally initiated actions). 6. able to express a positive connection and relationship to at least one significant• accessible adult. 7. able to describe participation in and a positive connection to one social group experience (school, club, hobby, peer group; music or art-related instruction;

sports, etc.). 8. 9. 10. 11. 12. 13. 14.

able to show sensitivity to his or her own feelings and those of others. able to approach and converse with peers, showing appropriate eye contact, using an appropriate tune of voice, displaying proper posture, and using appropriate language. able to approach and converse with adults, showing appropriate eye contact, using an appropriate tone of voice, displaying proper posture, and using appropriate language. able to manage stressful situations adequately. able to recognize when he or she needs help and effectively seek out that help. able to begin, follow through on, and complete tasks and projects. living with parents or primary caretakers who provide adequate shelter and basic living resources, do not engage in extremes of permissiveness or punitiveness, and have the capacity to contain their own conflict, discord, and disagreements concerning childrearing.

ness (Elias & Clabby, 1992). There also is an acknowledgment of the influence, but not the determining force (of. Belsky, 1980), of considerations related to the child's primary socialization environment. These skills are close to White's (1988) sense of what would provide a workable perspective concerning social competence. They represent aspects of functioning that: 9 are reasonably distinct but clearly interrelated; 9 are presented in practical terms which lend themselves to observation and lay discussion; 9 can be translated into areas for intervention and training at both person and environment levels (i.e., efforts can be directed toward creating environments which will encourage the development, nurturance, and continuing, broad expression of the skills across various role contexts); 9 are interrelated with other competencies not explicitly identified (which means that efforts to build the competencies in "lhble 1 will

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have a radiating effect without having to attempt to impact on each skill separately); and are likely to be associated with positive "adjustment;" however, cultural variations and developmental norms and expectations concerning the nature and degree of expression of these skills require the continued use of such terms as "appropriate," "adequate," and "realistic" in any overall listing of competencies.

A GUIDING VISION A guiding vision that will foster health and social competence in children and serve the purposes of primary prevention can be seen in Figure 2. In this vision of a schoolhouse, there is a shared prevention/promotion strategy/set of skills (denoted as "SPS"), a common framework that allows diversity to become synergy. It reflects what can happen when the social competencies of serf-control, social awareness and group participation, social decision making and problem solving, and other aspects of 1hble 1 are taught to individuals and adopted by the environments of children as an organizing principle. The confusion portrayed in Figure 1 persists in part because "instruction ...typically places little emphasis on the development of thinking and other higher order skills" (Levine, 1988, p. 118), partially because even model practice programs "are not and should not be seen as substitutes

__---~-- A C O M M O N F R A M E W O R K ~ PROVIDES S Y N E R G Y I

Fig. 2

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for improving the basic institutions of adolescent life" (National Research Council, 1993, p. 222), and because the slow pace of change in the schools is linked to the history and structure of education, unions, teacher and administrator training, national and state policies concerning education, and an inadequate shared vision of the need for urgent action as outlined earlier (Elias, in press). "lbo often, the magnitude of the problem can be such that efforts at change are discouraged. There is a need for clarity, focus, and simplicity; as the number of components and independent implementation contexts goes up, the core of the model must be simplified; continuity is required both horizontally-across related settings at a given point in time--and vertically--developmentally and historically. Creation of a simplified, coherent, and cohesive system will be enhanced by the presence of a shared prevention/promotion strategy or set of skills. Inspired by Sarason (1978, 1982), Cowen (1980), and Weick (1984), it is possible for each school-based professional in every setting to define "baby steps" and "small wins" that can contribute toward the goal of preventing harmful outcomes and promoting the social competencies necessary for meeting the challenges of the 21st century and beyond. The shared basis for this work can be the following set of beliefs, derived from the information presented earlier: 1. The life of each child must be valued as important. 2. The potential of each child as a contributor to society must be cherished and enhanced. 3. Involvement of children in substance abuse, violence, and other problem behaviors must seem as abhorrent to caregivers, socializing agents, policy makers, and prevention researchers and program developers as would be the case if members of their own families were so involved. 4. Primary prevention is emergent from the promotion of health and social competence; the latter are ends in themselves, reflecting what are children's inalienable, developmental "rights" (Masterpasqua, 1981); efforts to promote health and social competence should not have to justify themselves by their targeted preventive impact. 5. Primary prevention flows from the process of socialization and is limited in its success by the nature and totality of how children in different contexts of living are socialized. It is now up to those persons concerned with primary prevention--and therefore with the education and the socialization of children--to examine their efforts and determine the extent to which they are addressing focal

Health and Social Competence Promotion

21

skills and doing so in a coherent, developmental, and cross-culturally sensitive manner. The programs to convey skills to children exist; what is needed is the commitment of resources, time, and focused professional development activity guided by the tenets of knowledge in the primary prevention field (Consortium on the School Based Promotion of Social Competence, 1991) to turn the jumbled, well-intentioned schoolhouse into a bastion of educational synergy.

ACKNOWLEDGMENTS

I would like to thank my colleagues in the Society for Community Research and Action for many stimulating exchanges concerning primary prevention. The ideas in this article are based upon much additional reflection upon views presented in Building Social Problem Solving Skills: Guidelines from a School-Based Program (Elias & Clabby, 1992, Jossey-Bass, publishers).

REFERENCES American Psychological Association Commission on Violence and Youth (1992). Report of the American Psychological Association Commission on violence and youth. Washington, D.C.: APA. Association for Children of New Jersey (1993). Stolen futures. Newark, NJ: Association for Children of New Jersey. Battistich, V., Elias, M. J., & Branden-Muller, L. (1992). Two school-based approaches to promoting social competence. In G. Albee, L Bond, & T. Monsey (Eds.), Improving children's lives: Global approaches to prevention (pp. 212-234). Newbury Park, CA: Sage Baumrind, D. (1987). A developmental perspective on adolescent risk taking in contemporary America. In C. E. Irwin, Jr. (Ed.), Adolescent social behavior and health: New directions for child development (No. 37, pp. 93-126). San Francisco: Jossey-Bass. Belsky, J. (1980). Child maltreatment: An ecological integration. American Psychologist, 35, 320-335. Bronowski, J. (1971). The ascent of man. Boston: Little, Brown. Carnegie Council on Adolescent Development. (1989). Turning points: Preparingyouth for the 21st century. New York: Carnegie Corporation of New York. Center for Early Adolescence (1988). Before it's too late: Dropout prevent~n in the middle grades. Carrboro, NC: Center for Early Adolescence. Commission on the Prevention of Mental-Emotional Disabilities. (1986). The prevention of mental-emotional d/sab'd/ties. Alexandria, VA: National Mental Health Association. Consortium on the School-Based Promotion of Social Competence (1991). Preparing students for the twenty-first century: Contributions of the prevention and social competence promotion fields. Teachers College Record, 93, 97-105, Cowen, E. L The wooing of primary prevention. American Journal of Community Psychology, (1980), 8, 258-284. Dodge, K., Pettit, G., Mc'Claskey, C., & Brown, M. (1986). Social competence in children. Monographs of the Society for Research in Child developmen4 51

22

Elias

Duncan, D. F. (1994). The prevention of primary prevention, 1960-1994: Notes toward a case

study. Journa/of Primary ~

15, 73-80.

DuPaul, G., & Eckert, T. (1994). The effects of social skills curricula: Now you see them, now you don't. School Psychology O , merly, 9, 113-132. Eisner, E., Sternberg, R., Levin, H., & Gardner, H. (1994). Multiple intelligences--The theory in practice: A symposium. Teachers College Recor~ 95, 555-583. Elias, M. J. (1987). Establishing enduring prevention programs: Advancing the legacy of Swampscott. Amer/cun Journal of Communify Psychology, 15, 539-553. Elias, M. J. (1989). Schools as a source of stress to children: An analysis of causal and ameliorative factors. Journal of School Psycholo~, 27, 393-407. Elias, M. J. (1990a). The role of affect and social relationships in health behavior and school health curriculum and instruction. Journal of School Health, 60, 157-13. Elias, M. J. (1990b). Long-term social adaptation. In M. Green & R. Haggerty (Eds.), Ambu/atory pediatt/~ (4th ed.) (pp.64-68). Philadelphia: Saunder~ Elias, M. J. (1993). (Ed.) Social decision making and life skills developmenL" Guidelines for middle school educators. Gaithersburg, MD: Aspen. Elias, M. J. (1994). Consulting in school and related settings to promote the socialization of respons~le citizenship: A unifying approach to achieving social, health, and academic goals. Journal of Educational and Psychological Consultation, 5, 381-388. Elias, M. J., & Clabby, J. F. (1992). Building social problem solving sMlls: Guidelines from a school-based program. San Francisco: Jossey-Bass. Elias, M. J., Gager, P., & Hancock, M. (1993). Preventive and Social Competence Programs in Use in New Jersey Public Schools: Findings From a Statewide Survey: An Executive Summary of a Report from the School Intervention Implementation Study. New Brunswick, New Jersey: Rutgnrs University Psychology Department. Elias, M. J., Weissberg, R., Dodge, IC, Hawkins, J. D., Kendall, P., Jason, L., Perry, C., Rotheram-Borus, M. J., & Zins, J. E. (1994). The school-based promotion of social competence: Theory, research, action, and policy. In R. Haggerty, L. Sherrod, N. Garmezy, & M. Rutter (Eds.), Stress, risk, resilience in children and adolescents. (pp. 268-316). New York: Cambridge University Press. Ford, M. E. (1982). Social cognition and social competence in adolescence. Developmental Psychology, 18, 323-M0. Gager, P., & Elias, M. (under review). Conditions for Implementing Prevention Programs in High-Risk Environments: Application of the Resiliency Paradigm. Gardner, H. (1991). The unschooled mind. New York: Basic Books. Garland, A, & Zigler, E. (1993). Prevention of adolescent suicide. American Psychologis~ 48, 159-168. Gibbs, J., Huang, L., & Associates (1989). Children of color:. Psychological Interventions with minorify youth. San Francisco: Jossey-Bass. Gilligan, C. (1987). Adolescent development reconsidered. In C. E. Irwin, Jr. (Ed.),Adolescent social behavior and health: New directionsfor child development (No. 37, pp. 63-92). San Francisco: Jossey-Bass. Goodstadt, M. (1986). School-based drug education in North America: What is wrong? Journal of School Health, 56, 278-281. Gresham, F. M. (1994). Generalization of social skills: Risks of choosing form over function. School Psychology Quarterly, 9, 142-144. Hancock, M., Gager, P., & Elias, M. J. (1992). Factors Influencing the Effectiveness of Preventive and Social Competence Programs in New Jersey Public Schools: A Survey of Educators. (Working Paper #2, School Intervention Implementation Study). New Brunswick, NJ: Rutgers University Center for Applied Psychology. Hawkins, J. D., Catalano, R., & Associates (1992). Communities that care: Action for drug abuse prevention. San Francisco: Josscy-Bass. Hechinger, F. M. (1992). Fateful choices: Healthy youth for the 21st century. New York: Hill and Wang. Institute of Medicine (1993). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, D.C.: National Academy Press.

Health and Social Competence Promotion

23

Irwin, C. D., Jr. (Ed.) (1987). Adolescent social behavior and health: New Directions/or Child Deve/opme~ (No. 37). San Francisco: Josmy-Bass. Kantor, H. (1994). Managing the transition f~om school to work: The false promise of youth apprenticeship. Teachers College Record, 95, 442-461. I.~ukefeld, C., & Clayton, IV,.(1994). Drug prevention: The past as future? Journal o f ~ Prevat~n, 15, 59-72. Levine, D. (1988). Teaching thinkin~ to at-risk students: Generalizations and speculation. In B. Presaeisen (Ed.),At-risk sauta~ and thinking: Per~ectives from research (pp. 117-137). Washington, D.C.: National Education ~ t i o n / R e s e a r c h for Better Schools. Lickona, T. (1991). F_.duca~gfor chamcta:. How our schoo/s can teach respect and respons/b///0,. New York: Bantam-Doubleday-Dell. London, P. (1987). Character education and clinical intervention: A paradigm shift for U.S. schools, eh/De/ta Kappan, 68, 667-673. Masterpasqua., F. (1981). Toward a synergism of developmental and community psychology. Amer/can Psycho/og~ 36, 782-786. Mercer, J., Gomez-Palacio, M., & Padilla, E. (1986). The development of practical intelligence in cross-cultural perspective. In IV,.Sternberg & IV,.Wagner (Eds.) Practical intelligence: Nature and organimlion of competence in the everyday word (pp. 307-337). New York: Cambridge University Press. Mirman, J., Swartz, R., & Bareil, J. (1988). Strategies to help teachers empower at-risk students. In B. Presseisen (EEL),At-risk students and thinking.. Perspectivesfrom research (pp. 138-156). Washington, D.C.: National Education Association/Research for Better Schools National Commission on Children (1991). Beyond rhetoric:A new American agenda for children and fam///es. Washington, D.C.: National Commission on Children. National Commission on Excellence in Education (1983). A nation at risk." The imperative of educational reform. Washington, D.C.: U.S. Government Printing Office. National Research Council Panel on High Risk Youth (1993). Losing generations: Adolescents in high-risk settingx. Washington, D.C.: National Academy Press. Office of Educational Research and Improvement (1987). Dealing with dropouts: The urban superintendents' call to action. Washington, D.C.: U.S. Government Printing Office. Perry, C., Keider, S., & Komro, IC (1993). The social world of adolescents: Families, peers, schools, and the community. In S. Millstein, A. Petersen, & E. Nightingale (Eds.), Promoting the health of adolescents: New directionsfor the twenty-fret centusy (pp. 73-96). New York: Oxford University Press. Price, R., Cowen, E., Lorion, R., & Ramos-McKay, J. (Eds.) (1988). 14 ounces of prevention: A casebook for practitioners. Washington, D.C.: American Psychological Association. Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57, 316-331. Sarason, S. B. (1978). The nature of problem solving in social action. American Psychologis~ 33, 370-380. Sarason, S. (1982). The cu/ture of the school and the problem of change (2nd ed.). Boston: Allyn & Bacon. San Francisco: Jossey-Bass. Schinke, S. (1994). Prevention science and practice: An agenda for action. Journal of Primary Prevention, 15, 45-58. Schorr, L (1988). Wh,h/n our reach.-Breaking the cycle ofdisudvantage. New York: Doubleday. Shure, M. B., & Spivack, G. (1988). Interpersonal cognitive problem solving. In R. Price, E. Cowen, R. Lorion, & J. Ramos-McKay (Eds.), 14 ounces o/prevention." A casebook for pracationers (pp. 69-82). Washington, D.C.: American Psychological Association. Srebnik, D., & Elias, M. J. (1993). An ecological, interpersonal skills approach to drop-out prevention. American Journal of Orthopsychiatry, 63, 526-535. Sternberg, R., Okagaki, L, & Jackson, A. (1990). Practical intelligence for success in school. Educational Leadership, 48~ 35-39. Sternberg, R., & Wagner, R. (Eds.) (1986). Practical intelligence: Nature and organization of competence in the evayday world, New York: Cambridge University Press.

24

Elias

Waters, E., & Sroufe, L. (1983). Social competence as a developmental construct. Developmental Review, 3, 79-97. Weick, K. (1984). Small wins: Redefining the scale of social problems..Amer/caJt Psycholog/~ 39, 4049. Weimberg, R., & Elias, M. J. (1993). Enhancing young people's social competence and health behavior:. An important challenge for educators, scientists, and policymakers, and funders. Applied & Preventive P~JwloD', 2, 179-190. Weissberg, R. P., Jackson, A. S., & Shriver, T. P. (1993). Promoting positive social development and health practices in young urban adole~ents. In M. J. Elias (Ed.), Soda/

decision making and h'fe skills developmenL" Guideline~ for m~d~ school educators (pp. 45-78). Gaithersburg, MD: Aspen. Westchester County Social Competence in the Schools Task Force (1990). Promoting soc/a/ development in elementary school children: A task force report. Westchester County, NY: Department of Community Mental Health. White, B. (1988). Educating the infant and toddler. Lexington, MA: Lexington Books. William T. Grant Commission on Work, Family, & Citizenship (1988). The forgotten half: Pathways to success for America's youth and youngfam///es. New York: William T. Grant Foundation. Zins, J., & Forman, S. (1988). Mini.series on primary prevention in the schools: From theory to practice. School Psycholo~ Review, 17, 539-634.