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Summary school-and family based prevention
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SFBP 22-23Theoretical principles and framework
1. Definition
“Stopping a problem from ever occurring”
Prevention is more!
• delaying the onset of a problem behavior, especially for those at-risk for the problem
o if a problem is there very early in life most of the times it’s more extreme
• reducing the impact of a problem behavior
o like teaching the kid social skills, teaching parents how to act, teaching how to structure -> learning how
to handle negative things
• strengthening knowledge, attitudes, and behaviors that promote emotional and physical well-being
o promoting healthy behavior
• promoting institutional, community, and government policies that further physical, social, and emotional well-
being of the larger community
o rules and regulations put in place to prevent stuff like substance abuse
o not only focus on individual, but also on the environment
2. Why?
Why devote time and energy in prevention?
• Demonstrated to be an effective way to reduce psychological distress and enhance human functioning
• Reduces the costs of mental health care
o Promoting social skills in school is less expensive than the costs of therapy -> prevention is cheaper than
treatment
• Early and focused preventive interventions can limit the length and severity of symptoms and enhance functioning
o The earlier the prevention the better the prognoses will be
• Focus on strengths and competencies
3. Wat does prevention look like?
What kind of prevention have you been exposed to?
• Information, warning, advise and other preventive methods
= Ways to target/promote certain things -> separated actions
o Campaigns, websites, …
o Political actions
o Techniques, f.e. rewarding
o …
• Prevention programs (interventions)
= program, set of actions for preventions
For example: activities are placed together in a program to follow
• Multilevel prevention policy f.e., VAD
= methods & interventions/programs together
For example alcohol use prevention in school
You use 1 program targeting alcohol use. If you add a multilevel policy you could also target positive
Targeting different aspects to target a problem, not only focus on the problem or the group, but also positive
thinking/healthy behavior & the people surrounding your target audience
➔ Drug campaigns in school, suicide prevention, photo on cigarettes, covid campaigns
4. Categorization
Caplan (1964) primary, secondary and tertiary prevention (old)
Primary: prevention that focuses on focusing on the problem before it occurs. Focusing on the risk & protective factors.
Secondary: focused on screening & trying to find out who’s at risk & intervening before it becomes worse
Tertiary: to put in place after MH issues occur. Focus on recovery/treatment
➔ Focus on the problem
Gordon (1987)
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,SFBP 22-23
-> officially adopted by institute of medicine
Universal prevention: focus on everybody, not taking into account the problems that are already there f.e. prevention
applying into all of the 2ND grade (some kids might already have problems or will have higher risks to develop it -> this will
not be taken into account)
Selective prevention: target those who have a higher risk of developing a problem f.e. children of parents with psychiatric
problems have a higher risk to develop it themselves. -> so the focus is on those kids
➔ Here you have to know who is more at risk, which you don’t always know
Indicated prevention: target on those who already have symptoms, you want to prevent the worsening of the symptoms
➔ Gordon = Focus on target population
You should be able to know what type a given prevention method is
De Roos & van Dinther (2011)
Collective: focus on group of people (f.e. whole classroom) <-> individual
General (promoting well-being) <-> specific (f.e. anti-drug prevention)
Situational – focuses on the environment surrounding your target population (no alcohol
stores close to schools)
<-> person oriented – focusing on things within the person themselves
Indirect – works through mediators f.e. learning kids stuff by teaching their parents
methods <-> direct f.e. teaching the kids stuff
Most tertiary preventions are focused on the individual
Deklerck & Depudt (2001) ; Deklerck (2011)
Prevention pyramid
You have a multi-level prevention policy that is build up by using different prevention activities on different levels. It’s mostly
used within schools. This prevention pyramid categorizes all the different preventive activities that you can do within such a
prevention policy.
Level 0: is actually not within the school but it’s about creating a kind of environment around the school
f.e. bullying: you want to prevent bullying in school, this level focuses on what you can do within the society.
-> it focuses on law and regulation and actions to change attitudes toward bullying
f.e. There is a law against spreading naked pictures of children
Level 1: something you can do within the school. It focuses on the school culture. Trying to stimulate a positive school climate
in general
f.e. team building for teachers so that they feel good together, trying to get parents more involved in schools
-> putting preventive activities in place that have an effect on the school climate
When you have a positive school climate where students & teachers feel good, the chance of problems evolving
gets diminished
Level 2: focuses on strengthening the people within the school
f.e. teaching kids social skills, making their resilience higher, increasing empathy, …
these actions are focused on making the individual stronger & enhancing the protective factors within a person
Level 1 & 2 are focused on enhancing well-being in general
Level 3: specific prevention activities, these aren’t focused on increasing protective factors but diminishing risk factors
specifically for the problem you’re interested in
f.e. setting up clear rules & guidelines within the school of how we behave towards each other & what is allowed
and what not, teaching teachers to detect bullying.
On this level you can also implement a prevention program that specifically helps kids become more resilient towards bullying
Level 4: curative measures, these aren’t preventive anymore, these are curative activities you put into place to act out when
you are confronted with the problem. it’s how you handle the problem when you’re faced with it. Things you do when the
problem occurs.
f.e. what do you do when you have a case of bullying
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,SFBP 22-23
Level 3 & 4 are focused on the problem (diminishing the risks & handling the problem)
5. Importance of research and theory
To prevent problems/enhance well-being …
• One should target those factors that contribute to the development of problems → Risk and protective factors
o knowing the negative effects doesn’t necessarily mean that the use is going to be decreased. So it’s not a
risk factor.
• Using effective methods
o Scaring people out of it doesn’t work. If we see the same things over and over again, it won’t be useful
anymore
f.e. pictures on cigarettes packages -> not really effective in the prevention of smoking,
What are the risk and protective factors? Which methods are effective?
Knowledge comes from research & theory on (what changes) risk and protective factors of a given problem. -> you need
research to know what exactly you need to target.
6. Theoretical framework
How would you start when asked to find and implement a prevention program for a specific
problem.
e.g., school wants to promote healthy sexual behavior
Important to do things in the correct order (4 steps for the theoretical framework)
1. Analyze the question/problem/need/…
Describe the given problem
• Nature of the problem
• Etiology of the problem
• -> how do they define the problem, what are risk & protective factors -> so that you know how to target the problem
-> first you talk to the school
2. Selecting an intervention
What are the characteristics of the intervention?
• Goodness of fit:
o Target population
o Goals
o Change theory
o Method
• Effectiveness
• -> look for an intervention that fits your target (f.e. the video in the ppt is not effective because it didn’t fit the
target population, the message was not clear, it was supposed to be sarcastic)
3. Implementing an intervention
• Factors facilitating & inhibiting good implementation
• Advise and good practices on how to use facilitating factors to your advantage & how to overcome inhibiting
factors?
o If you choose a good intervention, it is crucial to implement it well, otherwise it won’t be a good
intervention then you can’t say that the program is effective)
4. Evaluating an intervention
• Effect evaluation (Are the goals achieved?)
• Process evaluation (Is the program implemented well?)
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, SFBP 22-23
7. Pitfalls (mistakes you can make)
Examples:
• Intervention focusses on wrong determinants
• Intervention does not fit
o The target population
o The goals you want to achieve
o …
• Trouble implementating the intervention
• The intervention is not effective
• …
8. Focus on prevention at school and at home
Focus of the present course:
1/ What you can do as psychological consultant within the school and/or pedagogical context?
2/ Prevention setting: School, home and peer context
Why?
• Make it possible to focus on prevention early in life (it will make it less severe & it will have a better prognoses)
• Youngsters spend substantial amount of time in these contexts
o Making them susceptible to influences of these contexts (f.e., teacher-child relationships; parent-child
relationships, peer relationships, …)
o Making them more easily accessible for prevention in these contexts
9. Prevention landscape in Flanders
• Many organisations
• Mostly use of (effective) preventive methods
• Less implementation of existing (empirically supported) interventions
Reinforcement: promoting positive behavior (you sit good on a chair, you’re so quiet, …-> = a preventive method not a
program, because you don’t have to follow a certain program
Preventive care in Flanders (zie Preventiedecreet 2003)
1/ Partner organizations (https://www.zorg-en-gezondheid.be/partnerorganisaties)
• Who? Expert organisations f.e. Vlaams Instituut voor Gezond Leven, VAD, Sensoa, Eetexpert, Kind & Gezin, Vlaamse
Instituut voor Suïcidepreventie, Vlaams Wetenschappelijke Vereniging voor Jeugdgezondheidszorg
-> they have a certain expertise on certain topics
• Task?
o Support Logo’s, field-organizations, individual care givers and others
o Inform, give advice, and develop interventions and support the implementation and use
• Sponsered by the Flemish government
2/ Local Health Support (Lokaal Gezondheids Overleg; LOGO’s)
• Task?
o Communicate preventive activities and interventions from Flemish government (f.e., partner
organizations)
o Follow up on the progress of the health goals 2025 (gezondheidsdoelstellingen 2025)
o -> they communicate about the things that partner organizations do/made, they communicate about
preventions
• Sponsered by the Flemish government
3/ Field organisations (https://www.zorg-en-gezondheid.be/organisaties-met-terreinwerking)
• What? Field: focus on end users in different societal sectors such as education, health and well-being, leasure time,
culture, work and local administration. Do NOT work with children and youth, but with intermedial groups such as
teachers and sports trainers
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