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Partnerships in preventing adolescent stress: increasing self-esteem, coping, and support through effective counseling.

Article Excerpt
Primary prevention initiatives are important not only for mental health professionals but for school personnel as well. We offer mental health counselors two prevention models: Bloom's Configural Equation and Albee's Incidence Formula as excellent tools to plan and implement prevention programs in schools and in community-wide efforts to improve adolescent well-being. We acknowledge that diverse environmental variables impact mental health. We offer guidelines for building community-based partnerships to increase adolescent coping skills and to provide them with adequate support systems. We critically assess both primary prevention models and outcome research and offer ideas in how to utilize them in the practice of mental health counseling.

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We need prevention programs and community-based partnerships if we are to impact adolescent mental health concerns. Most professionals know that youth are vulnerable to environmental risk factors. Some, however, do not fully understand the current mental health status of youth and the risk and protective factors associated with various mental health disorders. We intend to provide this information to mental health counselors so that we can take a proactive stance in support of health in our teen population.

CONTEXTUAL OVERVIEW OF ADOLESCENT MENTAL HEALTH CONCERNS

Four major health problems account for 72% of the mortalities in youth between the ages of 5 and 24. They are: motor vehicle crashes, unintentional injuries (i.e., falls, fires, poisonings), homicides, and suicides, according to the Centers for Disease Control and Prevention (CDC, 1993). In addition, sexually transmitted diseases as well as unwanted pregnancies affect millions of youngsters every year.

Failed efforts to cope with the anxieties and difficulties in life can lead to mental health problems. Prevalence rates of 12% for mental health disorders and 15% for maladjustment disorders for the nation's youth are common (Institute of Medicine, IOM, 1994; McCabe as cited in Walker & Townsend, 1998). Preventing psychological problems has become as important as intervening when they arise. Mental health counselors need to acquaint the profession with prevention models that can work for at-risk children and youth.

Promoting mental health can prevent further behavioral problems and improve the quality of life for youth (Walker & Townsend, 1998). New initiatives in mental health counseling need to include primary, secondary, and tertiary prevention efforts designed to detect, treat, and forestall mental health problems before they take hold.

Premise and Purpose

Schools and mental health agencies have known the importance of prevention since 1994 because of Acts such as School Reform and Mental Health Reform. These reforms cite schools as a focal point of public health and primary care initiatives (Short & Talley, 1997). The elevation of schools as a place to intervene and prevent problems is logical because health problems interfere with learning. Promoting a holistic view of the learner, we see that children do not live in a vacuum and that many factors can impede their academic performance. For this reason schools and primary care facilities can serve as a hub where a wide variety of services can address the needs of all youth. Building partnerships between mental health counselors and schools is now a critical aspect of prevention in today's environment.

Multiple challenges face adolescents who experience numerous risk factors. Mental health and school counselors can team up to reduce adolescent stress and increase their coping strategies. The rationale for building partnerships is that environments can produce or reduce stress; therefore, services need to be available in the environmental settings where adolescents live and work.

We hope to provide mental health counselors with three pieces of information: first, we offer a critical overview of the empirical literature on primary prevention programs that target adolescent mental health concerns. Second, we promote partnerships between mental health and school counselors that can best utilize community resources within a given geographic region. Adolescent coping and self-esteem can be increased when services are coordinated and when they target specific risk factors. Third and finally, we want to convince mental health practitioners that prevention models can guide clinical research and practice.

PRIMARY PREVENTION

Definition

Primary prevention in mental health counseling is basically creating a program to help youth before something debilitating happens Prevention goes beyond restoration and focuses on strengthening existing skills (D'Andrea, 1984; p.554).

Three critical elements are prerequisites to any effective prevention program: a group orientation, a sound theoretical foundation, and a proactive stance (Cowen, 1982). Of course, prevention programs target at-risk groups who have the potential to develop problems.

Advance Premises

Analyzing primary prevention practices and high-risk populations, D'Andrea (1984) noted that traditional mental health services lack primary intervention initiatives because they focus on remediation rather than on strengthening current skills. If primary prevention programs are to work, they must use strengths that...

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