Implementing school-based substance abuse interventions: methodological dilemmas and recommended solutions

Abstract

Aims: To review current knowledge about the most effective school-based interventions for child and adolescent problems, and to present dilemmas and potential solutions in mounting and evaluating school-based interventions for adolescent alcohol and other drug (AOD) use problems.

Design: Two literature reviews were conducted: (1) a broad and encompassing review of English-language articles published from 1990 to the present concerning school-based interventions for child and adolescent problems and (2) an exhaustive review of articles concerning Student Assistance Programs, which are the most popular approach to school-based AOD intervention in the United States.

Findings: Ten key components of effective school-based interventions were identified. In addition, six pervasive dilemmas in school-based AOD intervention research were discussed. Examples of potential solutions to these dilemmas were gleaned from an ongoing randomized clinical trial of a Student Assistance Program.

Conclusions: School-based AOD interventions have several potential advantages over more traditional clinic-based AOD interventions. Nonetheless, there are many challenges and dilemmas to conducting and evaluating interventions in school settings. With patience and guidance, these challenges can be addressed successfully.