Preventing Serious Antisocial Behavior in Inner-City Children: An Empirically Based Family Intervention Program

Abstract

This article describes a 22-week family intervention program, specifically designed to prevent antisocial behavior in ur nority children. This program was developed as one component of the Metropolitan Area Child Study, a multiyear delinquen prevention field trial. A theoretical model for strengthening aritical family processes related to the emergence of anti havior is presented, and specific intervention goals, moldalities, and activities are described. Recommendations for the ment, implementation, and evaluation of family based prevention programs are highlighted. AN EMPIRICALLY BASED FAMILY INTERVENTION PROGRAM* Patrick H. Tolan and Mary McKernan McKay Early displays of antisocial behavior are a serious public health issue. Urban areas in particular have crime rates 4 to 10 times higher than the national average, with the violent crime rate highest among inner-city African American and Latino young men (Fingerhut & Kleinman, 1990; Hammond & Yung, 1991). Because urban violence has risen dramatically since the 1950s, the prevention of antisocial behavior has become a national priority (Tolan & Guerra, 1994; Tolan & Loeber, 1993). Family factors have been consistently implicated in studies as among the most powerful predictors of aggressive behavior (Loeber & Stouthamer-Loeber, 1987; Tolan, Cromwell, & Brasswell, 1986). Also, intervention at a family level has shown significant promise in reducing the emergence of serious antisocial beahvior (Alexander, Barton, Schiavo, & Parsons, 1976; Henggeler, Melton, & Smith, 1992; Patterson, Chamberlain, & Reid, 1982; Tolan & Mitchell, 1989; Webster-Stratton, 1990). There are indications, however, that it is difficult to secure the involvement of families with children who display high levels of aggression or conduct disorders in mental health services (Reid, 1991). Further, once aggression level becomes a clinically significant problem and a conduct disorder is established, intervention effectiveness may be limited (Tolan & Loeber, 1993). Thus, there are clear advantages to implementing preventive interventions prior to the formation of serious, chronic problems and to focusing prevention on families. Previous studies have found that family intervention programs are less successful in involving families who are of low socioeconomic status, experience more stressors, and/or have fewer social resources (Miller & Prinz, 1990; Wahler & Dumas, 1989; Webster-Stratton, 1990). It is children from these segments of society who are most at risk for serious behavioral difficulties, yet they are the least focused upon in prevention programming. This article describes one effort to reach at-risk children and their families with a 22-week family intervention program specifically designed to prevent the development of serious antisocial behavior in urban minority children. We describe the critical family processes related to the emergence of childhood behavioral difficulties that guide the intervention design, features that enhance participation, and common impediments to family-oriented prevention. The family program described here was developed as part of the Metropolitan Area Child Study (MACS), a multiyear, delinquency prevention field trial (Guerra, Tolan, Huesmann, VanAcker, & Eron, 1990). The MACS program is a combined universal and selected prevention program meant to impact norms that support aggression in the general population and to reduce aggressive behavior in a high-risk sample. Prevention efforts can be differentiated by the population of interest (Gordon, 1983; Institute of Medicine, 1993; Tolan & Guerra, 1994). Universal programs focus on the whole population, are usually less extensive, and are designed to lessen subsequent prevalence. Selected programs target at-risk groups to lessen the proportion who later exhibit the problem to be prevented. Indicated populations programs focus on those exhibiting early forms or predisposing characteristics for the outcome to be prevented. …