An interview with Dr. Gilbert J. Botvin, a professor of psychiatry and public health at the Cornell University Medical College. Botvin is director of Cornell's Institute for Prevention Research, and developer of the Life Skills Training drug abuse prevention program. In describing the strengths of this program, Dr. Botvin told interviewer Charlene Porter why many traditional approaches to drug abuse prevention have failed.

Question: How do you define "life skills," and what do they have to do with the choice someone makes to get involved with drugs?

Botvin: First of all, it's important to keep in mind that the high-risk period for early involvement with drug use occurs at the beginning of adolescence. So we're talking about a problem that, by and large, has its genesis in childhood and adolescence. It's become clear to us that there isn't a single or even a few small factors that are involved in promoting drug use, but a complicated mix of factors. On the one hand, there are social influences, external influences -- from the environment, from the media -- that are promoting drug use. Influences are also coming from one's peers, one's friends. In addition, a number of other factors tend to promote drug use, and they relate to one's internal motivations to use drugs. So you have external factors promoting drug use, and internal pressures that might motivate one to use drugs.

It's our belief that the most effective types of prevention programs teach kids a set of general life skills that they can use to deal with the challenges of their everyday lives as adolescents. By enhancing their competency in these skills, we not only reduce their motivations to use drugs, but also their vulnerability, their susceptibility to the external pressures. In addition to general life skills, we are also teaching them information and skills that are specific to the problem of drug abuse. For example, we teach them how to effectively resist social pressure, how to resist pressure coming from the media and pressure coming from their friends, how to effectively say "no," how to identify and avoid high-risk situations where they know they may be pressured to use drugs.

There are two general categories of life skills that we teach. One category is a set of self management skills to enhance a sense of personal control and empowerment -- skills in making decisions, skills for coping with stress and anxiety. We also teach a set of social skills, such as communication skills, conversation skills, assertiveness, and skills that would help youth meet new people and make new friends.

Most of us have learned these skills as adults. Some of us have learned these things by observing the behavior of adults while we were growing up, but kids are increasingly spending more time with other kids. They're spending less time with adults, so you have a situation of the blind leading the blind. So we think it's important to teach these skills in a systematic way in a prevention program. By this combination of teaching general skills and problem-specific informational material related to drug abuse, we can cut drug abuse by 50 to 60 percent.

Q: Being a better communicator, knowing how to make friends -- what do those skills have to do with whether a kid is going to try drugs or not?

A: People have misunderstood the causes of drug abuse. It's not a simple decision that people make to use drugs or not use drugs. All the traditional approaches to provide kids with information about the dangers of smoking, drinking, and using illicit drugs have largely failed. Research studies evaluating those kinds of information dissemination approaches -- or even approaches using scare tactics to emphasize the dangers of drug use -- studies show that these approaches are totally ineffective.

The problem is much broader, and you need a holistic approach, one that's designed to target several different risk factors. A lot of the life skills that we're teaching are really protective factors. They're a way of buttressing kids up and decreasing their motivations.

Various factors promote drug use. For different kids, different factors seem to be more important. Some kids may use drugs if, for example, they feel uncomfortable in social situations. They may use drugs because they think it's going to help them deal with their social anxiety. By teaching them anxiety management techniques you give kids adaptive life skills, and those kids won't need to medicate themselves to deal with negative feelings coming from social anxiety.

Another aspect of this is that kids want to use drugs to gain entree into a certain peer group, to be accepted by a certain group of kids, or as a way of being more popular. By teaching them a set of social skills that enables them to meet new people and build healthy friendships, you reduce the motivation of kids to use drugs.

It's important to make kids aware of the fact that most kids don't use drugs. Kids seem to overestimate how many kids their own age, as well as how many adults, use drugs. That sense of "everybody's doing it" puts pressure on each and every kid to conform to what they perceive to be a norm, but which is a misconception. By making kids aware of the fact that most kids don't use drugs, by making kids aware of the fact that it's normal not to use drugs, you reduce the pressure to conform to these external standards that don't really exist.

So it's really a combination of all these factors together -- those that relate specifically to drug use and pressure to use drugs, as well as these more general life skills that give kids an increased sense of personal control and self-esteem, that decrease their anxiety in social situations, give them techniques to deal with many of the challenges that they confront in life, and, in general help them to be more happy and successful.

Q: You mention programs that emphasize the dangers of drugs have not been very effective, according to some studies. Is it because they lack this multi-dimensional approach you describe? Are they too one-dimensional?

A: Yes, that's exactly right. The information dissemination programs have been the ones I've highlighted because they've been the traditional approach to drug abuse prevention in America.

It seems logical that they would be effective. Your kids are using drugs, and you make them more aware of the dangers of using drugs, and they're likely to make a rational decision not to use drugs. But kids don't formally make a decision to use drugs. They slip into it. They gravitate toward using drugs, without formally thinking about it in most cases. It's not a rational process, so approaching it in a rational way by giving them knowledge and information doesn't help solve the problem.

It really is this multi-dimensional aspect of the problem that has been missed by past prevention approaches and has been incorporated into the Life Skills Training program. It really takes a comprehensive, holistic approach.

Q: One explanation that we frequently hear about a youngster who's gotten involved in drugs is that he "fell into the wrong crowd." How does Life Skills Training work to prevent a youngster from "falling in" with the wrong crowd?

A: In a couple of ways. By giving kids a set of general life skills, it helps them to succeed as adolescents. Kids who are having a hard time with adolescence -- socially, athletically, or academically -- those kids tend to gravitate toward a deviant peer group. They tend to move away from the kids who are on the success track, and gradually get on what researchers call a "different trajectory" in life. In some case, they move toward the deviant peer group because they think that's the only group that will accept them. They see themselves as losers. On the other hand, they may reject the values of the kids who are on the success track -- those who are doing well in school and doing well in sports -- and gravitate toward a more deviant set of values. Again, it's a combination of these internal and external reasons.

Some kids have a characteristic that's been referred to as sensation seeking. They are kids looking for high stimulation, for more excitement in life. Not all kids fall into this category, but a number of kids who are interested in using drugs have this characteristic of the high-sensation seekers. Taking risks, doing dangerous things, riding motorcycles, sky-diving -- kids who gravitate to these activities will often also use drugs.

So the Life Skills Training program, by teaching kids this variety of skills, reduces the likelihood that kids will gravitate toward a more deviant social network.

Q: What about the sensation-seekers? Is Life Skills Training something that can tame that search for the thrill?

A: It can't entirely, but it can to some extent. In the anxiety reduction skills, we teach relaxation training techniques to help kids gain control of their feelings when they start feeling stressed or anxious. It teaches them how to relax, to feel calm. These things are helpful for kids with attention deficit disorder or who may have a sensation-seeking personality. We have found that Life Skills Training does reduce risk taking. By having a set of skills to be in control of their own lives, kids are better able to not only control their impulses, but also to get on a success track and to develop feelings of excitement through more adaptive means than using drugs.

Q: What is the role of the parent as the child is learning these new coping skills?

A: That's part of this equation that we've just started to experiment with in the last couple of years. We're trying to make parents aware of the importance of monitoring their kids' behavior, making sure they're supervised, making sure they know who their kids' friends are. They need to assess the friendship network, and if kids are starting to gravitate toward a deviant peer group, then the parents can intervene to prevent that. It's relatively easy early on to prevent that. As kids get older, as kids become more entrenched with a deviant peer group, it becomes more difficult to change that.

Parents also need to make their children aware there's an anti-drug ethic in the family, an anti-drug norm. They should communicate that clearly. Parents need to set appropriate and fair rules and standards of conduct, and have punishment that's reasonable. There's a bi-modal distribution when it comes to discipline. As you might expect, kids coming from families where the parents are permissive are at a very high risk for using drugs. But also, those kids who come from families where the discipline is particularly harsh are at high risk for using drugs. Finding a happy medium between these two extremes is often a challenge, but parents need to be informed about the dangers of being either too permissive or too harsh in their disciplinary practice.

Q: So do you have great faith in the power of intervention to prevent drug abuse?

A: Yes and no. It's important to keep this in perspective. We have 20 years of research demonstrating that the Life Skills Training approach can cut drug use in half when you compare the kids in schools getting Life Skills Training with those in schools where they didn't receive the training. We have over a dozen studies published in scientific journals showing that this kind of prevention approach can significantly and dramatically reduce drug use. Our success rates go as high as 90 percent, but let's use a 60 percent success rate, for example, to illustrate this point. If we say that Life Skills Training , when offered to a particular group, will produce a 60 percent reduction in the number of kids who will turn to drugs, you're still missing 40 percent. Even the most effective prevention program is going to miss a lot of kids. So that's an important challenge.

Another important challenge: a prevention program, no matter how good it is, will tend to erode over time, unless you have ongoing intervention, what we refer to as a "booster" session. This is particularly true in the critical junior high school years.

I have a lot of faith based on the research evidence we have. But are we reaching everybody? No. There's still a substantial number of kids we're not reaching.

Q: Is it possible to reach every kid, or do you fear such a program is beyond our capabilities?

It is clearly beyond our capabilities right now. The jury's out on what our capabilities might be in the future. I'm confident we can increase and improve the effectiveness of our prevention programs. As knowledge develops, and we get a clearer idea on the underlying causes of drug abuse, it will make it easier for us to improve and refine our prevention approaches.

Most of what we've tried hasn't worked very well. It's important that we get beyond the conventional wisdom that prevention doesn't work, which does seem to be prevalent in the general public, and in the halls of Congress to some extent. We need to disseminate information firstly, and most importantly, that prevention can work. There are approaches out there that can make a difference if they're implemented carefully and properly. The second important point is that we've learned a lot in the past 20 years about what works and what doesn't work, but there's a huge gap between what researchers know and what practitioners continue to do. So we need to successfully translate what we've learned in the research arena into action by reaching out to program providers, prevention practitioners, and educators. We need to show them specifically the kinds of approaches that are effective.

Charlene Porter follows global issues for the U.S. Information Agency.