Alan Berkowitz, Ph.D.
Effective prevention by definition cannot be “piece-meal” but must be strategic both “within” and “across” risk areas. This in some cases can be in the form of a prevention curriculum as long as it is well constructed, has the buy-in of key players, and is effectively delivered. The prevention principles noted above apply to any prevention effort including a “strategic prevention curriculum.” Thus – as with the concept of a “centralized prevention office” – the answer is “it depends.” Having an over-arching curriculum is no guarantee that it will be implemented in an effective manner or accepted by the audience. One of the skills needed for effective prevention is the accurate diagnosis of what the environment will tolerate at each stage of the prevention process. Therefore, in some environments, smaller, more-focused strategic efforts will accomplish more whereas larger, broader attempts at more comprehensive efforts may fail. In terms of prevention, bigger and/or more centralized is better only when certain conditions exist, and these conditions are often lacking. We must therefore remember that effective prevention is always a matter of strategy in the context of a realistic appraisal of what is possible in a particular environment at a particular time. When prevention is done well, the range of what is possible can be expanded over time and broader efforts can then be undertaken.
Prevention practitioners often focus on the “what” of prevention at the expense of the “how.” Yet how we implement a particular strategy or program is often the critical element in determining its success. More effort thus needs to be focused on creating an infrastructure for effective prevention and to understanding that prevention as a process requires certain skills and takes place in stages, with particular tasks to be accomplished at each stage. The skills required included collaboration, conflict resolution, and problem solving, skills that a prevention practitioner may not perceive themselves as needing to have. Too often, practitioners implement a specific practice without attention to the larger context necessary for that practice to be effective. And too often prevention practitioners work in isolation from each other without collaborating across disciplines and issues. Finally, even when practitioners make the effort to receive the necessary training in a particular prevention strategy, they do not routinely include the opportunity for expert consultation in their long term prevention plan. In this case, when unexpected challenges or obstacles arise the program may flounder. I have found that even a minimum of one hour of expert consultation a month can help practitioners to anticipate challenges and implementation difficulties and resolve them efficiently when they arise. The good news is that collectively we now have available to us strategies that can work and an understanding of the context necessary for them to be effective. It is now incumbent on all of us to educate ourselves about the specifics of these effective prevention practices as well as about the process of prevention itself.