Youth Interventions

In Dana M. Rhule's (2005) article "Take Care to Do No Harm: Harmful Interventions for Youth Problem Behavior," she discusses the iatrogenic effects documented because of group interventions for problem youth. She explains that although such interventions are intended to ameliorate problem behaviors such as delinquency, aggression, and alcohol and drug use, it is often the case that they inadvertently increase negative behavior rather than improving it. She cites Lipsey (1992), who concluded that "approximately 29% of controlled interventions focusing on youth problem behavior produced iatrogenic outcomes" (Rhule, 2005, p. 619). Drawing on research and theory, Rhule (2005) identifies the peer group as performing a major function in youth problem behavior in terms of initiating, maintaining, and escalating it (Rhule, 2005, p. 619). She cites Stormshak et al. (1999), who contend that "the presence of many aggressive peers together in a group has been shown to contribute to a shifting of social norms, including a higher level of social acceptability and reinforcement for aggression" (Rhule, 2005, p. 619). Moreover, she points out that despite the lack of evidence suggesting that such interventions are successful, they continue to be used as standard treatment for problem youth (Rhule, 2005, p. 619).

Given the widespread use of group-delivery format interventions for troubled youth, it is disturbing that iatrogenic effects resulting from that format are common

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pt" and explore how such individuals "defy social norms by 'not doing' socially accepted behaviors." The authors find that five affirmation techniques-acknowledgment of responsibility, acknowledgment of injury, acknowledgment of the victim, discounting condemners, and reference to priority relationships-enable troubled youth to "remain steadfast to their ideals, beliefs and non-actions" (Copes & Williams, 2007, p. 247). Presumably then, by incorporating these five affirmation techniques within a specially developed peer group, a group delivery format might be effective and might be successful in avoiding iatrogenic effects. It is advisable to use the peer group approach only after the initial one-on-one counseling, however, and the intermediate adult group is still recommended as opposed to shifting the youth straight from one-on-one counseling into a peer group, regardless of how carefully it is constructed. Overall, the use of group intervention approaches with delinquent youth is contraindicated by the substantial evidence in the literature that these are not only largely ineffective but also highly susceptible to iatrogenic effects. Aggregating delinquent youth in a group setting-regardless of its intended purpose

Category: Psychology - Y