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Multimodal Substance Abuse Prevention

Ages 13-18

Rating: Level 3


The Multimodal Substance Abuse Prevention project was implemented at a residential treatment center for court-adjudicated, 13- to 18-year-old males. The main purpose of the project was to determine the effectiveness of a multimodal intervention program at reducing substance use and other illegal behavior. The program employed a triple module skills training classroom program, consisting of Botvin LifeSkills Training, the Prothrow–Stith Antiviolence Program, and the Rath Values Clarification procedure.

The Botvin intervention strategies included teaching participants 1) how to improve self-expression, 2) how to control and direct their behavior, 3) how to achieve personal and social skills, 4) how to cope with temptations and pressures to continue using drugs, and 5) a cognitive-behavioral method of understanding the effects of drugs, alcohol, and tobacco on health and behavior. Botvin strategies were modified to 20 sessions for this project.

The Prothrow–Stith intervention consisted of controlling tendencies toward violence and directing one’s energies along socially and personally acceptable lines. This is accomplished through increased awareness of the causes and effects of violence and the adolescent’s own risk of becoming a victim of homicide, learning to identify factors that lead to violence, realizing violence is a choice with short-term and long-term consequences, illustrating that violence is preventable, learning that anger is normal and can be expressed in healthy ways, understanding that controlling violence and anger is a part of maturing, identifying positive ways to express anger, and thinking about alternatives to violence in conflict situations. This is conducted in all 20 sessions.

The Rath intervention addressed clarifying one’s values, exploring others’ values, and attempting to develop and identify with a set of socially acceptable and desired values. This is done through various exercises that motivate the youths to question their conflicting and unclearly defined values.


The program was evaluated using an experimental design lasting 15 months. Youths from St. Gabriel’s Hall in Philadelphia, Pa., were randomly assigned to Group A, the intervention group (n=110), or to Group C, the control group (n=91). The race/ethnicity breakdown was 76.4 percent African-American, 13.6 percent white, 7.3 percent Puerto Rican, and 1.8 percent Asian-American for Group A and 69.3 percent African-American, 16.7 percent white, 8.8 percent Puerto Rican, and 2.7 percent Asian-American for Group C, with a mean age of 15½ for both groups. Most youths had used alcohol and other substances before entering the residential program. The prevalence rates for the entire sample were 79 percent for alcohol, 82 percent for marijuana, 72 percent for cigarette smoking, and 14 percent for PCP. Most of the youths lived in single-family households. All had committed at least one serious illegal offense and were subject to multiple risk factors in the individual, school, peer, and neighborhood domains. Youths were assessed at baseline, 9 months later when released from the residential treatment center, and 6 months after release.


The evaluation reveals that Group A showed significantly greater reductions in drug use and drug dealing. Group A also reported nonsignificant trends toward a greater reduction in degree of illegal behavior and alcohol use. Dosage analysis provides evidence that the effects are primarily due to the Botvin LST component and secondarily due to the Prothrow–Stith component of the program but are not related to the Values Clarification portion of the program.

Risk Factors


  • Anti-social behavior and alienation/Delinquent beliefs/General delinquency involvement/Drug dealing
  • Early onset of aggression and/or violence
  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use
  • Lack of guilt and empathy
  • Poor refusal skills

Protective Factors


  • Healthy / Conventional beliefs and clear standards
  • Positive / Resilient temperament
  • Social competencies and problem-solving skills


  • SAMHSA: Model Programs


Friedman, Alfred S., Arlene Terras, and Kimberly Glassman. 2002. “Multimodal Substance Use Intervention Program for Male Delinquents.” Journal of Child and Adolescent Substance Abuse 11(4):43–66.


Howard Waxman, Ph.D.
Belmont Center for Comprehensive Treatment
4200 Monument Road
Philadelphia, PA 19131
Phone: (215) 581-9177