_— __——__-__h__ Qua MAGIC 2 ABSTRACT AN EVALUATION OF THE STUDENTS, TEACHERS, AND RESIDENTS INVOLVED IN DRUG EDUCATION (S.T.R.I.D.E.) PROGRAM BY Javon Jackson The present study performed an experimental evaluation of a drug education program in two local high schools. It was hypothesized that the students who received the drug education program, when compared to a control group would: (1) score higher on an overdose drug knowledge test; (2) score lower on a drug usage test; (3) score higher on a self-esteem test; (4) score higher on an empathy test. The results supported only hypothesis four, i.e. students receiving the drug education program did better on the empathy test than the control students. Therefore, there were no significant differences between the experimental and control students on the drug knowledge, drug usage, or self-esteem tests. AN EVALUATION OF THE STUDENTS, TEACHERS AND RESIDENTS INVOLVED IN DRUG EDUCATION (S.T.R.I.D.E.) PROGRAM I BY _, xv” Javon Jackson A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Psychology 1975 TABLE OF CONTENTS DEDICATION . . . . . . . . . . . . . . . . . . . ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . LI ST OF TABLES I O O O O O O O O O O O O O O O 0 LIST OF APPENDICES . . . . . . . . . . . . . . . Chapter 1 0 INTRODUCTION 0 O O O O O O O O O O O I. The Problem . . . . . . . II. Factors Accounting for the Failure of Previous Drug Education Efforts . . . . Peer Influence . . . . . Drug Abuse is only a Symptom . . . . . . C. The Fallacy of Rationality . . . . A B III. Implications for Designing Drug Education Programs A. The Teacher . . . . . B. The Curriculum . . . . IV. The S.T.R.I.D.E. Program and Hypotheses . . . . . 2 0 METHOD 0 O O O O O O O O O O O O O O Subsystem . . . . . . . . . . . Phases of the Workshop . . . . . Subjects . . . . . . . . . . . . Design . . . . . . . . . . . . . Procedure . . . . . . . . . . . Confidentiality . . . . . . . . Instruments . . . . . . . . . . Page ii iii vi 10 l3 14 16 21 23 23 24 27 27 28 32 33 3. RESULTS 4. DISCUSSION BIBLIOGRAPHY APPENDICES 38 63 73 79 DEDICATION This dissertation is dedicated to my parents, The S.T.R.I.D.E. Drug Education Program, The Comprehensive Drug Treatment Programs, and to better drug abuse understanding. ii ACKNOWLEDGEMENTS First of all, I would like to thank Dr. Robert Calsyn, my committee chairman, for his guidance and extreme perse- verance in helping me in the Ecological Psychology program. This wonderful man gave me the time that I needed to fulfill my educational goals. He patiently helped me academically, financially, and spiritually. And, so with great love, appreciation and indebtedness, I humbly thank the most rele- vant psychologist in my life and in the world. ‘ I would, also, like to thank Dr. George Fairweather for his great program and for letting me be a small part of it. His teachings on interpersonal relations, overpopulation, and environmental preservation has helped me try to become a humanitarian. His Experimental Social Innovation approach to investigating and evaluating institutions seems to me to be the most accurate way to do field research. As a com— mittee member, his help was invaluable. Dr. Lawrence O'Kelly has been a great influence on me for the last seven years. I shall always be deeply grateful for his support especially in my formative years at M.S.U. when I was finding my way in graduate school. And, as a distinguished committee member, I sincerely thank him for his outstanding service. iii iv Dr. Charles Johnson, the other member of my committee, has made my committee one of the best ever assembled. I am devoutly appreciative to him for his knowledge, experience, effort, and time. I would, also, like to acknowledge Dr. Terrence Allen, Dr. John Wakeley, Dr. Louis Tornatzky, Dr. Ralph Turner, Drs. John and Karen Lounsbury, and Dr. Kent Jamison for helping me complete my graduate studies. I would, also, like to thank Bill Stevens, the former director and founder of the Students, Teachers, and Residents in Drug Education (S.T.R.I.D.E.) program; Dr. William Ives and Mr. Robert Townley, the research directors for the Compre- hensive Drug Treatment Programs; Eaton Rapids intermediate and high schools, expecially, to Mr. A1 Hanks; and, Sexton High School, especially, to Mrs. Neil Schnarch because without them this research would not have been possible. And, a special thanks to Bill Jacobs, Alicia Crenshaw, Sue Weesner, and Suzanne Palmer for their kindness. And, most importantly, a very special thanks to Dr. HEnry Smith. LIST OF TABLES Page The Treatment Design . . . . . . . . . . . . . . 29 The Internal Consistency of the 14 Assessment Variables . . . . . . . . . . . . 37 Means for the Intial School Effect at Each Level of Treatment and Attrition . . . . . . . 40 The Initial School Effects . . . . . . . . . . . 41 The Attrition Effect at Each Level of Treatment and School . . . . . . . . . . . . . 43 The Attrition Effects . . . . . . . . . . . . . 44 The Initial Treatment X School Interaction Effects at Each Level of Attrition . . . . . . 45 The Initial Treatment X School Interaction Effects . . . . . . . . . . . . . . 47 The Initial Treatment X School Attrition Interaction Effects . . . . . . . . . . . . . . 49 The Means and Standard Deviations of the 14 Assessment Variables at the Three Time Levels . . . . . . . . . . . . . . . . . . 51 APPENDIX A. B. C. LIST OF APPENDICES Page Introduction to the Drug Overdose Treatment Questionnaire. . . . . . . . . . . .79 Introduction to the Drug Usage Questionnaire . . . . . . . . . . . . . . . .86 Introduction to Self-Esteem . . . . . . . . . .93 Introduction to Empathy Training Questionnaire . . . . . . . . . . . . . . . .101 The Administrative Agreement . . . . . . . . .107 Table 11. Analysis of Variance of Pre-Test Scores for the Treatment Effects . . . . . .110 Table 12. Analysis of Variance of Pre-Test Scores for the School Effects . . . . . . . .112 Table 13. Analysis of Variance of Pre-Test Scores for the Attrition Effects . . . . . .114 Table 14. Analysis of Variance of Pre-Test Scores for the Treatment X School Interaction Effects . . . . . . . . . . . . .116 Table 15. Analysis of Variance of Pre-Test Scores for the Treatment X Attrition Interaction Effects . . . . . . . . . . . . .118 Table 16. Analysis of Variance of Pre-Test Scores for the School X Attrition Interaction Effects . . . . . . . . . . . . .120 Table 17. Analysis of Variance of Pre-Test Scores for the Treatment X School X Attrition Interaction Effects . . . . . . . .122 Table 18. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the Treatment Effects . . . . . .124 Table 19. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the School Effects . . . . . . . .126 Table 20. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the Time Effects . . . . . . . . .128 vi APPENDIX Page Table 21. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the Treatment X School Inter- action Effects . . . . . . . . . . . . . . . 130 Table 22. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the Treatment X Time Inter- action Effects . . . . . . . . . . . . . . . 132 Table 23. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the School X Time Interaction Effects . . . . . . . . . . . . . . . . . . . 134 Table 24. Analysis of Variance of Sample with Complete Data at All Three Measuring Points for the Treatment X School X Time Interaction Effects . . . . . . . . . . . . . 136 vii CHAPTER 1 INTRODUCTION I. The Problem A number of educational programs have been developed in response to increasing drug abuse in schools and in com- munities in general. In response to these drug problems, rehabilitation and treatment programs were developed although drug specialists felt that the only real hope in dealing with drug abuse was prevention. Nevertheless, the accumulation of studies in connection with drug abuse has been concentrated mainly on treatment aspects of drug ad- diction, the relationship between narcotics and social and cultural factors, or characteristics of drug users and their families (Laskowitz, 1965; Nyswander, 1956; and Preble, 1966). Although there has been little known research done in this particular area, there has been legislation passed and many have displayed an interest in the preventive aspects of drug abuse as well as in drug education programs. It has. been assumed that drug education courses, through a dissem- ination of knowledge concerning the nature and effects of drugs, would play an important role in the prevention of drug abuse (Amendolara, 1973). Although the national significance of drug education is indicated by the large amounts of government and private funds going to programs designed to have a variety of effects on what is often referred to as the "drug problem", recent reviews (Richards, 1971; Wald and Abrams, 1972), however, indicate that although many such programs exist, little is known about what methods are effective for what groups. Because there is some disagreement about what the goals of drug education should be, many educators feel that the primary goal should be to reduce drug usage. This is measured by asking students before and after taking a drug course how much they use drugs (often limited to marijuana), or whether they intend to use them. Berg's (1970) review of 71 drug usage surveys clearly indicates that drug abuse, especially among the young, is rapidly increasing. Increasing knowledge about drugs and drug usage is another goal of drug education. Although it is a goal which is more likely to be affected by education than is drug usage itself, few programs have reported on their success with respect to this goal. Another rationale for drug education programs has been to increase knowledge about drugs. While people routinely use drugs, they are considerably ignorant of drug effects. 3 This goal stems from data of numerous surveys which indicate a steady increase in the use of drugs over the past five to ten years (Berg, 1971). This common usage of drugs by people show that drugs are less associated with extreme attitudes and ideologies (Goldstein and Korn, 1972). For example, drug usage is not an exclusive characteristic of students, but it is an important aspect of adult life as well (Mellinger, Balter, and Manheimer, 1971; and Parry, 1971). While the usage of drugs has become more routine, ignorance about drug effects is widespread. In a survey conducted in 1968, 6,105 residents of New York State were asked to list the effect of several drugs. The most striking finding by Korn and Goldstein (1972) was the number of respon- dents who answered, "Don't Know": 50% for heroin, 48% for amphetamine, 42% for LSD, and 36% for marijuana (Glaser and Snow, 1969). That same year, a survey by Korn and Goldstein (1972) on an urban university campus (N-3,010) found that, of students who responded, 21% did not know whether heroin is addictive; 54% did not know that barbiturates were addictive, and 56% thought that hard liquor is not addictive. A follow- up survey of seniors in 1972 showed some reduction in these figures, but the extent of ignorance was still impressive. Similarly, the Delhi University study (1972) further found . . . that a great many young persons who experiment with illicit drugs have no valid knowledge about the possible legal and psycho—physiological consequences of their actions. It is reassuring that the vast majority of students, users 4 and non-users alike, are eager for more knowledge about drugs and their effects. However, since many students depend upon a misinformed peer group, relevant and honest education is clearly needed. Reacting to this problem, public and private agencies are funding an incredible variety of drug education programs, few of which are subjected to even nominal evaluation since the scant evidence that does exist suggests that with few exceptions most drug abuse prevention programs have negative, or at best, null effects (Jaffee and Clark, 1972; and Macro Systems, Inc., 1972). Brown and Klein (1975) concluded that present drug education programs are not significantly effective in changing attitudes toward drug abuse. And, Seabright (1973) found that the most common evaluation technique was to com- pare knowledge of drugs at the end of a program with knowledge before the program, and, in most cases, drug know- ledge increased. However, relatively little attitude change was found to occur when attempts were made to evaluate pro- grams by examining changes in attitudes toward drugs. Similarly, Robert L. DuPont, director of the President's Special Action Office for Drug Abuse prevention, has recently cited evidence of the failure of most drug-abuse educational effects (DuPont, 1974): "1. A survey of drug educators indicated that nearly three-quarters believed present drug abuse materials were ineffective and had stopped using them, 5 2. 1,500 students were surveyed regarding their attitudes toward existing drug-abuse information programs in their schools and the concensus of their opinions was that such programs were outdated and should be abolished, 3. The National Coordinating Council on Drug Education noted major inaccuracies in 84 percent of all current drug-abuse educational films, 4. A report from the National Education Association's Task Force on Drug Education indicated that funds for drug-abuse education were being misspent on poor material and misinformation. Not only have drug education programs generally failed to reduce drug usage, but, in some cases, the drug education program may have actually increased drug usage (Stuart, 1974; Wong and Zimmerman, 1974). The general conclusion is that drug education programs have been unable to achieve this goal (Swisher, Warner, and Herr, 1972). This is probably because drug usage among ado- lescents is a highly social activity more subject to influence by peer and family relationships than by formal classroom education (Blum, 1972). II. Factors Accounting for the Failure of Previous Drug Education Efforts What are some of the factors which may account for the failure of previous drug education programs to decrease drug abuse? A. Peer Influence Many drug education programs may have failed to reduce drug usage because their curriculum and teaching style ignored the importance of peer influence in drug taking behavior. Zimering (1974) found that students believed that one of the primary reasons why people take drugs was to emulate their friends. In general, students believed that people began using drugs between the ages of twelve and fifteen. These results indicated an increased peer pressure to use or try to use a drug between the ages of twelve and fifteen (sixth through ninth grades). This information is in agreement with his findings that during this time period the most dramatic increase in exposure and usage of drugs occurs. In addition, the amount of peer pressure experienced increases as the student advances in age. Further supportive evidence by Wolfson, Lavenhar, Blum, Quinnones, Einstein, and Louria (1972) showed that "more than 80% of the students who admitted to the use of drugs for other than medically approved reasons were introduced to drugs by someone whom they knew very well. The person who introduced the male students to drugs in each of the school classes was most likely a high school boyfriend. The person who was most likely to 'turn on' the female students varied from class to class. The freshmen girls were first intro- duced to drugs mainly by a high school girlfriend (35%), by a high school boyfriend (24%) or by a sibling (21%). Senior 7 girls were 'turned on' primarily by a high school girlfriend (30%), by a high school boyfriend (28%), or by a college boy- friend (13%). Only 7% of the senior girls were introduced to drugs by a sibling." The Delhi University study (1972) found that in a sample of 100 subjects that 79 subjects chose their friends as their initial source of drug usage, while 20 subjects chose no outside source and only one participant chose one's doctor as one's source of initial drug usage. Not only are students frequently initiated into the drug culture by peers, the peer group is also involved in sustaining the students in the drug culture. For example, Polk (1970) found that adolescents who were regular drinkers were more alienated from school, and were more involved in peer group relationships. Thus, it appears that school programs are destined to reach those who least need the information. While youth crave information about the drug culture surrounding them, information must be delivered in palatable form, if drug education programs are to be effective. It is clear from these studies that a drug education program which ignores the influence of peers and relies solely on a lecture format by adult authorities has little chance of reducing drug usage. B. Drug Abuse is only a Symptom Failure to recognize that drug abuse may only be a symptom of more pervasive personality problems and feelings 8 of alienation may partially account for the failure of previous drug education programs. Graham and Cross (1975) found that the drug users, as a group, displayed a set of values differing from non-users in that the users were more individual value oriented, sub- jective, unstructured, and anti-religious. Drug users also felt rejected at home, that there was little to talk about in common with their parents, and that their parents did not trust them or genuinely care about them. Perceiving a lack of concern on the part of school officials and faculty over whether they used drugs, attended classes, or in general abided by the school regulations, the drug users, conse- quently, felt that no one cared about what they did as long as they did not start trouble for others. Similarly, drug abusers tend to have less self-esteem than non-abusers. For example, Poe, Boynton, and Allman (1972) in their study found that non-abusers had higher positive self-concepts, reflected selves and ideal selves than drug abusers who had more negative self-concepts and reflected selves. The Delhi University study (1972) stated that students who were generally satisfied with their self-image were found less frequently in most of the drug user groups than those who wanted to change many things about themselves. However, the relative risks associated with low self-esteem were not particularly high, reaching a maximum of 3 to l for heroin usage. However, it is difficult to determine whether low self-esteem predisposes to drug usage or whether drug involvement lowers an individual's self-image. Samuels and Samuels (1974) conducted a study to determine if low self-concept is a common denominator as a causative factor of drug abuse among adolescents. Their results indicated that 75.5% of the SS considered low self- concept to be one cause of their turning to drugs and 91.9% felt that boredom and curiosity was another while 67.5% put the blame on peer pressure and 64.8% said that they were pleasure seeking. Other researchers have also recognized this need. Dohner (1973) stresses the point that greater emphasis must be placed on non-chemical alternatives to the search for self-knowledge, for meaningful human relations, for enduring values and for spiritual experiences. He suggests one alter- native is through "personal awareness development" whereby people develop their interpersonal awareness by learning to be aware of their own feelings, attitudes, and perceptions in order to evaluate the effect of their behavior on others. Philosophical-essential explorations is another alternative for youths. They seek personal meaning in their lives. They desire to find the answers to the questions "Who am I? What is my future, my goal, my role in society?" This is a difficult search because of the accelerated mobility of the American society, the loosening of family ties and the rapid rate of change. 10 C. The Fallacy of Rationality Many drug education programs may have failed because of an unwarranted faith in the rationality of students. They assumed that by providing information on harmful effects of drugs, students would make a rational decision not to use drugs. They used structured curricula, which presented factual information with very little student participation. However, several studies have found that a relatively high level of knowledge about drugs is associated with higher levels of drug usage, not lower usage as predicted by the the rational model. In a survey of adolescents in four Michigan communities, Stuart and Schuman (1972) found that: The non-users of every type of drug were found to have lower drug information scores than did the users, the difference being statistically significant for every drug except alcohol. By administering a scale to a large and varied population of students to assess affective, cognitive, and behavioral factors regarding drugs before and after a factual drug program, Hoffman (1971) found that the more knowledge people possessed about drugs, the more their attitudes were in favor of drug usage. Fejer and Smart (1972) provided some suggestion as to the temporal order involved in the association between drug usage and attitude. Their results indicated that relatively permissive attitudes, as well as, above average knowledge, about drugs occur prior to actual usage. However, non-users ll intending to use marijuana were still less in favor of legalization and had less knowledge about drugs than users. This suggested some changes do occur in both attitude and acquisition of knowledge after initiation of usage. While these correlational findings do not demonstrate that increase in drug information necessarily cause or even catalyze increases in drug usage--they do suggest that drug information per se is unlikely to inhibit usage. Although his research had some methodological flaws, Stuart's (1972) evaluation of drug education programs sup- ports the contention the didactic drug education programs which rely on students processing information on drugs and making a rational decision not to abuse drugs are miscon- ceived. Relative to controls, gs receiving drug education significantly increased their usage and sale of marijuana and LSD and their usage of alcohol while showing a signi- ficant increase in drug information and a decrease in worry about drugs. Similarly, Wong and Zimmerman (1974) concluded that their drug education program actually taught students to handle drugs in a safer manner because a decrease in drug related hospitalizations among their target group of students may not, in fact, have represented a decrease in usage, as they had previously assumed. In addition, they report no evidence that "audience appealing innovations such as ex-addict testimonials, tape recordings, movies, 12 role-playing techniques, etc." reduced drug usage. In fact, 33 percent of the participating students felt that the pro- gram actually encouraged illegal drug usage. Korn and Goldstein (1973) presented evidence concerning achievement of cognitive objectives in a college course on drugs. A mastery grading system insured that students learned to criterion. Reported experience with drugs did not change during the course and was unrelated to measures of learning and student ratings of the course and the instructors. Concern for friend's drug usage did in- crease and changes were observed in preferred sources of advice and information. Thus, students increased their willingness to ask drug course instructors for drug advice and increased their willingness to use more technical sources for information on drugs instead of less informed sources. Linder, Lerner and Drolet (1973) also found that drug usage among students taking a drug abuse course was significantly greater than among those students not taking such a course. Unfortunately, the research design was not adequate to determine whether the drug education caused the higher usage or whether higher drug users were more likely to enroll in this course. However, Korn and Goldstein (1973) findings did not support the idea that drug education encouraged experimen- tation with drugs. 13 In conclusion, while methodological limitations of some of the previous studies make it impossible to conclude that drug education programs actually lead to an increase in drug taking behavior, the studies clearly indicate that a rational, factual presentation of drug information is not sufficient for reducing drug abuse among students. McKee (1973) amplifies this point and makes some suggestions regarding the structuring of drug education programs. For instance, he found that drug users, being much more knowledgeable about drugs than non-users, were aware of the fallacy of considering "drugs" in a general, all- encompassing fashion, and instead made sharp distinctions between drugs, whereas non-users continually fail to do this. Although drug users indicated that they sometimes had traumatic experiences with drugs, they invariably mentioned that they would continue to use certain drugs in the future. Therefore, McKee suggested that prevention/educational programs should take into consideration both a large attitu- dinal difference from non-users and a certain sophistication among drug users, even at the high school level. III. Implications for Designing Drug Education Programs Assuming the factors surveyed in the previous sections do partially explain the failure of previous drug education efforts, how should future drug education programs be designed? 14 A. The Teacher The style of formal drug education programs beyond curricular problems often alienates youth. Because moral- istic presentations abound (Helmes, 1970) and because of the sensitivity of youth to hypocrisy, an entire talk can be rejected on the basis of one bit of misinformation. Effec- tive drug prevention approaches should allow for intensive interactions among participants (Capone, McLaughlin and Smith, l973)--a format that is not easy to bring about in classrooms. The active involvement of participants is re- quired when teaching rational decision-making about drugs-- not just a lecture by an expert or a talk by.a former addict. Nail and Gunderson (1975) found that authorities in drug abuse education agree that whoever presents the infor- mation must be someone who knows and will present facts accurately, who will feel comfortable and free in open dis- cussion, and who young peOple will like and trust. Galli (1974) found that the former drug user was overwhelmingly chosen by students (46.46%) as the person who should have the primary responsibility for presenting drug information. Similarly, Illinois drug education programs (Brown, 1973) have switched to a broader curriculum where drug abuse is taught within the context of other health issues such as consumer health, mental health, human growth, and develop- ment, nutrition, and disease. Teachers in Illinois have not been asked to totally abandon a didactic format when 15 presenting legal, historical, and pharmacological information on drugs, but they have been asked to adOpt a "soft-sell approach" and be more sensitive to their students' needs and interests. Since most school-based programs tend to be didactic, moralistic presentations that do not reach the youth who most need drug information, Sorenson and Joffe (1975) con- ducted a peer oriented drug education program in a community youth project. There youth and leaders shared feelings and knowledge about drugs in a candid atmosphere. Youth made decisions about program direction, format and curriculum. The authors concluded that peer oriented community-based drug education programs provided a viable format for reaching youth with information and encouraging them to make decisions about drug usage based on rational factors. The theory underlying the New York City Peer Group Leadership Program (Capone, McLaughlin, and Smith, 1973) was that students know more about the drug problem than do most teachers and other adults, and that they can more effectively persuade fellow students to refrain from using narcotics. The experience of the Peer Group Leadership Program was that the students soon expressed concern about better communications with adults, parents, and community; how to relate to their peers and to deal with drug related issues, including drug emergencies. 16 Thus, it would appear that one possible consequence of involving peers in the teaching of drug education pro— grams is a broadening of the curricula and the participants. B. The Curriculum The teacher is not the only target for change in drug education programs. Critics have insisted that the content of drug education programs should be changed as well as the style in which the content is presented. School-based drug information programs often have employed the narrow perspective that drug usage is a problem of youth, not recognizing the extent to which drugs affect society more broadly (Levy, 1972). Levy believes that drug education curricula should de-emphasize facts about drugs per se and focus more on the reasons that peOple use them. Thus, effective drug education programs should change an individual's knowledge and value system (Piorkowski, 1973; Myers, 1973) and require him to assess the consequences of drug involvement. As has been previously stressed, many educators consider drug abuse a symptom of more pervasive problems in self-development. Therefore, a number of drug education programs have recently broadened their curriculum to include possibilities for self-growth. For instance, Kane (1973) considers "Humanistic Education" as an important educational approach to drug education. He stresses the affective domain: students' feelings, fears, wishes--the things that l7 motivate them behaviorally. However, Kane feels that before a teacher can be effective in meeting the student's needs for self-understanding, interpersonal relations, values clarification, problem-solving and decision-making, one must know one's self by being able to confront one's own feelings, to demonstrate sensitivity to students' feelings and to show a clarity of consciousness about one's own values. Myers (1973) reported on the drug education curriculum developed by the Educational Research Council of America and the Dayton and Lima Public School systems which also empha- sizes development of the full potential of the human individual as its primary objective. This includes helping do what we do and why we do it the way we do it--and in- creased clarification of one's values and purpose of life. Another broader based curriculum of drug education can be found in behavior group counseling developed by Horan, Shute, Swisher, and Westcott (1973). Their curri- culum combines elements of the previous humanistic approaches with structured exercises. A typical workshop program would consist of a lecture on drug abuse prevention strategies with accompanying communication exercises. Two techniques which have been used in a variety of self-development approaches to drug education, including the program evaluated by this author, are values clarifica- tion and empathy training. Values clarification is a technique developed by Raths, Harmin, and Simon (1966). Teachers using this technique encourage students to make 18 thoughtful choices, to examine alternatives, and to consider what they value and cherish. They then encourage them to act on their values and to examine their actions to see if they are consistent with the values that they espouse. Teachers using this method tend not to answer, but give a less definitive response which tries to focus the student so that he can discover his own beliefs on a particular topic. While values clarification aims at having the student discover his own beliefs and values, empathy training attempts to develop the communication skills of an indivi- dual so that he can facilitate growth in others. Much of the research on empathy training comes from psychotherapy research where considerable support exists for the assumption that effective psychotherapy at least in part is contingent upon the patient's perception of the therapist as empathetic congruent, and having nonpossessive warmth (Truax and Carkhuff, 1964). Of these factors, accurate empathy (AE) has received the most support (Truax and Carkhuff, 1967). Truax and Wargo (1966) have stressed that most, if not all, psychotherapeutic orientations have emphasized the importance of the therapist's ability to understand the patient's "inner world" and to communicate this knowledge sensitively and accurately to the patient. Moreover, fourth-year post- graduate clinical psychology students have significantly used accurate empathy to bring about positive therapeutic results in patient's that they had treated (Bergin and Solomon, 1963). 19 There is also increasing evidence that suggests that empathy is "teachable" to professionals and to minimally trained nonprofessional people (Truax, Carkhuff, and Douds, 1964). Reddy (1969) found that behaviors such as empathy are teachable which supports the findings of Truax, Carkhuff, and Douds (1964) and Truax and Carkhuff (1967). Interpersonal Process Recall (IPR) is a procedure for teaching empathy which has been developed at Michigan State Unviersity by Dr. Norman Kagan and his associates over the last 12 years. This method is designed to enable people to learn to be more effective in their interpersonal relations and to have a positive influence on human interactions. Although the IPR process has been used primarily to teach peOple in the helping professions (counselors, physi- cians, psychologists), Kagan (1973) felt that IPR could be of great benefit by producing significant and measurable re- sults in improving the quality of life in an MSU dormitory hall. The results were encouraging, but not conclusive, mainly due to the fact that so few students were IPR trainers in the dormitory. IPR is the empathy training technique used in the program evaluation in this present study. In summary, perhaps the most complete list of suggestions for improving drug education programs has been provided by Mathews (1975). "1. Students should be involved 20 in the planning and implementation of every drug program that concerns students. 2. Drug programs must have clearly defined purposes when they are designed, and they should be ongoing, not crisis- oriented. 3. Systematic and well-designed evaluation is critical for every drug program. 4. The emphasis of drug programs should be on affective learning, not cognitive learning. The focus should be on people, not drugs; and on "why", not "what" or "how" (See D'Elia and Bedworth, 1971). 5. Group-process communication training should be provided to teachers so that they can learn to listen and better facilitate discussions with students (see Dearden and Jeckel, 1971). 6. An environment should be provided that encourages free, honest and serious discussion of student problems. 7. Participants in any drug program should be actively involved, not passively listening to a speaker or watching a film. 8. Existing printed materials and films should be greatly de-emphasized or eliminated, and that which is used should be carefully evaluated, paying particular attention to eval- uations made. 9. Look into peer counseling and value clarification techniques for possible application in one's school. 10. The school should not try to combat drug problems alone, 21 but in consort with other agencies and people in the community." IV. The S.T.R.I.D.E. Program and Hypotheses The present study is an evaluation of the Students, Teachers, and Residents Involved in Drug Education (S.T.R.I.D.E.) drug education program which was developed by the Comprehensive Drug Program under the direction of Bill Stevens in Lansing, Michigan. The S.T.R.I.D.E. program incorporates many of the principles of the self-development approach to drug education described in the previous section. A complete description of the S.T.R.I.D.E. program can be found in Chapter II. While a survey evaluation of the S.T.R.I.D.E. program indicated that 80 percent of all program participants des- cribed their experiences in the program in positive terms, the developers of this S.T.R.I.D.E. program were not content with these testimonials and approached the author for a more rigorous evaluation. They agreed to randomly assign students who wished to participate in the S.T.R.I.D.E. program to either the S.T.R.I.D.E. program or a nontreatment control group. Based on the goals of this S.T.R.I.D.E. program, the following hypotheses were tested: 1. After treatment, S.T.R.I.D.E. participants would be more knowledgeable about drugs and drug emergency procedures than the control group. 22 After treatment, S.T.R.I.D.E. participants would use fewer drugs, especially dangerous drugs, than the control group. After treatment, students receiving the S.T.R.I.D.E. program would feel more positive self-esteem than the control group. After treatment, the S.T.R.I.D.E. participants would be more skilled in empathy skills than the control group. CHAPTER 2 METHOD Subsystem The Students, Teachers, and Residents Involved in Drug Education (S.T.R.I.D.E.) program is a community mental health program serving Clinton, Eaton, and Ingham counties. S.T.R.I.D.E. is an innovative drug abuse prevention program designed to enable individual communities and school districts to use local human resources and talents to estab- lish and operate on-going, independent, effective drug education programs within their own communities. S.T.R.I.D.E. is a fifty hour, multi-phase workshop designed to reach the following objectives: 1. Reach all segments of the community and school system population. (Ideally, equal numbers of parents, students, and teachers participate in the program.) 2. Convey concrete learnable skills which can be used to counteract the causes of poor drug education and drug abuse which are (a.) the lack of personal communication skills and trust between various pOpulation segments; (b.) the lack of understanding of differing life-styles and value systems; (c.) the misinformation concerning both legal and 23 24 illegal drugs; (d.) the inadequate personal problem-solving skills to deal effectively with the day-to-day problems. (Each phase of the program represents a skill-oriented, mini-workshop concentrating on one of the above listed causal areas. These phases will be described in detail later.) 3. Create an environment where an optimum learning experience can take place in a short period of time. Most program phases take place in small skill-groups operated during school hours with teachers and students being released from classroom responsibilites. Expenses involved in relea- sing participants from classroom responsibilities were absorbed by the school system. The S.T.R.I.D.E. program, in turn, provided all personnel involved in training free of charge. 4. Trained interested local participants as instructors in all phases of the S.T.R.I.D.E. program and thereby provide the community with the adequate human re- sources needed to operate self-sufficient local programs. (A follow-up instructor training workshop is offered, at no further expense, to interested program participants on two consecutive weekends sometime after the initial workshop.) Phases of the Workshop The phases include: 1. Orientation 2. Communication Skills 25 3. Value Clarification 4. Problem-Solving Skills 5. Drug Information and Crisis Training 1. Orientation - The orientation phase lasted one half of a day. In this phase, gs learned the logistics of the S.T.R.I.D.E. operation. They were informed about their scheduled classes and classrooms, break times, and books. They were told what the S.T.R.I.D.E. goals were and were welcomed to criticise any parts of the S.T.R.I.D.E. program that made them feel uncomfortable as well as discussed any personal problems that they had. 2. Communication Skills Workshop — This phase lasted all day Saturday and Sunday. In this phase, §s were taught the first step in the helping relationship which was empathy. Empathy was emphasized, because it allows the speaker to feel safe and not to be judged or condemned because of his feelings. Students were taught that when the listener re- sponds to a speaker empathetically, he can feel comfortable and will continue talking to the listener. As the listener builds trust in this way, the listener facilitates both his own and the speaker's understanding of the speaker's feelings, and the listener helps him get a better handle on his problem. Lastly, the gs were taught that the listener will be learning to listen, to understand, and to communicate that under- standing. It is not enough for the listener to listen unless he understands what he has heard. It is of little use for the listener to understand unless he communicates. It is 26 useless for the listener to communicate unless the speaker can use the information. 3. Values Clarification - The values clarification phase lasted one half of a day. In this phase, gs were taught to help the speaker clarify his feelings and explore the speaker's thoughts about his problem. The SS focused on the kinds of issues the speaker saw as positive (rewarding) and those they saw as negative (punishing). They helped the speaker integrate his feelings with how he thought about his problem: the values and attitudes he attaches to his experiences. 4. Problem Solving - The problem solving phase lasted one day. In this phase, gs were taught to help the speaker clarify his problem, explore alternatives, plan strategies for change, and test out alternatives. 5. Overdose Aid - The overdose aid phase lasted two days. In this phase, gs were taught overdose aid and crisis inter- vention techniques. It was impossible to guarantee that the SS in the experimental groups received precisely the same treatment in all details. While some lecture seSsions for both groups were all given by the director of the S.T.R.I.D.E. program, in some other sessions small group work was emphasized and additional trainers were required. Thus, while the same number of sessions was allowed for each activity, the way that the material for each session was covered varied somewhat. 27 All §S received high school credit for completing the course. All gs had at least one year of high school remaining. Although students comprised only one-third of each drug training class with residents and teachers filling the remaining positions, the focus of this evaluation was on the effects of the program on students. Subjects This study originally consisted of 72 SS and was completed by 45 SS (experimental = 18, males = 5, females = 13; control = 27, males = 3, females = 24). From the Eaton Rapids schools, 11 experimental (males = 3, females = 8) and 24 control (males = 2, females = 22) £8 completed the assess- ment at all three time levels. From Sexton High School, 7 experimental (males - 2, females = 5) and 3 control (males = 1, females = 2) SS completed the assessment at all three time levels. The age range was 13 to 17 and the mean age was 14.844. The grade range was 8th to 11th and the mean grade was 9.378. All of the SS were White except one Chicano male from Sexton High School. Design Since all of the gs were obtained from a pool of volunteers from each of these three schools which had ex- pressed a desire to participate in the S.T.R.I.D.E. program, half of the SS from each respective school were randomly assigned to the experimental group to participate in the 28 S.T.R.I.D.E. program. The other half of the SS served as the control group. The design was a pre-test--post-test—-post-test design. The pre-test was administered one week before the experimental treatment. The first post-test assessment occurred three weeks after the treatment. The final post- test occurred 8 months later. Table 1 shows each school at each time level denoted by 't' in Table 1. At 't-l', the pre-test observation (01), the number of control SS is listed as well as the date of the first assessment. At 't-E', the experimental treatment (X), the number of experimental SS is listed as well as the data of the experimental treatment. At 't-2' the post-test observation (02), the date of the second assessment is listed as well as its phase interval in days and months from the initial observation (01)' At 't-3', the follow—up observa- tion (03), the date of the third assessment is listed as well as its phase interval. Procedure Pre—test Assessment volunteers for'the S.T.R.I.D.E. drug education program were seated in the Eaton Rapids High School cafeteria. These volunteers included both the inter- mediate and high school gs while volunteers from Sexton High School were seated in a reserved classroom. The director of S.T.R.I.D.E. introduced the E and reassured the SS that everything was safe. -263 .1. ar‘! my ..-J."-. 1.1.. l 2 .2, he. i! s . z I. 10......» e1, 29 wmhnz .m9 mmnnz .m9 wvmnz .m9 wooanz .99 Umuwamfioo unmoumm Hence .me mmuz .9 mmuz .9 anz .9 mvuz .9 mmsoum apon HMD09 .9 amenz .e woenz .e wmmnz .e wooauz .e ememaesoo unmoumm .e vmnz .p mmuz .o mmuz .U mmnz .p pmpmamaoo .p mmnz .o mmuz .o mmuz .0 mmuz .o pmcmflmmm .o mmuz mm Houucoo mmeuz .e ameuz .e wamuz .e wooauz .e ememaeaoo unmouma .e Hauz .n NHuz .n manz .n mauz .n Umpmamsou .Q manz .m manz .m mauz .m manz .m pmcmflmmd .m m N mauz HO manz mm Hmucwefiummxm m N x HO mvuz mpflmmm coumm .mlu. .mlu. .Hnu. .mlu. .mnu. .muu. .Hlu. cmflmmo ucmfiummu9 m£9 H OHQMB maoosom 3O wvvuz oauz .9 womuz .d M "Z .n oauz .m wemnz .m 9 "Z .w mauz .0 .MI#. .Nluw. .Hlu... .me at: ammuz .me manz .9 momuz .d m nz .n oanz .m wamuz .d A nz .m mHuz .6 m0 m0 Amsucos xmv mane com vema .mH .cmn smeaum .muu. wwwflz .mB mHHZ .9 womuz .d oauz .m leeeoe as want Hm mnma .m Hanna mmpmnsn9 .NIH. m9m0 9 mhma .m kumfl mmpcoz .WIU. wooauz .m9 wooanz .m OHHZ .3 oauz .m mooanz .m MHHZ .w o mwma .N Hflumm mmocoz .Hlu. pmumHmEoo usmoumm Hmu09 .m9 mmsouw nuom Hmu09 .9 Uwumamsou usmoumm .m emumaesoo .e Umcmfimmd .m oauz mm Houueoo pmumamfioo usmoumm .m emumaesoo .m pmcmflmmfi .0 mm amusmaflummxm manz MNHZ C09xmm .HH mam>umch mmmnm mmumo ages prscfiucoov H OHQM9 31 Amnucos my mate mmm w9mH .9H .cmn mmpmus£9 .mlfl. .NIU. .Hl#. .MIU. “canoe Hy mmmp om M9ma .em was hmpmusn9 .Nlfl. m9MU 9 m9mH .H 9m: mmpmm59 .MI#. 0 v9ma .vm aflumd wmpm099 .Hlfl. mam>umucH mmmnm mmu.MD @899 Aemseaueoov H magma 32 Confidentiality The E proceeded by stating his name and why he was doing this type of research. He tried to gain the Es trust by emphasizing extreme confidentiality and safety by using E aliases. Since this material was potentially incriminating, Es were assured that this evaluation was strictly for research purposes. Therefore, Es did not use their own names. Es throughout the various test times were instructed to con- sistently use one 'creative' alias. For those Es who forgot their aliases, the E informed these Es to choose their re- spective aliases from a written list of aliases. This method of insuring anonymity has been successfully demonstrated in drug research using junior college students over a three or four week lapsed interval (Rossi, Groves, and Grafstein, 1971). Next, the E passed out the questionnaires and scoring pencils. The E explained the demographic questions. There the E explained each of the 4 questionnaires and gave an example of each one. He then answered any questions that the Es had. At Eaton Rapids High School, all of the Es were tested at the same time in one large group. This same procedure occurred at Sexton High School. After everyone completed the assessment, the E asked the Es to turn in their questionnaires, answer sheets, and pencils. i I. 'I“. .‘l ., .‘ ’iis ‘3 'I" ”‘1’. If 33 Assignment to Conditions. The E assigned Es to the experimental and control groups by random assignment control- ling for sex and grade. He did this by first dividing the Es by sex at each grade level. The E counted the Es and wrote a number on a piece of paper representing each E and folded it up and placed it in a box. Next, the E let each E by sex at each grade level draw a number from the box. All the Es who drew odd numbers were placed in the control group while rfi'j all the Es who drew even numbers were placed in the experi- mental group. Post-test Assessment. The two post-test assessments (4‘- were conducted in the same manner as the pre-test assessment. Instruments The purpose of this evaluation was to determine the effectiveness of the S.T.R.I.D.E. drug education program on high school students with regard to the following areas: (1) Knowledge of Overdose Drug Treatment (2) Drug Usage (3) Self-Esteem (4) Empathy Training (1) The Drug Overdose Treatment Questionnaire--(OD). In order to test the Es' knowledge about what to do in emergency situations involving drug overdose, questions were selected from the Overdose Aid (1975) manual. Knowledge about other factors related to overdose aid is also included in both the questionnaire (see Appendix A) and in the manual. In? "El _ A'Y 34 (2) The Drug Usage Questionnaire-~The drug usage questionnaire was designed to measure drug usage frequency and severity by determining the amount and type of drug usage the Es reported. Because of the social stigma attached to drug usage, two methods were used to measure the amount of drug usage. The first method asked the Es about their current drug usage, expected drug usage within a year, and expected drug usage in their lifetime. The second method asked the Es about their friends' drug usage--current usage, expected usage ‘4. .1‘ within a year, and expected usage in their lifetime. ‘1’ Ten different types of drug usage categories comprised the drug usage questionnaire. All of the drugs familiar to the E were placed in one of the following categories: (1) Self-Usage of Nicotine (SKS) (2) Friends'-Usage of Nicotine (FSK) (3) Self-Usage of Marijuana (MSKS) (4) Friends'-Usage of Marijuanna (MFKS) (5) Self-Usage of Caffeine (SCF) (6) Friends'-Usage of Caffeine (FCF) (7) Self-Usage of Alcohol (SAL) (8) Friends'-Usage of Alcohol (PAL) (9) Self-Usage of Dangerous Drugs (SHD) (10) Friends'-Usage of Dangerous Drugs (SHD) The dangerous drug variables consisted of glue, methaqualones,amphetamines, tranquilizers, barbiturates-- hypnotics, Opiates, cocaine, and hallucinogens. 35 Since for any one drug current usage, expected usage within a year, and expected lifetime usage were highly cor- related (Jackson, 1975) only one score was calculated for each of the 10 drug categories (i.e., for any one category the current usage response, expected usage within a year response, and lifetime usage response were added together). The Es recorded the severity of their usage by marking each of the ten drug categories on only one of five incre— mented levels. The levels for the current drug usage variables were: (1) daily; (2) weekly; (3) monthly; (4) less than once a month; and (5) never. For the future drug usage variables, the levels were: (1) definitely will; (2) pro- bably will; (3) don't know; (4) probably will not; and (5) definitely will not. (3) The Self-Esteem Questionnaire-—(SSE) (see Appendix C)--This questionnaire consisted of the first seven inventory scales developed by Rosenberg (1965). These scales explored (l) self-worth; (2) self-stability; (3) faith in people; (4) sensitivity to criticism; (5) depressive affect; (6) day- dreaming; and, (7) psychosomatic symptoms. All items were rated on four-point scales. The four-points on most scales were strongly agree, agree, disagree, and strongly disagree. The other scales had similar increments. (4) The Jackson Empathy Training Questionnaire--(EMT) (EMP) (see Appendix D)--This questionnaire was designed to test the Es ability to relate to people in the helping relationship. 36 The reliability (internal consistency) of each measure as determined by Hoyt's (1941) analysis of variance appears in Table 2. These reliabilities were calculated on the pre- test data of the 45 Es who had completed data. Most of the reliabilities were in the acceptable to good range (.566 to .960). However, the reliability of vari- ables Overdose Drug Knowledge, Self-Usage of Caffeine, and Empathy Problem Solving were quite low. The Administrative Agreement The administrative commitment between the S.T.R.I.D.E. program, the Comprehensive Drug Treatment Programs, and the S.T.R.I.D.E. research director was made in order to insure that all parties were cognizant of their rights and privi- leges as well as their duties and responsibilities. The administrative agreement was needed so that none of the respective parties would try to change any of the agreed upon evaluation procedures after the research started. A copy of this agreement appears in Appendix E. 37 Table 2 The Internal Consistency of the 14 Assessment Variables of Dangerous Drugs (FHD) Nicotine (SKS) Dangerous Drugs (SHD) Marijuana (MSKS) Alcohol (SAL) Friends'-Usage of Marijuana (MFKS) Friends'-Usage of Nicotine (FSK) Friends'-Usage of Alcohol (FAL) Friends'-Usage of Caffeine (FCF) Empathy Technique (EMT) Overdose Drug Knowledge (OD) Caffeine (SCF) Variables l. Friends-usage 2. Self-Usage of 3. Self-Usage of 4. Self-Usage of 5. Self-Usage of 6. 7. 8. 9. Summation Self-Esteem 10. ll. 12. 13. Self-Usage of 14. Empathy Problem Solving (EMP) Reliability (Internal Consistency) .960 .953 .936 .928 .897 .891 .881 .771 .743 .676 .566 .339 .264 .048 CHAPTER 3 RESULTS Attrition Twenty—seven of the original 72 Es were lost through attrition. The 27 lost Es consisted of 14 females (F) and 13 males (M). To test the effect of attrition as well as the randomization procedure a 2 X 2 X 2 analysis of variance was conducted on age, grade, sex, and 14 dependent variables at the pre-test. The three factors were treatment condition (experimental or control), school (Eaton Rapids or Sexton), and attrition (Yes, No). Therefore, the Eaton Rapids ex- perimental complete data group is denoted (EREI); the Eaton Rapids experimental complete data group is denoted (ERE); the Eaton Rapids control incomplete data group is denoted (ERCI); the Eaton Rapids control complete data group is denoted (ERC); the Sexton experimental incomplete data group is denoted (SEI); the Sexton experimental complete data group is denoted (SE); the Sexton control incomplete data group is denoted (SCI); and the Sexton control complete data group is denoted (SC). 38 39 Treatment Effects The results of the treatment effects show that there were no significant differences between the control Es versus experimental Es on any of the pre—treatment variables. Therefore, the randomization procedure was effective (see Appendix F, Table 11). School Effects The results of the school effects show that there were initial significant differences between Eaton Rapids and Sexton high schools on the following variables: grade, self-usage of marijuana (MSKS), age, self-usage of dangerous drugs (SHD), friends'-usage of marijuana (MFKS), self-usage of nicotine (SKS), self-usage of caffeine (SCF), self-esteem (SSE), and self-usage of alcohol (SAL) (see Table 3 and Appendix F, Table 12). Since nine out of 14 assessment variables were significant at the (p < .05) level on the school effects, it is highly improbable that this finding occurred strictly by chance alone. The Es at Sexton High School were significantly older, more advanced in school, used more nicotine (SKS), alcohol (SAL), marijuana (MSKS), dangerous drugs (SHD), and had higher self-esteem scores and more friends that used mari- juana than did the Eaton Rapids Es who used only more caffeine (SCF) than did the Sexton Es (see Table 4). 4O 000.0 000.0 000.0 000.0 000.0 000.0 900.0 090.0 .0.0 000.0 000.0 000.0 900.0 000.0 HHH.0 000.0 000.0 M A<0 .0 000.00 000.00 000.9H 000.00 000.0H 00H.0H 000.00 090.00 .0.0 000.00 009.00 0H9.00 000.000 90H.09 000.00 000.00 000.00 M 000 .0 000.0 000.0 000.0 000.0 000.0 H90.0 000.0 000.0 .0.0 900.0 090.0 000.0 000.0 000.0 000.0 000.0 000.0 M 900 .9 000.0 009.0 009.0 000.0 000.0 000.0 000.0 000.0 .0.0 900.0 000.0 090.0 000.0 000.0 000.9 000.0 000.9 M 000 .0 000. 000.0 000.0 000.H 000.0 H00.0 000.0 000.0 .0.0 000. H90.H 000.0 000.0 000.0 000.0 000.0 000.0 m 0M92 .0 000.90 000.00 900.00 000.90 000.0 090.0 000.0H 000.0 .0.0 900.00 000.00 000.00 000.00 009.00 000.00 909.09 000.00 M 000 .0 990. 009. 000. 000.0 009. 000.H 000.0 000. .0.0 900.00 000.0H 000.00 90H.0H 000.00 HHH.0H 000.0H 000.00 M 00< .0 00H.H 000.0 090.0 900. 000.0 090.0 900.0 HOH.0 .0.0 900. 090.0 000.0 900. 000.9 000.0 000.0 000.00 M 0002 .0 990. 000. 000. 000. 000. 000.H 000.0 000. .0.0 000.00 090.0H 0H9.oa 90H.0H 000.0 900.0 000.0 000.0 M 00090 .H 0 n z 9 u z 9 u z 0 u z 00 u z 0 n 2 00 n z 0 u z 000 H000 00 H00 000 H000 mam Hmmm manmwnm> coauwvaoo coaufiuuu¢ 0am unmaummu9 mo Hm>mq scam um nommmm Hoonum Hmauwa .m «Heme H 0:» How mammz The Initial School Effects 41 Table 4. Variable Eaton Rapids N=35 Sexton N=10 1. Grade 2 = 9.280 2 =lo.440 (F = 43.325, p < .0001) 8.0. = .869 .0.= .502 2. MSKS i = 8.130 R = 1.511 (F = 35.540, p < .0001) 3.0. = 3.782 .0. = 2.475 3. Age 2 =14.810 i =16.060 (F = 33.152, p < .0001) s.0. = 1.039 .0. = .851 4. 500 i =85.34o i =68.470 (F = 17.184, p < .0002) 8.0. =10.545 . =19.193 5. MFKS i = 4.170 X = 1.170 (F = 9.451, p < 0032) 8.0. = 3.529 .0. = 1.957 6. sxs i = 7.030 X = 3.670 (F = 7.023, p < .0102) 8.0. = 4.478 .0. = 5.219 7. SCF i = 3.710 2 = 5.830 (F = 5.273, p < .0250) s.0. a 3.200 . = 4.302 8. SSE i =86.700 i =93.520 (F = 4.865, p < .0311) 8.0. =15.996 .0. =16.o47 9. SAL i = 5.410 E = 3.600 (F = 4.247, p < .0430) 8.0. = 3.087 .0. = 3.231 42 Attrition Effects The results of the attrition effects show that there were significant differences between Es who completed all of the questionnaires at all three time levels and Es who failed to complete all of the questionnaires at all three time levels on the following variables. The variables are sex, age, and empathy problem solving (EMP) (see Table 5 and Appendix F, Table 13). The Es that completed all of the questionnaires at each of the three time levels were significantly younger, more likely to be male, and scored higher on the empathy problem solving (EMP) variable than did the Es that did not complete all of the questionnaires at each of the three time levels (see Table 6). Since three out of 14 assessment variables were significant at the (p < .05) level on the attrition effects, it is highly improbable that this finding occurred strictly by chance alone. Treatment E School Interaction Effects The results of the school X treatment interaction effects show that there were initial significant differences as a function of the school X treatment interaction on the empathy technique (EMT) variable and the friends'-usage of alcohol (FAL) variable (see Table 7 and Appendix F, Table 14). The Eaton Rapids experimental groups (ERE+I) did worst followed by the Eaton Rapids control groups (ERC+I) followed by the Sexton control groups (SC+I) followed by the Sexton 43 900.H 000.H 000.0 H00.H 000.H H00.H 009.H H90.H .0.0 000.0 00H.0 000.0 90H.0 000.0 000.0 090.0 000.0 M 020 .0 990. 009. 000. 00H.H 009. 000.H 0H0.H 000. .0.0 900.0H 000.0H 00H.0H 90H.0H 000.0H HHH.0H 000.0H 000.0H M 00¢ .0 990. 000. 000. 000. 000. 000. 900. 900. .0.0 000.H 000.H 000.H 000.H 000.H 000.H 090.H 000.H M un00 .H 0 n z 9 u z 9 n z 0 u z 00 u z 0 u 2 HH u z 0 u z 00 H00 00 H00 000 H000 000 H000 0H00HH0> Hoonum 000 ud0fium0u9 mo H0>00 £000 00 000000 GOHuHHuu< 0:9 .0 0H009 44 Table 6. The Attrition Effects Variable Es Data Incomplete Complete N = 27 N = 45 1. Sex i = 1.515 X = 1.244 (F = 7.322, p < .0088) 3.0. = .507 3.0. = 1.244 2 Age i =15.741 i =15.214 (F = 4.787, p < .0324) 3.0. = 1.022 8.0. = .868 3. EMP i = 2.633 X = 3.723 (F = 4.761, p < .0328) 3.0. = 1.829 5.0. = 1.721 45 000.0 000.0 00H.0 000.H 000.H HOH.0 900.0 000.H n .0.0 900.0 0H9.0 00H.0 000.H 000.0 000.0 090.0 000.0 0 m A<0 .0 000. 000.H 090.H 000.H 0H0.H 000.H 00H.H 900. n.0.0 000.0 00H.0 000.0 90H.0 090.0 000.0 00H.0 000.H n M 920 .H 0 n z 9 u z 9 u z 0 u z 00 u z 0 n z HH u z 0 u z 00 H00 00 H00 000 H000 000 H000 0H00Hum> aOHuHuuu< mo H0>00 5000 um mu00000 :OHuomu0uaH Hoonom 0 ud0aum0u9 HmHquH 0:9 .5 magma 46 experimental groups (SE+I) who did best (see Table 8) on the empathy technique (EMT) variable. The Sexton experimental groups (SE+I) did worst followed by the Eaton Rapids control groups (ERC+I) followed by the Sexton control groups (SC+I) followed by the Eaton Rapids experimental groups (ERE+I) who did best (see Table 8) on the friends'-usage of alcohol (FAL) variable. Since only two out of 14 assessment variables were significant at the (p < .05) level on the treatment X school interaction effects, it is highly probable that this finding occurred strictly by chance alone. Treatment E_Attrition Interaction Effects The results of the treatment X attrition interaction effects show that there were no initial significant dif- ferences between treatments at each level of attrition. Thus, there were no attrition patterns as a function of experimental condition (see Appendix F, Table 15). School §_Attrition Interaction Effects The results of the school X attrition interaction effects show that there were no initial signigicant dif- ferences between Es as a function of the school X attrition interaction (see Appendix F, Table 16). Treatment E School E Attrition Interaction Effects The results of the treatment X school X attrition interaction effects show that there were initial significant 47 o~o.~ u .a.m wam.a n .n m Naa.H u .e.m mom.~ u.e.m “wee. v e .N9o.0 a 00 Hma.m n m Ham.H u m ~99.~ u m emm.m u m 400 .N 096. u .a.m 0mm.H u .a.m Hmm.H n .n.m Noo.H n.e.m Amao. v a .Nom.e a 00 mm~.m u m e~9.m n m maa.~ n m Hm0.~ u m 920 .H ca u z mH u z H+mm mm n z H+umm ea 0 z H+um unusuamue x Hoosum H+mmm oflnmfium> muc0000 :OHuumu0uaH Hoonum 0 ua0aum0u9 HMHuHaH 059 .0 0H009 48 differences on only self-usage of dangerous drugs (SHD) variable (see Table 9 and Appendix F, Table 17). The Sexton control group (SC) used significantly more dangerous drugs (SHD) followed by the Sexton experimental incomplete data group (SEI) followed by the Sexton experi- mental group (SE) followed by the Eaton Rapids experimental group (ERE) followed by the Eaton Rapids control group (ERC) followed by the Eaton Rapids control incomplete data group (ERCI) followed by the Eaton Rapids experimental incomplete data group (EREI) who used significantly less dangerous drugs. Since only one out of 14 assessment variables were significant at the (p < .05) level on the treatment X school X attrition interaction effects, it is highly probable that this finding occurred strictly by chance alone. Although there were some effects on school, attrition, treatment X school, and treatment X school X attrition, the crucial analyses in determing whether any bias was intro- duced into the analyses because of attrition involves looking at the treatment effects and the treatment by attri- tion effects. Since there was no significant differences between groups for any treatment effects or treatment X attrition interaction effects, no bias was introduced into the analysis. However, there may be some loss in the generalizability of these findings due to the attrition since there were significant attrition effects on variables sex, age, empathy technique (EMT), empathy problem solving (EMP), and self-usage of dangerous drugs (SHD). 49 Amqo. v a .me~.0 n 00 000.90 0H0.0H 90H.00 000.9H 000.0 090.0 00H.0H 000.0 .0.0 900.00 000.00 000.00 000.00 009.00 000.00 909.09 000.00 M 000 .H 0 u z 9 u z 9 u z 0 u z 00 u z 0 u 2 HH 0 z 0 n z om Hum mm Hmm omm Homm mmm H000 mHanum> 0000000 aOHuomu0uaH cOHuHuuu< Hoonum x ua0aum0u9 HmHuHcH 059 .0 0H009 50 Therefore, the internal validity of this design is not threatened by attrition since the treatment effects and the treatment X attrition interaction effects were not signi- ficant. However, the external validity is threatened somewhat by some attrition effects. Data Analyses A 2 X 2 X 3 analysis of variance was conducted on each of the 14 assessment variables. The factors were treatment (experimental-control), school (Sexton-Eaton Rapids), and time (pre-test, post-test, and follow-up test). Table 10 contains the means on each of the dependent variables for the four groups over the three measuring points. Treatment Effects The results indicated significant treatment effects on the empathy technique (EMT), and empathy problem solving (EMP) variables. The results show that in the analysis of the empathy technique (EMT) variable that the treatment effect was sig- nificant at the (F = 11.771, p < .01) level (see Appendix G, Table 18). The experimental Es did significantly better (i = 4.093, S.D. = 1.492) on the variable empathy technique (EMT) than did the control Es (Y = 2.901, S.D. = 1.375). (All means represent the means of the treatment effects ig- noring both the school and time effects.) 51 Table 10. The Means and Standard Deviations of the 14 Assessment Variables at the Three Time Levels Variable Time Experimental Control Eaton Sexton Eaton Sexton Rapids N = 11 N = 7 Rapids N = 24 N = 3 EMTl i1 3.182 3.857 2.875 2.000 s.0.l 1.168 1.676 1.513 .000 EMTZ 22 4.546 3.714 2.875 1.333 3.0. 1.508 1.799 1.541 1.155 EMT3 23 4.455 4.857 3.000 5.000 s.0.3 1.864 .900 1.319 1.000 EMPl 21 3.273 4.286 3.000 4.333 s.0.l 1.794 2.059 1.504 1.528 EMPZ 22 5.091 4.571 3.000 4.667 S.D.2 1.300 2.149 1.063 2.082 EMP3 i3 4.455 5.714 3.792 5.000 s.0.3 1.635 .756 1.587 1.000 001 El 10.000 12.143 10.542 13.667 s.0.1 3.286 4.706 3.203 .577 002 22 11.364 15.571 11.042 12.333 s.0.2 2.730 4.276 3.155 4.509 003 KB 10.636 15.143 11.458 12.333 s.0.3 3.295 4.100 2.670 .577 MSKSl i1 6.455 2.143 7.042 .667 8.0.1 4.927 4.375 4.038 1.155 MSKSZ i2 6.182 2.857 7.833 .667 8.0.2 4.094 4.375 3.908 1.155 MSKS3 23 5.909 2.571 5.917 5.000 s.0.3 5.186 4.237 4.605 1.000 52 Table 10. (continued) Variable Time Experimental Control Eaton Sexton Eaton Sexton Rapids N - 11 N = 7 Rapids N = 24 N = 3 5. SHDl i1 79.727 69.286 83.708 59.667 .0.1 15.120 20.147 9.438 27.062 SHD2 i2 82.182 68.000 83.417 64.000 .0.2 13.761 19.816 10.607 25.239 SHD3 23 82.727 75.857 80.875 92.000 .0.3 21.124 13.310 13.215 4.583 6. SALl i1 5.636 3.286 4.500 4.000 .0.1 3.107 2.215 2.949 4.359 SALZ 22 6.182 2.429 4.458 3.667 .0.2 3.401 2.370 2.963 4.619 SAL3 i3 5.182 2.429 3.917 2.000 .0.3 4.143 2.149 2.653 1.000 7. FHDl i1 65.091 57.000 64.125 48.667 .0.1 18.448 30.822 15.318 25.813 FHDZ 22 63.546 58.143 63.583 51.000 .0.2 16.884 26.264 11.632 24.249 FHD3 23 55.909 64.857 64.042 76.000 .0.3 26.440 19.962 17.297 23.580 8. SSEl i1 84.455 90.714 79.167 96.333 .0.1 24.353 17.192 12.524 13.650 SSE2 22 88.000 91.143 83.833 103.000 .0.2 24.932 14.416 16.557 14.799 SSE3 23 79.000 87.429 81.792 97.000 .0.3 26.351 17.415 14.271 25.239 9. SKSl i1 6.364 4.571 6.958 3.667 .0.1 5.045 5.769 4.418 6.351 sxsz i2 6.455 3.857 6.833 3.667 .0.2 4.906 4.413 4.488 4.726 sxs3 23 6.182 3.714 6.500 4.333 .0.3 4.600 5.707 4.917 4.509 53 Table 10. (continued) Variable Time Experimental Control Eaton Sexton Eaton Sexton Rapids N = 11 N = 7 Rapids N = 24 N = 3 10. SCFl i1 3.455 5.286 3.208 5.667 s.0.1 4.009 5.283 2.536 2.082 SCF2 22 4.273 4.429 3.875 4.333 s.0.2 4.407 3.409 3.353 1.528 SCF3 23 4.636 2.857 3.167 5.000 s.0.3 4.884 4.298 3.031 2.000 11. FSKl i1 2.273 2.571 2.208 .333 8.0.1 3.409 4.429 2.467 .577 FSKZ 22 2.273 3.000 2.333 .333 3.0.2 3.952 4.690 2.565 .577 FSK3 23 2.455 2.429 2.042 .000 5.0.3 3.857 3.823 2.956 .000 12. MFKSl 21 3.636 2.143 3.833 .000 8.0.1 3.443 4.413 3.266 .000 MFKSZ 22 2.000 2.429 3.667 .000 3.0.2 3.464 4.467 3.397 .000 MFKS3 i3 3.182 2.000 3.250 1.000 s.0.3 4.423 4.435 3.274 1.000 13. FCFl 21 3.636 2.429 3.500 3.667 s.0.l 2.203 3.599 2.432 1.155 FCFZ 22 3.546 2.714 2.875 2.667 s.0.2 3.560 2.752 2.028 2.082 FCF3 23 3.182 1.286 2.458 .667 3.0.3 2.857 1.890 2.340 .577 14. FALl 21 3.273 2.143 2.583 2.667 s.0.1 2.687 2.193 1.863 2.082 FAL2 22 3.273 2.571 2.917 2.333 s.0.2 2.867 3.101 1.909 2.309 FAL3 23 2.546 1.714 2.667 1.333 s.0.3 2.583 2.498 2.220 .577 54 Table 10. (continued) Variable Time Experimental Control Eaton Sexton Eaton Sexton Rapids N = 11 N = 7 Rapids N = 24 N = 3 15. Drug-Total i1 17.955 15.086 18.167 12.900 Scorel S.D.l 6.240 8.325 4.873 7.064 Drug-Total 22 17.991 15.043 18.179 13.267 Score2 S.D.2 6.130 7.566 4.685 6.648 Drug-Total 23 17.191 15.971 17.484 18.633 Score3 S.D.3 8.010 6.231 5.651 3.883 16. Empathyl i1 3.228 4.072 2.938 3.167 s.0.1 1.481 1.866 1.509 .764 Empathyz 22 4.819 4.143 2.938 3.000 s.0.2 1.404 1.974 1.302 1.619 Empathy3 23 4.455 5.286 3.396 5.000 s.0.3 1.750 1.480 1.453 1.000 55 The results show that in the analysis of the empathy problem solving (EMP) variable that the treatment effect was significant at the (F = 9.504, p < .01) level (see Appendix G, Table 18). The experimental Es did significantly better (E = 4.500, S.D. = 1.607) on the variable empathy problem solving (EMP) than did the control Es (X = 3.420, S.D. = 1.402). Since the empathy technique and the empathy problem solving variables are correlated, the above F tests are not truly independent. Therefore, the author also performed an F test on the combined empathy score. Since this test was statistically significant (F = 14.852, p < .01) level (see Appendix G. Table 18), the author concluded that the su- periority of the S.T.R.I.D.E. treatment groups on the total empathy score was a real significant difference. School Effects The results indicated significant school effects on the following five variables: overdose drug knowledge (OD), self-usage of marijuana (MSKS), self-usage of dangerous drugs (SHD), self-usage of alcohol (SAL), and empathy pro- blem solving (EMP). The results show that in the analysis of the overdose drug knowledge (OD) variable that the school effect was significant at the (F = 8.345, p < .01) level (see Appendix G, Table 19). The Sexton High School Es reported signifi- cantly more self-usage of marijuana (MSKS) (i = 2.267, S.D. = 3.361) than did the Eaton Rapids Es (Y = 6.695, S.D. = 3.613). 56 The results show that in the analysis of the self— usage of dangerous drugs (SHD) variable that the school effect was singnificant at the (F = 5.091, p < .05) level (see Appendix G, Table 19). The Sexton High School Es reported significantly more self-usage of dangerous drugs (SHD) (i = 71.300, 3.0. = 18.116) than did the Eaton Rapids Es (2': 82.314, 8.0. = 12.807). The results show that in the analysis of the self— usage of alcohol (SAL) variable that the school effect was significant at the (F = 5.070, p < .05) level (see Appendix G, Table 19). The Sexton High School Es reported signi- ficantly more self-usage of alcohol (SAL) (Y = 2.867, S.D. = 2.569) than did the Eaton Rapids Es (§'= 4.724, S.D. = 3.118). Since there were several drug usage variables, the above F tests are not truly independent. Therefore the author also performed an F test on the combined drug usage score. Since this test was not statistically significant (F = 2.573, p < .05) level (see Appendix G, Table 19), the author concluded that the school effect on the total drug usage score was a non-significant difference. The results show that in the analysis of the empathy problem solving (EMP) variable that the school effect was significant at the (F = 4.229, p < .05) level (see Appendix G, Table 19). The Sexton High School Es did significantly better (i = 4.800, S.D. = 1.619) on the variable empathy problem solving (EMP) than did the Eaton Rapids Es (X = 3.581, S.D. = 1.545). 57 Since the empathy technique and the empathy problem solving variables are correlated, the above F tests are not truly independent. Therefore, the author also performed an F test on the combined empathy score. Since this test was not statistically significant (F = 1.486, p < .05) level (see Appendix G, Table 19), the author concluded that the school effect on the total empathy score was a non-significant difference. There were no other significant effects on the other nine dependent variables. Time Effects The results indicated significant time effects on the empathy problem solving (EMP), and empathy technique (EMT) variables. The results show that in the analysis of the empathy problem solving (EMP) variable that the time effect was significant at the (F = 7.319, p < .01) level (see Appendix G, Table 30). All Es scored significantly higher on the empathy problem solving (EMP) variable at Time-2 (Y 4.332, S.D. = 1.649) and at Time-3 (Y = 4.740, S.D. 1.245) than they did at Time-1 (i = 3.723, 5.0. = 1.721). (All means represent the means of the time effects ignoring both the treatment and school effects.) The results show that in the analysis of the empathy technique (EMT) variable that the time effect was signifi- cant at the (F = 4.885, p < .05) level (see Appendix G, Table 20). All Es scored significantly higher on the 58 empathy technique (EMT) variable at Time-3 (E 4.179, 3.0. 1.208) than they did at Time-1 (i = 3.136, 5.0. 1.289) and at Time-2 (i = 3.200, 5.0. = 1.565). Since the empathy technique and the empathy problem solving variables are correlated, the above F tests are not truly independent. Therefore, the author also performed an F test on the combined empathy score. Since this test was statistically significant (F = 9.940, p < .05) level (see Appendix G, Table 20), the author concluded that the time effect on the total empathy score was a real significant difference. There were no other significant time effects on the other 12 dependent variables. Treatment E School Interaction Effects The results of the school X treatment interaction effects show that there were no significant differences as a function of the school X treatment interaction on any of the 14 variables (see Appendix G, Table 21). Treatment E Time Interaction Effects The results of the treatment X time interaction effects show that there were no significant differences between treatments at each level of time. Thus, there were no time patterns as a function of experimental condition on any of the 14 variables (see Appendix G, Table 22). 59 School E Time Interaction Effects The results indicated significant school X time interaction effects on the following four variables: self- usage of dangerous drugs (SHD), friends'-usage of dangerous drugs (FHD), empathy technique (EMT), and self—usage of marijuana (MSKS). The results show that in the analysis of the self-usage of dangerous drugs (SHD) variable that the school X time interaction effect was significant at the (F = 6.861, p < .05) level (see Appendix G, Table 23). While there was not much change in the use of dangerous drugs by Eaton Rapids Es over time, there was a tendency for Es at Sexton to de- crease their usage of dangerous drugs over time. The results show that in the analysis of the friends'- usage of dangerous drugs (FHD) variable that the school X time interaction effect was significant at the (F = 6.308, p < .05) level (see Appendix G, Table 23). While Eaton Rapids Es' scores on friends'-usage of dangerous drugs in- creased slightly over time, Sexton Es' scores on friends'- usage of dangerous drugs decreased somewhat over time. The results show that in the analysis of the self-usage of marijuana (MSKS) variable that the school X time inter- action effect was significant at the (F = 5.135, p < .05) level (see Appendix G, Table 23). While Es at Eaton Rapids slightly increased their usage of marijuana over time, the Es at Sexton decreased somewhat their usage of marijuana over time. 60 Since there were several drug usages variables, the above F tests are not truly independent. Therefore, the author also performed an F test on the combined drug usage score. Since this test was statistically significant (F = 5.482, p < .05) level (see Appendix G, Table 23) the author concluded that the school X time interaction effect on the total drug usage score was a real significant difference. The results show that in the analysis of the empathy technique (EMT) variable that the school X time interaction effect was significant at the (F = 6.182, p < .05) level (see Appendix G, Table 23). While Es at Eaton Rapids slightly increased their empathy technique scores over time, the Sexton Es exhibited a curvilinear pattern where the Time-2 empathy technique scores were lower than empathy technique scores at Time-l and at Time-3. Since the empathy technique and the empathy problem solving variables are correlated, the above F tests are not truly independent. Therefore, the author also performed an F test on the combined empathy score. Since this test was not statistically significant (F = .499, p < .05) level (see Appendix G, Table 23) the author concluded that the school X time interaction effect on the total empathy score was a non-significant difference. There were no other significant school X time interaction effects on the other 10 dependent variables. 61 Treatment E School E Time Interaction Effects The results indicated significant treatment X school X time interaction effects on the self-usage of marijuana (MSKS) and the self-usage of dangerous drugs (SHD) variables. The results show that in the analysis of the self- usage of marijuana (MSKS) variable that the treatment X school X time interaction effect was significant at the (F = 5.802, p < .05) level (see Appendix G, Table 24). While Eaton Rapids Es' scores on marijuana usage slightly increased over time, Sexton control Es' scores greatly decreased, and Sexton experimental Es' showed lowest marijuana usage at Time-2 than at Times 1 and 3. The results show that in the analysis of the self-usage of dangerous drugs (SHD) variable that the treatment X school X time interaction effect was significant at the (F = 5.113, p < .05) level (see Appendix G, Table 24). While Eaton Rapids experimental Es' scores on self-usage of dangerous drugs slightly decreased over time, Sexton experimental Es' scores decreased somewhat, Sexton control Es' scores de- creased substantially, and Eaton Rapids control Es' scores slightly increased. Since there were several drug usage variables, the above F tests are not truly independent. Therefore, the author also performed an F test on the combined drug usage score. ,Since this test was not statistically significant (F = 2.337, p < .05) level (see Appendix G, Table 24), the author 62 concluded that the treatment X school X time interaction effect on the total drug usage score was a non-significant difference. There were no other significant treatment X school X time interaction effects on the other 12 dependent variables. CHAPTER 4 DISCUSSION The lack of a significant treatment effect on any part of the pre-test or demographic variables indicates the ran- domization procedure was effective. Although 27 Es were lost due to attrition, the lack of any significant treatment X attrition interaction effects suggests that the attrition did not negate the effectiveness of the randomization proce- dure. However, the presence of significant main effects due to attrition may restrict the generalizability of these findings. School Effects Although the main effects of school and interactions involving the school effect are not interesting theoreti- cally, they should be mentioned briefly. Sexton Es scored significantly higher on several drug usage variables, but also showed a tendency to show greater decreases in these same variables over time than did Eaton Rapids Es. Time Effects The main effect of time on the empathy problem solving variable may be partially explained by a social development 63 64 process whereby the Es are becoming more socially mature and sensitive as they grow older. Treatment Effects Empathy. There were significant treatment effects on the empathy technique (EMT) and the empathy problem solving (EMP) variables. There were no significant treatment effects on any of the other variables. The amount of work- shop time devoted to empathy training as compared to time spent on other activities may at least partially explain why the S.T.R.I.D.E. Program produced significant effects on the empathy variable but not on the other variables. Two out of the six S.T.R.I.D.E. workshop days were devoted to empathy skills. Another day and a half was devoted to the develop- ment of the related skills of values clarification and problem solving. Two days were devoted to overdose drug knowledge aid while there was no specific time allotted to techniques for reducing drug usage or for increasing self- esteem. Thus, perhaps the S.T.R.I.D.E. workshop achieved its objective in training people to become more empathic because nearly twice a much time was allocated to empathy training as compared to any other training component. Overdose Drug Knowledge There was no treatment effect on the overdose drug knowledge (OD) variable. Two out of the six S.T.R.I.D.E. workshop days were devoted to overdose drug knowledge and 65 still no improvement was found in the experimental Es. The reason for this failure is due primarily because overdose drug knowledge simply cannot be learned in two days. There are hundreds of drugs, and many overdose aid procedures. Drugs taken alone or in combination with other drugs or sub- stances affect victims differently. Factors such as how much was consumed, how long ago it was consumed, what was its true generic compostion, was the victim a new or veteran user of drugs especially the culprit drug, and what was the victim's drug tolerance level are extremely important issues in treating drug victims. And, in spite of the fact that the Es were given an Opportunity to practice what they had learned in the lecture section on overdose drug aid by treating trainees, who role—played as emergency clients, and were given feedback from instructors and peers on their newly acquired skills, still there was no improvement in the overdose drug aid scores. However, it is important to note that failure to increase drug knowledge may not be detrimental to a program whose primary goal is to reduce drug usage. Research by Stuart and Schuman (1972) found that non-users of every drug were less knowledgeable about drugs than users. In addition, they found drug education programs not only failed to reduce drug taking behavior, but in fact, may have in- creased drug usage (see also: Swisher, Crawford, Goldstein, and Yura, 1971). 66 While stuart and Schuman (1972) study had methodological short-comings, they do suggest that the failure of the present program to increase drug knowledge may not be disastrous with respect to reducing drug usage. Drug Usage There were no significant treatment effects on the drug usage variables. Since there was no specific time allocated for advocating a reduction in drug usage in the S.T.R.I.D.E. workshop, it is not surprising that the Es' drug usage and their friends' drug usage were not decreased by the S.T.R.I.D.E. workshop training. However, many of the Es especially at the Eaton Rapids schools consumed a minimum of dangerous drugs so that a decrease in drug usage would be difficult to detect since initial low drug usage resulted in a basement effect. Although his research had some methodological flaws, Richard B. Stuart (1974) supports these findings in his study of drug usage in drug education programs. He found that neither format nor content factors influence the re- sults of the program. Relative to controls, Es receiving drug education significantly increased their use and sale of marijuana and L.S.D. and their use of alcohol while showing a significant increase in drug information and a decrease in worry about drugs. When the interaction between drug usage, knowledgepand worry was examined it was shown that usage tends to rise as a function of a combination of high knowledge and low worry but not as a function of 67 increases in one without the other. It is, therefore, suggested that drug education efforts may have iatrogenic effects, and it is strongly recommended that all such pro- grams assess their consequences at least in terms of Es' drug usage. Similarly, Halleck (1970) and Swisher, Crawford, Goldstein, and Yura (1971) found that much of what goes on in the name of drug education may actually be "pushing" rather than preventing. Jaffee and Clark (1972) and Macro Systems, Inc. (1972) found that the scant evidence that does exist sug- fests that with few exceptions most drug abuse prevention programs have negative, or at best, null effects. This is probably because drug usage among adolescents is a highly social activity more subject to influence by peer and family relationships than by formal classroom education (Blum, 1972). Seabright (1973) found in her review of a number of drug abuse prevention programs that there is unanimous agreement among drug education specialists that the one- shot, "crash" program is ineffective. Recent reports from the National Commission on Marijuana and Drug Abuse (1972) confirm the need for imple- mentation of programs which do more than provide information about drugs. If the problem is, as the commission suggests, a problem of human behavior, then programs should be 68 introduced which educate toward the goal of more effective decision making in a variety of situations. Although drug education efforts have not been effective in reducing drug usage behavior, other techniques which are more firmly rooted in social psychological theories of attitude change have produced some positive effects. Fear arousal is one technique which has produced interesting results. For example, at least six studies by Higbee (1969) have shown that high fear appeals are superior to low fear appeals in creating persuasion about cigarette smoking behavior. However, other research indicates that high fear appeals may not be as effective as low fear appeals if the Es have prior experience or knowledge about drugs. For example, with respect to marijuana cigarette smoking Smart and Fejer (1974) found that low fear messages were more successful than either high or medium fear messages in per- suading marijuana users to discontinue useage. However, for non-marijuana users there was a curvilinear relationship, with the medium fear messages being the least successful. However, these results should be accepted with some caution, since they reached significance only at p < .10 > .05. Smart and Fejer (1974) also demonstrated the superiority of high fear messages over low fear messages in situations where drug knowledge was low. They found high threat messages produced greater reluctance to try a "non- existent" drug than did low threat messages. 69 The above findings clearly underscore the importance of knowing the audience before designing an intervention program aimed at reducing drug usage. If the audience is primarily drug users, it is highly unlikely that a one-sided high threat message will be effective. On the other hand with an inexperienced audience, the high fear arousal condi- tion may be more effective than the low fear arousal. Personality traits such as anxiety also mediate the effec- tiveness of the various fear messages. For example, Smart and Fejer found that the medium fear message had less effect on the intent to use marijuana for the medium anxiety group, while with high anxious Es, no evidence was found that high fear messages were less effective than low or medium fear messages. In conclusion, the authors suggest that persons interested in designing programs aimed at drug education consult the attitude change literature first. The inter- action of audience characteristics with variables such as source credibility, logical or emotional appeals, primary and recency effects, have potential relevance to designing such programs. However, the authors' recommendations was to be tempered somewhat by the harsh reality that attitude change does not always correlate with behavior change (Wicker, 1969). Self-Esteem There was no treatment effect on the self-esteem (SSE) variable. Since there was no specific time allotted for ».. ..~II.-.{:'.‘3"J:' m m .-.-_"'_' ' “lung—.m- ~__ . 70 self-esteem in the S.T.R.I.D.E. workshop, the failure of the S.T.R.I.D.E. program to increase self-esteem is not surprising. Nevertheless, it does seem important at this point to remind the reader that several studies (Samuels, 1974; Poe, Boynton, and Allman, 1972) have demonstrated that drug taking behavior is related to low self-concept. Given this reminder several program suggestions for incresing the self- esteem of adolescents are provided in the following paragraphs. Kane (1973), Piorkowski (1973), and Myers (1973) all argue that the primary function of drug programs should be development of the individual to one's fullest potential. Therefore, they urge that considerable time be spent dealing with the students' fears, wishes, and other feelings. Other researchers have recognized this need. Dohner (1973) suggests one non-chemical alternative is through "personal awareness development" whereby people develop their own feelings, attitudes, and perceptions in order to evaluate the effect of their behavior on others. And Samuels (1973) believes that for a drug education program to be effective that it must stress the individual's own intrinsic values and attitudes interwoven in the whole syndrome of drug use, abuse, and addiction. He cited the Dale County Schools whose focus is on affective rather than cognitive levels of development. They seek to develop the inter-intra personal skills, coping skills, and the 71 improvement of self—concept for their students. The schools provide opportunities for the growth and development of self-concept, self-worth, and interpersonal relationships which have been found to be an underlying aspect in one's involvement in the abuse of drugs as well as in any other deviant aspect of behavior. The focus of elementary students is on awareness of feelings, mastery of those feelings and social interaction. The focus of secondary students is on peer counseling and/or teen counseling programs where coun— selors are trained in active listening skills, value clarification techniques and problem solving and decision- making skills which are of importance to themselves as well as those that they counsel. Therefore, the activity segment of the program relies on offering activities through which young people can achieve goals of socialization, sensory experience, and emotional growth which are in and of them- selves one of growth, but also can act as alternative activities to drug abuse involvement. However, it should be noted that the efficacy of this program is still unde- termined, and more research needs to be done. In summary, the concensus of may programs is that the drug users need worthwhile alternative activities to alle- viate some of their boredom and to channel their curiosity. If they kept busy through after-school programs, community centers, special courses, (i.e., transcendental meditation, Yoga, music), then they would have less time and need for drugs. These types of worthwhile activities would probably 72 bolster their self-concept and increase their self-esteem. Therefore, since students spend a significant amount of time in school, the school system must develop educational programs that will help students cope with life and form sound values and attitudes about drugs and life in general. Students should also learn to recognize and be able to deal with their feelings in a constructive manner. The S.T.R.I.D.E. program attempts to do this with its empathy workshop. However, providing an ongoing after- school program of alternatives was beyond the scope of its resources. Again, it is important to point out that the author is not aware of any empirical research demonstrating the effectiveness of such approaches in increasing self- esteem and/or decreasing drug usage. Conclusion In summary, the S.T.R.I.D.E. program was very effective in increasing the empathy skills of the workshop participants. However, the S.T.R.I.D.E. program was not effective in increasing overdose knowledge and self-esteem of the participants. Nor did the S.T.R.I.D.E. program have any significant effect on the drug usage patterns of its participants. BIBLIOGRAPHY BIBLIOGRAPHY Amendolara, F. R. Modifying attitudes toward drugs in seventh grade students. Journal of Drug Education, 1973, E(1), 71-78. Berg, D. Compilation of drug incidence surveys. 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Glaser, D., & Snow, M. Public Knowledge and Attitudes on Drug Abuse in New York State. Research Division, New York State Narcotic Addiction Control Commission, Albany, N.Y., 1969. Goldstein, J. W., & Korn, J. H. Judging the shape of things to come: Lessons learned from comparisons of student drug users in 1968 and 1970. Department of Psychology, Carnegie-Mellon University, Report, 1972, 72-2. Graham, D. L., & Cross, W. C. Values and attitudes of high school drug users. Journal of Drug Education, 1975, _§_(2) p 97-107. Halleck, S. The great drug education hoax. The Progressive, 1970' 3_4_' 1-7. Helm, S. Educational aspects of drug abuse in our community. Community Health Services, Rochester, New York: University of Rochester, 1970. Higbee, K. L. Fifteen years of fear arousal: Research on threat appeals, 1953-1968. Psychological Bulletin, 1969, 13, 426-444. Hoffman, A. Real Research in Drug Education: The Irrelevant Variable, 1971. (ERIC ED, 058 571) Horan, J. J., Shute, R. E., Swisher, J. D., & Westcott, T. B. A training model for drug abuse prevention: Content and evaluation. Journal of DrugEEducation, 1973, E(2), 121-126. 75 Hoyt, C. Test reliability obtained by analysis of variance. Psychometrika, 1941, E, 153-160. Jackson, J. A. The Cross—Lagged Panel Correlation of the Students,Teachers, and Residents in Drug Education (S.T.R.I.D.E.) Drug Program. Unpublished manuscript as the comprehensive requirement for Ecological Psychology, 1975. ' Jaffee, D., & Clark, T. Unpublished drug education evaluation study, funded by the Department of Health, Education, and Welfare. Behavior Today, E(46), 1972, 2. Kagan, N. Can we improve the ways in which peOple relate to each other? Influencing human interaction, Educational Development Program Report. Michigan State University, East Lansing, Michigan, (36), 1973. Kane, H. The Challange of Preventive Drug Education. Symposium presented at the meeting of the International Congress of Drug Education, Montreux, Switzerland, 1973. Korn, J. W., & Goldstein, J. W. Psychoactive drugs: A course evaluation. Journal of Drug Education, 1973, ,§(4), 353-367. Laskowitz, D. Psychological characteristics of the adolescent addict. In H. Harm (ed.), Drungddiction In Youth, New York: Pergamon Press, Inc., 1965. Levy, M. H. Background considerations for drug programs. In U. S. Department of Justice, Bureau of Narcotics and Dangerous Drugs. Guidelines for Drungbuse Prevention, U.S. Government Printing Office, 1972. Linder, R. L., Lerner, S. E., & Drolet, J. C. Drug use by students of drug abuse. Journal of Drug_Education, 1973, 3(3), 309-315. Macro System, Inc. Unpublished drug education evaluation study, funded by the Department of Health, Education, and Welfare. Behavior Today, 1972, E(46), 2. Mathews, W. M. A critique of traditional drug education programs. Journal of Drug Education, 1972, E(l), 57. McKee, M. R. Main street, U.S.A.: Fact and fiction about drug abuse. Journal of Drug Education, 1973, E(3), 275—295. Mellinger, G. D., Balter, M. B., & Manheimer, D. I. Patterns of psychotherapeutic drug use among adults in San Fran- cisco. Archives of General Psychiatry, 1971, EE, 385-394. 76 Myers, E. The Effects of a Drug Education Program Based on a Causal Approach to Human Behavior. Symposium pre- sented at the meeting of the International Congress on Drug Education, Montreux, Switzerland, 1973. Nail, R. L., & Gunderson, E. K. The youthful drug abuser and drug abuse education--closing the credibility gap. Journal of Drug Education, 1975, E(l), 65-75. National Commission on Marijuana and Drug Abuse. Marijuana: A Signal of Misunderstanding. Washington, D.C.: Government Printing Office, 1972. Nyswander, M. The Drug Addict as a Patient. New York: Grune and Stratton, 1956. Parry, H. J. Patterns of psychotropic drug use among American adults. Journal of Drug Issues, 1971, E, 269-273 Piorkowski, G. H. Drug education at its best--the shaping of values and anti-drug attitudes. Journal of Drug Education, 1973, E, 31-38. Poe, N., Boynton, K., & Allman, P. A Comparison of Self- Concept, Reflected Self and Ideal Self of Drug Abusers. Unpublished manuscript, Florida Atlantic University, 1972. Polk, K. Drinking and the Adolescent Culture. Unpublished manuscript, Lane County Youth Project, Eugene: Oregon, 1970. Preble, E. Social and cultural factors related to narcotic use among Puerto Ricans in New York City. The International Journal of the Addictions, 1966, E(l), 38-40. Raths, L., Harmin, M., & Simon, S. Values and Teaching. Columbus, Ohio, 1966. Reddy, W. B. Effects of immediate and delayed feedback on the learning of empathy. Journal of Counseling Psychology, 1969, EZ(1), 59-62. Richards, L. Evaluation in drug education. School Health Rosenberg, M. Society and the Adolescent Self-Image. Princeton University Press, Princeton, New Jersey, 1965. 77 Rossi, P. H., Groves, W. E., & Grafstein, D. Life Styles and Campus Communities. Pamphlet-questionnaire, Baltimore: John Hopkins University Department of Social Relations, 1971. Samuels, D. J., & Samuels, M. Low self-concept as a cause of drug abuse. Journal of Drug Education, 1974, 3(4), 421-437. Seabright, C. L. A look at some current programs. Journal of Drug Education, 1973, E(2), 127-139. Smart, R. G., & Fejer, D. The effects of high and low fear messages about drugs. Journal of Drug Education, 1974, 1(2), 224-235. Smith, R. F., & Smith, L. S. Overdose Aid. Michigan Department of Social Services, 1972. Sorensen, J. L., & Joffe, S. J. An outreach program in drug education: Teaching a rational approach to drug use. Journal of Drug Education, 1975, E(2), 87. Stuart, R. G. Teaching facts about drugs: Pushing or preventing, (in press). Journal of Abnormal Psychology, 1974. Stuart, R. B., & Schuman, M.C. Tripping and Takinggin Mid-America: A Survey of Teenage Drug Abuse in Four Michigan Communities. Lansing, Michigan: Office of Drug Abuse and Alcoholism, 1972. Swisher, J., Crawford, J., Goldstein, R., & Yura, M. Drug education: Pushing or preventing? Peabody Journal of Education, 1971, EE, 68-75. Swisher, J., Warner, R., & Herr, E. Experimental comparison of four approaches to drug abuse prevention among ninth and eleventh graders. Journal of Counseling Psychology: 1972, EE(4), 328-32. Truax, C. B., & Carkhuff, R. R. Significant developments in psychotherapy research. In L. E. Abt & B. F. Reiss (eds.), Progress in Clinical Psychology, New York: Grune & Stratton, 1964, E. Truax, C. B., & Carkhuff, R. R. Toward Effective Counseling and Psychotherapy: Training Practice. Chicago: Aldine, 1967. 78 Truax, C. B., Carkhuff, R. R., & Dougs, J. Toward an integration of the didactic and experiential approaches to training in counseling and psychotherapy. Journal of CounselingEPsycholong 1964, ll, 240-247. Truax, C. B., & Wargo, D. G. Psychotherapeutic encounters that change behavior: For better or for worse. American Journal of Psychotherapy, 1966, 3;, 499-520. Wald, P. M., & Abrams, A. Drug education, in the drug abuse survey project. Dealing with Drug Abuse. New York: Praeger, 1972, 123-172. Wicker, A. W. Attitudes versus actions: The relationship of verbal and overt behavioral responses to attitude objects. Journal of Social Issues, 1969, EE(4), 41-78. Wolfson, E. A., Lavenhar, M. A., Blum, R., Quinones, M. A., Einstein, 8., & Louria, D. B. Survey of drug abuse in six New Jersey high schools. 1. Methodology and general findings. In Einstein, 8., & Allen, S. (Eds.), Proceedings of the First Internation Conference on Student Drug Surveys (Sept. 12-15, 1971 Newark, New Jersey) New York: Baywood Publishing Company, Inc., 1972, 25. Wong, M. R., & Zimmerman, R. Changes in teachers' attitude toward drugs associated with a "social seminar" course. Journal of Drug Education, 1974, 4(4), 361-367. — Zimering, S. Health and drug education--how effective? (An instrument to evaluate your drug education programs.) Journal of Drug Education, 1(3), 1974, 269-280. APPENDICES APPENDIX A APPENDIX A Group 5. Rank 1. Experimental 1. 7th grade 2. Control 2. 8th grade 3. Non-volunteer 3. 9th grade 4. 4. 10th grade 5. 5. 11th grade Test time 6. Age (See question number 7 also) 1. t-l 2. t-3 1. ll 3. t-4 2. 12 4. t-5 3. 13 4. l4 5. 15 School 7. Age (Continued) 1. Eaton Rapids 1. 16 2. Harry Hill 2. 17 3. Sexton 3. 18 4. 4. l9 5. 5. 20 Sex 8. Race 1. Female 1. White 2. Male 2. Black 3. Chicano 4. Oriental 5. Other 79 80 INTRODUCTION TO THE DRUG OVERDOSE TREATMENT QUESTIONNAIRE Since part of the S.T.R.I.D.E. drug education program is designed to instruct trainees in administering drug over- dose aid in emergency situations, you will be asked about your knowledge of drugs and their effects on users. 10. ll. 12. 13. 81 Overdose Treatment Questionnaire Treatment for brain damage victims involves a. b. c. d. e. Keeping the victim warm and lying down with his head elevated giving the victim liquids taking convulsion precautions, and moving with great care A and C A, B, and C In the treatment of blood clots, one should d. e. elevate the body part and apply pressure to keep the clot from moving the vein can be ligated where serious danger of clot moving occurs apply ice to hurry healing and keep up treatment until clot has scarred into place A and B A, B, and C Which is not a hallucinogen that mixes up the brain's chemical signals? a. b. c. d. e. LSD STP Glue Marijuana C and D If one suffers from sedative confusion, he does not a. b. c. d. e. appear drunk close his memory regress in behavior (act much younger) vigorously move or run around the area stop breathing What type of blood poisoning carries surface germs throughout the body due to improper injection techniques? a. hepatitus b. abscess c. sterile abscess d. septicemia 6. none of the above 14. 15. 16. 17. 18. 19. 20. 82 Which of the following statement(s) is (are) true? a. b. c. d. e. In a. b. c. d. e. Infected blood clots cause heart attacks. Uninfected blood clots cause heart attacks. Uninfected blood clots cause strokes. A and C B and C opium confusion, the subject is rarely laughing or overly happy careless hurt without any warning pain sleepy violent or dangerous In the treatment for Opium confusion, do not a. b. c. d. e. try to keep subject quiet give stimulants such as coffee, tea, or tobacco give a sedative give alcohol C and D A shock victim does not have a. b. c. d. e. a cold sweat a weak pulse a rapid pulse low blood pressure high blood pressure In opiate overdose, the victim does not a. b. c. d. e. fall into a deep sleep have pinpointed pupils have pupils that will not change in light have a slow pulse breath very slowly Anesthesia may be caused by a. b. c. d. e. alcohol barbiturates heroin B and C all of the above Which of the following is not a myth about alcohol? a. b. c. d. e. alcohol is a stimulant a little drinking doesn't affect one's driving a drink or two will improve one's skill alcohol warms the body there are not any quick methods for sobering up 21. 22. 23. 24. 25. 26. 83 Which of the following is not a myth about alcohol? a. b. c. d. e. alcohol acts as an aphrodisiac and increases sexual prowess alcohol does not affect adults and teen-agers alike eating can prevent drunkenness mixing drinks causes drunkenness drunks belong in jail Which of the following is a myth about alcohol? once the alcoholic becomes sensitive or addicted to alcohol, he does not have to remain addicted through- out life approximately one out of fifteen drinkers become alcoholics the length of time it may take for the disease to develOp varies considerably from person to person denying alcoholism is as much a part of the disease as drinking alcohol alone does not cause alcoholism Which of the following diseases can be transmitted through dried blood from dirty injection equipment? a. b. c. d. e. The a. b. c. d. e. malaria syphillis serum hepatitus A and C all of the above fastest drug that can stop breathing is Freon Glue Heroin Barbiturates Alcohol Cardiac massage should not be considered when a. b. c. d. e. the victim has stopped breathing no pulse is found in wrist, neck, or groin no sound can be heard with the ear directly over the heart pupils are pinpointed pupils are dilated In cases of overdose by mouth, there is no need to a. b. C. find out what drug it is determine whether the drug was in liquid, solid, pill, or capsule form induce vomiting if stimulants are involved 27. 28. 29. 30. 31. 32. 84 d. induce vomiting if barbiturates are involved e. dilute the drug with water Symptoms of brain hemorrhage can be all of the following except a. unequal pupils b. slow breathing c. unequal reflexes d. paralyzed limbs e. abnormal reflexes In the treatment of stroke-like complications, the helper should not a. treat for shock b. consider alcohol sedation c. move to a hospital as soon as possible d. give artificial respiration if necessary e. watch for convulsions Treatment of sedative overdose does not require a. treatment for shock b. monitoring Of life signs c. keeping subject awake d. artificial respiration if necessary e. hospital care as soon as possible Which of the following is not true of severe opium overdose? a. the victim has a difficult time trying to fall back to sleep b. breathing decreases c. heart action decreases d. death can come rapidly and without warning e. pupils are pinpointed In severe Opiate overdose, the helper should not a. let the victim sleep it off b. monitor life signs c. keep subject stimulated if "on the nod" d. use caffeine and nicotine e. apply artificial respiration if necessary Which of the following does not cause any serious body dependency? a. codeine b. tranquilizers c. barbiturates d. LSD e. amphetamines 33. 34. 35. 36. 37. 38. 85 Crashing from amphetamines causes a. b. c. d. e. the victim to feel very tired a hopeless mental attitude serious changes in blood pressure a slow pulse all of the above Which of the following cannot as a rule cause convulsions? a. b. c. d. e. LSD benzedrine amphetamines strychnine mescaline Which of the following is most likely to cause convulsions? a. strychnine b. psilocybin c. marijuana d. THC e. Opiates The unconscious state of hyperventilation is not accom- panied by a. collapsed lungs b. muscle shakes c. signs much like nerve damage due to the chemical changes in the blood d. headaches e. a sensation of not being able to get a deep breath In transporting overdose victims to a treatment facility, the trained helper should not a. b. c. d. e. tell the subject what you are going to do use conventional cars where possible use ambulances, medical paraphenalia, sirens if at all possible transport subjects in rear seat of the vehicle have people with the subject in the rear seat Convulsion treatment should not include a. b. C. d. e. using an object to prevent the mouth from closing, that will not damage the teeth tilting the head so that the throat will empty restricting movement of limbs to prevent injury using stimulants as a reliable anticonvulsant for conscious victims all of the above APPENDIX B APPENDIX B INTRODUCTION TO THE DRUG USAGE QUESTIONNAIRE As you know there is considerable concern about drug usage among all segments of the population including high school students; we want to find out what kind of drug usage your school has. Remember that we need honest answers and by using your aliases, you have strict confidentiality. We would like to know about your own personal usage of drugs, and the drug habits of your friends. We know that some of you have not tried drugs yet, but you may want to use drugs in the future. 86 87 ¢z02 0020 2029 0000 NHZBZOZ NHMMMS NHHHG .mmsuc 0:030HHO0 0a» 005 mHucmuuso so» 9H0c0sw0u0 3oz 30H0n 0umowcc0 0000Hm 0HHmccoHum0sO 00000 msua .00 .00 .00 .90 .00 .00 .00 .00 .00 .H0 .00 .00 88 ¢2¢Dme¢2 .Nm mcflamomma Amom ~mam .amqv mzmwozHUDAAdm .H@ mm» .mmmmoo mszmmmm .ow mzHAMDm .mm mcflnmwoe .caoumn mm9¢HmO .mm mmmNHqHDOZdMB .hm mm20Am2 muzo 2429 mmmq 9439202 942MHz MqHfin mwbmo m w m N H .mmsuv maH3oHHom msu mm: maucmunso mcawanm use» wapcmswmum 3o: 30Hmn mumoflncfl mmmmam wuwmccowummno mUMmD mama 89 ¢2m HHH3 so» was» ma pH 9meHH 30: mumoavcfl mmmmam wHHMGGOHummso momma mama .mm .9m .mm .mm .wm .mm .Nm .Hm .om .mm .mm .9m 92 ¢z¢ame¢z .oaa mafiamomma Amum .mem .omqv mzmwozHUqufim .moa mm» .mwmmoo mszmmmu .moa mzHm Hafi3 mwcmfluw H502 umnu ma ufl mamxfia 3o: mumowncfl wmmmam muwmcnofiummso wmmms mama APPENDIX C APPENDIX C INTRODUCTION TO SELF-ESTEEM Now, you will be asked questions concerning feelings you may have about yourself. We realize that what you feel about yourself may change from day to day. Therefore, for this questionnaire, answer the questions on the basis of how you feel about yourself right now. 93 111. 112. 113. 114. 115. 116. 117. 94 Are you ever troubled with sick headaches? a. Often b. Sometimes c. Almost never d. Never I certainly feel useless at times. a. Strongly agree b. Agree c. Disagree d. Strongly disagree Do you ever bite your fingernails now? a. Often b. Sometimes c. Almost never d. Never Do you often find yourself daydreaming about the type of person you expect to be in the future? a. Very often b. Sometimes c. Rarely d. Never Most of the time I would rather sit and daydream than do anything else. a. Strongly agree b. Agree c. Disagree d. Strongly disagree Do you ever have trouble getting to sleep or staying asleep? a. Often b. Sometimes c. Almost never d. Never In general, how would you say you feel most of the time--—in good spirits or low Spirits? Very good spirits Fairly good spirits Fairly low spirits Very low spirits QIOU‘D’ 118. 119. 120. 121. 122. 123. 124. 95 Some people say that most people can be trusted. Others say you can't be too careful in your dealings with people. How do you feel about it? a. Most people can be trusted b. Some people can be trusted c. You can't be too careful sometimes d. You can't be too careful all the time Does your Opinion of yourself tend to change a good deal, or does it always continue to remain the same? a. Strongly agree b. Agree c. Disagree d. Strongly disagree I feel I do not have much to be proud of. a. Strongly agree b. Agree c. Disagree d. Strongly disagree How often do you feel downcast and dejected? a. Very often b. Fairly often c. Rarely d. Never I guess you could call me a "dreamer." a. Strongly agree b. Agree c. Disagree d. Strongly disagree Human nature is really c00perative. a. Strongly agree b. Agree c. Disagree d. Strongly disagree I take a positive attitude toward myself. a. Strongly agree b. Agree c. Disagree d. Strongly disagree 125. 126. 127. 128. 129. 130. 131. 96 I wish I could be as happy as others seem to be. a. b. c. d. Strongly Agree Disagree Strongly I feel that I a. b. c. d. Strongly Agree Disagree Strongly How sensitive a. b. c. d. On a. b. c. d. N0 Extremel Quite se Somewhat Not sens the whole, Strongly Agree Disagree Strongly agree disagree have a number of good qualities. agree disagree are you to criticism? y sensitive nsitive sensitive itive I think I am quite a happy person. agree disagree one is going to care much what happens to you, when you get right down to it. a. b. c. d. Strongly Agree Disagree Strongly agree disagree I have noticed that my ideas about myself seem to change very quickly. a. b. c. d. Strongly Agree Disagree Strongly Would you say others or more inclined to look a. b. c. d. T0 T0 T0 To help help look look agree disagree that most peOple are more inclined to help out for themselves? time time some of the time most of the time others most of the others some of the out for themselves out for themselves 97 132. If you don't watch yourself, people will take advantage of you. a. Strongly agree b. Agree c. Disagree d. Strongly disagree 133. On the whole, I am satisfied with myself. a. Strongly agree b. Agree c. Disagree d. Strongly disagree 134. I wish I could have more respect for myself. a. Strongly agree b. Agree c. Disagree d. Strongly disagree 135. Are you ever bothered by pressures or pains in the head? a. Often b. Sometimes 0. Almost never d. Never 136. How disturbed do you feel when anyone laughs at you or blames you for something you have done wrong? a. Deeply disturbed b. Disturbed c. Fairly disturbed d. Not disturbed 137. Are you ever bothered by your heart beating hard? a. Often b. Sometimes c. Almost never d. Never 138. I daydream a good deal of the time. a. Strongly agree b. Agree c. Disagree d. Strongly disagree 139. 140. 141. 142. 143. 144. 145. 98 On the whole, how happy would you say you are? a. Very happy b. Fairly happy c. Not very happy d. Very unhappy I get a lot of fun out of life. a. Strongly agree b. Agree c. Disagree d. Strongly disagree Are you ever bothered by shortness of breath when not exercising or not working hard? a. Often b. Sometimes c. Almost never d. Never Are you ever troubled by your hands sweating so that they feel damp and clammy? a. Often b. Sometimes c. Almost never d. Never All in all, I am inclined to feel that I am a failure. a. Strongly agree b. Agree 0. Disagree d. Strongly disagree Are you bothered by nervousness? a. Often b. Sometimes c. Almost never d. Never Do your hands ever tremble enough to bother you? a. Often b. Sometimes 0. Almost never d. Never 146. 147. 148. 149. 150. 151. 152. 99 I feel that nothing, or almost nothing, can change the opinion I currently hold of myself. a. b. c. d. Strongly agree Agree Disagree Strongly disagree Criticism or scolding hurts me terribly. a. b. c. d. Strongly agree Agree Disagree Strongly disagree I feel that I'm a person Of worth, at least on an equal plane with others. a. b. c. d. Strongly agree Agree Disagree Strongly disagree Do you ever find that on one day you have one opinion Of yourself and on another day you have a different Opinion? a. Yes, this happens often b. Yes, this happens sometimes c. Yes, this rarely happens d. NO, this never happens Some days I have a very good Opinion of myself; other days I have a very poor Opinion of myself. a. Strongly agree b. Agree c. Disagree d. Strongly disagree At times I think I am no good at all. I am a. b. c. d. Strongly agree Agree Disagree Strongly disagree able to do things as well as most other people. Strongly agree Agree Disagree StrOngly disagree 100 153. Are you ever bothered by nightmares? a. Often b. Sometimes c. Almost never d. Never APPENDIX D APPENDIX D INTRODUCTION TO THE EMPATHY TRAINING QUESTIONNAIRE One important aspect of the S.T.R.I.D.E. training program involves teaching people how to listen to others and help them with their problems. In this questionnaire, you will be asked how a potential "helper" should respond to the "person in need." 101 154. 155. 156. 157. 158. In a. b. c. d. e. In a. b. c. d. e. In d. e. 102 The Empathy Training Questionnaire helping someone, the helper should keep questions to a minimum keep response short avoid giving suggestions all of the above none of the above helping someone, the person in need clarifies his problems explores alternatives plans strategies for change tests out alternatives all Of the above a helping relationship, the helper should first help the person in need understand the feeling he's experiencing at that time help the person in need pinpoint who or what is causing his situation to exist find out if the person in need's feelings are justified or not A and B B and C During the latter stages of a helping relationship, the helper should In organize the order of activities that need to be followed to carry out a solution plan help the person in need identify the things that might cause the person in need to give up help the person in need understand what kinds of things the person in need is afraid will happen if he tries to solve his problem B and C A and C helping people, the trained helper responds to stated feelings of the person in need checks out other feelings that may be present but are not clearly stated by the person in need points out the thing he sees in the person in need that does not seem productive B and C A and B 159. 160. 161. 162. 163. 103 When a person who trusts you and respects your opinion comes to you with a problem and wants more than just empathy, you should a. tell the person what you would do in that situation b. ask him what he thinks he should do c. joke with the speaker occasionally d. persuade the speaker to change the behaviors you see as destructive e. not let him kid himself about the ways he's feeling In helping the person in need solve his problem, the helper should a. help the person in need identify the initial changes he wants to make in order that his final goal may be reached b. help to explore what he will do should an alterna- tive not work c. help the person in need identify the amount of success the helper needs d. A and C e. all Of the above The best thing to do when a person comes to you with a problem initially a. call the police b. send him home c. find out what the problem is d. find out what the person is feeling e. find out what can be done to solve his problem After a person has talked for a long time, or has talked to you on many occasions about the same problem, the best thing you can do for a person like this is to a. refer him to a psychologist b. tell him how he might be able to get out of his situation c. ask him why he keeps doing the same thing d. find out who or what is causing his problem e. ask what he would like to change In helping someone, the helper should a. divert the person in need b. ask open-ended questions c. joke with the person in need d. persuade the person in need e. B and D 104 164. When helping someone, if the person in need says, "My parents have been fighting, and it really hurts me to watch it," the helper should respond by saying, a. "It sounds like your parents fight as much as mine do, but it's normal." b. "It sounds like your parents fight a lot." c. "It sounds like you're thinking about running away from home?" d. "It sounds like you feel hurt." e. "I hear you saying that you're hurt, but I also get the feeling that you're pretty frustrated." 165. When helping someone, if the person in need says, "All my friends are smoking marijuana, and I'm scared to try it. But, it seems like when I don't use it, my friends don't like to be around me," the helper should respond by saying, a. "Well, you know, it's not a dangerous thing. Why don't you use it." b. "You seem pretty scared." c. "You should pick new friends." d. "Since drugs are bad for your health, you should never experiment with them." e. "You seem scared and pretty lonely.“ 166. When helping someone, if the person in need says, "I really don't think that my parents love me. They always put me down when I try to talk with them," the helper should respond by saying, a. "Of course they love you." b. "Don't be silly, all parents love their children." c. "It sounds like you must have done something pretty terrible. What did you do?" d. "It sounds like it hurts a lot when your parents don't listen to you." e. "It sounds like everything will work out all right." 167. When helping someone, if the person in need says, "I can't seem to get out Of this depression...Well, it's not a depression because...anyway, going to school and working at the same time...I never get to have, uh, well, I guess sometimes I do O.K. It's just that I want to get away... no, not get away...just rest. Maybe I could quit school," the helper should respond by saying, a. "I don't understand. What can I say?" b. "This thing is really troubling you, but I'm really feeling pretty confused." c. "I hear you saying that you feel depressed." 168. 105 "I hear you saying that you feel confused and afraid." "Why don't you take some time off from school and from work?" When helping someone, if the person in need says, "I'm afraid my son is getting into drugs because his grades in school have gone down." the helper should respond by saying, a. "You should talk to his teachers." b. "You seem to be saying that you are afraid that your son is using drugs." c. "You seem worried about your son's grades." d. "You seem to be worried about your son's grades, and you're trying to blame it on dope." B and C 106 Questionnaire Answers The Drug Overdose Treatment Questionnaire 9. D 19. E 29. A 10. D 20. E 30. A 11. C 21. B 31. A 12. D 22. A 32. D 13. D 23. E 33. E 14. E 24. A 34. A 15. E 25. D 35. A 16. E 26. C 36. A 17. E 27. B 37. C 18. D 28. B 38. D Jackson Empathy Questionnaire Empathy Technique (EMT) Empathy Problem Solving (EMP) 154. D 158. A 162. E 166. D 155. E 159. B 163. B 167. B 156. A 160. E 164. E 168. E 157. D 161., D 165. E APPENDIX E APPENDIX E THE ADMINISTRATIVE AGREEMENT Agreement The following administrative agreement between the Students, Teachers, and Residents Involved in Drug Education (S.T.R.I.D.E.) program of the Comprehensive Drug Treatment Programs and the research director insures that all parties are cognizant of their rights and privileges as well as their duties and responsibilities. The project is being enacted in an effort to determine the effects Of the S.T.R.I.D.E. drug education program on drug usage and self-esteem of high school students. In order that the responsibilities of all individuals involved in the project are not misunderstood, the following responsibilities of each are hereby agreed to: ON THE PART OF THE S.T.R.I.D.E. ADMINISTRATION OF THE COMPREHENSIVE DRUG TREATMENT PROGRAMS-- 1. That the research director will have access to the S.T.R.I.D.E. Office, equipment, and personnel in pre- paring questionnaires and performing other related activities. 2. That the staff will agree to random assignment of students within any one school-subject to the agree— ments Of the participating schools-into Group I, the 107 ON 1. 108 first treatment group, and Group II, the second treatment group. Group II will not begin the treatment phase until after Group I has completed its treatment phase. That the staff will aid the research director in any problems with school administrators related to ad- ministering tests and random assignment. That all data concerning project participants will be made available to the project director. THE PART OF THE RESEARCH DIRECTOR-- That he shall assume complete responsibility for the evaluation of S.T.R.I.D.E. in the proposed school systems as long as it is understood that this does not limit other evaluation from taking place during this period. That he shall keep the confidentiality of all data concerning the project participants. That he shall make available all reports on research evaluation of the program to the S.T.R.I.D.E. staff. These agreements shall be in effect during February 1973 to October 1973. S.T.R.I.D.E. Administration- COMPREHENSIVE DRUG TREATMENT PROGRAMS Research Director Date APPENDIX F 110 0mm. 0mm. 900. «am. 00.H ow< .0 Amomv mawmmwmo 000. 0mm. Nm9.mH mmq.m <0.H mo mwmmalwamm .w 9000 owvaSOGM mom. 0mm. qmw.ma 000.0 «0.0 wave wmovuo>o .9 AmMWSV mamSnfiumz mo mmq. Hmo. 00¢.0H 099.0 00.0 mwmm0|.m0amwum .0 . Anmmv mwsuo msoumwamo wqm. 9mm.H 090.0wa mmq.mqm 00.H mo mwmmalwamm .m Amzmv mcfi>aom OOH. moa.a Hom.~ mNm.m so.H amapoum Asumaam .4 Ammmv Nqa. wo~.~ 990.00N 009.Hmm «0.H ammummlmamm .m moo. 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HmN. «mm.ma HH~.m «o.H wane mmouum>o .mH NNO. mew. moo. aqa. qo.a mwmuo .NH AHZMV mavfianumH qmq. mom. omm.H omo.H qw.a hsumaem .HH oqq. «co. nqm. Nun. «o.a mw< .OH Aqwcb uouum mfimonuoaxm mv manmwum> Awmscfiucoov .9H maamH APPENDIX G 124 Amva mcHuOUHz Neg. mmm. oH9.wm ooq.~m Hq.H mo mmmmaumamm .m Hoq. Hm“. Nom.HHMH 0H~.mqm H¢.H Ammmv ammummuwamm .9 Ammmv wwsun maoumwcmn «mN. omH.H mq~.ooq Hoo.on H¢.H we mmmmpnmamm .o Aoov mwvmazoax Ham. 9¢H.H mo.a~ me.q~ H¢.H wane mmocum>o .m AmMmzv mamanfiumz oaa. me.a mmm.mq wmo.ow H¢.H mo mwmm:-MHmm .q Amzmv wafi>fiom woo. **qom.m wnm.m mow.mm H¢.H amaaoum unumaam .m AHZMV msvaanome Hoo. *«HNN.HH Nom.m owm.mq H¢.H mnumaam .N muoum HmuOH mooo. «*Nmm.qH 9mN.HH omH.noH H¢.H . unumaam .H m m Houum mmumsvm cme m@ mammaum> muumwmm unwaummuy map you mucfiom wcwunmmmz mmucy HH< um mama mumaaaoo nuaB maaawm mo mocmwum> mo mfim>awa¢ .wH manna o xfiucmaa< 125 AA Awmscfiucoov .wH maan 126 Amomv mafimmmmo omH. Hoo.~ ooo.oH ooo.- Ho.H mo mwmmou.moamfium .o Amva mafiuougz NoH. om~.~ oH9.om Hoo.HmH Ho.a mo owmmoumamm .9 oHH. m9m.~ moo.a~om om9.omomH H¢.H among .o AmZmV waH>Hom ooo. «oN~.o o9o.m moo.oa Ho.H amaooum mnumoam .m Aqo .H m m Houum mmumsvm ammz mw wanmfium> muommwm Hoosom man How mucwom waaunmmmz mmuna HH< um Mama mumamaoo nuwa mHQBMm mo mommaum> mo wflmhama¢ .oH «Home 127 AHZMV wsvfianumy moo. ooo. 9oo.m ooo. Ho.H 9numoam .oH Aammv mwaun mnoumwamn Hmo. oom. o9m.9o9 Hom.ooH H¢.H mo momma-.moamfium .mH Agony mafiuooaz ooo. oom. oM9.NN oom.o H¢.H mo mommou.moam«um .oH Amomv mafimmmmo Hom. on. omo.o~ o~o.o Ho.H mo mommaumamm .mH omo. ooo. 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