Component analysis of a school-based substance use prevention program in Spain: contributions of problem solving and social skills training content.

Espada J.P., Griffin K.W., Pereira J.R. et al.

Uniquely this Spanish study eliminated either problem solving or social skills training from secondary school drug education to see if these really were active ingredients in reducing substance use. Probably they were was the conclusion, though there were no statistically significant differences between the full programme and the excised versions.


Training in social skills and in problem-solving skills feature in many contemporary drug use prevention programmes. The former aims to promote assertiveness, empathy and social negotiation strategies, the latter, self-reliance and coping skills. Commonly these components are taught as generic skills first and then applied to situations related to substance use.

An example is the Spanish school programme Saluda which aims to delay the onset of alcohol and drug use. Its problem-solving components aim to help pupils understand and appreciate the advantages of non-consumption and the disadvantages of drug abuse by first applying problem-solving methods to everyday situations, and then specifically to substance use scenarios. The social skills components aim to help pupils develop skills related to active listening, initiating, maintaining and concluding conversations, expressing opinions and positive feelings, and defending one’s personal rights, such as saying ‘No’ and coping with peer pressure. Both types of components are taught mostly via skill-focused activities. Each is the focus of two different sessions of the 10-session programme, offering the opportunity to try variations which omit one but not the other as a way of testing which components are needed to generate the programme’s impacts. This was the strategy adopted by the featured study, which replaced the missing sessions with general discussion sessions not involving any skills training activities.

The study recruited 341 of the 358 students in 14 classes in two secondary schools. Whole classes were assigned to the full Saluda programme, to the programme with social skills but not problem solving training, to one with problem solving but not social skills training, or at random to education as usual until the final follow-up assessments had been completed a year after the Saluda lessons had finished.

Main findings

At the start of the study there were no statistically significant differences between pupils assigned to the different options. However, by the end questionnaires completed by the pupils revealed that those offered any version of Saluda had over the last month drunk alcohol significantly less often than pupils in education-as-usual classes. Though the biggest impact was seen with the full programme, there were no statistically significant differences between the three versions of Saluda. Similar findings emerged in respect to willingness to use alcohol or illegal drugs (actual use of the latter was too rare to be analysed), except that this pattern emerged in the surveys taken immediately after the lessons had ended as well as a year later.

The study also assessed the impact on the relevant skills of omitting lessons focused on these skills. In respect of problem solving skills, after the lessons ended both versions of the programme which had included the relevant training led to better skills (as assessed by a questionnaire) than among pupils not offered the programme at all, but this difference persisted to the final follow-up only after the full programme. In respect of social skills as reflected in reported difficulties with family, peers, or the opposite sex, on no measure were there any statistically significant differences between the three versions of the Saluda programme. Other findings revealed no obviously consistent pattern.

The authors’ conclusions

In general, findings indicated that the three versions of the Saluda programme were all significantly more effective at curbing drinking and intention to use substances than usual education only, but not significantly different from each other. However, there were indications that effectiveness may diminish unless training in both social and problem-solving skills is retained in the programme.

As assessed by average scores at the final follow-up, the largest advantages over usual education in drinking and in problem solving were seen after the full programme. In respect of problem solving, the full programme also bettered the version which included the relevant training, suggesting that social skills training acts synergistically with problem-solving training to improve problem-solving skills.

In terms of effects on skills, the programme without social skills training produced inconsistent changes in the relevant skills, as did the programme without problem solving skills training. It should be cautioned however that non-random assignment to the education options means the results may be due to differences between the pupils.

This draft entry is currently subject to consultation and correction by the study authors and other experts.

Source: Prevention Science: 2012, 13(1), p. 86–95.  June 2013.

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