The Positive Effect of the Rational Addiction Prevention Program (RAPP) on Adolescents with High Risk for Drug Consumption

Abstract

The aim of this longitudinal study was to determine the effect of an original prevention program (RAPP) on the behavioral and cognitive characteristics of adolescents with high risk for substance consumption. Seventy-six Mexican adolescents 12–15 years old (38 with high risk (HR) and 38 with low risk (LR)) were selected. RAPP was applied for 3 months. Resilience, social skills, attitudes towards substance use, ability to delay a reward, and inhibitory control were assessed in these adolescents, before and after the RAPP intervention. Both groups improved their scores; however, HR achieved greater changes than LR. Findings suggest that HR have behavioral characteristics that can be considered as risk factors for substance consumption (low levels of resilience, low social skills, little family support, positive attitudes towards substance use). RAPP proved to be an effective program for preventing these risk factors for substance use in adolescents.

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Funding

This study was funded by CONACYT (Grant Number CB2012#178811).

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Correspondence to Olga Inozemtseva.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Appendix

Appendix

Session 1 Presentation and ice breaker activities
 Introduction Objective
Present the purpose of the prevention program
Ice breaker activities
Set the rules for working together
Activity 1
Integration activity: Do unto others as you would have them to unto you
Activity 2
Integration activity: counting altogether up to 20
Session 2 Wellbeing and happiness from philosophy approach
 Ethics and values Objective
Perceptions of well-being and happiness
Contents
The role of ethics in the pursuit of happiness and wellbeing
Living with values and its relation to well-being and happiness
Activity 1
Discussion of ethics and values
Activity 2
Introducing yourself with a letter. Write five attributes and 5 weaknesses of your personality
Activity 3
The instructor reads a short Sufi-reading and the students are invited to reflect on its meaning
Session 3 Personal skills and decision-making
 Self-efficacy Objectives
Training sense of competence to increase wellbeing
Learn not to depend on instant success
Learn to postpone immediate rewards
Content
Discipline and perseverance
Activity 1
Establishing my personal goal during this training and making plans to accomplish it
Multimedia presentation about decision-making and factors that interfere in making or not making decisions
Multimedia presentation about perseverance quotes
Activity 2
Training inhibitory control: students play a balloon gambling game
Session 4 A–B–C–D–E Rational Emotional Behavior Therapy for adolescents
 Rational thinking Objective
Teach students the difference between irrational and rational thinking
Content
Irrational thinking and its relation to disturbing feelings such as self-blame, guilt, anger, sadness, etc
Activity 1
The instructor presents a multimedia presentation with phrases where people are thinking irrationally and rationally
Activity 2
Brainstorming about the most frequent scenarios in which adolescents think irrationally
Activity 3
The instructor presents scenarios that make the connection between thinking and feelings
Session 5 Practicing the A–B–C–D–E of Rational Behavioral Emotional Therapy
 Social rejection management Objective
To increase students’ level of frustration and tolerance
Contents
Social rejection management.
Adaptive responses to social rejection
Decision-making
Accepting no as an answer
Activity 1
Differentiating rational and irrational beliefs when making decisions
The instructor presents examples of problems that adolescents experience in their daily life and how to best handle the situation
Activity 2
Role-play on how to handle frustrating feelings
Activity 3
Role-play with peers on how to deal with guilt after making a poor decision
Session 6 Irrational concepts
 Self-concept development Objective
Analyzing irrational concepts about life
Contents
Irrational concepts will be discussed, such as feelings of inferiority, feelings of superiority, failure, and need for approval
Activity 1
The instructor discusses common irrational concepts of adolescents. Rational concepts replace irrational thoughts.
Activity 2
The instructor gives each student cards with the concepts discussed previously and the students provide their points of view
Activity 3
The instructor talks about ego and how it affects our mental health. A multimedia presentation is analyzed with images about how adolescents feel when their ego is hurt or when they suffer ego-related feelings
Session 7 Learning about thoughts
 Irrational thinking Objective
Learning how to distinguish real thoughts from unreal thoughts
Contents
How to recognize normal thoughts and intrusive thoughts.
Coping with unwanted thoughts
Activity 1
Distinguishing the difference between what I want, what I wish, what I have, and what I deserve
Activity 2
The instructor gives some examples of common desires that youth have, such as having a lot of money, being successful, and romantic love
Activity 3
Learning how to accept thoughts, change thoughts, and not let thoughts lead to unpleasant feelings
Session 8 Emotional resilience
 Coping strategies Objective
To examine resentments and the anger associated with them. Learning about forgiveness
Contents
Resentment, forgiveness, and accepting the past
How to forgive people who have hurt us
How to relate better to friends, learning to listen, respecting others’ opinions, finding and recognizing virtues in others
Activities
Learning how to interact and socialize with a peer they do not know using role-play
Session 9 Spiritual resilience (mindfulness)
 Irrational beliefs about spirituality Objective
Learning the difference between spirituality and religion
Discuss irrational thinking about God and religion
Contents
Faith in oneself and faith in a higher power
Live in the present, forgive the past and embrace the future
A new vision about forgiveness.
Forgiveness as a self-present
Activity 1
Presentation of concepts of divine punishment children are commonly taught. Discussion about how concepts of divine punishment could affect behavior
Activity 2
Presenting funny images about being punished and behavior that is a gateway to heaven
Activity 3
Discuss the connection between what children learn based on religious beliefs, including the following irrational ideas:
Good people go to heaven. Irrational beliefs about God and religion
Session 10 Attitudes towards substance use
 Irrational thinking about substance use Objective
Irrational and social imaginary representations of substance use
Contents:
Consequences of substance use
Social beliefs about substance use
Dealing with peer pressure
Saying no without feeling guilty
Activity 1
Role-play on saying no to friends who want you to try smoking or drinking
Activity 2
The instructor introduces the play and gives some examples of how to cope with peer pressure. He will ask one participant to invite him to drink a beer. The main learning in this dynamic is how to deal with the feeling of saying no. People may feel guilty, or feel they are losing a friend, etc

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López-Ramírez, E., Huber, M.J. & Inozemtseva, O. The Positive Effect of the Rational Addiction Prevention Program (RAPP) on Adolescents with High Risk for Drug Consumption. Child Psychiatry Hum Dev (2021). https://doi.org/10.1007/s10578-021-01133-6

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Keywords

  • Adolescents
  • Substance use
  • Risk factors
  • Preventive intervention