Because these programs are based on well-established clinical theories, they have a strong theory of change.3 Little information about these theories, however, was included in the information provided by the programs, and very little information was provided about the quality of the services actually provided. Such information is critical if these programs are to be implemented in other settings and programs by staff members who are not clinical psychologists or social workers. Certainly the primary prevention efforts should be replicable in after school community-based programs. But more information will be needed about the specifics of the programs before this is possible.

Greenberg and Colleagues

Greenberg and colleagues (1999) reviewed 130 universal, selective, or indicated mental illness prevention programs for children and adolescents. The universal prevention programs targeted whole populations of youth. The selective programs targeted individuals or subgroups identified as at risk for developing mental disorders. The indicated prevention programs targeted individuals identified as having early warning signs of mental disorders but not yet meeting diagnostic criteria. Out of 130 total programs, researchers selected 34 using the following criteria: a randomized experimental design or quasi-experimental design with a comparison group; pretest and posttest measures; a written manual specifying the theory and procedures used in the program intervention; a clearly defined sample, with adequate information about their behavior and social characteristics; and some evidence of positive mental health outcomes. Follow-up assessments were preferred but not required. This review focused less on the personal and social assets identified in the committee’s framework and more on the features of the programs themselves and on prevention of problem behaviors. In general, the researchers concluded:

  1. Multiyear preventive programs produce longer-lasting effects than short-term programs.


“Theory of change” is described as a clear, substantive theory that explicitly states the process by which change should occur. Ideally, this theory should be the driving force in program development and should guide the decision of what to measure and how. See Chapter 7 for elaboration.

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