of treated cases and 36 percent of untreated or treatment-as-usual control cases.

Given the limitations of many of these studies and the risk of serious adverse events, the positive results found are not sufficient to recommend such interventions as a standard for practice. However, the interventions show considerable promise, and several studies are under way. Continued research in this area should be a high priority. The existence of standard criteria across multiple sites, such as in the North American Prodrome Longitudinal Study (a collaborative, multisite investigation into the earliest phase of psychotic illness), would be invaluable in conducting such research.

MENTAL HEALTH PROMOTION

Mental health promotion programs aim to improve positive outcomes among young people. Some programs share elements with universal prevention programs when they attempt to reduce negative emotional and behavioral outcomes as well as to improve positive mental health outcomes. As a natural consequence of shared risk and protective factors, mental health promotion and prevention strategies also have shared outcomes. As mentioned in Chapter 3, meta-analytic and qualitative reviews demonstrate significant overlap between the strategies, although promotion programs are distinguished by their primary emphasis on positive aspects of development, including developmentally appropriate competencies. This section first reviews interventions aimed at fostering positive development. It then examines lifestyle factors that promote mental health.

Interventions Aimed at Fostering Positive Development

A common feature of most validated programs aimed at fostering positive development and preventing the development of problems is the emphasis on supportive environments or “nurturance.” From the prenatal period through emerging adulthood, such interventions are supportive of individuals and their caretakers and provide positive reinforcement for prosocial behavior. Home visitors encourage young mothers to develop new skills, including how to comfort and interact warmly with their infant. Preschool teachers attend to, praise, and reward the developing skills of their children. The Good Behavior Game reinforces cooperative behavior among teams of children. Trainers praise parents for trying new skills in nurturing their children.

The creation of supportive environments also involves acceptance. Parents who are aggressive toward their children are not confronted; they are simply prompted to try more positive methods of being with their children (Webster-Stratton, 1990). College students who are drinking too much are



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