UNITS 4&5

Code: PSY 641 -G

Course instructor : Miriam
Mohan

RECENT TRENDS &

APPLICATIONS
IN COMMUNITY
PSYCHOLOGY
KEY CONCEPTS IN COMMUNITY INTERVENTION MODELS –
PREVENTION AND PROMOTION

Reflect
I. Think of personal actions in your life which were impactful, long
lasting
 who implemented them ? any other factors?
II. What programmes exist in our university as preventive programmes?
• How do they prevent?
• Are they really effective?
• Any strengths or shortcomings?
Reflect ….

III. In a mid-size commercial-residential neighbourhood,there are several

health needs. Children need preventive vaccination, sometimes there
are short-term infections across age groups , reproductive health is
also a concern.
2 PHCs located there which cater to an approx. population of 4200
people. Two government doctors work on two shifts a day and come on
a consultancy basis on 3 days of the week, thus leaving emergency
situations largely unaddressed.
Although a larger government hospital and several private clinics are
within a 10 kms radius, they are still not accessible for residents due to
factors like distance, cost and so on.

• What are the primary needs of the community in this locality ?

• Does promotion of justice & equity work OR prevention of oppression
or marginalization work?
• What does it mean to prevent something?
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• Prevention science is interdisciplinary and Findings from a well –known study
collaborative & occur in many places. (Albee, 1959)
(law, education, government, public • professional-to-patient method for
health, social work, the corporate providing psychotherapy
world, and several fields of psychology
(especially developmental, organizational, • epidemiological studies showed a -
school, educational, and clinical).
• strong relationship between
socioeconomic status, ethnicity, and
• Members of other disciplines often services received.
collaborate on research and interventions • members of poor and minority
that appear as part of collections of work
in community psychology. groups were more likely to receive
severe diagnoses, to receive
medication rather than
psychotherapy, and to be seen in
groups rather than individually.
• preferred clients were those most
like the therapists—male, Caucasian,
1) Psychotherapy may not work.
verbal, and successful.
2) Even if it does work, we can’t provide it to everyone who
needs it.
3) Even if we could provide it, it is not equally available for all
groups
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REDEFINING PREVENTION

• Everyday prevention efforts. Some examples… What do they involve?

• Developing desired competencies, skills, and abilities.

• Overall health and quality of life become the goal, more than simply
preventing psychiatric disorders or types of problem behaviors.

• Wellness is a more fitting goal of preventive efforts.

• Refers to life satisfaction or gratification in living .It is a transactional
concept linked to the social ecology within which people live (Cowen
(1991, 2000) .
• Central to how community psychologists think about prevention of
disorder and promotion of competence and wellness.
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PREVENTION AND PROMOTION – 2 SIDES OF THE SAME COIN?

PREVENTION OF DISORDER AND PROMOTION OF

WELLNESS AND COMPETENCE

• Prevention of HIV/AIDS • Promoting Healthy Sexual

Infection Behaviors
• Prevention of Childhood • Promoting Positive
Behavior Disorder Parenting
• Prevention of Bullying and • Promoting Safe School
School Violence Climates
 CONCEPTS FOR UNDERSTANDING PREVENTION 7
AND PROMOTION
MODEL 1 Caplan (1964) : Primary, Secondary, and Tertiary Prevention
Primary Secondary Tertiary
• not in a condition of known • given to populations • given to populations who
need or distress. The goal is showing early signs of a have a
to lower the rate of new disorder or difficulty - early disorder, with the intention
cases (from a public health intervention for “at risk ” of
perspective to reduce the • creates a potential for limiting the disability
incidence) of disorders. stigmatization— both caused by
because they do not the disorder, reducing its
currently have a disorder intensity
and because they might and duration.
never develop one
• reduce potentially harmful • preventing future
circumstances before they • Assumes method of reoccurrence or additional
have a chance to create determining which complications –
difficulty. individuals are at risk “rehabilitation”.
• improving methods of risk
identification represents an
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MODEL 2
Universal Preventive Selective Preventive Indicated Preventive
Measures Measures Measures
• designed to be • people at above- • individual
offered average risk for peoplewho are
to everyone in a developing considered at high
given population behavioral or risk for developing
group. emotional disorder in the
disorders. future.
WHAT • risk characteristics • focuses on
QUESTIONS are associated whether an
DOES THIS with the approach prevents
RAISE ? development of a specific disorder,
Examples … particular not in terms of
disorders but are competence
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Discuss : Some takeaways from this concept…

• a preventive way of thinking VS
the treatment-oriented medical,
psychiatric, mental health, and • relabel secondary
social service fields. prevention as treatment
• Link the concepts of prevention given because of early
and treatment identification and tertiary
• Prevention, even tertiary, is on a
prevention as rehabilitation
community level services.
• helps to provide a clearer
• trying to keep away what is not distinction between
(yet) there. Would it ever arrive prevention and treatment
if the prevention effort was not of specific or severe
in place? problems.
• Others have stated that if
prevention is to be worthwhile,
then one must specify what one
is preventing ; Emphasis on
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DO PREVENTION PROGRAMS WORK ?

Click icon to add picture
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POLITICS OF PREVENTION AND PROMOTION PROGRAMS

• Issues of prevention and mental health have never been isolated from political and
ideological considerations.

• Research in recent years has focused on biological factors in mental health, and the
mental health field is seeking to prove itself to be rigorous and cost-conscious.
Insurance companies and federal granting agencies prefer to pay for clear
prevention outcomes rather than support efforts to improve health. Why?

• Goals of prevention programs are generally easier to understand and evaluate than
the goals of promotion programs, they may receive greater support among
policymakers.

• Community psychology knowledge is used to provide preventive interventions to

specific populations to prevent specific disorders and at other times to general
populations microsystems to promote overall wellness.
• The outcomes of these interventions are measured in terms of lowered incidence of a
specific disorder and/or in terms of increased competence for coping, as appropriate.
• Goal of merely preventing disorders sets our sights too low ; Minimally functional, VS
functioning to fullest potential.
• Programs that focus solely on preventing negative outcomes will not be designed to
ensure optimum development

• Debate on where emphasis of time and resources is best placed: on prevention or promotion.
Within these areas, there are varying options for emphasis (e.g., based on age,
socioeconomics, gender, and ethnicity).

• Advocates of the prevention view argue : Research should be directed toward isolating and
reducing the operation of risk factors most closely targeted with specific disorders ; selective
and indicated interventions.

• Advocates for promotion argue that many people are not in a state of sound psychological
well-being despite not having specific disorders.

• Programs that are aimed at the prevention of a specific problem may be focused on
perceived deficits in the population, ignoring community psychology’s focus on strengths and
building competencies VS broader health promotion focus.

• The distinction between the two types of programs becomes even more confused as health
promotion programs are often evaluated in terms of specific prevention goals, basically
because those types of goals are easier to specify and measure.
END GOAL OF PREVENTION IS DEVELOPING COMPETENCE 14
BOWER (1972) - 3 TYPES OF SETTINGS TO ACCOMPLISH GOALS

Secondary
settings
(workplace,
KISS – KEY
leisure,
INTEGRATED Formal /
community
SOCIAL informal
organizatio
SYSTEMS settings
ns,
Primary
media/inter
net/
cyberspace Challenges ?
END GOAL OF PREVENTION IS DEVELOPING COMPETENCE 15
BOWER (1972) - 3 TYPES OF SETTINGS TO ACCOMPLISH GOALS

Ailing in
difficulty Short term
institutions – assistance
AID
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Illness
correctional High degrees
Challenges
Endeavours – of assistance
ICE
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SOCIAL ECOLOGICAL LEVELS OF ANALYSIS

Developmental
rights
Individual as (Masterpasqua,
developing and1972)
Prevention adapting in
is not interactive
inoculation environments
2 PREVENTION EQUATIONS 18

• Elias (1987) revision of the formula :

• environmental-level formula :
• Formulated as a way of address the factors responsible for
summarizing the factors that are the incidence of behavioral and
linked to the development of emotional disorders in populations
behavioral and emotional disorders rather than just in individuals.
and to emphasize possible avenues
for prevention and promotion • factors as they are exhibited in
efforts. settings (e.g., families, schools,
organizations, neighborhoods and
• The first formula was developed by societies)
George Albee in 1982 to illustrate
the factors leading to behavioral
and emotional disorders.
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DECODE THE FORMULAE :

• risk is increased as a function of stressors and risk

factors in the environment and decreased to the extent
to which protective processes are enhanced
• properties of settings, not attributes of individuals
• The numerators and denominators of both equations
are a reflection of the diathesis-stress model.
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ACTIVITY

Give examples of the factors and the types

of possible interventions each factor
suggests