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Drive for life – a group-based intervention for antisocial youth

Drive for life is an intervention targeting youth with a history of truancy and other behavior problems that increase the risk for social and educational disadvantage. Drive for life offer youth supervised challenging leisure activities in groups of five each week for one year.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

Published: Report no: ut201914 Registration no: SBU 2019/75

Question

Does ‘Drive for life’ reduce truancy and other antisocial behaviors among children and young people?

Table with identified studies

Table 1 Systematic reviews
Included studies Population/intervention Outcome
Fossum et al, 2016 [1]
56 studies
(45 RCT)
n=2589
Population
Children and adolescents (age: 2–17 years), treated due of conduct problems

Intervention
Any psychological intervention aimed at reducing conduct problems, aggressive, oppositional and maladaptive behaviors, or enhancing prosocial behavior through counselling, training programs or predetermined treatment plans.
Change in conduct problems

Follow-up
At least 3 months
Authors' conclusion:
Changes in conduct problems from post-treatment to follow-up were larger in studies with cognitive behavior therapy (CBT) or a combination of behavior therapy (BT) and CBT compared to BT and family therapy. Individual treatments resulted in larger changes in aggressive behavior as compared to group treatments or a combination of these. Treatment effects for both conduct problems and the presumed mediators seem to last, but changes were small.
Sawyer et al, 2015 [2]
66 controlled intervention trials:
34 prevention
32 therapy
n=11 645
Population
Youth aged less than 18 years with antisocial behavior

Intervention
Psychosocial interventions
Changes in youth antisocial behavior

Follow-up
At least 12 months
Authors' conclusion:
Results from 66 intervention trials revealed modest long-term benefits for target interventions relative to control conditions (mean d=0.31). Reductions in antisocial behavior were evident for an average of four years following completion of interventions (range=1 to 35 years), /…/ peer group interventions were less effective when samples contained more boys or older youths than when samples had fewer boys or younger youths. This finding is consistent with concerns that have been raised (see Dodge et al., 2006; Weiss et al., 2005) about the potential iatrogenic effects of group-format intervention practices for antisocial behavior in adolescents (e.g., group therapy or anger management classes). Indeed, there is converging evidence from the clinical and developmental research literatures that high-risk youths tend to reinforce each other's antisocial behavior (i.e., deviancy training), which reduces the benefits of interventions that group these youths together
Welsh and Rocque, 2014 [3]
574 studies
(minimum requirement in study design: before-and-after measures)
Population
Children and adults with antisocial behaviour
Offenders

Intervention
Group or individual interventions
Outcome measure of delinquency or offending

Follow-up
Not stated
Authors' conclusion:
The studies covered a wide range of interventions, from anti-bullying programs at schools, to second responder interventions involving police, to the Scared Straight program for juvenile delinquents, with more than half taking place in criminal justice settings. Boot camps and drug courts accounted for the largest share of studies with harmful effects. /…/ Theory failure, implementation failure, and deviancy training were identified as the leading explanations for harmful effects of crime prevention programs, and they served as key anchors for a more focused look at implications for theory and policy. /…/ Our findings may offer some insight on the deviancy training effect. We found, much like Dodge et al. (2006), that harmful juvenile crime prevention programs are more often conducted in groups. In our sample, we did not find one study with a harmful effect that was delivered on an individual basis for juveniles. In their overall criticism of this view, Weiss et al. (2005) argued that individual-oriented programs may just happen to be more successful.
Ang and Hughes, 2002 [4]
28 RCT and 10 CT Population
Children aged 6–18 years with conduct problems

Intervention
Social skills training interventions, individually, in group or mixed treatment
Social or behavior adjustment

Follow-up
Not stated
Authors' conclusion:
This study used meta-analytic techniques to summarize treatment outcomes associated with skills training interventions with antisocial youths. Across all 38 studies and measures of outcome, the average effect size was .62 /…/ Given the heterogeneity of effect sizes for the 38 studies, an analysis of factors that might account for this variability was warranted. Consistent with previously mentioned hypothesis, skills training interventions delivered in the context of homogeneous groups of deviant peers produced smaller benefits (ES = .55) than did skills training interventions delivered in the context of either individual treatment or mixed groups of prosocial and deviant peers (ES = .70).

References

  1. Fossum S, Handegård BH, Adolfsen F, Vis SA, Wynn R. A meta-analysis of long-term outpatient treatment effects for children and adolescents with conduct problems. Journal of Child and Family Studies 2016;25:15-29.
  2. Sawyer AM, Borduin CM, Dopp AR. Long-term effects of prevention and treatment on youth antisocial behavior: A meta-analysis. Clin Psychol Rev 2015;42:130-44.
  3. Welsh BC, Rocque M. When crime prevention harms: A review of systematic reviews. Journal of Experimental Criminology 2014;10:245-266.
  4. Ang RP, Hughes JN. Differential benefits of skills training with antisocial youth based on group composition: A meta-analytic investigation. School Psychology Review 2002;31:164-185.

Literature search

Project group

Knut Sundell, Laura Lintamo, Sara Fundell and Miriam Entesarian Matsson at SBU.

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