Project Towards No Drug Abuse (TND)

About the program

Project TND is a substance abuse prevention program designed to address the needs of youth in continuation high schools. Continuation high schools serve students who are unable to remain in the regular school system for functional reasons, including difficulties in attendance, insufficient school credits, or problematic substance use.

Project TND curriculum uses interactive teaching techniques to provide cognitive motivation enhancement activities, information about the consequences of drug use, correction of cognitive misperceptions, communication and coping skills enhancement and tobacco cessation techniques. Project TND + MI involves delivery of a single motivational interviewing (MI) booster session approximately 1 month after completion of Project TND.

Who does it work for?

Project TND is designed for 14–21-year-old youths. Project TND has only been evaluated in the USA. A randomized control trial was conducted with 1426 participants (496 in the Project TND + Motivational Interviewing group, 430 in the Project TND only group and 500 in the no-treatment control group). Most participants were 16 years old and Hispanic. Just over half of participants were male (56%) and just over half the participants lived with both parents. Most participants reported having had sexual intercourse, however less than half reported using a condom the last time they had sex.

Project TND has not been evaluated in Australia or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• TND participants’ belief of drug use myths decreased
• Project TND participants’ value of their own health increased
• Project TND participants’ drug use intentions decreased
• Project TND participants’ perceived prevalence norms about the number of their peers having unprotected sex decreased (i.e. participants were less likely to perceive that many of their peers are having unprotected sex)

No effect:

• The program had no effect on participants’ motivation to improve
• The program had no effect on participants’ social self-control
• The program had no effect on participants’ assertiveness
•  The program had no effect on participants’ engagement coping (addressing stress rather than disengaging from stressors)
• The program had no effect on participants’ decision-making confidence or decision-making avoidance.

How effective is it?

Overall, Project TND had mixed effects on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT)/quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects

How is it implemented?

Project TND is delivered over 12 sessions lasting 45 minutes each, over a period of 4 weeks.

Project TND is delivered by health educators trained in the TND curriculum. The 12 sessions comprise the following content:

1. Active Listening: Students are introduced to Project TND and discuss the importance of being active listeners. They also learn listening and communication skills
2. Stereotyping: Students learn that believing in stereotypes can lead to self-fulfilling prophecies and can put one at risk, limiting the choices of both the person who is stereotyping and the target of the stereotype. They also learn to deny or justify their drug abuse.
3. Myths and Denials: Students learn to identify myths associated with drug use, how to distinguish a truth from a falsehood, and how people use various beliefs to deny or justify their drug abuse.
4. Chemical Dependency: Students learn about the course of negative consequences associated with chemical dependency. They also learn about the various roles that people play in relationships with chemically dependent family members.
5. Talk Show: Students role-play a talk show whose guests are affected by drug abuse. They learn about many physical, emotional, and social consequences of chemical dependency.
6. Stress, Health and Goals: Students learn various ways to cope with stress and the importance of health as a life value in accomplishing life’s goals.
7. Tobacco Basketball and Use Cessation: Students play a “tobacco basketball” question game and learn about tobacco use consequences and cessation. They are also introduced to a brief quit manual.
8. Self-control: Students learn to examine their own level of self-control, how to match their behaviour to different social contexts, and the importance of being assertive.
9. Marijuana Panel: Students learn about the consequences of marijuana use through use of a group “panel” activity. Students role-play those affected by marijuana use.
10. Positive and Negative Thought and Behaviour Loops: Students learn how positive thinking, choices, and behaviour, or negative thinking, choices and behaviour are tied together as process “loops.” They are motivated against the development of drug use consequences of which they may not be aware. Students are also provided with reasons for violent behaviour and violence prevention material.
11. Perspectives: Students present different views on such topics as public smoking laws and drug use and find out that most people have moderate views regarding drug use. Alignment of attitudes and behaviour is suggested.
12. Decision-making and Commitment: Students realize they have made choices and can make different decisions regarding drug use and abuse. They consider different options to make a commitment to themselves regarding drug use.

How much does it cost?

The costs for Project TND were not reported in the study.

Where does the evidence come from?

1 RCT conducted in the USA with a sample of 1426 people (Lisha et al., 2012).

Further resources

Lisha, NE, Sun, P, Rohrbach, LA, Spruijt-Metz, D, Unger, JB, & Sussman, S 2012, ‘An evaluation of immediate outcomes and fidelity of a drug abuse prevention program in continuation high schools: Project Towards No Drug Abuse (TND)’, Journal of Drug Education, vol. 42, pp. 33-57, 10.2190/DE.42.1.c.

The following study is particularly relevant to Project TND:

Sussman, S, Earleywine, M, Wills, T, Cody, C, Biglan, T, Dent, CW, Newcomb, MD 2004, ‘The motivation, skills, and decision-making model of ‘drug abuse’ prevention’ Substance Use & Misuse, vol. 39, pp. 1971-2016, DOI 10.1081/JA-200034769.